CONTENTSCLINICOIMMUNOLOGIC STATUS IN ANGINA AND ITS CORRECTION BY XIMEDONEIt is established that there are changes in immune status on the level of cellular and humoral links retaining in a period of early and late reconvalescence, in patients with relapsing forms of angina in acute period of the disease. Inclusion of ximedone in combined therapy results in reducing the duration of intoxication syndrome and local inflammatory process making it possible to recommend it for pathogenetic treatment in relapsing forms of angina. ROLE OF ATYPICAL AGENTS IN ETIOLOGY OF OUTPATIENT PNEUMONIAS IN YOUNG PEOPLEIn order to study the etiological role of atypical agents - Mycoplasma pneumoniae and Chlamydophila pneumoniae 292 patients with confirmed pneumonia admitted during one year from closed collectives were examined. Sputum of patients in acute state of pneumonia was investigated by polymerase chain reaction. Predominance of these agents in autumn - winter period was revealed. Monitoring of atypical agents by polymerase chain reaction method makes it possible to conclude on their increasing role in etiology of outpatient pneumonia in closely related collectives in young persons. EFFECT OF DURATION OF IV DRUG ABUSE ON THE COURSE AND PROGNOSIS OF HIV-INFECTIONThe effect of duration of IV drug abuse on the course and prognosis of HIV-infection by the results of clinico-immunologic indices in 93 patients is studied. It is established that the degree of emaciation and decompensation of the immune system in IV drug abusers is directly dependent on the duration of taking narcotics. During three-years observation the immunologic indices in IV drug abusers taking narcotics for more than two years were reliably lower than in the other group. The unfavourable course of HIV-infection with early development of secondary clinical manifestations and pronounced dysbalance of the immune system is noted in patients with prolonged duration of IV drug abuse. CURRENT METHODS OF RADIOLOGY DIAGNOSIS OF PANCREATIC CARCINOMAThe resolving capability of complex radiology methods is studied and diagnostic algorithm of tumors and pancreatic diseases is developed. In 98% (p<0,01) cases the complex radiology examination made it possible to reveal pancreatic carcinoma and to differentiate it with other tumors of hepatopancreato-duodenal zone. The developed algorithm increases the informativity of radiology diagnosis, reduces time and number of diagnostic procedures, decreases radiation load on patients. DIAGNOSTIC POSSIBILITIES OF MAGNETIC RESONANCE CHOLANGIOGRAPHY IN CHOLEDOCHOLITHIASIS AND STENOSING LESIONS OF THE COMMON BILE DUCTAs many as 46 patients with choledocholithiasis and stenosing lesion of choledocha are examined to study diagnostic possibilities of magnetic-resonance cholangiography. It is established that this examination makes it possible to reveal concrements independent on their chemical structure, to determine exactly the nature of biliary system lesion and to develop the optimal treatment method. ULTRASOUND SCANNING ALGORITHM OF THE POSTOPERATIVE WOUND FOR PREVENTION OF WOUND COMPLICATIONS AFTER IMPLANT HERNIOPLASTY OF VENTRAL HERNIASThe prospective nonrandomized envestigation is carried out, in which the possibility of reduction of the incidence of wound complications after implant hernioplasty of postoperative ventral hernias using the ultrasound scanning algorithm of the postoperative wound was studied. In the group of patients where the ultrasound scanning algorithm was used the duration of hospital treatment in postoperative period, general number of wound complications, as well as the incidence of suppuration rate were reliably less than in the group where this algorithm was not used. ANESTHESIA AND IMMEDIATE POSTOPERATIVE PERIOD IN CARDIOSURGICAL PATIENTS OPERATED BY MINIMUM INVASIVE TECHNIQUEThe efficiency of thoracic epidural anesthesia in cardiosurgical operations, performed in 194 patients with vices of atrioventricular valves by minimum invasive technique, is studied. Comparisons are made in two groups - operated in multicomponent anesthesia (34 persons) and with additional use of epidural anesthesia (70 persons). It is shown that in the second group the dose of phentanil decreases by a factor of 7-10 and the dose of inhalation anesthetics decreases by a factor of 2-3, the duration of artificial ventilation of lungs, the intensity of pain syndrome, analgetic expenditure, terms of activization of patients and their presense in revivification ward, the number of postoperative complications decrease. The conclusion on pathogenetic justification and efficiency of the use of high thoracic epidural anesthesia in minimum invasive surgery of the heart is made. ON THE ROLE OF COMPLEX PROGRAM OF AUTOHEMOTRANSFUSIONS IN CARDIOVASCULAR SURGERYTreatment results of 272 patients operated on heart in conditiÏns of artificial circulation using