Vol 77, No 5 (1996)

Crisis causes and necessity of public health reform in Russia

Amirov N.K., Albitsky V.Y.


The need to reform the healthcare system is due to three reasons: the country's transition to a market economy amidst the deep economic crisis that has engulfed Russia, the deteriorating state of public health, the complete exhaustion and actual failure of the highly centralized, administratively (command)-distributed healthcare system.

Kazan medical journal. 1996;77(5):321-325
pages 321-325 views

Theoretical and clinical medicine

New prognostic index in myocardial infarction

Leshchinsky L.A., Ponomarev S.B., Multanovsky B.L., Lipovetsky Y.M.


The subsequent rehabilitation measures for the specific patient using a new prognostic index can be defined in hospital treatment. This index is used to predict the ability to work in myocardial infarction, possesses high precision and reliability of difference in comparison of groups of patients with various results of diseases.

Kazan medical journal. 1996;77(5):326-330
pages 326-330 views

Artificial pulmonary ventilation in the therapy of polyorganic insufficiency in children with pyoseptic diseases

Mironov P.I., Latypov I.Z., Biryukov A.V., Feoktistov V.P., Khasanov R.S.


The experience of the performance of artificial pulmonary ventilation using "Servoventilator" 900 C and 300 respirators in 32 children with grave pyoseptic diseases complicated by polyorganic insufficiency syndrome is analyzed. The advantages of the use of modern respirators in complex therapy of the children under observation are shown. During prolonged artificial pulmonary ventilation, the levels of partial oxygen pressure and carbonic acid in capillary blood are held close to physiological. The scheme of gradual transfer of children to spontaneous breathing is proposed.

Kazan medical journal. 1996;77(5):331-333
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Diagnostic and prognostic value of the investigation of external respiration function and bronchial reactivity in children with respiratory allergoses

Potemkina A.M., Klykova T.V.


The state of bronchial patency and hyperactivity in children with preasthma and bronchial asthma is studied. The combined examination with compulsory functional pulmonary tests allows to select a bronchospasmolytic drug individually for a patient and to define the efficiency of prescribed specific and nonspecific therapy in the disease dynamics.

Kazan medical journal. 1996;77(5):334-340
pages 334-340 views

Disorders of rheologic properties of blood in patients with uterus myomas

Koptilova E.N., Levin G.Y.


The state of rheologic properties of blood and hormonal status is studied in 91 operated patients with uterus myomas. Aggregational properties of thrombocytes, erythrocytes and their deformation dynamic viscosity are investigated in blood taken from ulnar vein and uterus veins. The increased viscosity syndrome of blood especially in uterus is revealed. The correlation of these disorders and hormonal indices is stated.

Kazan medical journal. 1996;77(5):341-342
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Statistical aspects of extrauterine pregnancy

Mazitova M.I.


As many as 244 cases of extrauterine pregnancy on evidence of three gynecologic institutions of Kazan in 1994—1995 are analyzed. It is noted that it occurs as frequently as in previous years. It is emphasized that special consideration should be given to the search of effective methods in the prevention of remote result of operative interventions, the use of ultrasonic scanning, laparoscopy and other current diagnosis methods.

Kazan medical journal. 1996;77(5):343-345
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Clinical significance of mycoplasma infection in women with a poor obstetric history

Maltseva L.I., Chernov V.M., Maltseva E.S., Fedorov R.V., Sofronov V.V.


It is shown that mycoplasma infections have generalized nature and are attendant infection plurality marker in women with aggravated obstetric anamnesis. This category of patients is the group of high risk for various obstetric pathology: usual premature fetus, premature birth, grave forms of gestosis, fetus intrauterine infection as well as pyo-inflammatory complications during pregnancy and after birth.

Kazan medical journal. 1996;77(5):345-347
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Antigens HLA in patients with terminal chronic renal insufficiency in inhabitants of Tatarstan Republic

Kurmyshkin A.A., Mukhametzyanov I.S.


Antigenic polymorphism HLA А, В, C, DR of 72 inhabitants of Tatarstan Republic with terminal chronic renal insufficiency being on chronic programmed hemodialysis is studied. In their comparison with control group of 151 persons the reliable association of terminal chronic renal insufficiency with antigens B27 and Cw2 remaining after P correction according to the number of tested antigens HLA (k = 44) is revealed. Greater survival, rate on programmed hemodialysis is found in persons, with antigen B27. It shows the selection of persons with antigens HLA promoting their higher biocompatibility with dialyzator materials.

