Vol 81, No 3 (2000)

The prevalence of congenital developmental defects among children in Tatarstan Republic and its dynamics for the last five years are studied. Their role in mortinatality structure, infant mortality is analyzed. The program of preventing congenital defects by creating the prenatal diagnosis service including the US screening of pregnants, medicogenetic consultation, invasive methods of prenatal diagnosis is suggested. The introduction of the current monitoring of congenital developmentale defects is necessary to control the efficiency of the suggested prevention measures.

The combined clinical social examination of 118 children prematurely bom of the I—II degree is earned out. As many as 118 children bom at full tenns, selected as case-control (by sex, age) are examined for comparison. The preschool aged children prematurely born children had higher morbidity level according to taking medical advice, examination data including psychic behaviour disorders and insufficient physical development. The obtained results should be taken into account in clinical examination of such children.

Level of different ensymes was determined in blood serum of patients with bronchial asthma, chronic obstructive bronchitis, chronic nonobstructive bronchitis, pneumonia and 22 healthy persons. In severe chronic obstructive bronchitis in contrast to bronchial asthma, the increase of activity in blood serum was found which can serve as a differential and diagnostic indicator. In the acute phase of pneumonia and severe chronic nonobstructive bronchitis the increase of alkaline phosphatase, gamma-glutanul transferase activities occurred, and in pneumonia activity of aminotransferases increased as well. By discharde of patients from the hospital the studied indicators remained elevated. It is necessary to continul the search of further ways of Correction of enzyme changes with estimation of prognostic value of some indicators in case of favoreble outcome of pulmonary diseases.

The results of the treatment of 27 patients with biliobiliary fistulas — serious complications of cholelithiasis which for the most part were not diagnosed before operations and were unexpected during interventions as to cholecystitis or mechanical jaundice are given. The operative treatment presents difficulties and should be directed both to tte elimination of biliobiliary fistulas and to the correcti® of patholigic changes in biliary ducts. Five cases of successful treatment of biliobiliary fistulas by miniaccess are given. The postoperative mort ality was 22,2%.

Peripheral blood and punctates taken in 13 primary patients, 6 of which had acute myeloblastic leukemia and 7 — chronic myeloleukemia are studied. The peripheric blood in 3 healthy volunteers is studied for control. The method of revealing the tissue factor activity in blood cells of patients with leukemia is suggested. Previously described expression of the tissue factor by myeloblasts of patients with acute myeloblastic leukemia in peripheral blood as well as in bone marrow punctates is confirmed. It is shown that in patients with chronic myeloleukemia expression of the tissue factor activity is carried out by myeloblasts in peripheral blood as well as in bone marrow punctates. The results contradict the conception maintaining the principal impossibility of forming principal the tissue factor by blood cells. The development of disseminated intravascular blood coagulation syndrome and hemophilia under the influence of the tissue factor in leukocytes is possible not only in acute myeloblastic leukemia but in chronic myeloleukemia.

Hypoglucocorticoidemia caused by systemic injection of chloditane {[2(chlorphenil)-2-(4- chlorphenil)-l]-l dichlorethane} promotes normalizing the content of glycosaminoglykanes in blood of rats with alloxan diabetes. The increase of concentration of the total glycosaminoglykanes in liver tissue of these rats on the 30th day occurs as a result of the accumulation. The determination of the content W sulphatized glycosaminoglykanes can be used to reveal the metabolic disorders in the connective matrix in alloxan diabetes.

The laboratory and instrumental criteria are developed for the objective estimation of the endogenous intoxication syndrome in peritonitis. The neutrophil reactive response index in 210 patients and ultrasound morphometry of the enteric wall in 54 patients with diffuse peritonitis along with clinical and biochemical investigation methods make it possible to concretize endotoxicosis degree and treatment efficiency.