program of autohemotransfusion, basic components of which are preoperative reservation of autoplasmÁ, intraoperative reservation of autoblood, reinfusion of washed erythrocytes are studied. It is established that preoperative reservation of autoplasma and intraoperative normovolemic hemodilution are effective methods of blood economy in cardiosurgery in hemorrhage from 20% to 30% of circulating blood volume and in more severe hemorrhage it is nesessary to combine them with reinfusion of washed erythrocytes. RELATION OF INDICES OF CARDIORESPIRATORY SYSTEM AND PHYSICAL EFFICIENCY OF SPORTSMEN OF DIFFERENT AGEThe relation of indices of cardiorespiratory system with physical efficiency values is considered. Strong correlation between the complex estimation index of providing organism with oxygen and the indices of absolute and relative efficiency in groups of youths and adult sportsmen shows the necessity of using this factor to estimate compensatory and adaptive reactions of cardiorespiratory system during physical exercises with increasing power. CHARACTERISTIC OF ANTIARRHYTHMIC ACTIVITY OF DIMEPHOSPHONEAntiarrhythmic activity of dimephosphone in experimental arrhythmias of different genesis is studied. It is established that on the models of calcium chloride, adrenaline and strophanthine arrhythmias dime-phosphone in doses 200-600 mg/kg has antiarrhythmic activity correlated with activity of lidokain and cytochrome C. The mechanism of action of the drug is obviousby the capability to restrict ischemic processes in myocardium rather than the direct action on ionic conduction channels. CLINICAL EFFECTS OF HYPERCORTISOLEMIA IN PUBERTAL-JUVENILE DYSPITUITARISMThe incidence of basic physical manifestations of hypercorticism in pubertal-juvenile dyspituitarism is studied and the connection with hypercortisolemia is followed. The average level of cortisol in blood was within the normal range only in 15 patients. The excess of indices of daily excretion with urine 17-OKC was revealed only in 26 patients. The parallelism between release of one of basic metabolites of gluco-corticosteroids and cortisol level in blood was absent. The basic clinical effects of hypercorticism in pubertal - juvenile dyspituitarism are hormonally metabolic trophic skin breaks, arterial hypertension, secondary erythrocytosis. PECULIARITIES OF EPILEPTIC ATTACKS IN PREMATURE CHILDRENAs many as 40 children aged 1,5 months to 15 years whÏ were Ádmitted with epilepsy with various manifestations were examined. Changes in 8 children were revealed using computer tomography and nucleomagnetresonance tomography of brain. It is established that attacks in premature children are characterized by polymorphism of manifestations with prevailing generalized tonicoclonic symptomatic forms of epilepcy resulting more often in disorders of high cortical functions, invalidization and social desadaptation. It is necessary to perform complex examination in neonatal convulsions of the patient. INDICES OF SOMATOSENSOR INDUCED POTENTIAL AND MAGNET STIMULATION IN PATIENTS WITH PANIC ATTACKS DEPENDING ON RATE OF NA+/Li+-COUNTERTRANSPORT IN ERYTHROCYTE MEMBRANEEffective and affective tracts of brain in various rate of passive transmembrane ionotransport are studied. It is established that in patients with panic attacks the state of affective and effective systems reflecting the peculiarities of pathologic integration with increasing tension of functional systems changes very significantly in the presence of geneticaly determined high rate of transmembrane ionotransport. REHABILITATION OF PATIENTS WITH CEREBRAL HEMIPARESES COMPLICATED BY SECONDáRY MYOFASCIAL PAIN SYNDROMEThe dependence of severity of pain in trigger points and their number on the disease period, muscle tonus state and paresis degree in extremities is revealed in patients with poststroke hemipareses. The treatment and estimation of its efficiency at various rehabilitation stages in patients with cerebral hemipareses are suggested. Combination of cryotherapy and tension is effective at early stages of the recovery treatment, the combination of cryotherapy and tension with local injections of anesthetic is effective at later stages. COMBINED ESTIMATION OF THE TREATMENT RESULTS OF TEMPOROMANDIBULAR JOINT DISFUNCTIONThe role of functional methods in combined estimation of the treatment results of temporo-mandibular joint disfunctions with pain and combined symptoms is studied. Electromyography, roentgeno-graphy and computer tomography were carried out. Roentgenography of temporomandibular joint gives only the picture of topographic elements of joint. Roentgenocomputer tomography was carried out to clarify the diagnosis. It is concluded that only combination of clinical, functional and roentgenologic examination of patients with "temporomandibular joint disfunctions with pain and combined symptoms" makes it possible to