Vol 70, No 3 (1989)

Viral hepatitis B is one of the key unsolved problems of modern medicine and is of great interest for clinicians of different profiles. Relevance of the problem is confirmed by high non-decreasing morbidity, possibility of severe course with the threat of fatal outcome, development of chronic forms of the disease, absence of reliable methods of etiotropic therapy. The study of hepatitis B became possible based on the verification of the diagnosis through the indication of specific markers of the virus, in particular its surface antigen (HBsAg). In our practice we have consistently used first-generation methods, firstly gel precipitation reaction (GPR) and counter immunoelectrophoresis (CEP), and later the highly sensitive methods, reverse passive hemagglutination reaction (ROPGA) and enzyme immunoassay (ELISA).

Lingering course of acute viral hepatitis is formed in 9.3% of patients, reliably more often (in 28.2%) in hepatitis B (in hepatitis A - in 5.2%) and is one of the main causes of process chronicity. According to results of follow-up observation, after acute viral hepatitis with cyclic course the majority of recurvalescents recover. Chronic persistent hepatitis was registered only in 44 (2%) out of 2187 patients. Among patients with hepatitis with a prolonged course, complete recovery was noted only in 16.7% of patients.

We studied the clinic of dysentery Flexner's disease I b in 30 children under one year of age with severe forms of the disease and in 10 patients of the same age with a lethal outcome. The diagnosis in all cases was confirmed by bacteriological examination data. Artificial feeding accounted for 25% of 40 observed patients, 15% of them had hypotrophy, 12.5% - exudative diathesis, 15% - previous history of intestinal infection.

The aim of our work was to study the state of hypothalamic-pituitary-adrenal system in patients with GLPS in comparison with electrolyte metabolism parameters depending on the period and severity of the disease. Twenty-four patients with GLPS, aged 16 to 53 years, were under observation. Most of them were young (23-24 years old). There were 19 men and 5 women. The diagnosis was made on the basis of clinical, epidemiological and laboratory data.

Drug-induced anaphylactic shock usually develops in mature people and much less often in children, and mostly in older children. Anaphylactic shock in children of the first year of life has been described only in isolated cases. In this connection we consider it advisable to describe a case of anaphylactic shock in a child aged 2 months and 11 days.

Physical activity tolerance in pulmonary tuberculosis is determined to a greater extent by the state of pulmonary ventilation and to a lesser extent by pulmonary gas exchange, the latter being partially compensated by hemodynamic factors. The appearance and severity of dyspnea in such patients are largely associated with obstructive disorders at the level of medium and small bronchi, which determines the relevance of correction of these disorders. Among bronchodilators of adrenomimetic type of action one of the most effective is Berotec, which not only improves bronchial permeability, but also increases mucociliary clearance.

The aim of the study was to investigate the functional state of the thyroid gland in patients with various forms of candidiasis in order to clarify the possible role of thyroid dysfunction in the pathogenesis and treatment of candidiasis. 116 patients with candidiasis were divided into 4 groups. Group 1 included 20 children (9 boys and 11 girls) aged from 2 to 15 years with chronic candidiasis of the skin and mucous membranes lasting from 1.5 to 14 years. The 2nd group consisted of 20 patients (5 men and 15 women) aged 16 to 45 years with the same disease lasting from 1 year to 30 years. Group 3 included 44 patients (14 men and 30 women) aged 16 to 55 with candidiasis of the respiratory system and gastrointestinal tract with duration from one year to 16 years. Group 4 included 32 women from 21 to 58 years of age with vaginal candidiasis lasting from one to 20 years. The control group consisted of 21 healthy individuals (8 men and 13 women) aged 25 to 40 years.

Clinical observations suggest that coronary atherosclerosis may develop against the background of normal blood lipid content - normolipoproteinemia. As a diagnostic method of atherosclerosis with normolipoproteinemia the authors suggest using fat load and determination of the activity of hydrolytic liver enzymes using antipyrine test. They revealed in such patients reduced fat tolerance and decreased activity of liver hydroxylases. However, these tests are insufficiently selective, since fat load cannot reflect cholesterol metabolism abnormalities, and the antipyrine test cannot determine cholesterol hydroxylase (CH) activity, since the latter are highly specific for the substrate.

The aim of this study was to comprehensively assess the influence of the main biomedical factors (diseases suffered during pregnancy, extragenital diseases, pregnancy complications, prematurity, skewness, etc.) on the level of dental morbidity in children for the development of primary prevention measures and improvement of dental care for the population. The program included a detailed study of maternal health, the course of pregnancy and childbirth, the child's health, physical development, and nutrition. In accordance with this program, a research map of socio-hygienic, medico-biological and other factors influencing dental morbidity in children was developed. A total of 2,274 families were examined, with 97 to 205 families in each age group of children.

The aim of this work was to evaluate different types of CDA for treatment of common bile duct terminal obstruction based on the analysis of immediate and long-term results (3-5 years) of surgical treatment as well as postoperative complications and to choose an optimal method of CDA placement and conditions for its performance. We divide indications for CDA placement into absolute and relative ones. The absolute indications are as follows: a) cholangitis with dilatation of common bile duct over 2 cm; b) small stones of common bile duct with mechanical jaundice; c) stones in area of large duodenal nipple not removed; d) "arrow" narrowing of the terminal section of choledocha over 2 cm. We consider as relative such indications as uncertainty in complete removal of stones and pancreatic head tumor.

