CONTENTS
ALGORITHM OF MANAGING PATIENTS WITH BLEEDING GASTRODUODENAL ULCERSAnalyzed were the results of treatment of 796 patients with bleeding gastroduodenal ulcers. Endoscopic hemostasis and hemorrhage relapse prophylaxis were performed in the main group (676 patients) by a method of individualized local treatment by glue applications depending on the ulcer defect condition. In the control group (120 patients), traditional therapy was carried out. It was found that usage of local treatment of bleeding gastoduodenal ulcers with glue applications reduces the risk of hemorrhage relapse by 3 times. XANTHINOL-NICOTINIC TEST IN CHILDREN WITH ACUTE SURGICAL PATHOLOGY OF THE ABDOMENThe usage of vasodilators along with the xanthinolnicotinic test promotes the improvement of blood circulation and microcirculation of the intestine, increases the motor function of the intestine during no less than 5 hours. Introducing into clinical practice of the criteria of individualized reaction of the patient's autonomic nervous system makes it possible to ensure adequate vascular therapy and promotes early and effective restoration of the intestinal peristalsis, allowing timely prophylaxis of adhesions of the abdominal cavity. 3D ECHOGRAPHY IN TRANSHEPATIC DRAINING OF BENIGN RETENTIONAL GROWTHSShown are the results of transcutaneous transhepatic draining of benign retentional masses under control of three dimensional echography. The transcutaneous interventions were carried out under intravenous anesthesia using a "free hand" technique with a special drainage kit. 96% ethanol was used as a sclerotic agent. Proposed mini-invasive method allows adequate medical intervention in complex clinical cases. DIFFERENTIAL DIAGNOSIS OF CECOILEAL REFLUX DISEASE AND IRRITATED BOWL SYNDROMEShown is the significance of differential diagnosis of gastroenterological disease. Highlighting of the symptoms and summarizing them into a disease makes it possible to change the treatment tactic significantly from conservative to operative methods. In 283 out of 752 patients with irritated bowl syndrome during investingation an insufficiency of the ileocecal valve which needed a surgical correction was found. Satisfactory results were obtained in 93,3% of the operated patients. ENDOTOXIN IN THE CLINICAL PRESENTATION AND PATHOGENESIS OF CHRONIC PYELONEPHRITIS IN CHILDRENEndotoxin level in serum and urine was studied in 116 children with different forms of secondary chronic pyelonephritis. Standard treatment scheme were supplemented by enterosorbent "Lactofiltrum" and probiotic "Biphicol", which lead to faster normalization of endotoxin level in serum and urine and reduction of clinical manifestation of pyelonephritis. OBJECTIFICATION OF DIAGNOSTICS OF ACUTE GESTATIONAL PYELONEPHRITISDesigned was a scale of determining the severity of the course of acute gestational pyelonephritis based on the mathematical analysis of the main parameters of clinical investigation of 80 female patients. Shown is that the pathogenetic basis of acute gestational pyelonephritis is the systemic inflammatory reaction, and thus its markers can be used as objective criteria of the severity of the inflammatory process. USAGE OF MINERAL WATER IN PATIENTS WITH NEPHROLITHIASIS AFTER RECEIVING A DISTANCE SHOCK-WAVE LITHOTRIPSYStudied was the possibility of increasing effectiveness of treatment and rehabilitation of patients with nephrolithiasis after receiving a distance shock-wave lithotripsy by including mineral water "Belokurikhinskaya-Vostochnaya 2" into complex therapy. In all administered patients noted was an elevation of the urine enzymes activity compared to the control, which indicates the increase in permeability of the cell membrane as a result of tubular interstitial nephritis. Established were the facts that the usage of mineral water "Belokurikhinskaya-Vostochnaya 2" in the complex treatment of patients with nephrolithiasis promotes the improvement of the functional condition of the kidney, decreases the urine enzymes activity and leads to stabilization of the nephron membranes in 100% of the patients. PRIMARY AND SECONDARY DELAYED TIGHT SUTURES OF THE URINARY BLADDER AFTER SUPRAPUBIC SINGLE-STAGE AND DOUBLESTAGE TRANSVESICAL ADENOMECTOMYShown was the fact