Vol 50, No 5 (1969)
Towards the 100th anniversary of the birth of V.I. Lenin
Social conditions and human health
Abstract
Socio-economic and socio-hygienic factors play an increasingly important role in strengthening the health of workers under socialism and communism. Every year in our country, in solving this problem, the proportion of broad social and health measures increases, among which an important place is occupied by the rise in the welfare of the people, the growth of national income, public consumption funds, etc. Figuratively speaking, the medicine of the future, the medicine of the communist society will not be so much medicamentous as socio-hygienic in the broadest sense. and in the humane sense of the word.
Attending physician of the Ulyanov family A. A. Kadyan (To the 120th anniversary of his birth)
Abstract
Alexander Alexandrovich Kadyan was born on April 1 (14), 1849 in St. Petersburg. His father Alexander Zakharovich Kadyan, with the rank of captain, was "a teacher of the third kind of the Second Cadet Corps." After graduating from the First St. Petersburg Men's Gymnasium, A. A. Kadyan was "recognized worthy of a commendable certificate... with the award of a silver medal", and on September 15, 1866, he was enrolled as a student of the Medical and surgical Academy.
Lectures
About breast toad, its prevention and treatment
Abstract
In the modern understanding, thoracic toad (angina pectoris) in its typical manifestation is pain behind the sternum or in the heart area, arising due to a lack of oxygen in the heart muscle, in most cases caused by the fact that the request for blood flow from the heart muscle exceeds its flow through the coronary vessels. The latter is usually caused by damage to the walls of the arteries of the heart, most often by their atherosclerosis. Violation of coronary blood flow may be the result of dynamic changes (spasm) in a certain area of the coronary system. But sometimes the need for oxygen exceeds its usual size, and this also causes pain in the heart area. Such conditions arise as a result of an increase in the intake of catecholamines into the blood, which has been reported by many, and first of all by Raab. Various experiences also lead to an excessive intake of catecholamines into the heart. The resulting metabolic disorders in the heart muscle can manifest pain. The variety of mechanisms leading to breast toad makes it difficult to prevent it.
Theoretical and clinical medicine
Myocardial infarction in patients with diabetes mellitus
Abstract
To date, there is no consensus on the relationship between myocardial infarction and diabetes mellitus. Some authors [18, 19, 20, 24, 29, 33 et al.] note a more frequent occurrence of myocardial infarction in diabetes mellitus, others [4, 34, etc.] did not find the effect of diabetes mellitus on the frequency of myocardial infarction and mortality in it. A number of authors [6, 7, 11, 13, 16, 24 et al .] indicates a more severe course of diabetes mellitus on the background of myocardial infarction and myocardial infarction on the background of diabetes mellitus, high mortality, shorter life expectancy after myocardial infarctions, repeated myocardial infarctions, frequent ruptures of the heart muscle, severe collapses. Joslin et al., Heinsen believe that in diabetes mellitus, as a rule, myocardial infarctions are pain-free, while others do not find a difference in the symptoms of myocardial infarctions in diabetes mellitus. There is no unanimity on the issue of thrombosis in diabetes mellitus. So, Fearuley, Chakraborti found in diabetes mellitus a decrease in fibrinolytic activity and an increased tendency of the blood to thrombosis. According to Thomas, Lee, Rabin, Coodale et al., the frequency of thromboembolic complications and lysis time in patients with diabetes mellitus and myocardial infarction do not differ from those in patients with a heart attack without diabetes.
Primary myocardial infarction in old age
Abstract
In accordance with the working classification of age periods adopted at the Leningrad and International Symposia on Gerontology, we studied the features of the clinic and the course of myocardial infarction in old age (75-89 years). We are monitoring 56 patients who have suffered a primary myocardial infarction. All patients were engaged in highly skilled mental work (scientists, artists, etc.). They have been on the dispensary register of the polyclinic for many years, their working and living conditions are very similar. There were 51 males and 5 females.
About myocardial hypertrophy in obese patients
Abstract
For obese patients, the lesion of the left heart is clinically typical. The occurrence of left-heart failure is facilitated by the early and frequent development of atherosclerosis in these individuals [11], as well as the frequent combination of obesity with hypertension [1]. Another clinical variant is a pulmonary heart with right-heart failure (B. B. Kogan, 1962). During catheterization of the pulmonary artery in overweight patients, a number of authors revealed hypertension of the small circle [13, 16, 19, 32].
