Vol 46, No 3 (1965)

With many internal diseases, such phenomena develop in which emergency medical measures are required to alleviate the condition of patients and even save their lives (for example, developing myocardial infarction or acute domestic poisoning). In other diseases, the question of the severity of the patient's condition and the urgency of medical care is decided by the severity of clinical manifestations, the occurrence of dangerous complications. Examples of such conditions are cardiac asthma with some myocardial lesions, complete atrioventricular block with Morgagni-Edens-Stokes syndrome with various anatomical processes in the His bundle, paroxysmal tachycardia, bleeding from internal organs, coma, etc.

Rheumatoid arthritis (infectious nonspecific polyarthritis), due to its high prevalence and severity of the course, occupies a prominent place in the clinic of internal diseases. Advances in the study of the etiology and pathogenesis of this disease have led recently to the development of fairly effective therapeutic measures (therapy with salicylates, pyrazolone drugs, resoquine, corticosteroids, ACTH, gold preparations; antibacterial therapy; physiotherapeutic and balneological procedures, corrective operations, etc.). The rational use of these methods of treatment requires accurate and detailed diagnostics from the doctor, taking into account the type of arthritis, its clinical course, stage and phase, localization and pathomorphological forms of the inflammatory process in the joints, the functional state of the articular apparatus, and the nature of extra-articular lesions.

The issue of tissue metabolism of proteins and protein-carbohydrate compounds in rheumatism and rheumatoid arthritis is currently the subject of a clash of opinions. It is closely connected with the profound changes in the paraplastic substance of the connective tissue, characteristic of "connective tissue diseases" (Klemperer, 1962), revealed in recent years (AA Tustanovsky, AL Zaides, GV Orlovskaya, 1960).

In recent years, clinicians are increasingly using biochemical techniques to determine the activity of the rheumatic process in terms of tissue destruction. It is known that as a result of changes in connective tissue during an active rheumatic process, mucoproteins accumulate in the blood and tissues. The diphenylamine test and the reaction to sialic acids, used to detect active rheumatism, are based on the determination of mucoproteins in the blood. These reactions are based on the detection of one of the constituent parts of mucoproteins (E. G. Larsky, S. S. Mutin).

Currently, the majority of domestic and foreign authors consider rheumatism as an infectious-allergic disease. The close relationship of acute and chronic streptococcal infections with rheumatism is well known (D. D. Lebedev, A. V. Dolgopolova, E. I. Volkova, Lorenz, Stollerman and others). To prevent recurrence of rheumatism, drug prevention is currently considered effective, and, in particular, prolonged-acting penicillin preparations.

When treating children with epidemic hepatitis, we carried out a strict and prolonged bed rest. The diet provided for the elimination of fat in the first days, its restriction in the following and the predominance of easily digestible carbohydrates.

In recent years, works have appeared that indicate the development of oxygen deficiency in epidemic hepatitis (V. P. Bezugly, 1960; M. L. Orman, 1963; Z. Ya. Abdulkhadzhaev, 1963). However, this issue is not given due attention both in the study of pathogenesis and in the treatment of this disease.

If in the pathogenesis of portal hypertension in adults, the central place belongs to the intrahepatic block (cirrhosis of the liver), then in children, an extrahepatic block is a frequent cause of portal hypertension.

The overall mortality rate among patients operated on for acute cholecystitis has significantly decreased in recent years and ranges from 1.3% to 2.4% (GG Karavanov and FA Spektor, Ya. I. Grinberg). However, when analyzing these indicators, it turns out that among those who died after surgery, the bulk of them are people aged 60 and older. According to B.A.Petrov, the mortality rate at this age was 12.2%, according to B.A.Korolev and D.L. Pikovsky - 13.7%, according to A.I. Masumov - 25%, according to B.M. Khromov and L.P. Vinogradova - 45%. Apparently, an explanation for this should be sought in the pronounced phenomena of atherosclerosis, the frequent presence of more or less severe concomitant diseases, a decrease in the body's resistance to infection and a decrease in tolerance to surgical trauma. The latter, when it comes to cholecystectomy, remains quite significant. Apparently, each patient should carefully measure the severity of the forthcoming surgical intervention with his general condition. It is pertinent to recall that even at the 17th-18th congresses of Russian surgeons S.P. Fedorov, E.R. Hesse, P.A.Herzen and N.N.Petriv suggested resorting to cholecystosmia in seriously ill patients. In subsequent years, due to the significant activation of tactics in acute cholecystitis, the indications for cholecystostomy were sharply narrowed.

The main method of treatment of malignant tumors of the sigmoid and rectum continues to be surgical intervention. The most radical are recognized one-stage combined abdominal-perineal operations (S. A. Holdin, 196'5). Anesthesia during these operations presents certain difficulties, since these operations are very traumatic, accompanied by significant blood loss, and when they are performed, patients have to be moved from one position to another.