that main condition for performing suprapubic transvesical adenomectomy using primary or secondary delayed tight sutures of the urinary bladder is the reliability of hemostasis of the prostate bed. The most adequate method of hemostasis was the usage of hemostatic removable catgut ligatures which were applied on the neck of urinary bladder. This method allowed performance of single-stage and double-stage transvesical adenomectomy using primary tight sutures of the urinary bladder. INTERNAL SPERMATIC VEIN EMBOLIZATION IN VARICOCELE, COMPLICATED BY REPRODUCTIVE DISFUNCTIONProposed is a method of embolization of the internal spermatic vein. The effectiveness of endovascular Xray techniques of treatment of varicocele combined with reproductive dysfunction was defined. It was established that endovascular X-ray surgical treatment is one of the most informative and safe methods of surgical correction of varicocele. The method of double level occlusion of the left internal spermatic vein in varicocele made it possible to decrease the radiation exposure of the patients and staff at the same time providing an optimal low relapse frequency. CLINICAL MORPHOLOGICAL ASPECTS OF DIFFERENT METHODOLOGIES OF MEDICAL ABORTIONA comparative analysis of efficacy and safety of various methods of interruption of pregnancy at early terms of gestation was presented. Medicamentous interruption of pregnancy was shown to be the least traumatic, exerting minimal influence on the reproductive health of women. Developed was a system of prophylactic measures to decrease the risk of possible complications after abortion. THE USAGE OF A PLASMA AUTOFIBRONECTIN CONCENTRATE IN COMBINED TREATMENT OF PATIENTS WITH TROPHIC ULCERS OF THE LOWER EXTREMITIESAnalyzed was the effectiveness of usage of the plasma autofibronectin concentrate in complex treatment of 116 patients with trophic ulcers of the lower extremities due to chronic venous insufficiency. Analysis of the investigation results showed the effectiveness of the proposed method which makes it possible to improve the results of treatment of patients with trophic ulcers of the lower extremities, to achieve shortening of the hospital admission period and the length of the preoperative period. THE CONDITION OF THE OXIDATIVE AND ANTIOXIDATIVE SYSTEMS IN PATIENTS WITH OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITIES IN THE PRESENCE AND ABSENCE OF HOMOCYSTEINEMIAThe state of the oxidant - antioxidant system was studied in 55 patients with atherosclerosis and 50 healthy people. The activities of superoxide dismutase (SOD), glutathione peroxidase (GP), catalase (CAT), the content of malonic dialdehyde, ceruloplasmin and nonprotein thiole groups were detected in patients with and without hyperhomocysteinemia (HHC). Results indicated that the formation of lipid peroxides in HHC patients was more prominent and not balanced by antioxidant system, particularly in severe HHC. GP activity and SOD/CAT coefficient were significantly decreased in HHC patients. The important roles of HHC and "oxidative stress" in pathogenesis of atherothrombotic complications were suggested. RISK FACTORS OF MULTIPLE DISEASESThe purpose of this investigation was to study the prevalence of risk factors of multiple diseases based on multiple logistic regression method. Studying 1050 male and 1271 female adult patients, it was revealed that alcohol is the most common risk factor among males and females in mono-, bi- and multipathology. Prevalence of overweight, arterial hypertension, dyslipidemia and abnormal ECG significantly increased in the groups of males and females from mono-, bi- and multipathology. Overweight, arterial hypertension and age were the main risk factors in multiple diseases. THE PREVALENCE OF VOLTAGE SIGNS OF LEFT VENTRICULAR HYPERTROPHY AND THEIR INTERRELATION WITH THE DISPERSION OF QTINTERVAL AND VELOCITY CHARACTERISTICS OF THE ELECTRIC ACTIVITY OF THE HEARTStudied were the criteria of left ventricular hypertrophy according to ECG data and their interrelation with the dispersion of QT-interval and velocity characteristics of the electric activity of the heart in a cross-sectional epidemiological study of the population of Chelyabinsk city in the group of 18-64 years of age. The