Vol 62, No 5 (1981)

The long-term results of conservative and surgical treatment of 200 patients with closed uncomplicated fractures of the thoracic spine were analyzed and tables of the frequency of signs that characterize this group of patients were compiled. Based on the data obtained, tables were compiled for the computational prediction of the outcomes of closed uncomplicated fractures of the thoracic spine with conservative and surgical treatment. The use of computational prediction tables in the practice of medical institutions will make it possible to objectively assess the condition of the victim, determine the effectiveness of a particular treatment method and recommend the most appropriate one.

The results of clinical and electroencephalographic examination of 72 victims who underwent mechanical (strangulation) asphyxia are presented. The electrical activity of the brain was restored as the condition improved (normalization of respiration and cardiac activity) in the process of resuscitation. The dependence of the frequency-amplitude characteristics of the electroencephalogram on the duration of asphyxia has been established.

85 patients with large-focal myocardial infarction aged from 38 to 72 years were examined. All patients received complex treatment, and 42 of them received additional prednisolone at a dose of 20-25 mg per day by mouth in the first 6-8 days from the onset of the disease. Studies have shown that the inclusion of prednisolone in the treatment complex has a beneficial effect on the course of myocardial infarction: it accelerates the normalization of protein SH-groups, protein fractions, serum enzymes, electrolytes in the blood and catecholamines in daily urine, gives a diuretic and natriuretic effect without causing an increase in caliuresis.

The effectiveness of intramuscular administration of usual (800 thousand units per day) and increased (12 million units per day) doses of benzylpenicillin in 281 patients with acute, prolonged and chronic pneumonia was studied. Increased doses of the drug had a therapeutic effect in 80% of patients in whom its use in usual doses was unsuccessful. When using higher doses, the dependence of the effect of penicillin on the resistance to it of the coccal flora isolated from the sputum of patients was leveled. The high efficiency of penicillin therapy led to the conclusion that gram-positive cocci play a decisive role in the etiology of pneumonia. It was concluded that it is advisable to prescribe higher doses of benzylpenicillin intramuscularly in the absence of the effect of using it in usual doses, only if the intramuscular administration of high doses of benzylpenicillin is unsuccessful, one should switch to intravenous infusions or use semisynthetic drugs.

Alloplastic transplants of the thyroid-parathyroid complex were performed under the cover of immunosuppressants (6-mercaptopurine and hydrocortisone) and without them in 15 patients suffering from thyroid-parathyroid insufficiency. Transplants were performed on the vascular pedicle according to Bogoraz. The results were tracked over periods from several months to 14 years. A more favorable clinical effect was noted in the postoperative period in those patients who received immunosuppressants.

704 patients with toxic goiter were examined. A test with a dosed irritant revealed adrenal insufficiency in 50.7% of patients. The use of glucocorticoid therapy is recommended at all stages of treatment of patients with toxic goiter.

Methods for studying the stomach in transmitted light throughout the operation have been developed: reverse transillumination fibrogastroscopy, targeted forward and reverse transillumination angiography, and pigmentary injection transillumination angiography. The studies were carried out during the operation and on removed preparations. Of the 464 operated patients, 346 had stomach cancer, 45 had peptic ulcer disease, 43 had polyps, and 30 had non-epithelial tumors. Features of angioarchitectonics of the stomach are important for the recognition of initial lesions - erosions, ulcers, polyps.

Disorders of intramural blood flow are observed in mechanical disorders of the patency of extraorganic vessels caused by thrombosis, embolism, ligation of certain branches, metastases to regional lymph nodes. The latter was noted as an anatomical substrate of ischemic enteritis, gangrene of the affected ileum in carcinoid tumors [12]. The second type is such disorders of blood flow, in which the patency of the vessels is preserved. There is reason to consider stress ulcers as a consequence of non-occlusive gastric ischemia. In their pathogenesis, a violation of microcirculation in the mucous membrane plays a role; more often they occur in the proximal stomach.

Stabilization of the frequency of intestinal complications in typhoid fever was noted. With typhoid perforated peritonitis, symptoms of peritoneal irritation may not be detected.

Based on ten years of experience in treating patients with genital endometriosis, a three-stage system of clinical examination of this contingent of patients is recommended (reception and examination by a gynecologist-endocrinologist, examination and preparation of a treatment program in an equipped gynecological hospital, observation and treatment by a gynecologist at the place of residence). Active dispensary observation and treatment in the 3rd group of dispensary registration contribute to the most complete rehabilitation of patients with genital endometriosis.

Treatment of patients with circulatory failure with ulcerative necrotic lesions in the oral cavity should be carried out in a therapeutic hospital. With local treatment, it is not recommended to inject ulcers with a solution of penicillin with novocaine and excision of necrotic areas.