Plastic surgery Van-Guk-Boari has a number of advantages over ureteroneocystostomy. Ureteroneocystostomy can be recommended only for injuries of the ureter at a distance of up to 5 cm from the bladder, while the Van-Hook-Boari operation can be carried out even with injuries of the ureter at a distance of up to 10-11 cm.Ureteroneocystostomy leads to vesicoureteral reflux with subsequent infection of the kidney, after the plasty of the ureter according to Van Hoek-Boari, as a rule, this complication is not observed.

Early rupture of amniotic fluid is often a serious obstetric pathology that darkens the prognosis of labor for the mother and especially for the fetus. According to the summary statistics of N.I. Frolova, the frequency of operative delivery in this phenomenon ranges from 6.8% to 26%, stillbirth - from 3% to 11.9%, fetal asphyxia - from 3.1% to 20.9%, early child mortality - from 4.7% to 25%, postpartum diseases of mothers - from 4.6% to 22.6%.

Blowing out the fallopian tubes is the simplest and most common method for diagnosing tubal infertility.

In recent years, the widespread distribution of urogenital trichomoniasis among men has been established. From 1960 to 31 / XII 1964 under our supervision there were 1584 people with trichomoniasis, of whom 1130 were sick with a fresh form of invasion and 454 - chronic.

Among the various head injuries, scalped wounds of the soft tissues of the skull occupy a special place. These injuries often occur in women, whose hair gets into rotating parts of machines and mechanisms, which leads to detachment of various sizes and detachment of the scalp from the underlying tissues of the cranial vault and the formation of an extensive wound surface that requires plastic replacement.

M., 39 years old, was admitted on 18 / X 1962 with complaints of recurrent headaches, at times - dysuric phenomena. Ill since 1959 and is under dispensary observation by a therapist for hypertension. At the next visit, a large number of leukocytes were found in the patient's urine.

In our clinic from 1946 to 1960. 1696 patients with uterine fibroids were treated, of which 1207 were operated. Among the complications of myomas, we observed fibroid necrosis in 63 patients (5.2%), edema - in 25 (2.07%), malignant degeneration in 5 (0, 4%) and hyaline transformation in 8 (0.66%). Necrosis of submucous fibroids was found in 40 patients, interstitial - in 19, subserous - in 3, and vaginal fibroids - in one.

We examined more than 100 people aged 40–65 years. X-ray examination revealed aortocardiosclerosis. During the transition from the horizontal to the vertical position, the systolic pressure in these patients decreased by 20-40 mm, and remained low after 5 minutes.

Through careful questioning, we ascertained the nature and diet of mothers during pregnancy and lactation. The state of health of women and the course of pregnancy were found out.

Here is our observation. Z., 37 years old, was admitted to the hospital on 16 / II 1962 with complaints of bleeding from the urethra, difficulty urinating, accompanied by pain and burning sensation due to the presence of the wire in the bladder.

In the urological department of the 5th city hospital in Kazan, during the period from 1951 to 1960, 394 men and 281 women were treated with ureteral stones. In the right ureter, stones were found in 298 patients, in the left - in 357 and in 20 - in both ureters.

Penile elephantiasis is a very rare disease, more common in tropical and subtropical countries.

Mercury preparations of the organic series: salirgan, merkuzal, promeran, novurit, etc. usually do not give any side reactions with prolonged (up to several months) use (1. G. Antonov, 1954). However, some individuals have an intolerance to these drugs.

We applied Zhen therapy to combat various functional disorders and complications of the postoperative period in 103 patients. 98 of them had a pronounced therapeutic effect, 5 patients had no effect. Impact on the zhen points, according to our observations, is an effective method of treating various reflex disorders of the postoperative period. However, we combine Zhen therapy with other treatments as needed.

K., 26 years old, was delivered at 23:00 20 / XII 1963 with complaints of abdominal pain, especially below the navel, general weakness, vomiting. She fell ill acutely at 12 o'clock 20 / XII. Pain appeared in the iliac regions, then throughout the abdomen, vomiting twice, general weakness. The last period was on November 21st. The stool is liquid, without any admixture of blood, free urination.

Currently, the country's chemical industry produces a large number of various organophosphorus preparations used to combat harmful insects. These drugs include dimethyldichlorovinyl phosphate (DDVP).

One of the most common causes of hearing loss is otosclerosis - a disease that appears at a young, blooming, most working age, often leading to disability. Statistical data indicate a significant frequency of this disease (1% of the total adult population of the world, and according to some information, even 6-10%).

For successful sounding of the duodenum, it is important to prevent the tube from folding during its advance through the stomach.

At present, when physical development and all-round upbringing of a person have ceased to be only a theoretical problem and are already being practically carried out by our party and the Soviet state, the further development of this problem has attracted close attention of both scientists and practitioners of many specialties. This is understandable, since in order to make the eternal dream of the all-round improvement of humanity painful, it is necessary, both in theoretical and practical aspects, to study this problem in relation to modernity, which will help find a more correct way to resolve it.