prevalence of left ventricular hypertrophy according to the voltage signs was 13,9%. Left ventricular hypertrophy occurred significantly more frequently in the ages 55 and older, and 2 times more frequently in the male population than in the females. MICROCIRCULATORY DISTURBANCES IN WOMEN OF THE POST-MENOPAUSE PERIOD WITH ARTERIAL HYPERTENSIONStudied were the clinical and functional peculiarities of microcirculation in 110 women of the postmenopause period with arterial hypertension depending on the degree of elevation of the blood pressure, intensity of the climacteric syndrome and the influence of the hypotensive therapy used in combination with hormonal replacement therapy on parameters of microcirculation. Shown was the fact that in these patients hypotensive therapy with berlipril in combination with climen has a positive effect on microcirculation, which is revealed by a significant decrease of spasm and active congestion signs with a transformation of blood circulation into a normocirculatory type in most cases. THE INFLUENCE OF SHORT-COURSE HIGH DOSAGE THERAPY WITH ATORVASTATIN ON THE CONDITION OF OXIDATIVE STRESS AND ENDOGENOUS INFLAMMATION IN PATIENTS WITH DIFFUSE ATHEROSCLEROSIS .Studied were two groups of patients in which operations on the aorta and its branches were planned. The first group of patients received standard therapy with nitrates, antiaggregants, ACE-inhibitors. The second group of patients in addition to standard therapy received 60 mg of atorvastatin daily for 10-12 days. In the blood serum and in the red blood cells the indices of the antioxidative system and of the malonic dialdehyde were determined. Using enzyme immuno-detection the level of C-reactive protein and interleukin 6 was acquired. Established was the fact that atorvastatin administered in an intensive shortcourse regime inhibits the processes of oxidative stress and endogenous inflammation, which makes it possible to recommend its usage for prepa-ration of patients with diffuse atherosclerosis for surgery on the aorta and its branches. A PROGNOSTIC ASPECT OF TREATMENT OF PATIENTS AFTER MYOCARDIAL INFARCTION WITH CAPTOPRILAn evaluation of captopril treatment of patients with a Q-wave positive myocardial infarction and its influence on the 30-month long prognosis was studied. 93 out of 182 patients made up a group which received captopril. It was shown that in patients receiving captopril the incidence of developing stable angina and recurrent infarctions was significantly lower. Multifactor analysis showed that the low incidence of recurrent infarctions in patients of the captopril treatment group did not depend on any other clinical factor. ELECTROPHYSIOLOGICAL PECULIARITIES OF AMBLYOPIA IN CHILDREN WITH HYPERTROPIC ASTIGMATISMStudied were the clinical peculiarities of meridional form of amblyopia with hypertropic astigmatism, defined the diagnostic criteria together with the development of objective diagnostic methods. In all patients the investigation of induced visual potentials was carried out by applying stimuli as black and white stripes with a rectangular profile of illumination with angular dimensions of 60 and 20 minutes, which enable selective excitation of the receptive retinal fields which are oriented along the arch of the main meridians of the astigmatic eye. Established were profound functional changes in patients with complex hypertropic astigmatism as none of the main meridians appeared functionally valuable. Traced was the significant skewness of the visual acuity and parameters of induced visual potentials in the main meridians. RECOVERY OF THE VISUAL FUNCTIONS USING A METHOD OF SELECTIVE STIMULATION OF RECEPTIVE FIELDS OF THE RETINA IN TREATMENT OF MERIDIONAL FORM OF REFRACTIVE AMBLYOPIA IN CHILDREN AND ADOLESCENTSTreated were 126 children (231 eyes) with complex hypertropic astigmatism. A method of selective excitation of a receptive field of an amblyopic meridian was included into complex treatment of 89 children (172 eyes). Shown was the effectiveness, pathogenetic validity of the method and a greater preservation of the achieved treatment results in comparison with the patients treated by traditional methods. CEREBRAL VASCULAR DISORDERS IN CHILDREN WITH CEREBRAL SPASTIC INFANTILE