Kazan medical journal. 1996;77(5):348-350
pages 348-350 views

Nature of regional lymphogenous metastatic spreading in rectum carcinoma

Gataullin I.G.


In the absence of visible damaged lymph nodes it is appropiate to supplement radical operation by expanded lymphadenectomy in following cases:

1) in localization of the tumor in anal and inferior- ampullar parts of the rectum;

2) in tumors growing through all the layers or beyond the rectum wall (T3 and T4 stages);

3) in endophitic type of the tumor growth;

4) in low-differential and mucinous adenocarcinomas;

5) in the tumor of size more than 5 sm2.

Kazan medical journal. 1996;77(5):351-353
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Immunohistochemical characteristic of regional lymph nodes in carcinoma

Tsyplakov D.E., Petrov S.V., Shamsutdinov N.S.


The lymph nodes regional to various organs carcinoma are studied by immunohistochemical methods using monoclonic antibodies to CD-antigens. It is stated that in the course of metastatic spreading of the tumor the intensity of cellular immunity reactions decreases abruptly on retention of humoral immune reactions. The factors providing local immunity ineffectivity are revealed:

1) a decrease of the number of CD 1 (+) and CD 10 (+) of blast forms, predecessors of activated T- lymphocytes;

2) a blockade by humoral antibodies CD 20 (+) and antibodies producers of T-cellular cytotoxic effect;

3) a deficiency of CD 8 (+) of T-suppressors capable to oppress immunoglobulin products.

Kazan medical journal. 1996;77(5):354-356
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То the problem of temporary disablement examination in the treatment of bursitises, hydromas and ganglions

Lebedev S.D.


As many as 97 cases of ulnar bursitises, 24 — prepatellar and 13 — popliteal hygromas along with 22 cases of ganglions on arms and legs, the efficiency of their treatment methods depending on temporary disablement period are analyzed. The great efficiency of the ultrasound treatment with hydrocortisone, liquid removal using punctures, the injection of hydrocortisone with Novocain to the synovial bursa cavity and immobilization of full value is revealed.

Kazan medical journal. 1996;77(5):356-359
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Sparing arthrosis method in fibrous flexion and extension contracture of proximal interphalangeal or metacarpophalangeal joints of hand fingers

Nettov G.G.


The sparing anatomic arthrosis method for interphalangeal or metacarpophalangeal joints of hand fingers in their fibrous contractures at periods of not above 2,5—3 months after trauma is developed and tested in clinical practice. The proposed dorsal transtendinous access allows to mobilize the joint atraumatically retaining the anatomic integrity of capsular and ligamentous structures of the traumatized joint. The recovery of the joint function is the result of its early development.

Kazan medical journal. 1996;77(5):360-362
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Treatment tactics for dislocation fractures of the shoulder joint

Zulkarneev R.A., Zulkarneev R.R.


Mismatch of the articular surfaces, weakness of the large capacity shoulder joint bag, lack of ligaments in it, increased stress at home and during work, causing early degenerative-dystrophic shifts in the surrounding tissues, are the reasons that predetermine the fact that up to 50% of all dislocations occur in the shoulder joint and up to 7-10% of all fractures in the shoulder bone, with its proximal part being affected in 70% of cases. The latter is explained by the elderly and old age of the victims, among whom the phenomena of osteoporosis are not so rare.

Kazan medical journal. 1996;77(5):363-364
pages 363-364 views

Applications of polarographic analysis in medicine

Khamitov R.F., Valimukhametova D.A.


Among the physico-chemical methods used in medicine is the polarographic analysis (PA), first proposed by Academician J. Geirovsky. PA is based on determining the dependence of the current strength on the applied voltage during electrolysis of a solution in a special electrolyzer. The current-potential relationship is expressed graphically in the form of polarization curves (polarograms). Each electroactive substance under certain conditions (background electrolyte solution) has its reduction potential. The half-wave potential of the polarogram (electrode potential at which the current value equal to half of the limiting diffusion current is reached) reflects the qualitative feature of the substance.

Kazan medical journal. 1996;77(5):365-367
pages 365-367 views

Short articles

Possibilities of X-ray computed tomography in differentiation of benign and malignant gastric ulcers

Gorshkov A.N., Akberov R.F.


