Vol 63, No 3 (1982)

The problem of organizing geriatric care is attracting more and more attention of the health and social security authorities of developed countries, which is primarily due to the progressive aging of their population. According to UN statistical forecasts, in the industrialized countries of the world, the number of people aged 60 and over will increase by 54% in the period from 1970 to 2000, with an overall population growth of only 21%. According to the same data, the percentage of people over 60 years old in the Soviet Union during the same period will increase from 11.5 to 17, that is, more than 7b part of the country's population. Particularly numerous will be the contingents of the population aged 75 and over, who for health reasons are often deprived of the ability to self-service and who need well-organized medical and social assistance.

68 women with various neuropsychiatric disorders in menopause were examined. A significant place among these disorders was occupied by reactive states, in which menopause itself was a psychogenic factor. A peculiar change in behavior was revealed in 12 women. It manifested itself as a reaction of the hysterical type in the form of "reality mystification" and was observed, on average, 1-2 months after the onset of menopausal disorders. The reaction of the personality to menopause as a significant phenomenon arose in the form of hysteroid behavior only in those women who, before the menopause, were inclined to hysterical forms of reaction that had not previously reached a significant degree of severity.

The data of angiographic, oscillographic and rheographic research methods were compared in 63 patients with obliterating diseases of the lower limb arteries. It has been established that arterial oscillography and rheovasography objectively reflect and document the changes occurring in the arterial bed of patients with obliterating endarteritis and atherosclerosis, only when they are used together. The pharmacological test with nitroglycerin makes it possible to differentiate organic and functional changes in the arterial bed only in the initial stage of the disease, in later periods it only helps in predicting the course of the disease. Angiographic methods of examination clarify the diagnosis, localization and length of the literary process.

In 60 healthy individuals and 85 patients with gastric ulcer and duodenal ulcer, the state of microcirculation of the conjunctiva of the eye and the level of glycoproteins in the gastric juice were studied. It has been shown that one of the reasons leading to a decrease in the level of mucins in gastric juice may be mucosal hypoxia caused by impaired microcirculation.

The duration of duodenum acidification was studied in patients with duodenal ulcer, depending on the age, duration of the disease and the presence of concomitant pathology on the part of the biliary system. Significant violations of acid-neutralizing function were revealed in the early stages of the disease and with concomitant lesions of the biliary tract. The use of diadynamic currents has a positive effect on the acid-neutralizing function of the duodenum.

When comparing the functional and morphological parameters of the liver in patients with chronic calculous cholecystitis in 64%, a discrepancy was found between the data of biochemical blood tests and the severity of diffuse organ damage. The results of morphometric analysis, indicating a change in the histophysiological parameters of the liver, also did not have the corresponding functional criteria. In order to improve the diagnosis and therapy of gallstone disease, it is recommended to supplement clinical and laboratory studies with an intravital morphological study of the liver.

On the basis of 340 operations for destructive forms of appendicitis, it was shown that subserous appendectomy as a plastic method of peritonization of the stump of the appendix in acute inflammation reliably seals and peritonizes the stump, without disturbing blood circulation in the wall of the cecum, which creates favorable opportunities for eliminating residual inflammation in the cecum.

Experimental studies and clinical testing of suture material made from the intestines of cattle and pigs were carried out. According to its properties (strength, resorption, reliability of sterilization, absence of allergenic reaction), catgut from the intestines of pigs and cattle can be recommended for introduction into surgical practice.

89 children were diagnosed with gastrointestinal diseases caused by opportunistic microflora. The severity of the disease and the severity of individual symptoms can vary from mild to severe toxic forms. When treating such patients, antibiotics should be limited, if possible, and biological products should be widely used: bacteriophages, colibacterin, bifidumbacterin, vitamins.

Obesity, as you know, is often combined with atherosclerosis, hypertension and their characteristic left-heart failure. Least of all, in our opinion, obesity is associated with cor pulmonale and right-heart failure. "Pickwick syndrome", it is also known as "Ioe syndrome", "cardiopulmonary syndrome of patients with obesity", "obesity-hypoventilation syndrome".