PARALYSIS AND CONVULSIVE SYNDROMECerebral blood circulation disorder and its possible pathogenetic role in children with cerebral spastic infantile paralysis and convulsive syndrome were studied. The necessity of prescribing vasoactive drugs together with specific anticonvulsive therapy was underlined. VENTRICULAR SUBGALEAL BYPASS SURGERY IN THE ACUTE PERIOD OF INTRAVENTRICULAR HEMORRHAGES IN THE NEWBORNThe evaluation of effectiveness of ventricular subgaleal bypass surgery in treatment of the newborn with complicated hydrocephaly and severe forms of intraventricular hemorrhages was carried out. Its usage made it possible to achieve sufficient decrease of lethality and risk of future incapacitation along with economizing on the time and funds needed for treatment. TRANSCRANIAL ELECTRIC STIMULATION IN A COMPLEX REHABILITATIVE TREATMENT OF PATIENTS WITH ISCHEMIC STROKES IN THE EARLY PERIOD OF REHABILITATIONStudied was the clinical effectiveness of transcranial electric stimulation in treatment of 75 patients with ischemic strokes in the early period of rehabilitation. Established was the improvement of patient condition after transcranial electric stimulation: reduction of the spastic component, increase of the range of motions, decrease of the anxiety level in the main group of the patients in comparison to the same indices of the control group. ABOUT THE ROLE OF PROPRIOCEPTION IN MYOFASCIAL PAIN SYNDROME OF THE NECK IN DYSCOORDINATED MOTIONShown are clinical and physiological materials of the study of dyscoordinated motion (ataxia) in myofascial pain syndrome of the cervical level. The leading complains of the patients was rocking during walking and standing still without systemic vertigo. The assessment of the functional condition of the vestibular apparatus showed the decrease of excitation. The registration of the induced brain activity showed disinhibition of neuronal groups of the brainstem. Proposed was the fact that cervical ataxia is caused by an imbalance and deficit of proprioception in the zone of myofascial hypertonus. DYNAMICS OF MICROBIAL FLORA DURING TREATMENT OF PATIENTS WITH CHRONIC PARODONTITIS BY OZONATED OLIVE OILDynamics of microbial flora during treatment of patients with mild and average degree of chronic parodontitis at different stages of treatment were studied. As an alternative to antibacterial treat-ment, application of ozonated olive oil was used. It was shown that proposed method decreased the velocity of microbial colonization of gingival cavities in patients with chronic parodontitis. NUTRITIONAL CHARACTERISTICS AND WORKING CONDITIONS OF PREGNANT WOMENStudied was the alimentary status of 656 practically healthy pregnant women. The percentage ratio of protein calories in the diet of the pregnant women was in the normal range. In the diet of the women the amount of calories obtained from fat products was in average 22% lower than the recommended norms. The number of calories obtained from carbohydrates was higher than physiological. The monitoring results of the energetic expenditure during a day and the calorie content of the diet indicated the exceeding consumption of calories over their expenditure during the day, which can lead to a greater than normal increase of the woman's body mass. THE STRUCTURE OF INFANTILISM IN PATIENTS WITH SOMATOFORM DISORDERSStudied was the structure of mental infantilism in 42 patients with somatoform autonomic disorders. Shown was the fact that the principal position in the structure of mental infantilism in patients with somatoform autonomic disorders is held by the property "Weakness of I" as an emotional nstability, which cannot express itself due to high restraint. The behavioral component "Weakness of I" was presented by sociability and conformity as a dependency on other opinion, evaluation and demand of the surrounding, a tendency to avoid conflicts. EPIDEMIOLOGY OF RODE ACCIDENT TRAUMATISM IN PERM' REGIONAnalysis of rode accident traumatism in Perm' region showed that the number of victims for the last five years increased by 6.1%. Causes of death in 95% cases were combined injuries. Injuries of the head, the chest and extremities were registered more frequently than other injuries. © 1995-2008 Kazan State University |