Vol 68, No 2 (1987)

To date, the diagnosis of surgical emergencies is carried out mainly according to the results of conventional clinical and laboratory tests, giving a significant number of diagnostic errors in daily clinical practice (according to our data, from 11 to 21.4%). There is a need to use express diagnostic methods, which would objectively and quickly indicate the nature and severity of the pathological process in abdominal cavity. These primarily include laparoscopic studies.

Gastric and duodenal ulcer is one of the most common diseases of the digestive tract. Failure of conservative therapy forces to resort to surgical treatment, aimed at suppression of the main aggressive factors leading to ulcerogenesis - reduction of hydrochloric acid and pepsin production, elimination of motor and evacuatory disorders.

Craniocerebral trauma currently occupies one of the leading places among injuries of various localizations (up to 40%) and is characterized as "killer number 1". The main task of modern therapeutic measures in the acute period of severe craniocerebral trauma is not only to extend the life expectancy of the injured, but also to create the most favorable conditions for restoration of functional activity of the brain, prevention and reduction of possible extra- and intracerebral complications, reduction of adverse neurological and psychiatric consequences in the long-term period.

Treatment of patients with open fractures of the long bones is an important problem for practical healthcare due to the severity of this pathology, the high risk of complications, the duration of treatment, and the large number of unsatisfactory outcomes. The choice of the method of bone fragment immobilization is one of the challenging tasks faced by traumatologists in providing emergency care to patients with open fractures of the long tubular bones. The advantages of early extrafocal external fixation in this pathology are well known.

The study of cardiac muscle metabolism is of significant interest due to the specificity of metabolism and function, the frequency of cardiac lesions, observed in most cases against the background of atherosclerotic process, polymorphism and severity of myocardial infarction course. It is known that in the heart muscle, depending on the conditions, mainly glucose, fatty acids, ketone bodies, lactate, amino acids are utilized as energy substrates. The possibility of autonomous synthesis of NAD-coenzymes apparently contributes to the provision of multidisciplinary enzymatic processes for catabolism, energy supply, and anabolic transformations. There are reports in the literature about disruption of NAD+/NADH + H+ ratio in experimental myocardial infarction and in patients in the acute phase of the process.

The study of drugs affecting bronchial patency is an important aspect of modern phthisiopulmonology, since bronchospasm is noted even in small forms of pulmonary tuberculosis. The relevance of studying this issue is also determined by the high frequency of combining tuberculosis and chronic nonspecific lung diseases (23%-93.7%) and primarily with chronic obstructive bronchitis.

Peripheral nervous system disorders with temporary disability rank third in the overall structure of morbidity. They are second only to respiratory diseases and trauma. Therefore, the development of effective methods for the treatment of neurological complications of spinal osteochondrosis is extremely relevant both from the medical and social points of view.

Treatment and rehabilitation measures for schizophrenia are not limited to the elimination of psychotic conditions, but also have as their goal the possible social re-adaptation of patients, which includes both professional and labor activity, and social adaptation. The family as the primary social group in which an individual forms and learns about himself as a person and which mediates his relations with society, forms a special psychological environment with maximum closeness of communication. Family relations therefore necessarily affect the course of the disease. Full social compensation of the mental defect is not achieved without active participation of the patient's consciousness and without a critical attitude toward the disease. Without taking into account self-consciousness it is impossible to study interpersonal relations, including family relations.

Bladder replacement surgery with an intestinal graft requires temporary urine diversion from the intestinal bladder in the postoperative period. There are various methods: urethral, suprapubic, and combined. The most common of them is suprapubic drainage [1-3]. The majority of authors perform suprapubic drainage of the intestinal bladder by means of derivative and adductive knees of an intestinal graft on the skin with the subsequent insertion of a rubber tube into its cavity. This method of drainage is accompanied by the formation of a spongiform fistula of the bladder, which can be eliminated only by repeated surgical intervention with installation of a permanent urethral catheter.

Bernard-Soulier disease, a congenital macrocytic thrombocytopathy, was first described in 1948. Currently, this pathology has again attracted the attention of many researchers, as the study of its pathogenesis has deepened the understanding of the mechanisms of the hemostatic process concerning the interaction of platelets with the damaged vessel wall. This rare disease (70 cases were described by 1983) is inherited as an incomplete autosomal recessive trait and is observed with equal frequency in males and females. Bleeding from mucous membranes of the nose, mouth and other organs, petechiae and ecchymoses on the skin usually appear in early childhood. Hemorrhagic syndrome is usually of moderate severity, but often (in 17% of patients) is the direct cause of death due to bleeding from the gastrointestinal tract or hemorrhage in the brain and its membranes.