To the diagnosis of transitional forms of coronary insufficiency
Abstract
To date, the clinical picture of the main forms of coronary insufficiency (angina pectoris and large-focal myocardial infarction) has been studied in some detail. However, in recent years, clinicians and pathologists have begun to identify transitional forms of coronary insufficiency, which, according to A. L. Myasnikov, include small-focal myocardial infarction and acute focal myocardial dystrophy. Differential diagnosis of these forms based only on clinical, ECG and generally accepted laboratory tests is extremely difficult, and sometimes impossible. Recently, a number of additional research methods have been proposed, among which a special place is occupied by the study of biochemical parameters that allow, according to Yu. V. Anshelevich, G. V. Gracheva, S. M. Gusman et al., P. V. Pakhomova, etc., to distinguish between these two forms of coronary insufficiency.
About the "electric position" of the heart
Abstract
From the point of view of adherents of the concept of "locality" of unipolar leads, biopotentials related only to those areas of the heart muscle that are "adjacent" to the differential electrode, namely, to the epicardial surface of the left ventricle, are recorded in the thoracic leads of 5-6. In this regard, the ECG in U5—6 is usually compared in form only with those leads from the extremities, which, firstly, are also unipolar and to which, secondly, the epicardial surface of the left ventricle can adjoin. Adherents of the considered "localistic" concept believe that aVL can satisfy these conditions if the electrical position of the heart is horizontal, or aVF if it is vertical (Wilson et al., 1944). Similarly, the similarity with aVL or aVF of the ECG in the thoracic leads of U1—2 is evaluated, which, according to the mentioned view, reflects the bioelectric activity of the right ventricle, namely its epicardial surface.
Corrected orthogonal ECG leads in patients with chronic coronary insufficiency
Abstract
Corrected orthogonal ECG leads open up the prospect of increasing diagnostic capabilities and at the same time simplifying the ECG method of examination. We have shown the advantages of the modified Frankov system of corrected orthogonal leads in the study of patients with overload and hypertrophy of the ventricles of the heart, mitral stenosis, myocardial infarction. The present work aims to study ECG changes in the same system in patients with coronary insufficiency without any indication of a previous myocardial infarction.
Modern views on the treatment of open fractures of long tubular bones
Abstract
Variants and pathomorphological characteristics of open fractures of long tubular bones of peacetime are extremely diverse. In some cases, soft tissue injuries are only a small point wound caused by a bone fragment, in others, the ends of one or two bone fragments, having perforated the skin, protrude and gape in the skin wound, lying on its surface; fractures with more extensive damage to the bones and soft tissues of the limb are observed and, what should be especially emphasized, with significant contamination of tissues in the wound; finally, there are particularly severe types of open fractures, when there is extensive bone crushing, deep irreversible destruction of soft tissues, and sometimes complete separation of limbs.
Structure of ventricular systole in patients with atherosclerotic cardiosclerosis complicated by atrial fibrillation
Abstract
Atrial fibrillation in the form of permanent and paroxysmal forms often complicates the course of atherosclerotic cardiosclerosis [1, 2, 3, 12, 16, 17]. Atrial fibrillation, despite the absence of parallelism with the degree of structural changes in the heart, is the result of significant shifts in the physiological properties of the heart muscle and, regardless of the causes that caused it, it can lead to severe circulatory insufficiency with retrograde stagnation. However, the constant form of atrial fibrillation and its paroxysms have different effects on intracardiac hemodynamics and the functional state of the myocardium.
Static and traumatic diseases of the knee joint
Abstract
Attention is drawn to the high frequency of diseases of the knee joint in comparison with other departments of the musculoskeletal system. For 22 years (from 1947 to 1968), 8,106 patients were operated on in the orthopedic department of our department, including 1,394 (17.2%) with various knee joint pathology. Over the same years, 47,410 patients with diseases of the musculoskeletal system were admitted to the consultation center, 10,159 of them with knee joint pathology (21.4%).
Intraosseous and compression osteosynthesis in the treatment of fractures and false joints of the lower leg bones
Abstract
In the general surgery clinic of the Kuibyshev Medical Institute for 17 years (from 1950 to 1966), 1,468 patients with various fractures of tubular bones, including fractures of the shin bones — 292 (19.88%), and about two thirds of them (192) were at the most mobile and active age - from 21 to 50 years old. There were 217 men and 75 women.
Hip arthrodesis in the aftermath of polio
Abstract
In case of pathology in the hip joint, the most appropriate operations are those that restore function. However, there is a group of patients who are shown arthrodesis as a forced measure. Considering that opinions on indications for hip closure in the aftermath of polio are contradictory, we decided to express our point of view on this issue.
