Vol 70, No 4 (1989)
- Year: 1989
- Published: 15.08.1989
- Articles: 40
- URL: https://kazanmedjournal.ru/kazanmedj/issue/view/5127
Full Issue
The scientific and technological revolution and the formation of ecological thinking among doctors
Abstract
The scientific and technological revolution and social progress have led to the development of productive forces in many countries, including our own, but at the same time have had consequences that have had a deleterious effect on nature and all living things.
According to WHO, improving the environment is a task that is beyond the capacity and power of health authorities. Such a conclusion is quite logical. Many bodies should be involved in this problem, and the goal is that they should effectively make a difference in improving human health while using the resources at their disposal.
Study of the dependence of public health on atmospheric air pollution
Abstract
The need for comprehensive studies of public health in connection with environmental pollution is due not only to the possible deterioration of health, but also to the loss of working time and reduced product production as a result of increased morbidity. It is especially important to establish a quantitative relationship between the degree of air pollution and the health of the child population.
Effects of organofluorine compounds on the body of workers in industrial conditions
Abstract
Organofluorine compounds, despite the constant expansion of their applications and the synthesis of new drugs, remain poorly understood. At the shop where the technological process is carried out according to the closed type, the leading unfavorable factor is the pollution of the working area air with trifluoropropylmethyldichlorosilane.
Analyzing sickness rate with temporary work disability of the workers of this production we paid attention to higher indexes of cases and days of disability per 100 workers (80 cases and 688 days) than in the control group (66 cases and 562 days) numbering 111 people (employees of accounting, computer center) selected by the method "copy-pair" by age. In addition, we also noted cases of allergic diseases in the apparatus workers of the workshop.
Causes of occupational injuries in the dairy industry
Abstract
All the causes of occupational traumatism can be grouped into three groups: technical, sanitary-hygienic and organizational-personal (subjective).
The study of occupational traumatism at the dairy industry enterprises of the Saratov region in 1967-1976 and in 1977-1986 showed that during the first observation period the organizational-personal (subjective) causes amounted to 48.1%, sanitary-hygienic causes to 17.4%, technical causes to 19.6%, and other causes to 14.9%. In the second observation period, the ratio of causes was different: technical causes accounted for 9.4%, sanitary and hygienic causes for 23.8%, and subjective causes for 66.8%.
Physical exercise test in the diagnosis of coronary heart disease and arterial hypertension in locomotive engineers
Abstract
Coronary heart disease and arterial hypertension occupy an important place in the structure of therapeutic pathology in locomotive engineers. It is known that physical activity increases myocardial oxygen demand. Normally, it is compensated by the increase of coronary vessels flow rate. In pathological conditions, coronary circulation reserves are reduced, which leads to myocardial hypoxia and decreased tolerance to physical load. The use of these stress tests in medical examination, in particular bicycle ergometry, allows not only to estimate the state of cardiovascular system, but also to increase the efficiency of detection of the mentioned diseases.
The aim of the present work was to study the level of tolerance to physical load, diagnose coronary heart disease and arterial hypertension in locomotive engineers by bicycle ergometry test data.
Criteria for Evaluation of Hemodynamic Status and Physical Tolerance in Postinfarction Cardiosclerosis
Abstract
Exercise tolerance in patients with coronary heart disease with postinfarction cardiosclerosis is determined by the level of coronary and myocardial reserve. At the same time, the larger the surface of the infarcted area and the number of coronary arteries affected by atherosclerosis, the lower the exercise tolerance. The presence of close correlation between heart size and the degree of coronary insufficiency, the size of postinfarction scar, its localization, the level of end-diastolic pressure in the left ventricle prompted us to check the diagnostic significance of the most informative X-ray cardiometry parameters for postinfarction cardiosclerosis patients in the assessment of the functional state of the circulatory system and the possibility to predict physical performance without ergometric study.
Differential diagnosis of rheumatic mitral stenosis by m-echocardiography
Abstract
Since the first steps of echocardiography, reduction of diastolic opening of the mitral valve has been one of the main signs of rheumatic mitral stenosis, but meanwhile this fact documents only mitral blood flow limitation, which can occur not only at valve, but also at supravalvular and subvalvular levels and has nothing to do with rheumatic etiology of valve lesion. This article is devoted to the discussion of these controversial issues and the role of M echocardiography in the differential diagnosis of rheumatic valve lesion.