One of the tasks of the social and labor rehabilitation of persons with aphakia is to create conditions conducive to the preservation of the ability to work. There were 270 patients under dispensary supervision (from 1 to 5 years); under the age of 40 - 1 (0.4%), from 41 to 50 years - 4 (1.5%), from 51 to 60 years - 3 (1.1%), over 60 years - 262 (97 %). Thus, the main group of patients consisted of pensioners. All patients underwent cataract cryoextraction. Visual acuity with correction at discharge of 0.6-1.0 was noted in 94 (34.8%), 0.3-0.5 in 151 (55.9%), 0.1-0.2 in 25 (9.3%) people.

An analysis of referrals to our clinic of maxillofacial surgery showed that in the Bashkir Autonomous Soviet Socialist Republic there was previously a belated diagnosis and hospitalization, multi-stage movement of patients with facial injuries. 34.1% of patients received specialized care in the clinic on days 4-10, and only 15.5% of patients received on the first day. For 64.7% of patients, first aid was provided by surgeons, doctors on duty in rural, regional, city hospitals, doctors and paramedics of emergency medical care who did not have special experience in the clinic and treatment of facial injuries.

Heparin preparations used in clinics of our country (produced in Minsk, Kaunass, Baku, Hungary and Czechoslovakia) differ in their biological activity. Heparin is a variable molecular weight polymer of about 17,000 daltons. Its monomer unit consists of a-glucuronic acid esterified with another sulfuric acid at carbon 2, glucoseamine esterified with sulfuric acid at carbon 6 and at the amino group of carbon 2, and L-iduronic acid. The remains of glucuronic acid and glucosamine, iduronic acid and glucosamine are linked by glycosidic a (1 -> 4) bonds.

About 1000 observations of pancreatic cysts and fistulas have been published. Pancreato-pleural fistulas are extremely rare. GD Vilyavin (1977) described a left-sided pancreato-pleural fistula. We did not find any publications on right-sided pancreato-pleural fistulas. Our observation is of interest from the point of view of diagnostics and surgical tactics.

In the structure of diseases of the small intestine, tumor lesions have a small specific weight, but in terms of their severity and unsatisfactory results of treatment they deserve special attention. We have observations of 26 patients with small intestine tumors. 14 people were admitted urgently, 12 were hospitalized for examination in connection with the assumption of an intra-abdominal tumor. There were 14 women, 12 men; the age of patients is from 17 to 68 years, of which almost half (12 people) are not older than 40 years. If we take into account that 2/3 and even more patients with malignant colon tumors are older than 40 years, then a significant difference in the contingent of these two groups of patients becomes noticeable

We observed 67 women aged 20 to 50 with menstrual dysfunctions. 10 of them had amenorrhea, 11 had Stein Leventhal's syndrome, 43 had dysfunctional uterine bleeding, 3 had menopausal and postmenopausal syndromes, an X-ray examination of the skeleton was conducted, and of various etiologies, osteoarticular changes were found in 45% of these patients.

Violations of urination, especially after extirpation of the uterus, are a common complication of the postoperative period. They manifest as frequent urination or urinary retention, but patients usually feel the urge to urinate. These complications are amenable to drug therapy and physical therapy. We observed a patient who, after the operation of extirpation of the uterus, did not urinate and did not feel the urge to urinate. They appeared only two months after the operation as a result of acupuncture.

The efficiency of the work of the "one day" hospital - prehospital examination of thoracic patients on an outpatient basis is analyzed. It is shown that this form of patient care significantly reduces the time of diagnosis and hospital stay, as well as increases bed turnover and increases the surgical activity of the hospital.

The scientific activity of Professor P.F.Lesgaft at Kazan University is a bright page in the history of the medical faculty and a noticeable trace in the social and cultural life of our city. And the so-called Kazan "Lesgaft case" became known throughout Russia.

In modern clinical medicine, especially in surgery and resuscitation, transfusion methods of treatment occupy an important place. This is due to the success in the procurement, stabilization, preservation and fractionation of blood and bone marrow, the creation of effective blood preparations and blood substitutes for targeted action.