Complete regeneration of the collarbone
Abstract
One of the anatomical and physiological features of a child's body is the high regenerative capacity of bone tissue. These qualities are possessed, in particular, by the ribs, fibula, clavicle, which are often restored during subcostal resection of them for a considerable length.
Bypass surgery with a large subcutaneous vein in severe ischemic syndromes
Abstract
The technique of reconstructive operations on small-diameter arteries, in particular on the arteries of the lower leg, is insufficiently developed. Therefore, the success of surgical interventions on such vessels is still insignificant. Moreover, today there is still no completely satisfactory method of restoring blood flow even in the arteries of the femoral-popliteal segment. Almost all surgeons refused to use synthetic prostheses for obstruction of the femoral and popliteal arteries. Equally revised is the attitude to intimotrombectomy for long-range arterial thrombosis. In patients with deep changes in the walls of the arteries, accompanied by circulatory disorders, these operations usually give extremely unsatisfactory immediate results; successful outcomes are rare. With thrombosis, blood circulation not only does not return to the initial preoperative level, but, as a rule, worsens and often requires amputation even in such patients who have been operated on for intermittent lameness.
Electroencephalogram for epileptic status and asphyxia
Abstract
Electroencephalography (EEG) is one of the most adequate methods of studying convulsive states. However, publications related to the study of brain biopotentials both in patients with epileptic status and asphyxia are few and based on isolated observations, and we could not find works devoted to the comparative analysis of EEG in these conditions that are somewhat similar in clinical terms.
Neurological changes after asphyxia
Abstract
During the resuscitation of people who suffered strangulation asphyxia, we managed to save 62 victims. All of them were taken to the intensive care unit in a serious or extremely serious condition, unconscious. The duration of strangulation ranged from 4-5 to 8-9 minutes . The victims were admitted to the hospital within a period of 30 minutes to 4 hours. The first medical aid was provided by the resuscitation teams of the ambulance station.
On the technique of resuscitation in mechanical asphyxia and its effect on the condition of the animated
Abstract
Despite a fairly significant number of works devoted to the clinic of post-fixation conditions, there is no clear, pathogenetically justified resuscitation technique after hanging, and the influence of resuscitation methods on the outcome of recovery has not been studied.
Features of ultrasound perception in otosclerosis and Meniere's disease
Abstract
Recently, a number of reports have appeared in the literature on the diagnostic use of ultrasound to differentiate various forms of hearing loss, which significantly expands the possibilities of modern audiometry [3, 4, 6]. The available data allow us to conclude that the perception of ultrasound occurs in the cochlea [1, 5, 9, 10, 11]. This can also be indirectly confirmed by the results of the experimental work of R. A. Zasosov and V. F. Undritz (1935).
Treatment of adenovirus conjunctivitis with chlorophosphenal
Abstract
The treatment of viral, including adenoviral, eye diseases is a difficult and far from solved task. Currently used chemotherapeutic agents and antibiotics do not have the desired effect. Therefore, the search for new treatments for viral diseases is an urgent problem.
Excretion of gonadotropins in dysfunctional uterine bleeding
Abstract
The study of the gonadotropic function of the pituitary gland is important in revealing the mechanisms underlying the regulation of the normal menstrual cycle and the occurrence of its disorders, in particular dysfunctional uterine bleeding. G. S. Stepanov (1962), O. N. Savchenko (1967) note that the release of gonadotropins in this pathology is at the level of values recorded in normal menstrual cycle outside the periods of physiological peaks. However, these authors did not compare the excretion of gonadotropins with the indicators of the endocrine function of the ovaries and with the clinical picture of dysfunctional uterine bleeding, which makes it difficult to use their findings in elucidating the pathogenesis of the disease. In addition, their data were obtained in menopausal patients. The gonadotropic function of the pituitary gland in patients in puberty and reproductive periods has not been studied.
The blood sugar level of women suffering from genital cancer in the treatment of radiant energy
Abstract
We studied the blood sugar content in 54 women suffering from genital cancer before treatment with radiant energy and 1-2 months after it. In 10 of them, the study was carried out before and after giving sugar at the rate of 0.8 g per kilogram of weight, five times, with an interval of 30 minutes. The women were between the ages of 30 and 64. The blood sugar level was determined by the Hagedorn and Jensen method. The tests were performed in the laboratory of the clinic (head-Petshitska). Treatment with radiant energy was carried out in medium doses.
