Vol 68, No 5 (1987)

In the Political Report of the CPSU Central Committee to the XXVII Congress of the Party "There is no greater value for each individual and for society than health". We must consider health problems from a broad social point of view".

In recent years, Soviet and foreign researchers have paid increasing attention to the study of socio-biological and hygienic factors influencing the duration of natural feeding. The influence of hereditary causes on the development of hypogalactia is insignificant, which is confirmed by its rapid growth in recent decades. Early transfer to artificial and mixed feeding is a gross violation of the evolutionary biological chain "pregnancy - birth - lactation" and often harms the health of the woman and child, violates the microclimate of the family. This prompts the study of the causes leading to hypogalactia and the search for new ways and methods of their elimination.

Hygienic assessment of working conditions in the magnetic tape finishing and processing area is an urgent task. Strict requirements to technology and quality of products dictate the need to maintain a certain thermal-humidity regime and exceptional air purity in the room. Work in windowless and windowless rooms is carried out in conditions of artificial microclimate, isolation from the external environment, lack of ultraviolet rays and can, according to some authors, adversely affect the well-being of workers and morbidity.

Workers in the conditions of modern oil refineries are exposed to a complex of chemicals and intensive industrial noise. The most constant components of chemical compounds are the ultimate, unsaturated and aromatic hydrocarbons, determined in most cases at a level much lower than the MPC. Under the action of low-intensity factors, the peripheral blood picture can serve as a significant indicator.

The large scale of production and insufficient study of the mechanisms of combined effects of low-intensity factors in conditions of progressive technology and high labor culture have determined the need for comprehensive hygienic, clinical, immunological and toxicological studies.

Dispensationalization of the entire population dictates the need to find and implement new forms of preventive work in the practice of health care. Among them, the fight against meteopathies is of particular importance. High sensitivity of patients to unfavorable heliogeophysical and meteorological factors is known; if preventive work is carried out among such patients, their morbidity decreases. However, the prevention of meteotropic reactions in hospitals and polyclinics is not widespread, which is due to the lack of study of this problem and organizational difficulties. It is believed that meteotropic reactions depend on abrupt weather changes, solar activity, electromagnetic and acoustic oscillations. It is impossible to take into account all mentioned factors in daily practice of a physician without creating a special service.

We analyzed TB incidence among adolescents in Saratov Region in 1981-1983 and compared it with the incidence among related age groups - children 12-14 years old and young adults 18-19 years old. As can be seen from the table, primary forms of tuberculosis in children predominate, while in adolescents and young adults secondary forms (in half of them - infiltrative tuberculosis and in a quarter - focal) predominate. The more frequent occurrence of exudative pleurisy and extrapulmonary forms is apparently due to the special reactivity of adolescence. However, the dramatic differences in the frequency of primary and secondary tuberculosis in children of pubertal age and adolescents can hardly be explained by reactivity features alone. We should think that primary forms of tuberculosis in adolescents are poorly diagnosed; therefore, predominantly secondary forms are determined. To address this question, we compared the detection of tuberculosis in children, adolescents, and young adults.

In the system of rehabilitation measures for vibration disease preference is given to complex therapy with the inclusion of medications, physical therapy procedures and balneological factors.

In recent years, published data on the inexpediency of the use of etiotropic agents in the treatment of some acute intestinal infections, in particular salmonellosis. Positive results were obtained using rehydration therapy both orally and by intravenous infusions.

Phagocytes as an effector link of pathological immune reactions in rheumatoid arthritis, interacting with immune complexes, release into the environment lysosomal enzymes and oxygen radicals, which destroy synovial membrane and joint cartilage, which imparts autoantigenic properties to tissues. At the same time, neutrophils and monocytes phagocytize immune complexes and products of tissue destruction, contributing to their removal from the body. It can be assumed that in extra-articular manifestations of rheumatoid arthritis, when the above processes develop in other organs, blood phagocytes will be more active than in isolated joint syndrome.

Syringomyelia is one of the widespread diseases of the nervous system: in different regions of the USSR its incidence is 25-34 per 100 thousand inhabitants. The average rate in the Udmurt ASSR per 100 thousand inhabitants is 34.25 ± 1.57. Syringomyelia usually progresses slowly, leading to a reduction or loss of ability to work, disability at a young, employable age. Women aged 20-40 years most often suffer from this disease.

In this paper, the task was to study the indicators of potential performance of the female body during the day, to make a circadian chronogram of catecholamine excretion and to compare it with the literature data on circadian rhythms of labor activity.

To diagnose alcoholism, mainly clinical methods of examination of patients are used. At the same time, more and more attention is paid to the development of biochemical tests in order to assess the disease more objectively. A number of studies have studied the effect of alcohol abuse on the activity of serum gamma-glutamyl transpeptidase (g-GTP). This enzyme is widely distributed in organs and tissues, which accounts for the lack of specificity of the test. Serum g-GTP activity has been shown to be elevated in all types of hepatobiliary disorders, including hepatitis, cirrhosis, congestion, metastasis, as well as in pancreatitis, chronic nephritis, etc. Hepatic gGTP is an enzyme sensitive to the effects of ethyl alcohol, and therefore can serve as an objective test for identifying alcohol abusers.