Providing care to children who have aspirated foreign bodies into the airways is often a difficult task. Its solution depends on the nature, forms, localization, fixation of foreign bodies and the duration of their stay in the tracheobronchial tree. As a rule, it requires individualization of the treatment tactics and the choice of the optimal instrument. Currently, bronchoscopy is the main method of foreign body removal, but when they are firmly embedded in the walls of the tracheobronchial tree it becomes necessary to perform surgical intervention.

Although every woman can terminate an unwanted pregnancy in a gynecological hospital, out-of-hospital abortions, in spite of the preventive work, remain an important problem of obstetrics and gynecology today. We analyzed 479 case histories of out-of-hospital abortions from the gynecology department of the 5th city hospital in Kazan, specialized in septic complications in obstetrics.

We have analyzed angiomorphological changes of the venous system of the lower limbs in varicose veins revealed by simultaneous catheterization of the femoral, popliteal veins, marginal vein of the foot and compared the obtained data on the deep vein valve system status by invasive method with the results of percutaneous Doppler sonography.

We studied 105 patients aged 19- 60 with crepitating tendovaginitis of the forearm from 1980 till 1982, 72 % of them were men with the lesion of the right forearm (69 %). All three symptoms (pain, swelling, crepitation) were revealed only in 79 (75.2%) patients with localization in 73 (92.4%) in the lower third of the forearm in the projection of the long extensor muscle and its short extensor, in 6 patients - in the wrist joint and dorsal surface of the hand.

To date, many methods for the treatment of dental hard tissue hyperesthesia have been proposed, but their lack of effectiveness has led to the search for new methods of treatment. We studied the effectiveness of helium-neon laser radiation for dental hyperesthesia not associated with periodontal pathology. We observed 24 patients aged from 34 to 70 years with dental hard tissue hyperesthesia of I to III degree.

We studied working conditions in the production of polyurethane foam products for the automotive industry. Polyurethanes are synthesized by interaction of isocyanates with polyesters in the presence of stabilizers, catalysts, emulsifiers, foaming agents, colorants, etc. Of all compounds used, the most toxic are toluene diisocyanate (TDI), diphenylmethane diisocyanate (DMI) and the amines triethylenediamine, triethanolamine.

A distinctive feature of the assessment of public health in connection with the impact of environmental factors at the present time is, on the one hand, the development of unified research methods, on the other - the emergence of a large number of fundamentally new methods, allowing to obtain a large amount of diverse information of targeted and applied nature.

Nowadays, to prevent exacerbation of chronic cholecystitis it is recommended to follow a strict diet, in particular to limit consumption of fats. But it is known that fats and some other foodstuffs cause shrinkage of gallbladder, free it from bile and possible presence of gallstones and bacteria. Any violation of the outflow of bile from the gallbladder, stagnation of bile in it contributes to the formation of gallstones and the development of infection in the bladder, and therefore exacerbation or appearance of cholecystitis.

M.K. Mikhailov's book fills a gap in the issues of neuroradiology of childhood. It consists of three chapters. Chapter I presents materials on the X-ray diagnosis of diseases of the skull and brain in children. The author clearly and consistently characterizes the methods for examining the liquor system and cerebral vessels. Chapter II is devoted to X-ray diagnosis in pediatric otorhinolaryngology. In Chapter III, the author describes the X-ray diagnosis of spinal and spinal cord injuries and diseases in children. 

The symposium was attended by scientists from the USSR, USA, Italy, Hungary, Poland, Yugoslavia, GDR, Czechoslovakia, Finland, France. Prof. V.A. Negovsky, Director of the Institute of General Resuscitation of the USSR Academy of Medical Sciences, USSR State Prize laureate, Academician of the USSR Academy of Medical Sciences, made a keynote address. The report analyzed the formation of the science of resuscitation, its current achievements and prospects for development.

The plenum of the All-Union Scientific Society of Obstetricians and Gynecologists was devoted to obstetric hemorrhages. Corresponding member of the USSR Academy of Medical Sciences, Professor G. M. Savelyeva (Moscow) in her report "Principles of reimbursement of blood loss in obstetric hemorrhage" recommended the following tactics of infusion and transfusion therapy based on the results of examination of 200 parturients. For blood loss of 0.6-0.8% of body weight, the total volume of infusions should be 80-100%, and hemotransfusions can be abstained from. For infusions preference should be given to gelatinol, reopolyglucin, their combination with crystalloids.

On December 18, 1986, a meeting of the party and economic activists of the republic was held in Kazan with the agenda "Universal care to healthcare". Secretaries of city and district CPSU committees, chairmen and deputy chairmen of executive committees of city and district councils of people's deputies, heads of district and city health departments, chief doctors and secretaries of primary party organizations of republican institutions and central district hospitals, employees of the Pharmacy Administration of the TASSR Council of Ministers, heads of ministries and departments, industrial enterprises and construction organizations, scientists and teachers of higher and secondary medical educational institutions took part in it.