Vol 79, No 1 (1998)

More than 30 year experience of the use of electroimpulsive therapy in cardiac rhythm disorders is analyzed. The rate and character of complications in this type of the treatment, the conditions of their development and the possibilities of their prevention are studied. It is noted that electroimpulsive therapy can be used only in the presence of direct indications.

The combined analysis of cardiac rhythm variability indices, signal-averaged electrocardiogram noting late potentials of ventricles is performed. As many as 158 patients with various forms of ischemic cardiac disease and 70 persons of the control group are examined. Signal-averaged electrocardiograms are registered in dynamics during 18 months, cardiac rhythm variability indices are determined, echocardiography is performed.

As many as 33 patients with chronic pulmonary diseases suffering from various degree of pulmonary insufficiency and 20 patients with chronic cardiac diseases with different stage of cardiac insufficiency are examined in stationary conditions. The control group without cardiac and pulmonary diseases and patients with combination of cardiac and pulmonary diseases are stood out. Single use of the dosed aerosol berotek caused the reliable rise of increase indices of the majority of ventilation factors in patients with chronic pulmonary diseases and unreliable rise in patients with chronic cardiac diseases. The functional ventilation test with berotek can be used in differential diagnosis of chronic cardiac and chronic pulmonary insufficiency.

The mathematical model of the crossover femoro-femoral autovenous bypass operation using in the treatment of unilateral occlusions of iliac veins is created. The optimum conditions of crossover bypass functions on the basis of hydrodynamic laws are determined. The most important factors providing the success of the bypass operation are the sufficient diameter of a bypass and the gradient of pressure at its ends. The dependence between them is inversely proportional and its correlation can be fixed by experiments. The conservation ef valve function, of the crossover bypass has a relative meaning because a reverse blood flow is not hemodynamically meaningful even in the absence of valves.

Antithrombin III (AT III) is the physiological inhibitor of a series of activated clotting factors. Its diminution increases the tendency of thromboembolism. In cases of acute DIC, AT III binds to thrombin and to other activated factors in circulation. Thereby both partners of the reaction become inactive. When by this mechanism the available biologic activity of AT III diminishes below about 50% of normal any further inactivation of active clotting enzymes is greatly inhibited. In such cases, the mechanism of DIC decompensates and the full symptoms of consumption coagulopathy develop. It was, therefore, obvious to attempt a substitution with concentrates of AT III in such cases. In different randomized trials it could be shown which effect AT III concentrates had on the outcome of Die. In these tests it could be clearly shown that repeated administration of AT HI concentrates in a dose that keeps AT III activity constantly around 100% had the following advantages over therapy with heparin. The duration of symptoms of DIC could be considerably shortened from an average of 120 h in the heparin group to 40 h in the AT HI substitution group. Furthermore, in most severe cases of acute consumption coagulopathy due to septic shock, the death rate could be considerably and highly significantly diminished in the patients who received AT III. Similar results were also found by different authors who were able to demonstrate that the average survival rate in patients with septic shock increased from 20% to over 70% when AT III was substituted. Key Words: Antithrombin III—Heparin—Diffuse intravascular coagulation.

Gestosis is one of the most common complications of pregnancy and childbirth and is one of the main causes of maternal and perinatal mortality. This pathology is characterized by inadequate adaptation of the mother's body to the development of the ovum. Currently, the priority of immune disorders in the genesis of preeclampsia is undeniable. Among the etiological factors, vascular disorders, neuroendocrine disorders, and primary enzymatic dysfunction of the placenta are also distinguished. Modern forms of gestosis are very diverse.

Primary tracheal cancers account for 0.1-0.2% of the number of all malignant neoplasms, which was established by I.V. Davydovsky (1940). Cancer accounts for half of all tracheal tumors. The age of patients varies widely, but persons over 40 years of age prevail.

A patient with suspected myocardial infarction (MI) or with a confirmed diagnosis should be admitted to a specialized (cardiological) hospital. Its treatment includes five main aspects: patient support, pain relief, reperfusion with thrombolytics and aspirin (all patients should receive 300 mg of aspirin tablets), heart rate correction, and respiratory resuscitation with defibrillation.

The symposium was attended by large delegations from Japan, Australia, and the countries of the Pacific region along with the heads of scientific schools in Europe, the USA and Canada. Russia was represented by 20 people.

A book has been released that will undoubtedly go down in the history of healthcare. The author is Yakov Georgievich Pavlukhin, Honored Doctor of the RSFSR, surgeon, health care organizer, who has worked for decades in the health care system in leadership positions. This book demanded a truly titanic work from the author.