Clinical manifestations of hemorrhagic and thrombotic complications are observed in 30% of patients with neoplastic processes. In laboratory studies of hemostasis, cases of abnormalities reach 80-90%. Moreover, migrating thrombophlebitis is often the first manifestation of a far advanced malignant process. Thrombophlebitis in tumors is characterized by atypical localization - on hands, neck, breast, but most often - on lower leg. Thrombosis in patients with tumors of different localizations occupies the third place according to the frequency after pathology of cardiovascular system and complications arising after surgical interventions; it occurs in 18% of lethal outcomes from tumor process. Thrombosis may precede the formation of metastases. Arterial emboli and non-bacterial thrombotic endocarditis are often found in malignant diseases.

The team of the Department of Tuberculosis of the S.V. Kurashov Kazan Medical Institute together with the medical unit No. 11 of Kazan. For several years they have been studying the impact of some production factors that have an allergic effect on certain categories of employees. Medical and consulting assistance in medical diagnostic and organizational work, especially on early detection, effective treatment and preventive measures of allergic and other respiratory diseases, as well as pathology of internal organs, are provided by employees of the Tuberculosis Department. Thus, directly in the shop floor medical stations they perform monthly medical consultations with patients, give advice on treatment and diet, preventive measures, prescribe medicines and other therapies, monitor the effectiveness of treatment. Employees of the department also conduct medical consultations on the basis of the department. In necessary cases for the employees of the company they organize consultations of other specialists, help to conduct additional (radiological, laboratory, functional) research.

The content of total protein and protein fractions was studied in children with various forms of goiter before and after surgery (day 1-2) and before discharge from the clinic (day 10-12). 106 patients were examined preoperatively and 102 in the postoperative period. Fifty-two children had euthyroid nodular goiter, 49 - hyperthyroid, 5 - hypothyroid. Thyroid gland enlargement of degree III was in 57 patients, IV-V in 49 patients. For comparison, similar studies in the blood of 20 healthy children were performed (see Table).

We studied the results of ischemic heart disease treatment in the conditions of cardiopulmonary sanatorium "Livadia" (Kazan) by means of "Electroson-4t" apparatus and nitroglycerin ointment. Constant pulse current with pulse frequency 5-10 Hz and procedure duration 30 min were used (treatment course - 10 sessions every other day). Nitroglycerin was used in the form of 2% nitromazine (Finland).

The aim of this work was to investigate the degree of bacterial contamination of the nipple surface, areola and surrounding skin in healthy non-pregnant women.
The study was carried out in 120 female students aged 18 to 24 years. The density of bacterial populations per cm2 of skin was studied in 60 of them by the imprinting method, and in the remaining 60 - by the P. Williamson and A. Kligman washout method.

The efficiency of the early rehabilitation treatment system was determined according to its results in 229 patients with closed diaphyseal fractures of the tibia bones who were hospitalized from 1983 to 1985.
The patients were divided into 2 groups. The 1st group included 142 patients treated with the standard methods: 74 - conservatively (by skeletal traction with the subsequent immobilization by hyposis bandage); 25 patients had plunge metal osteosynthesis (by plates, screws); 43 patients after unsuccessful attempt of conservative treatment had transposition osteosynthesis by Ilizarov apparatus at the terms of 3-4 weeks to 2.5-3 months after injury. Early functional treatment of patients in this group was difficult because of the forced position of the patients as well as the plaster casts fixing the adjacent joints.

Imperfect osteogenesis (Lobstein disease, Wrolick disease, etc.) is a hereditary disease transmitted both autosomal dominant and autosomal recessive and characterized by impaired bone formation. It is clinically manifested by blue sclerae, discolored tooth enamel ("amber" teeth), loose joints, muscle atrophy, and increased bone fragility. Subcostal fractures with little local pain and swelling are predominantly seen in this disease. They can be complete and incomplete, often fused at an angle, which leads to deformities of limbs and thorax in the form of disproportionately short arms and legs while the head, trunk, and feet are normal in size. The phalanges of the fingers are never broken. The configuration of the skull is characterized by a broad forehead bulging forward and steeply upward, the temporal bones overhanging the ear canals; the ears are protruding downward and outward.

Thromboplastic and fibrinolytic properties of uterine tube extracts of 48 cadavers of women and girls who died and died of various causes were studied. Among them there were 16 cadavers of children under 10 years old, 16 of women of childbearing age and 16 of 50-75 years old. Uterine tube extracts were prepared at the rate of 20 mg of tissue per 1 ml of physiological solution. Total coagulating and thromboplastic activity of the extracts was judged by their effect on the clotting time of bestrombocyte plasma during recalcification and prothrombin utilization in it. Addition of 0.1 ml of the extract of initial concentration reduced the clotting time of low platelet plasma and increased prothrombin utilization in it. Similar effect of uterine tube extracts in all three age groups persisted until their dilution of 50 thousand times. The obtained data indicate rather high thromboplastic activity of fallopian tubes, which is the same at any age.

The struggle for the reduction of morbidity with temporary disability acquires special importance in conditions of acceleration of socio-economic development of the country. Various kinds of errors in the examination of temporary disability - unreasonable issuance or prolongation of the certificate of incapacity for work and, on the contrary, unjustified refusal to issue and prolong the certificate of incapacity for work - have a significant impact on the formation of the morbidity rate. Due to the insufficient staffing of polyclinics with doctors of narrow specialties, certain difficulties in the examination of temporary disability are experienced by therapists when admitting non-specialized patients. As studies have shown, 72-81% of the patients from the total number of those examined by neurologists were referred to them by district therapists, while 32% of them did not need neurological care.

In May 1987, Professor Irina Nikolaevna Dyakonova, Head of the Department of Nervous Diseases of Kazan Institute for Advanced Training of Physicians, Doctor of Medical Sciences, celebrated her 70th birthday.