On the significance of the depressive effect of pregnancy in hypertension
Abstract
As in the experiment [5, 6, 14, 15, 17], so it is in the clinic [1-4, 8-11, 13, 16, 18, 19] it has been established that pregnancy has a depressant effect on increased blood pressure. Almost all authors believe that the decrease in blood pressure is temporary. However, opinions regarding the timing of pregnancy, at which blood pressure begins to decrease, as well as the duration of this decrease are contradictory. According to D. F. Chebotarev, it occurs in the first sixteen weeks of pregnancy, according to Theobald — in the first half of pregnancy, according to other authors [1, 9, 13, 18] — from the middle of pregnancy. O. F. Matveeva, S. M. Becker, L. F. Antonov observed a decrease in blood pressure with the onset of pregnancy. The degree and duration of pressure reduction depend on the stage of development of hypertension.
Short articles
Shoulder-scapular periarthritis and its treatment
Abstract
This suffering is caused by the development of dystrophic processes in the periarticular tissues, accompanied by reactive inflammation. The occurrence of the disease is facilitated by acute or chronic trauma, less often by an infectious process.
Prolonged artificial respiration
Abstract
K., 40 years old, was admitted on July 26, 1968 with complaints of numbness of the whole body, difficulty swallowing, lack of air, palpitations, pain in the neck, a feeling of fear of death. Ill for 5 days. In April, May, June 1968, he worked in the forest and repeatedly removed the ticks embedded in the skin.
Severe combined injury in a child
Abstract
G., 7 years old, was admitted on 15/IV 1968 40 minutes after a transport injury in an extremely serious condition, unconscious, with motor anxiety. Pulse 130, low filling and tension, blood pressure 70/0, shallow breathing, 14 v min. Blood with an admixture of cerebrospinal fluid is released from the right and left external auditory passages and the right nasal passage. Anisocoria. The pupils' reaction to light is sluggish. Floating gaze. Corneal and swallowing reflexes are absent. The child does not react to the painful stimulus. Left-sided hemiparesis. Periodically, hypertonicity in the right extremities, left tendon and periosteal reflexes are greater than the right ones. Abdominal reflexes are absent. Babinsky's bilateral symptom and Oppenheim's symptom on the right. There are no meningeal signs.
Multiple foreign bodies of the lung, pericardium and heart
Abstract
M., 31 years old, entered the surgical department on 23/Ѵ 1967 with the diagnosis: foreign bodies (needles) in the left lung and heart, angina pectoris. Upon admission, he complained of shortness of breath during physical exertion, pain in the heart area with irradiation in the shoulder and shoulder blade on the left, arising at the slightest tension, palpitations, weakness.
Bullet combined wound of the right kidney and liver
Abstract
G., 20 years old, was taken to the surgical department on 8/II 1963 30 minutes after a bullet wound to the right half of the chest. Upon admission, the condition is severe, abdominal pain, vomiting without blood impurities. Pulse 82, satisfactory filling, BP 115/77. In the area of the 10th intercostal space on the right along the anterior axillary line, there is a wound of 1.0x1.0 cm (entrance hole), the second (exit hole) is on the right in the upper lumbar region, with uneven edges, measuring 4x4 cm; blood flows out of it. The stomach is tense, does not participate in the act of breathing, is painful. The Shchetkin-Blumberg symptom is negative. There is a dull feeling in the right half of the abdomen. The patient does not urinate. The urine released by the catheter is intensely stained with blood.
About the use of antibiotics in acute appendicitis
Abstract
The Department of Hospital Surgery No. 1 of KSMU has been conducting a bacteriological study of abdominal exudate in destructive forms of appendicitis for a number of years. It is sown on blood agar, sugar broth, Tarozzi medium, Endo. Along with the establishment of the type of microflora, its sensitivity to antibiotics is determined by the method of indicator disks.
Excretory function of the stomach in diseases of the gastrointestinal tract
Abstract
We observed 75 men and 22 women aged 20 to 70 years. 33 of them had duodenal ulcer, 10 - gastric ulcer, 14 - liver and gallbladder diseases, 12 - gastritis with preserved secretion and 16 — with reduced, 2 - stomach cancer and 10 were healthy (control group).