X-ray computed tomography has become one of the main ways to diagnose diseases of the parenchymatous organs of the abdominal cavity. But in gastroenterology it is still not widely used. On the one hand, this is due to the anatomical and physiological peculiarities of the gastrointestinal tract, and on the other hand - to the fact that there are other quite effective ways and methods of diagnosing diseases of the stomach and intestines (radiological and endoscopic).

Kazan medical journal. 1996;77(5):368-368
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Experience of leskol therapy of patients with ischemic heart disease

Latfullin I.A.


Elevated serum cholesterol (CH) levels are an established risk factor for coronary artery atherosclerosis. Despite impressive evidence linking hyperlipidemia and coronary artery atherosclerosis, until very recently it was not possible to show that therapy leading to lower blood lipids reduces overall mortality.

Kazan medical journal. 1996;77(5):369-370
pages 369-370 views

Influence of motor mode on the formation of blood stroke volume in rats

Vakhitov I.K., Abzalov R.A.


We investigated blood stroke volume (BV) in growing rats during an abrupt transition from systematic muscle training to hypokinesia, as well as from limited motor activity at early age to subsequent muscular exertion. In the experiments we used white mongrel rats, which had different regimen of motor activity from the age of 14 days. In the 1st group animals were provided with unrestricted motor activity; in the 2nd group, after 4 weeks of swimming training they were sharply restricted in their motor activity for 4 weeks; in the 3rd group, after hypokinesia for 4 weeks the rats were gradually started to be trained. Blood stroke volume was determined by tetrapolar thoracic rheography using Kubitschek's formula.

Kazan medical journal. 1996;77(5):370-370
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A case of Reiter's disease difficult for diagnosis

Bakulev A.L.


Reiter's disease is now a frequent cause of joint damage at a young age and leads to temporary or permanent disability. The prognosis of the disease is largely determined by the timeliness of diagnosis and treatment. In addition to the classic triad (arthritis, conjunctivitis, inflammatory process of the urogenital tract), in 20-60% of cases of Reiter's disease there are lesions of the skin and mucous membranes in the form of balanitis, blenoreal keratoderma. Presence of disseminated psoriasiform rashes often causes difficulties in diagnosis, leads to irrational therapy, chronicity of the disease and complications. This is evidenced by our observation.

Kazan medical journal. 1996;77(5):370-371
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Simplified calculation of genetic risk

Sergeeva N.A.


Calculating the risk of transmitting a hereditary disease to offspring is important in the practice of medical genetic counseling. Most universal formulas are cumbersome, and their use assumes that the frequency of the mutant gene is already known or is calculated from special tables. Despite the complexity of the calculation procedure, it is necessary to determine the type of inheritance when using information only about sick family members and their kinship relations, taking into account the possibility of incomplete manifestation of the genotype.

Kazan medical journal. 1996;77(5):371-372
pages 371-372 views

Surgical removal of solitary metastasis of colorectal cancer to the lungs

Ayupov R.T., Safiullin R.V., Khasanov S.R.


Despite the wide discussion in the literature about the possibility of surgical treatment of distant metastases of colorectal cancer to various organs, the reports about surgical removal of colorectal cancer metastases to the lungs are still rare. According to literature data, frequency of lung surgeries for malignant tumor metastases of various localizations makes up to 4.6% of surgeries for lung cancer, and the 3-year survival rate is observed in 50% of cases, 5-year - in 38%.

Kazan medical journal. 1996;77(5):372-372
pages 372-372 views


Hygienic problems of products and production of domestic chemicals

Khamitova R.Y.


In our country, the production of household chemicals (HFCs) was established in the mid 60's: their volumes increased sharply, the assortment expanded. In the USSR by the end of 80s the production of household chemicals exceeded 9 million tons per year, and in the world - 60-65 million tons against 6 million tons and 28 million tons in 1965 respectively.

Kazan medical journal. 1996;77(5):373-377
pages 373-377 views

Levels of dose loads in participants of the accident consequences liquidation at the Chernobyl Nuclear Power Station

Korolev V.I.


The dose loads obtained by participants of the Chernobyl accident liquidation are given according to the author’s calculations. In the interval of smag. doses (1 —50 sSv) of external irradiation the equivalent tissue dose for gonads may be equal to 0,57—28,60 sSv; for red bone marrow — 0,69—34,60 sSv; for thyroid gland — 0,63—31,60 sSv. In emergency works the multifactor action on an organism occurs: radiation, radiogenic stress, unusual weather and climate conditions, unfavourable action of individual protection measures.

Kazan medical journal. 1996;77(5):378-380
pages 378-380 views

Социальная гигиена

Peculiarities of the way of life in young girls

Sadykova T.I.