Use of 99Tc-diphosphonate scintigraphy in the diagnosis of arthritis
Abstract
Early diagnosis of arthritis is a challenge for clinicians because clinical signs, biochemical and immunological studies are not specific enough, and radiography reveals changes in bone tissue only in the unfolding clinical picture of the disease. Therefore, radioisotope diagnostics of bone and joint diseases with pyro-monodiphosphonate or methylene diphosphonate labeled with 99Tc is becoming more widespread.
Vasorenal hypertension
Abstract
The term "vasorenal hypertension" combines all cases of high persistent arterial hypertension based on some variant of renal artery lesion or its branches. According to statistics, vasorenal genesis of hypertension is confirmed in 1.5-5% of patients with hypertension.
Here is our five-year experience of examination and treatment of patients with vasorenal hypertension. From 1983 to 1987 we examined 342 patients admitted to the Republican Clinical Hospital for arterial hypertension of unclear cause.
Diagnostic algorithm for iron deficiency anemia
Abstract
Iron deficiency anemia, which is based on iron deficiency in the blood serum, bone marrow, depot and tissues, is more common than other forms of anemia. The most frequent etiological factors of iron deficiency anemia are known to be various kinds of blood loss: menorrhagia and metrorrhagia (in women), from the gastrointestinal tract (peptic ulcer, erosions, diverticula, hemorrhoids, non-specific ulcerative colitis, etc.), hematuria, nasal and uterine bleeding. The causes of this anemia can be tumors of various localizations, rare diseases (pulmonary hemosiderosis, glomus cysts), worm infestations, chronic infections, enteritis and intestinal resection. Anemia can also occur in women during pregnancy and lactation, when the body's need for iron increases, in adolescents with an insufficient baseline level (if their mothers suffered from iron deficiency anemia), and in donors.
Impaired platelet haemostasis in patients with myelodysplastic syndrome
Abstract
One third of patients with myelodysplastic syndrome die before the development of leukemia from infectious and hemorrhagic complications; after the onset of acute myeloleukemia this figure reaches 59%. Therefore, the relevance of studying hemostatic disorders in preleukemic conditions is dictated primarily by the need to preserve the lives of patients. Literature data indicate the absence of significant changes in the plasma-coagulation component of hemostasis and fibrinolytic processes. At the same time, hematopoietic dysfunction in myelodysplastic syndrome necessarily includes megakaryocytic bone marrow, which cannot but affect the functional state of the platelet apparatus, the assessment of which was the main task of this work.
β2-microglobulin in the diagnosis of nephrotoxic effects of aminoglycosides
Abstract
Widespread introduction of antibiotics of aminoglycosides group into clinical practice necessitates adequate dynamic monitoring of functional state of the kidneys in terms of early detection of their possible nephrotoxic effect. According to the literature, the incidence of renal damage during treatment with glycosides ranges from 15 to 35%.
Effect of short-term oxygen inhalation on hemodynamics and ventilation in pulmonary tuberculosis patients
Abstract
Among all methods of treatment of chronic respiratory diseases only long-term oxygen therapy can prolong patient's life, while the effect of drugs on the survival rate of this group of patients has not yet been proven. Favorable effect was also noted in pulmonary tuberculosis. Since most mechanisms of the influence of oxygen on the body have been studied in nonspecific chronic respiratory diseases, it seemed relevant to investigate these mechanisms in pulmonary tuberculosis and compare the results with relevant data in the literature.
Analysis of the effectiveness of counter-cycling treatment of peptic ulcer patients with blood products and traditional methods
Abstract
The problem of gastric and duodenal ulcer treatment, in spite of many proposed methods and means, remains far from being solved until now. In the modern concept of ulcerogenesis some researchers in the development of peptic ulcer disease attach great importance to biogenic amines, in particular to histamine, which, affecting the lining cells, stimulates the secretion of gastric juice of high acidity, changes capillary blood circulation and acts on trophic processes in the mucosa of gastroduodenal zone. It has been found that in patients with peptic ulcer disease the content of histamine in the blood is increased, especially during exacerbation of the disease; at the same time in patients the processes of binding and inactivation of histamine are disrupted.