Protein loss in colon polyposis
Abstract
In various diseases of the gastrointestinal tract, especially those that are accompanied by diarrhea, the body loses a large amount of protein and nitrogenous substances. In this regard, the study of serum proteins in patients suffering from colon polyposis is of great interest, since diarrhea and rectal bleeding are the leading symptoms of this suffering. The serum protein was determined by a refractometer, and the protein fractions were determined by electrophoresis on paper. More than 200 patients with polyps and polyposis of the colon were examined. Depending on the duration of the disease, the prevalence of the pathological process and its clinical course, various degrees of hypo- and dysproteinemia were revealed. A significant number of patients showed pronounced hypoproteinemia (sometimes below 5 g%) with a decrease in the albumin-globulin coefficient to 0.8-0.5.
Elephantiasis of the external male genitalia
Abstract
M., 35 years old, with dementia syndrome, was admitted on 26/XII 1967 with complaints of a sharp increase in the penis and scrotum, making it difficult to urinate and walk (Fig. 1). He has been ill since 1946, when he first suffered erysipelas of the scrotum and penis, subsequently recurring 2-3 times annually. After erysipelas, the scrotum and penis began to swell and increase from year to year. For a long time, but unsuccessfully, he was treated in a district hospital. Due to the futility of conservative therapy, he entered the urological department of the Republican Hospital for surgical treatment.
Repeated ruptures of the uterus along the scar after cesarean section
Abstract
For 20 years, 2 women have been operated on in maternity hospitals in Kirov for repeated rupture of the uterus. Previously, they had sutured lacerations along the scar after cesarean section. In both women, the rupture of the uterus occurred during the first pregnancy after suturing the rupture of the uterus. Given the rarity of such pathology, we decided to bring our observations.
Dynamics of trace elements in the blood during sensitization
Abstract
Trace elements seem to play a well-known role in the development and course of allergic dermatoses. The study of metabolic disorders of trace elements in allergic skin diseases creates prerequisites for the search for new methods of pathogenetic therapy.
Reviews
The use of ultrasound in obstetrics and gynecology
Abstract
In 1958, the first data appeared on the use of ultrasound for the diagnosis of certain gynecological diseases, as well as in obstetric practice for the establishment of presentation, multiple pregnancy, polyhydramnios, vesicular drift, measuring the size of the head [24, 25, 26, 27, 46, 48, 49].
Innovation proposals
Our technique of mediastinoscopy
Abstract
Proposed by Carlens (1959) mediastinoscopy - diagnostic exploration of the anterior superior mediastinum by suprajugular access - presents data to solve the problem of the nature of the process in the lung, as well as operability in lung cancer [2, 4, 16, 23].
Hygiene
Healthcare mangement
Some results and prospects for the development of nephrological care in Tatarstan
Abstract
Kazan is one of the few cities in Russia and Europe where specialized neurological care has existed since the end of the last century. The teaching of the course of nervous diseases at the Medical Faculty of Kazan University was introduced back in 1870 and was entrusted to the Doctor of Medicine A. A. Unlucky. In 1887, the Department of Nervous Diseases was organized, which until 1892 was headed by Prof. D. P. Skalozubov, a student of the founder of Russian neurology A. Ya. Kozhevnikov; during this period, the department was housed in two rooms, one of which served as a 4-bed ward, and the other as a laboratory, where, in addition, outpatient appointments were held.
Conferences
The Third All-Russian Congress of Therapists (7-12/II 1969, Leningrad)
Abstract
The congress was attended by about 2,000 scientists and practitioners from all the Union republics, including 200 professors and 300 candidates of sciences of various medical specialties. This allowed a comprehensive discussion of scientific problems — the role of infections in the clinic of internal diseases; rheumatoid arthritis; new in the diagnosis and treatment of major internal diseases.
Questions of artificial blood circulation (Based on the materials of the XII scientific session of the Institute of Cardiovascular Surgery of the USSR Academy of Medical Sciences) (12-16/V 1969, Moscow)
Abstract
The director of the Institute, Prof. V. I. Burakovsky, noted that the body's response to artificial blood circulation depends on the volume of perfusion, blood oxygen content and saturation, carbon dioxide elimination and anesthesia. The body's reaction to homologous blood is insufficiently studied. It consists mainly in the redistribution of blood, its "sequestration" and violation of microcirculation. With artificial blood circulation lasting 1-1.5 hours with high volumetric perfusion rates and optimal anesthesia, circulatory disorders occur with reversible changes in internal organs. Longer artificial blood circulation causes redistribution of blood, microcirculation disorders, depletion of the adrenal glands, impaired vascular permeability. The adequacy of perfusion should be determined by many indicators (by the reaction of the adrenal glands and vascular system, ECG, EEG data, urine excretion, the state of gas exchange in tissues).