The peculiarities of the way of life in 250 girls aged 15—16 are studied by anonymous questionnaire. As many as 98,8% of the questioned girls tasted strong drinks. Nearly 73% of the girls drink them principally in family celebrations. As many as 4,4% of the girls smoke regularly, 23,2% of them — from case to case. As many as 14% of the girls lead sexually active way of life. The connection between various forms of behaviour of this contingent is revealed. The most dangerous age of the girls accustomed to bad habits is 13—14. Little information of the infection of venereal diseases and aids is connected with a lack of activity of physicians, teachers and parents in sexual education of girls.

Kazan medical journal. 1996;77(5):381-382
pages 381-382 views

Occupational hygiene

Physiologicohygienic estimation of conditions and nature of women-workers in aircraft building production

Berezin I.I.


The results of peculiarities of the action of production factors and working process on the functional state of workers for hermetic sealing and electromounters of aircraft building production are given.

The complex of physiological examinations performed in shift dynamics has revealed the greatest changes in neuromuscular system of workers during hermetic sealing. Electromounting operations are accompanied by the development of pronounced elements of fatigue in central nervous system and visual analyzer.

Kazan medical journal. 1996;77(5):383-386
pages 383-386 views

Healthcare mangement

Experience of organizing the city centralized pediatric cardio-rheumatology service in Kazan

Ignashina E.G., Gaponenko V.A.


In June 1991, a pediatric outpatient consultative and diagnostic department was opened on the basis of the Kazan Cardiology Dispensary in order to improve the care of children with cardiorheumatic diseases by gradually establishing a centralized pediatric cardiorheumatic service in the city. We preliminarily analyzed the level of cardiorheumatologic care for children, which as of June 1991 did not meet the needs of the city residents, and we developed the stages of organizing a fundamentally new service.

Kazan medical journal. 1996;77(5):387-388
pages 387-388 views

Expert evaluation of the quality of work of ambulance physicians

Yarullin M.A., Rodionov I.Y., Ishmetov R.P.


We have developed a comprehensive, covering almost all aspects of a physician's activity, system of expert evaluation of the effectiveness of emergency and urgent medical care. The main criteria are correctness of filling out the card of emergency medical aid call, patient's accompanying sheet, validity of patient's delivery to the hospital for consultation, hospitalization, validity of complaints of population and operative department of SSiNMP about the work of ambulance team doctor or operatively registered shortcomings.

Kazan medical journal. 1996;77(5):389-391
pages 389-391 views

Assistance to the practicing physician

Diagnostic value of pulmonary-ear blood flow velocity and peripheral venous pressure determination

Andreev V.M.


A slowing of the blood flow rate (BFR) is one of the earliest signs of circulatory insufficiency. In 1935, oxyhemometric determination of the velocity of blood flow in the small circle of circulation was proposed. Although the pulmonary-ear SC determination method includes the areas of the large and small circulatory circle, it mainly characterizes the blood flow through the pulmonary vein system - from the pulmonary capillaries to the left ventricle. Blood from aorta reaches ear capillaries very quickly due to high velocity of movement through arterial system, so this time can be neglected. The oxyhemometric and isotopic methods have been shown to give similar results. The oxyhemometric method for determining SC in the small circle is considered to be the best.

Kazan medical journal. 1996;77(5):392-394
pages 392-394 views

Structure of lethality in burn disease and ways of its reduction

Shafikov I.Z., Akhmerov A.B., Mirgasimova D.M., Yulmeteva D.G.


The relevance of the problem of burn injuries at the present time is beyond doubt. This is evidenced by the significant number of victims admitted to the relevant hospitals. The reduction of lethality, complication rate and disability constitutes the most important task in the treatment of these patients.

Kazan medical journal. 1996;77(5):395-396
pages 395-396 views

Новые методы и инструменты

Device for subcutaneous phlebotomy

Izmailov G.A., Izmailov S.G.


The phlebotomes for reliable shutdown from blood circulation of subcutaneously dilated branches of large and small subcutaneous veins of the femur, crus and foot are suggested to improve surgical treatment methods of varicose disease. The technology of subcutaneous dissection of venous collaterals using phlebotomes is described. The observations of 80 operated patients show resistant immediate and distant results with good cosmetic effect allowing to recommend the instruments for a wide use in surgical practice.

Kazan medical journal. 1996;77(5):397-398
pages 397-398 views

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