Dynamics of kininogenesis in patients with peptic ulcer disease against the background of drug therapy
Abstract
Many aspects of pathogenesis, diagnostics and treatment of peptic ulcer disease continue to attract the attention of researchers. In pathogenesis of this disease a great role is given to biologically active substances, among which the most powerful are kinins. The revealed increase of kinin system activity in the acute period and its decrease in the remission period of peptic ulcer disease began to be considered as participation of this system in pathogenesis of the disease. There were developed recommendations on the use of antienzyme drugs (trasylol, contrical, etc.) in order to inhibit the activity of kallikrein-kinin system of blood in patients with this pathology.
On the tactics for catarrhal appendicitis
Abstract
The issues of diagnostics and treatment of acute appendicitis are systematically covered in the periodical press, but insufficient attention is paid to the tactics of non-destructive (catarrhal) form of appendicitis, the causes of rather frequent removal of morphologically unchanged processes in patients with the clinical picture of acute appendicitis and measures to reduce the number of needless appendectomies.
Some authors consider appendectomy mandatory in all cases of pain syndrome in the right iliac region. Thus, according to S.D. Lebedev, appendectomy is performed in 84.4% of patients admitted with suspected appendicitis. The unchanged appendectomies, which, in the author's opinion, contribute to the reduction of appendicitis morbidity.
Dependence of clinical manifestations of neuroendocrine syndromes and treatment results on the severity of endocraniosis
Abstract
The high frequency of neuroendocrine disorders in gynecology requires elucidation of their pathogenetic mechanisms in order to develop effective methods of treatment and further rehabilitation of patients. In women with neuroendocrine disorders, endocraniosis in various manifestations is often revealed. The radiological picture of endocraniosis is quite diverse and includes different types of hyperostoses of the bones of the cranial roof and skull base, calcifications of the dura mater and certain brain areas. The most pronounced manifestation of endocraniosis is hyperostosis of the inner lamina of the cranial vault bones - frontal, parietal, and occipital.
Possibilities of clinical and radiological differential diagnosis of non-lymphogranulomatous lymphomas and mediastinal lymphogranulomatosis
Abstract
Despite a significant number of works devoted to malignant lymphomas, early differential diagnosis of these tumors and malignant neoplasms of the mediastinum in general, as well as differentiation of variants in the group of malignant lymphomas itself remain undeveloped. This is especially true for isolated lesions of the mediastinum. Radiological picture of mediastinum and lung lesions in malignant lymphomas is extremely diverse. It depends on the combination of lesions of different groups of mediastinal lymph nodes, their size, localization, as well as on the stage of the disease. Is it possible to distinguish in this polymorphic picture the features peculiar only to lymphogranulematosis, non-lymphogranulematous lymphomas (lymphosarcomas and reticulosarcomas are combined by this term according to WHO classification of 1976) or these diseases cannot be distinguished radiologically from each other? Some authors answer that there is no dependence of the radiological picture on the histological variant of malignant lymphomas, while others point to some differences. Therefore, we would like to dwell on the clinical and radiological data allowing differential diagnosis of non-lymphogranulomatous lymphomas and lymphogranulematosis.
Disruption of neuroendocrine status due to marriage
Abstract
Menstrual dysfunction in women of reproductive age is a frequent pathology that leads to infertility. Endocrinological infertility has a significant specific weight among other forms of disorders of generative function, its frequency reaches 35-40%. A special group of patients with primary infertility are women who have just married. It is noticed that the beginning of sexual life is not indifferent to the young body: in some people with the beginning of sexual life menstruation became less frequent and as a result a persistent amenorrhea was established. No endocrinological disorders were clinically detected.
Clinical significance of microcirculation assessment in women with threatened abortion
Abstract
Pregnancy failure is one of the pressing problems of modern obstetrics. According to the WHO committee of experts, in 10-25% of cases the pregnancy ends in spontaneous termination. A variety of etiological factors that lead to pregnancy termination causes a wide variability of medical, surgical and physical treatment methods. One of the leading pathogenetic mechanisms of pregnancy failure is myometrial hypoxia due to hemodynamic disorders in the uterus. The latter cause a decrease in the excitability threshold of the muscular wall of the uterus and increase its contractility.