As many as 242 women with extrauterine pregnancy were operated using the endoscopic method. The removal of uterine tube was carried out in 157 women with pronounced changes of uterine tube, the reconstructive operation with preserving of the tube was carried out in 87 women. The removal of fetal ovum was carried out by squeezing or vacuumaspiration with the following retrograde hydrotubation. The tube part was removed with application of tubotubar anastomosis in 32 women. Hysterosalpin- gography and kymotubal insufflation showed the efficiency of organ saving operations. The use of endosurgical treatment methods of extrauterine pregnancy made it possible to avoid laparatomy in tubal pregnancy excluding hemorrhagic shock caseg.

Development of methods for early diagnosis of diseases, prediction of the course of pathological processes are among the priority areas in medicine. Studies of cellular ion-transport systems turned out to be promising for solving these problems. Thus, it was established [46] that for a number of diseases — some types of epilepsy, migraine, episodic ataxia, periodic paralysis — channelopathies are the primary link in pathogenesis, and in the treatment of these diseases, agents stabilizing the operation of ion channels are effective.

In recent years, the prevalence of cerebrovascular pathology has increased among both elderly and younger people. Among the causes of death, it ranks second (after acute heart disease), and in terms of disability, it ranks first (3.2 per 10,000 population) [6].

In recent years, there has been a revision of the concept of primary hyperparathyroidism (PHPT), which, according to available data, is the third most common endocrine disease.

In Tatarstan, cases of infections that did not occur before began to be noted. One of them is leishmaniasis, a protozoal vector-borne infection caused by intracellular parasites of the genus Leishmania transmitted by mosquitoes. With this type of infection, mainly the internal organs (visceral form) or the skin and mucous membranes (cutaneous form) are affected. In the CIS, it is registered in the countries of Central Asia and the Caucasus. In Kazan, over the past 2 years, 2 cases of visceral leishmaniasis were detected, imported from Georgia and Tajikistan. In both cases, the patients were children: in the first, the Mediterranean-Central Asian variant was diagnosed, in the second, the Indian variant.

Limb avulsions are the most severe injuries of the musculoskeletal system. Among the causes of damage, separations due to the ingress of limbs under rail transport, into working machines and units, dominate. Bleeding from the wound with this type of injury is usually insignificant or absent at all, which is explained by damage to the wall of the main vessels at different levels. The thrombus in the lumen of the stump is intertwined and firmly held by all the shells of the ruptured vessel. The most severe injury is the complete separation of the scapula with the entire upper limb. Rapid rotation of the arm leads to twisting of the tunicae externae of large vessels, there is no severe bleeding when the limb is torn off.

The decrease of the number of patients from 15,3 to 7,8% with the first revealed pathology late in the course of the disease without essential treatment effect and their growth from 36,5% to 46,5% with early diagnosis and steady positive treatment results are due to the organization in 1995 of the diagnostic centers in Tatarstan Republic. The positive results obtained show the high treatment efficiency, medical, social and economic profitability of diagnostic centers as one of the important subsystems of health protection.

Toxocariasis is a zoonotic invasion with a long relapsing course (from several months to several years) and polymorphic clinical manifestations of an immunological nature. The causative agents of toxocariasis belong to the class of roundworms of the genus Toxocara. Two species of this genus are known: T. canis is a helminth of the canine family and T.cati is a helminth of the cat family. The role of T. canis in human pathology has been firmly established, and T. cati is still under discussion. These nematodes are widespread in cats and dogs. Affected animals excrete a huge number of eggs with feces, causing a high contamination of the soil. Up to 50% of samples from children's sandboxes contain invasive toxocara eggs, which are very resistant and persist in the soil for several years. Children under 5 years of age are most commonly infected. The main source of infestation for children are dogs, especially puppies. Infection occurs through direct contact with an infested animal whose coat is infected with infective eggs. Children with geophagy are most at risk of infection, especially when playing in the sand or with a dog.

May 2000 marked the 100th anniversary of the birth of one of the most famous leaders of the Kazan Medical Institute, the head of the Department of Hospital Surgery, Professor Rustam Alyamovich Vyaselev. He headed the institute from February 1947 to December 1963. It was a rather difficult period, including difficult post-war years. Under the leadership of R.A. Vyaseleva Institute not only strengthened its position as one of the largest medical universities, but also made significant progress in its development.