Vol 77, No 5 (1996)

The need to reform the healthcare system is due to three reasons: the country's transition to a market economy amidst the deep economic crisis that has engulfed Russia, the deteriorating state of public health, the complete exhaustion and actual failure of the highly centralized, administratively (command)-distributed healthcare system.

The subsequent rehabilitation measures for the specific patient using a new prognostic index can be defined in hospital treatment. This index is used to predict the ability to work in myocardial infarction, possesses high precision and reliability of difference in comparison of groups of patients with various results of diseases.

The state of bronchial patency and hyperactivity in children with preasthma and bronchial asthma is studied. The combined examination with compulsory functional pulmonary tests allows to select a bronchospasmolytic drug individually for a patient and to define the efficiency of prescribed specific and nonspecific therapy in the disease dynamics.

As many as 244 cases of extrauterine pregnancy on evidence of three gynecologic institutions of Kazan in 1994—1995 are analyzed. It is noted that it occurs as frequently as in previous years. It is emphasized that special consideration should be given to the search of effective methods in the prevention of remote result of operative interventions, the use of ultrasonic scanning, laparoscopy and other current diagnosis methods.

Antigenic polymorphism HLA А, В, C, DR of 72 inhabitants of Tatarstan Republic with terminal chronic renal insufficiency being on chronic programmed hemodialysis is studied. In their comparison with control group of 151 persons the reliable association of terminal chronic renal insufficiency with antigens B27 and Cw2 remaining after P correction according to the number of tested antigens HLA (k = 44) is revealed. Greater survival, rate on programmed hemodialysis is found in persons, with antigen B27. It shows the selection of persons with antigens HLA promoting their higher biocompatibility with dialyzator materials.

The lymph nodes regional to various organs carcinoma are studied by immunohistochemical methods using monoclonic antibodies to CD-antigens. It is stated that in the course of metastatic spreading of the tumor the intensity of cellular immunity reactions decreases abruptly on retention of humoral immune reactions. The factors providing local immunity ineffectivity are revealed:

1) a decrease of the number of CD 1 (+) and CD 10 (+) of blast forms, predecessors of activated T- lymphocytes;

2) a blockade by humoral antibodies CD 20 (+) and antibodies producers of T-cellular cytotoxic effect;

3) a deficiency of CD 8 (+) of T-suppressors capable to oppress immunoglobulin products.

The sparing anatomic arthrosis method for interphalangeal or metacarpophalangeal joints of hand fingers in their fibrous contractures at periods of not above 2,5—3 months after trauma is developed and tested in clinical practice. The proposed dorsal transtendinous access allows to mobilize the joint atraumatically retaining the anatomic integrity of capsular and ligamentous structures of the traumatized joint. The recovery of the joint function is the result of its early development.

Mismatch of the articular surfaces, weakness of the large capacity shoulder joint bag, lack of ligaments in it, increased stress at home and during work, causing early degenerative-dystrophic shifts in the surrounding tissues, are the reasons that predetermine the fact that up to 50% of all dislocations occur in the shoulder joint and up to 7-10% of all fractures in the shoulder bone, with its proximal part being affected in 70% of cases. The latter is explained by the elderly and old age of the victims, among whom the phenomena of osteoporosis are not so rare.

X-ray computed tomography has become one of the main ways to diagnose diseases of the parenchymatous organs of the abdominal cavity. But in gastroenterology it is still not widely used. On the one hand, this is due to the anatomical and physiological peculiarities of the gastrointestinal tract, and on the other hand - to the fact that there are other quite effective ways and methods of diagnosing diseases of the stomach and intestines (radiological and endoscopic).

We investigated blood stroke volume (BV) in growing rats during an abrupt transition from systematic muscle training to hypokinesia, as well as from limited motor activity at early age to subsequent muscular exertion. In the experiments we used white mongrel rats, which had different regimen of motor activity from the age of 14 days. In the 1st group animals were provided with unrestricted motor activity; in the 2nd group, after 4 weeks of swimming training they were sharply restricted in their motor activity for 4 weeks; in the 3rd group, after hypokinesia for 4 weeks the rats were gradually started to be trained. Blood stroke volume was determined by tetrapolar thoracic rheography using Kubitschek's formula.

Calculating the risk of transmitting a hereditary disease to offspring is important in the practice of medical genetic counseling. Most universal formulas are cumbersome, and their use assumes that the frequency of the mutant gene is already known or is calculated from special tables. Despite the complexity of the calculation procedure, it is necessary to determine the type of inheritance when using information only about sick family members and their kinship relations, taking into account the possibility of incomplete manifestation of the genotype.

In our country, the production of household chemicals (HFCs) was established in the mid 60's: their volumes increased sharply, the assortment expanded. In the USSR by the end of 80s the production of household chemicals exceeded 9 million tons per year, and in the world - 60-65 million tons against 6 million tons and 28 million tons in 1965 respectively.

The peculiarities of the way of life in 250 girls aged 15—16 are studied by anonymous questionnaire. As many as 98,8% of the questioned girls tasted strong drinks. Nearly 73% of the girls drink them principally in family celebrations. As many as 4,4% of the girls smoke regularly, 23,2% of them — from case to case. As many as 14% of the girls lead sexually active way of life. The connection between various forms of behaviour of this contingent is revealed. The most dangerous age of the girls accustomed to bad habits is 13—14. Little information of the infection of venereal diseases and aids is connected with a lack of activity of physicians, teachers and parents in sexual education of girls.

The results of peculiarities of the action of production factors and working process on the functional state of workers for hermetic sealing and electromounters of aircraft building production are given.

The complex of physiological examinations performed in shift dynamics has revealed the greatest changes in neuromuscular system of workers during hermetic sealing. Electromounting operations are accompanied by the development of pronounced elements of fatigue in central nervous system and visual analyzer.

In June 1991, a pediatric outpatient consultative and diagnostic department was opened on the basis of the Kazan Cardiology Dispensary in order to improve the care of children with cardiorheumatic diseases by gradually establishing a centralized pediatric cardiorheumatic service in the city. We preliminarily analyzed the level of cardiorheumatologic care for children, which as of June 1991 did not meet the needs of the city residents, and we developed the stages of organizing a fundamentally new service.

A slowing of the blood flow rate (BFR) is one of the earliest signs of circulatory insufficiency. In 1935, oxyhemometric determination of the velocity of blood flow in the small circle of circulation was proposed. Although the pulmonary-ear SC determination method includes the areas of the large and small circulatory circle, it mainly characterizes the blood flow through the pulmonary vein system - from the pulmonary capillaries to the left ventricle. Blood from aorta reaches ear capillaries very quickly due to high velocity of movement through arterial system, so this time can be neglected. The oxyhemometric and isotopic methods have been shown to give similar results. The oxyhemometric method for determining SC in the small circle is considered to be the best.

The phlebotomes for reliable shutdown from blood circulation of subcutaneously dilated branches of large and small subcutaneous veins of the femur, crus and foot are suggested to improve surgical treatment methods of varicose disease. The technology of subcutaneous dissection of venous collaterals using phlebotomes is described. The observations of 80 operated patients show resistant immediate and distant results with good cosmetic effect allowing to recommend the instruments for a wide use in surgical practice.