Pathogenetic prerequisites for prescribing antioxidants to pregnant women with diabetes mellitus
Abstract
Excessive formation and accumulation of lipid peroxides are found in cardiovascular diseases, diseases of the gastrointestinal tract and bronchopulmonary system, endocrine pathology. Of particular interest is the study of lipoperoxidation processes in diabetes mellitus, a disease accompanied by a pronounced disturbance of fat metabolism and changes in membrane function. A large number of obstetric complications, high maternal and perinatal morbidity and mortality, adverse health consequences for mother and child associated with diabetes mellitus require new approaches to early diagnosis and treatment of detectable disorders in the mother.
Peculiarities of caesarean section with preliminary isolation of peritoneal cavity
Abstract
The success of any surgery largely depends on a detailed knowledge of anatomy, peculiarities of the relationships of fascias, fascial spaces, and other tissues and organs in the surgical area. Nevertheless, in obstetric practice, the fascial sheets of the lower parts of the anterior abdominal wall and bladder are usually overlooked when performing a cesarean section, while the importance of restoring the fascial formations is emphasized by many authors. Being an extension of the bony skeleton, fasciae not only form a support for muscles and organs, but also limit the spread of infection, preventing the generalization of the process. It is especially important when performing cesarean section with preliminary isolation of peritoneal cavity in women of high risk group for the development of septic-epidemic diseases.
Psychopathological features of acute intoxication with xenobiotics with central cholinolytic action in patients with substance abuse
Abstract
Clinical symptomatology of acute poisoning by drugs with central cholinolytic action is little known to practitioners. Drug dependence due to systematic intake of drugs is accompanied by tolerance to them and loss of control over intake, the consequence of which is often acute poisoning.
Hyperinsulinemia in multiple sclerosis
Abstract
Elevated insulin levels not accompanied by a decrease in blood glucose are found in various non-endocrine pathologies. An increase in basal insulin has been detected in psoriasis, as well as in children with chronic lung disease. In atherosclerosis, hyperinsulinemia is detected both on an empty stomach and during glucose tolerance test (GTT), which, combined with dyslipoproteinemia, increases the risk of coronary heart disease.
Orthostatic iliopsoas-lumbar spasm in torsional dystonia and parkinsonism
Abstract
In the study of the pathogenesis of muscular dystonic syndromes, it is very important to identify the role of central and peripheral factors and their correlation in the formation of the disease pattern. It is known that the peripheral focus often plays a significant role in the inversion of pathological mechanisms in conditions of decreased activity of the central ones. The correlation of these factors can be illustrated by the recently described clinical picture of iliopsoas lumbar spasm, which is not so rare in the practice of a neurologist.
Principles of intensive therapy for rhinogenic orbital and intracranial complications
Abstract
Patients with rhinogenic orbital and intracranial complications require urgent care and treatment involving various specialists. On the basis of the clinical material for 35 years including 347 orbital and 33 intracranial complications the modern rational tactics of their emergency therapy at inflammatory diseases of the paranasal sinuses was developed. Treatment of patients with orbital and intracranial rhinogenic complications requires timely wide scale surgical intervention and vigorous medication therapy. Urgent surgical intervention on all affected paranasal sinuses with revision of the orbit or cranial cavity is mandatory. X-ray examination of the paranasal sinuses, puncture of the maxillary sinuses and trepanopuncture of the frontal sinuses, EEG, ECHO-EG, REG data help in determining the volume of surgical intervention. As a rule, it is necessary to open all affected sinuses on one side or even switch to the other side. In rare cases, it is necessary to open all perinasal sinuses on both sides. When performing a radical operation of the frontal sinus, it is necessary to perform mandatory revision of the other sinus through the intercorporal septum.
Carbohydrate metabolism in diabetic patients with hypertension treatment
Abstract
For the purpose of rational therapy of diabetes mellitus, it is important to consider the effect of medications on carbohydrate metabolism, which may change ambiguously in diabetic patients compared to healthy individuals under the influence of drug treatment. In recent years, interest in this issue has undoubtedly increased and has prompted numerous publications containing disparate, unsystematized data on various drugs, mainly on the results of studies of insulin content and glucose levels.
