Vol 69, No 6 (1988)

The progress of health care today depends to a large extent on the progress in pediatrics, the level of infant mortality and health indicators of children, especially in the first year of life. Therefore, it is no coincidence that the problems of perinatal pathology are among the highest priorities in modern medicine. Pediatric neurologists have been able to show and prove that a huge place in perinatology is occupied by birth injuries of the nervous system. Even minimal trauma, depending on which structures are damaged, can lead to irreversible changes up to and including death.

Peridural anesthesia as a method of anesthesia continues to attract attention because it has no pathological effect on the functions of vital organs, except for rare cases of severe hypotension. There are controversial opinions regarding the effect of peridural anesthesia on cardiodynamics. Some authors believe that peridural blockade reduces the tonic action of sympathetic nerves, resulting in bradycardia, decreased myocardial contractile function with depressed cardiovascular system. Others argue that during peridural anesthesia there are no significant changes in intracardiac hemodynamics. According to others, moderate concentrations of anesthetic penetrating into the circulating blood increase cardiac output and slightly increase BP.

One of the indications for bone grafting is a bone defect resulting from the removal of bone tumors. This report describes the experience of bone grafting in 161 patients who underwent bone resection due to tumors and tumor-like processes of limb bones (Table 1). According to their age the patients were distributed as follows: 17 to 20 years old - 39 patients, 21 to 30 - 51, 31 to 40 - 46, 41 to 50 - 14, over 50 - 11.

We (M.Z. Sigal, S.S. Ksembaev) proposed a method of estimation of blood pressure in vessels of maxillofacial area: arterial pressure - in facial, upper and lower lip arteries, venous - in upper and lower lip veins. The study was carried out with the help of M.Z. Sigal and A.I. Lisin's apparatus.

The aim of the work was to develop diagnostic criteria for recurrent rheumatic heart disease and its variants differing in severity. To solve this question we used a complex of clinical, laboratory, instrumental data, as well as the results of pathological anatomical examination. WHO criteria with determination of streptococcal antibody titers were used during examination of soles. Besides routine methods of laboratory study, the state of body's immune system was evaluated: reaction of inhibition of leukocyte migration (RTML), titer of anti-streptococcal antibodies, measures of completed and incomplete phagocytosis, activity of blood serum acid phosphatase. The type and group of streptococcus were determined in nasopharyngeal smears. ECG and Echo-CG were recorded. The state of central hemodynamics was studied with mechanocardiography according to N.N. Savitsky.

Being supporters of early intervention, we have performed vacuum aspiration of the uterine cavity contents in 62 laboring women over the past two years to prevent the spread of infection beyond the endometrium. During this operation, unlike uterine curettage, the basal layer of the endometrium, the venous lacunas of the internal layer of the myometrium and the myometrium itself are not traumatized. The negative pressure created by the vacuum aspirator prevents the uterine contents from penetrating the venous network.

The prophylactic method developed by us (application for invention "Method of medication prophylaxis of myopia progression" No. 4171900/14-467 of 04.01.1987) is simple and not connected with any restrictions in everyday life, studies or work. Its implementation does not require significant labor and time from both medical personnel and the patient. Let us briefly describe the essence and substantiation of our method.

In order to add new objective data to the existing diagnostic complex of pneumonia and its complications, as well as to monitor the course of treatment and make prognosis of the disease we performed a comprehensive comparative study of patients using polarographic and pneumotachographic methods. We followed up 56 patients with acute pneumonia (men - 36, women - 20), aged 15 to 66 years (mean age - 41 years). Pneumonia in 15 (26,8%) patients was without complications, in 25 (44,6%) it developed against the background of chronic bronchitis, in 5 (8,9%) it was complicated by abscessed; in 4 (7,1%) patients there were acute bronchitis, in 3 (5,4%) bronchocarcinomas and cancer metastases into the lungs were revealed, in 4 (7,2%) acute pneumonia occurred against the background of exacerbation of non-pulmonary somatic diseases. Control group consisted of 21 people aged 16-24 years.

The aim of our study was to determine the pathogen supporting the inflammatory process in the genitals of infertile patients, its sensitivity to antibiotics and the effectiveness of treatment measures, carried out taking into account the data obtained by ejaculate culture. Eighty patients aged 21 to 33 years old with secretory toxic form of male infertility were examined. Clinical examination revealed signs of chronic inflammation in the prostate in 32 men, in the testicular appendages in 12 men, and chronic urethritis in 2 men. In 34 patients the inflammatory process had no clinical manifestations, but the ejaculate showed a large number of leukocytes.