The wide spectrum of pharmacological activity, diversity of biological action, efficiency in low concentrations, absence of accumulation in the body, and low toxicity determine the prospects for the use of peptide bioregulators in clinical practice. At the same time, the existing obstacles in their use in practical medicine are caused by the rapid decomposition after administration, the modulatory character of their action, which depends on the initial functional state of the body, a weakly pronounced effect when taken orally, and the difficulty of crossing the blood-brain barrier. One approach to solving these problems is the targeted synthesis of new highly effective substances with selective and prolonged action, possessing the necessary stability and specific means to receptors along with natural peptides.

We observed 300 patients with GLPS, in 150 of whom the disease was accompanied by abdominal pain. The usual corrective conservative therapy resulted in abdominal pain abatement, cessation of vomiting and recovery. Some patients had severe pains and had to be relieved by injections of 50% analgin solution with dimedrol and 1% promedol solution. They were especially intensive on days 3-6 of the disease during hemorrhagic and renal manifestations.

The aim of this work was to study secretory (acid-forming and proteolytic) functions of the stomach in patients and recovering patients with hemorrhagic fever with renal syndrome (HFRS).
Seventy-six relapsed HFRS patients under 50 years of age without concomitant or past gastrointestinal diseases were examined. Dynamic follow-up was performed in the same patients. Diagnosis in all patients was confirmed serologically (4-fold increase of antibody titers by MFA method in dynamic examination of sera). The control group consisted of 26 healthy individuals.

In 1987, 4171 children were examined for possible enterobiasis. Children referred by polyclinic physicians had the following signs of suspected disease: 42.5% had abdominal pain, 20% had anal itching, 12.5% had vascular dystonia, 1% had eosinophilia, and 1% had vulvovaginitis; 23% of the children had no complaints. The method of tape scraping from the perianal folds, which provides more complete detection of infestation, detected pinworm eggs in 346 (8.3%) children. In the family centers of enterobiasis 623 adults were examined; 4.9% of them were diagnosed with enterobiasis, 348 children were contacted, among them 8.6% of the children were infected.

To assess the effect of smoking on ventilation-perfusion relations in 62 smokers and 30 non-smokers aged 20 to 57 years old we used mass spectrometry to determine partial pressure of O₂ and CO₂ in alveolar air (pАО₂ and рАСО₂) and growth rate of рСО₂ in alveolar exhalation phase (ΔpACO₂/tA).
To exclude heart and lung diseases, in addition to the general clinical examination, we studied GEL, SPR1 and Wotchal-Tiffno index. These indices in the healthy and smoking groups were within normal limits and did not differ significantly, although they were slightly decreased in smokers.

We present the results of treatment of patients aged 20 to 40 years with infected miscarriages complicated by metoendometritis and sepsis, with purulent mesenteric diseases of the uterine appendages and peritonitis.
Patients in the 1st group (20 people) received hemodez along with the usual complex therapy; in the 2nd group (30 people) - polydesis. The case histories of 12 patients (Group 3) with similar pathological processes who were not prescribed detoxifying blood substitutes were analyzed for control purposes.

Human immunodeficiency virus (HIV) infection is a slowly progressive disease with long-term multiplication of the virus in lymphocytes, macrophages, and nerve tissue cells, causing impaired immune and neurological regulation of the body, which leads to the death of the patient from secondary lesions associated with increasing immunodeficiency (AIDS).

During 1974-1976 and 1983-1986 we studied the state of health of university students in Yoshkar-Ola. For each period the health characteristics of 4440 students were presented, separately by faculties and courses, and the structure of diseases was traced.
According to our observations, during 1983-1986 there was some increase in general morbidity of students of both universities. According to the analysis of morbidity, students most often sought medical assistance for colds (acute respiratory infections-42.7%), ENT-organ diseases (pharyngitis, maxillary sinusitis, angina-11.2%), injuries (sprains, strains, bruises of the upper and lower extremities-12%), gastrointestinal diseases (gastroduodenitis, duodenal ulcer, cholecystitis, biliary and intestinal dyskinesia - 4.6%), less often - due to cardiovascular (hypertension, neuro-circulatory dystonia) and pulmonary (bronchitis, chronic pneumonia -3.6%) diseases. Dental diseases were represented by dental caries, typical for students of both universities.

The purpose of this work was to study the spread of epidemic parotitis among students of 9-10th grades of secondary schools and vocational schools. Analysis of data on morbidity in Saratov from 1979 to 1983 showed a relatively high morbidity of epidemic mumps among the general population and students of schools and vocational schools in particular. The situation changed dramatically after 1984, when the morbidity rate among the general population decreased sharply, and cases of parotitis among students of vocational schools and senior high schools became sporadic, in some years not observed at all. There is reason to believe that these changes in the morbidity rate were the result of mass immunization against mumps in the most susceptible age groups of the population.

For identification of microorganisms, chemical and bacteriological studies, indicator papers are increasingly being introduced, eliminating the use of liquid differential media, various test systems, etc. They are attractive because of their simplicity, reliability, and long storage time. This report presents the results of approbation of papers developed in Kazan Research Institute of EMP for the detection of nitrate and nitrite reductase in representatives of various genera of microorganisms.

The monograph is written on a topical topic. Practical radiologists experience great difficulties in diagnosing diseases of bones and joints. This can be explained by the complexity of the perception of X-ray semiotics of diseases and therefore there is a great need for this kind of monographs. X-ray diagnosis of diseases of bones and joints needs to be generalized and popularized. The book is written for radiologists, oncologists, traumatologists, and orthopedists and consists of five chapters addressing private pathology.

Phthisiatricians of TASSR together with doctors of general treatment network and the public are working on the implementation of the target program of accelerating the rate of reduction of tuberculosis in the republic for 1985-1990, approved by the Council of Ministers of the Tatar ASSR, using the achievements of scientific and technical progress, materials and decisions of phthisiatric congresses, orders of public health authorities, scientific developments and recommendations.