Bacterial endotoxins and diseases of the digestive system
Abstract
For many years, researchers have been interested in the question: do bacterial endotoxins penetrate the intestinal barrier intact? Despite the abundance of factual data obtained in clinical and experimental studies, this question still remains open.
Application of the acetylcholine test to study the effect of air pollution on respiratory function
Abstract
In the literature there are no data on the use of acetylcholine test to study changes caused by the effects of air pollution in the respiratory system of healthy children. Given the significantly higher level of respiratory system diseases, including allergic etiology, among children living in areas with a high degree of air pollution, these studies seem to be very relevant.
Hypertrophic cardiomyopathy
Abstract
Hypertrophic cardiomyopathy is due to a so-called primary myocardial lesion. In typical cases, the interventricular septum is hypertrophied to a greater extent than the free wall of the left ventricle. Another variation of this disease is uniform concentric myocardial hypertrophy with a significant increase in heart mass. Although the etiology of hypertrophic cardiomyopathy is unknown, it is thought to be genetically determined by autosomal dominant transmission with a high degree of penetrance. The burdened heredity and familial nature of the disease occur in almost 60% of these patients, so the examination of their close relatives is of particular interest.
On the causes of diagnostic errors in the detection of gastrointestinal cancers
Abstract
Qualified medical care of the population to a great extent depends on the quality of diagnostic work at the polyclinic stage.
To study the causes of delayed diagnosis of gastrointestinal tumors we analyzed case histories of 2120 patients treated at the gastroenterology department during three years. Gastric tumors of various localizations were revealed in 32 patients, in 9 patients - tumors of large intestine. The average age of the patients was 56 years.
Reflex Therapy in the Complex of Restorative Treatment of Traumatological and Orthopedic Patients
Abstract
A number of authors have shown the possibility of using reflexotherapy in the complex of means of rehabilitation of patients with traumatological and orthopedic profile.
We analyzed a ten-year experience of using reflexotherapy in the complex of rehabilitation treatment of 196 patients with consequences of limb fractures and 187 patients with osteoarthritis of large joints. Among them there were 56% men and 44% women at the age of 21 to 67 years old.
Visitors to trauma hospitals as a possible source of hospital-acquired infection
Abstract
The presence of visitors in trauma hospitals is to some extent natural and desirable: communication with relatives and acquaintances has a beneficial effect on the neuropsychiatric status of patients who have suffered trauma or are about to undergo surgical intervention, especially considering their prolonged inpatient treatment. In some cases, visitors are involved in the care of patients. However, visitors to trauma hospitals can be additional sources of infection, influencing the spread of nosocomial staphylococcal infection, which has so far received little attention.
Surgery of cutaneous anomalies of the sacrococcygeal region
Abstract
There are very few articles on the treatment of epithelial coccygeal passages in the periodical literature. Therefore, it is not surprising that these diseases are not recognized in a timely manner, and serious mistakes are made in their treatment. It is believed that in the acute period of the disease there are all conditions for radical surgery, but a number of authors suggest performing radical surgery after signs of acute inflammation subside in a period of 5 days to 6 months.
Results of treatment of female genital diseases in the balneo-physiotherapeutic association of the complex of sanatoriums-preventoriums
Abstract
The organization of the balneo-physiotherapy association (BFO) of the complex of sanatoriums-preventoriums of Kuibyshev Regional Council of Trade Unions made it possible to concentrate the efforts of doctors and nurses transferred from sanatoriums-preventoriums and to organize a powerful therapeutic base. BFO works in two shifts from 8 to 21 hours, serves 14-15 visits each sanatorium-preventorium. Treatment is provided with and without a break from work. The complex of sanatoriums annually treats 23-24 thousand people.
Functional splint for treating clavicle fractures
Abstract
For the treatment of clavicle fractures, we developed a functional splint, which is an improved splint of S. I. Kuzminsky. It provides repositioning and stable fixation of fractures, allows us to maximally raise, retract and keep the shoulder girdle in an elevated position during the period necessary for the fracture to heal.
Professor Vsevolod Vasilievich Talantov
Abstract
In August 1989 it will be 60 years since his birthday and 36 years of working activity of honored doctor of TASSR, Head of Endocrinology Department of Kurashov Kazan Red Banner Order of Labor Medical Institute, doctor of medical sciences, Prof. V. Talantov.