For the purpose of laser phototherapy, helium-neon lasers with a wavelength of 632.8 nm and an output power of 15-25 mW are most often used today. For the treatment of patients with long-term healing wounds, trophic ulcers and bone fractures, the "Clinic" device was made on the basis of a carbon dioxide laser with a wavelength of 10.6 μm, in which two LG-23 generators are used, which makes it possible to simultaneously irradiate two affected areas of the body or two sick.

T., 55 years old, choked on a fish bone while eating. After 2 days, she was admitted to the ENT clinic with complaints of sore throat, hoarseness, sharp difficulty in swallowing and breathing. The general condition of the patient is severe, the neck is enlarged due to edema of soft tissues, the skin is pale, on the anterior surface of the chest there are massive subcutaneous hemorrhages. The patient retains a forced position, cannot lie on the couch on her own. Palpation of the neck and interscapular region causes severe pain. Temperature 39.3 °.

We present an observation of severe concomitant closed chest trauma complicated by traumatic pneumonia, bilateral hemopleuritis, heart contusion, hemopericarditis, kidney contusion, post-hemorrhagic anemia. K., 61 years old, a driver, fell from the body of a car, hitting his back on the asphalt. I didn’t lose consciousness. There was no hemoptysis. I was able to get to my garden plot on my own and worked there for some time. In the evening, chest pains intensified, shortness of breath appeared.

We present two observations of isolated damage to the gallbladder in blunt abdominal trauma. 1. K., 24 years old, fell out of the 5th floor window. Delivered to the trauma department in 30 minutes by the ambulance service with a diagnosis of blunt trauma to the abdomen with damage to internal organs: Fracture of the right hip; alcoholic intoxication.

An radiology examination of 59 women with ectopic pregnancies was carried out. 44 of them (group 1) had a tubal pregnancy in the ampulla, 8 (group 2) had a non-developing pregnancy in the accessory horn of the uterus (pregnancy duration from 12 to 20 weeks) and 7 (group 3) —Abdominal pregnancy (in 6 — secondary at 16 to 24 weeks and in 1 — primary with a full-term dead fetus in the subhepatic region). The diagnosis of abdominal pregnancy was confirmed by X-ray examination using fractional cervicohysterosalpingography. Iodolipol, urotrast, and verografin were used as contrast agents.

In recent years, descriptions of cases of toxic epidermal necrolysis - Lyell's syndrome in children - have increasingly appeared in the periodical literature. Most authors consider this disease as a toxic-allergic reaction to various medicinal substances: antibiotics, sulfa drugs, etc. Cases of Lyell's syndrome in children after administration of measles and tetanus toxoid are described. The prognosis of the disease is difficult: 30% are fatal. Patients die from toxicosis at the height of the disease or from septic complications.

We have seen an allergic reaction to a single gold crown. P., 40 years old, complained of pain and edema in the upper lip, which arose 2 weeks after the gold crown was reinstalled on the central upper incisor. The same changes on the lip have already been observed once, and their appearance also coincided with the establishment of a gold crown on the same tooth.

Intracerebral tumors early cause intracranial hypertension, especially in temporal lobes. However, this course of the disease is not the rule. This is confirmed by our observation. In Sh., 29 years old, in early 1973, shortly after general hypothermia, there appeared minor epileptic seizures in the form of absences, accompanied by anxiety and a feeling of unpleasant odors.

Our proposed method for the rapid elimination of hammer-like deformity of the first toe is illustrated by the figure. The tendon of the long flexor of the first toe 1 is exposed in the projection of the main phalanx 2 from the skin incision 5 along the plantar surface, then it is cut off at the site of attachment and passed through the bony canal 4 drilled closer to the base, a tendon loop 3 is formed on the main phalanx 2 .. the interphalangeal joint is arthrodesised 6 and fix the needle 8, passed through the end phalanx 7.

1981 marks the 100th anniversary of the birth (29 / ІѴ 1881) and 10 years since the death (30 / ІІІ 1971) of the outstanding Soviet neurologist Leonid Ivanovich Omorokov. The history of his life and work is remarkable in many ways. In 1904 he voluntarily left the student's bench at the St. Petersburg Medical-Surgical Academy and went as a military doctor to the front in Manchuria. After graduating from the academy (1907), under the leadership of V.M.Bekhterev, he carried out a clinical and experimental study on gas exchange in mental illness.

The peer-reviewed manual is essentially the first Russian monograph devoted to the most important problem - the differential diagnosis of internal diseases. Previous similar editions (M. Mattes, 1929, R. Hagglin, 1965) were translated and, naturally, did not reflect the main provisions of the doctrine of the Soviet therapeutic school. In the preface, written by Academician E.I. Chazov, it is rightly noted that the system of thinking proposed by the author attracts attention by its full compliance with the daily diagnostic work of a doctor at the patient's bedside.