reveal pathology, to make correct diagnosis, to follow the treatment dynamics and its results. FUNCTIONAL ACTIVITY OF SEGMENTAL AND SUPRASEGMENTAL PARTS OF NERVOUS SYSTEM IN PATIENTS WITH DIFFUSE TOXIC GOITERThe reflex activity of brain is studied in 46 patients with diffuse toxic goiter by registration and analysis of H-reflex and wink reflex. The increase of reflex excitability of spinal and supraspinal parts of nervous system is manifested in decrease of the threshold of causing reflexes, their latent periods as well as in increase of amplitude and duration of reflex responses. SONOGRAPHIC DIAGNOSIS OF INTRAUTERINE INFECTION OF THE FETUSThe data on sonography in women with pregnancy complicated by intrauterine infection of the fetus are studied. It is established that the data of dopplerometry, fetometry and placentometry are the most in formative indices of prediction and development of intrauterine infection of the fetus. It is appropriate to use the combined clinicolaboratory and functional studies for objective diagnosis of intrauterine infection of the fetus. USE OF VITAMIN ADAPTOGENIC DRUGS IN COMBINED THERAPY OF PELVIC INFLAMMATORY DISEASES109 women with chronic salpingoophoritis infected by chlamydia and mycoplasma are examined. Adaptogen (royal capsules) were included in treatment of 50 women, 59 women received standard therapy. Treatment with adaptogene stimulates phagocytic activity of neutrophiles what is especially important in the treatment of patients with persisting urogenital infection. FUNCTIONAL STATE OF KIDNEYS BY DYNAMIC SCINTIGRAPHY IN PATIENTS WITH CERVICAL AND OVARIAL CARCINOMAThe complex radiology study of urologic complications including ultrasound methods, computer tomography and dynamic scintigraphy of kidneys with angiophase is carried out in 238 patients. Functional and organic changes in kidneys by dynamic scintigraphy were found in more than 70% of patients with carcinoma. Dynamic scintigraphy can be recommended in combination with other radiology methods to all patients with malignant diseases of genitalia. REHABILITATION OF PRE-SCHOOL CHILDREN WITH DELAYED PSYCHIC DEVELOPMENTClinicopsychologic peculiarities of pre-school children with delayed psychic development and rehabilitation in the "Nadezhda" Center of Children Development in Kirovo-Chepetsk are presented. Data of rehabilitation results of 103 pre-schol children are given. Dynamics of neurosis-like and psychopathy-like syndromes and experimental and psychological data were analyzed. The results show high efficiency of medical, psychological and pedagogical rehabilitation of pre-school children with delayed psychic development. SOCIO-DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF MENTALLY RETARDED PATIENTS COMMITTING SOCIALLY DANGEROUS ACTIONSAs many as 212 patients on forced treatment in psychiatric hospital of specialized type were examined by clinico-psychopathologic and clinicoepidemiologic methods. Basic demographic, social and clinical characteristics of mentally retarded patients related with their socially dangerous actions were determined. Their main psychopathologic mechanisms were intellectual incompetence (in 29,2%), absence of emotional controll (in 28,8%), disinhibition and perversion of inclinations (in 12,3%). These mechanisms are correlated with clinical manifestations of the disease, as well as with simplified and individual nature of socially dangerous actions. Recommendations on organization of timely and differential prevention of delinquencies by mentally retarded persons are given. EFFICIENCY OF DISPENSARY ORTHODONTAL CARE IN CHILDRENThe deep study of prophylactic medical examination method in comparison with reception by taking medical advice is performed to estimate effect of dynamic observation and rehabilitation of children in orthodontist. The experimental group consisted of 1194 pupils of schools where active revealing of disorders of growth and development of maxillodental system as well as dynamic observation and rehabilitation were carried by district doctors. The control group consisted of 787 persons of similar age having orthodontal care by taking medical advice.. Calculations showed that efficiency of orthodontist work directed to early rehabilitation of children with disorders of growth and development of maxillodental system increases 3,1 times in comparison with efficiency in reception by taking medical advice. EXPERT ESTIMATION OF QUALITY OF PROVIDING PREMEDICAL CARE TO RURAL POPULATIONThe role of assistant medical staff in providing medical care to rural population is emphasited. The authors developed methods of estimation of quality of provided premedical care including six indices: quality of diagnosis, medical care, premedical care,tactical decisions by doctor's assistant, production indices and the complex index of quality of premedical care. © 1995-2008 Kazan State University |