Combined hand trauma is observed in 85.5% of cases in persons under 50 years of age and leads to loss of professional ability to work in 41.8% of cases and to disability in 19-43% of cases. Therefore, treatment of concomitant hand injuries remains an urgent problem at the present time. Due to diagnostic errors, 61.3% of patients with median and ulnar nerve injuries refer to specialists only 3 months after injury. Simple diagnostic tests have been suggested: inability to oppose the I finger, inability to grasp a cylindrical object with the I finger, which is typical for median nerve injury. If a patient cannot cross II and IV fingers over or under III finger, it indicates ulnar nerve damage, and if he is unable to strike the table with half-bent fingers (II-V), it means the median and ulnar nerves are injured.

We studied the injury rate among the workers of the Bugulma Porcelain Factory in 1982- 1987, taking into account the working conditions of the workers. The peculiarities of production at the plant include tedious, monotonous work on the conveyor belt at high temperature. The factory exists for 13 years. The young age of the workers - from 18 to 40 years - also draws attention.

Knee fractures account for 1.5-2.2% of all skeletal injuries. While fractures of the patella without displacement are treated conservatively by applying a deep posterior plaster cast with a "drying" cast placed on the anterior surface of the joint, displaced fractures require surgical intervention. In the case of multiple comminuted and fractured patellar fractures with displacement, in which it is impossible to bring all fragments together using P-shaped lavsan or sutures, the best outcomes can be achieved by endoprosthesis, that is, removal of the entire fractured patella and replacing it with an endoprosthesis. In this report, we would like to share our experience with patellar endoprosthesis according to G.S. Samoilov performed for a multiaxial fracture in the hospital.

In 1985-1987, we treated 142 patients (77 male and 65 female) aged 1 to 85 years old with purulent wounds and purulent-necrotic lesions of soft tissues at the surgical department of the Central Regional Hospital. Pathogenic microflora isolated from wounds was found to be sensitive to kanamycin, ampicillin, streptomycin, monomycin, carbenicillin.

The most objective and sensitive method of bronchial obstruction diagnosis is determination of maximal expiratory flow at different levels of bronchial tree. Despite the lack of clear boundaries of the norm, the flow indices according to spirography allow early diagnosis of bronchial permeability disorders, which facilitates the diagnosis of obstructive bronchitis and bronchial asthma.

Idiopathic amyloidosis, unlike secondary amyloidosis, develops in the absence of previous disease. Its clinical presentation is multifaceted, determined by the lesion of certain organs and highly variable during the course of the disease. All manifestations of the disease are nonspecific. In contrast to secondary amyloidosis, idiopathic amyloidosis more often involves cardiovascular, respiratory, digestive and urinary systems. In vivo diagnosis of idiopathic amyloidosis is difficult due to its imitation of many diseases; in practice, it is recognized less often than it occurs.

The decisions of the 27th Congress of the Communist Party of the Soviet Union noted the need to strengthen measures for the prevention of traumatism, which is one of the main causes of temporary disability, disability and mortality, especially among the young and most able-bodied people. Further improvement of traumatological and orthopedic care, its scientifically substantiated and precise organization are of particular social and economic importance.

All mass lesions are characterized by such a basic common feature as a mismatch between the number of victims and the possibilities of rendering medical aid. It should be emphasized that the provision of medical care in disasters is significantly different from that which is possible in normal conditions. The decisive tasks and the organizational tactics change; the severity of the conditions with the time factor increases. The peculiarities of medical and tactical situation in disasters require further scientific and practical development of ethical and deontological principles, connected with the doctor's activity.

Over the past 8 years, the pediatric department of the All-Russian Scientific and Research Center "VTO" has been actively performing extra-articular surgeries for the treatment of congenital sub- and dislocation of the hip, aimed at correcting all elements of the hip joint deformity in one or two stages. Open reduction is usually combined with intervertebral osteotomy according to Pauwels. Pathological anteversion and valgus of the proximal femur are eliminated to normal age values. In order to prevent postoperative external-rotational contracture and reduce compression in the hip joint, we perform plasty of the external femoral rotators and the pelvic-trochanteric muscle group. We also actively apply pelvic component correction in children with an acetabular index of more than 30°. When the acetabular roof is slightly oblique in young children, we perform a Salter osteotomy.

Doctor of Medical Sciences, Professor Mukhamet Khairutdinovich Vakhitov celebrated his 70th birthday on November 10, 1988. Mukhamet Khayrutdinovich is the author of more than 50 works, including monographs devoted to the contribution. Mukhamet Khayrutdinovich is the author of 50 works, including monographs devoted to the contribution of Kazan scientists to the development of preventive medicine, life and activity of Prof. F.G. Mukhamedyarov and others.