CONTENTS
POSSIBILITIES OF MODERN COMBINATION THERAPY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND BRONCHIAL ASTHMAThe effectiveness of combination of an inhaled steroids and short-acting broncholytic was compared with effects of the short course (2 weeks) of prednisolone added to the same inhaled combination in patients with moderated chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA). It was shown that the new long-acting broncholytic tiotropium bromide could be recommended in stable moderate COPD, where as in exacerbation and severe disease short courses of oral prednisolone are expedient; prednisolone being much less effective in COPD than in BA. Inhaled steroids are effective both in moderate and severe BA. Short course of prednisolone in severe BA enables fast relieve of obstruction and subsequent use of inhaled steroids in combination with broncholytics provides further bronchodilation. CORRELATION BETWEEN THE MECHANISMS OF PSYCHOLOGICAL DEFENCE AND FORMATION OF BOUNDARY MENTAL DISORDERS IN PATIENTS WITH ARTERIAL HYPERTENSIONThe factors of psychological defence in patients with arterial hypertension (AH) and in people with normal blood pressure (BP) were studied. 359 women were included: 260 with I-II stage of AH and 99 healthy women with normal BP. In hypertensive patients with mental disorders some psychological defence mechanisms (increase of reactive education, substitution, suppression with the trend to the increase of the level of compensation) were more pronounced as well as their disadaptation combination. All these may condition the emergence of boundary mental disorders in these cohort of patients and need to be taken into consideration while delivering psychotherapeutic correction. QUALITY OF LIFE OF PREGNANT WOMEN WITH ARTERIAL HYPERTENSIONThe evaluation of quality of life and of clinical - psychological correlates was carried out in 67 pregnant women with various forms of hypertension and in 12 healthy pregnant women. That moderate reactive and personal anxiety, reflecting mobilisation of adaptation reactions, was observed at all stages of pregnancy. The quality of life of pregnant women with hypertension is much lower than in their healthy counterparts. The following types of attitude to disease were common in pregnant women with hypertension - anosognosic, harmonious, diffuse disadaptation and ergopathic. PECULIARITIES OF EJECTION FRACTION OF LEFT VENTRICLE AND ITS VARIABILITY IN GIRLSPeculiarities of ejection fraction of left ventricle and its variability depending on the prevalence of power oscillations in slow-wave range in junior and senior school girls were studied. High-frequency oscillations prevail in slow-wave range of ejection fraction in the majority of examined girls. Lack of significant differences in ejection fraction values in predominance of various slow-wave oscillations was shown. It was suggested that slow-wave variability of ejection fraction represented general regulatory influences and intra-cardiac mechanisms of regulation of cardiohaemodynamics at rest. PECULIARITIES OF MEMBRANE-DESTABILISING PROCESSES AND THE ANTIOXIDANT DEFENCE STATUS OF ERYTHROCYTES IN PATIENTS WITH MULTIPLE SCLEROSISCorrelation of clinical presentation of patients with multiple sclerosis and membrane destabilising processes were studied on the erythrocyte model. Quantitative and qualitative changes of the structure of lipid phase of erythrocyte membranes were detected. The measure of the changes correlated with the severity of multiple sclerosis. Activation of lipid peroxidation does not only accompany the disease, but is considered to be the essential feature determining the course and prognosis of the disease. OZONE CORRECTION OF LIPID PEROXIDATION AND ANTIOXIDANT SYSTEM IN PATIENTS WITH ACUTE VIRAL HEPATITIS BComplex clinical-biochemical evaluation of lipid peroxidation and antioxidant defence processes in interrelation with functional liver status was carried out in 69 patients with acute viral hepatitis B. Intravenous ozone methodology was used for correction of membrane disorders in 28 patients. Ozone treatment had positive effects on lipid peroxidation and activity of antioxidant defence: stimulation of oxygen-dependent processes, improvement of liver functions and wellbeing of patients with acute viral hepatitis B. EXPERIMENTAL THERAPY OF TOXIC ACUTE GASTRITIS WITH ZEOLYTE-CONTAINING TREPELChanges of gastric secretion function in acute gastritis in rats treated with oral zeolyte-containing trepel were studied. Oral administration of trepel to experimental rats decreased the development of hyper-acidic condition and hyper-acidic gastritis. EPIDEMIOLOGICAL ASPECTS OF PROFESSIONAL AND SPONTANEOUS URINARY BLADDER CANCERThe incidence of urinary bladder cancer in population of Samara and Tambov oblasts in 1960-1998 was studied. Intensive and standardised indices of incidence were calculated by indirect method. Comparative analysis of trends in the incidence in general as well as in gender and age groups revealed higher incidence in Tambov oblast, while its stable increase was shown in Samara oblast. EXPERIMENTAL IMMUNOTHERAPY OF PYO-INFLAMMATORY PROCESSES IN TRAUMAS CAUSED BY BURNSCombined use of imunofan with lidocaine aimed at the increase of anti-infection resistance in pyo-inflammatory processes of mixed ethioligy (Pseudo-monas aeruginosa, Staphylococcus aureus, Candida spp. And E.coli) was proved effective in experiments on mice and rats with trauma caused by burns. DISORDERS OF NEUROMUSCULAR APPARATUS IN TRAUMATIC DISEASE OF SPINAL CORDClinical-myography studies were carried out in 68 patients of 18-39 years of age to determine the pathophysiological mechanisms of development of movement disorders in patients with trauma of lower-toracic and lumbar segments of vertebrae with damage of spinal cord at various stages of traumatic disease. "Bio-electrical silence" or potentials of fasciculations, emerging at the attempts of voluntary contraction of paralysed muscles, of low amplitude with decreased total excitability of spinal moto-neurones were registered on legs' muscles of patients with symptoms of total or partial blockage of spinal conductivity in acute phase and in period of developed clinical presentation. In rehabilitation period restoration of spinal functions or automatism of the segments lower to the site of damage was accompanied by the increase in electrical activity of muscles, total excitability of spinal motoneurones, involvement of large alfa-motoneurones and inhibition processes of the central nervous system. COMBINATION THERAPY WITH PROSPIDINE AND METHOTREXATE IN PATIENTS WITH PSORIASIC ARTHRITIS63 patients with psoriasic arthritis of II-III activity and I-III roentgenologic stages were examined. 30 patients were treated with prospidine combination. In combination treatment versus monotherapy with methotrexate progression of roentgenologic changes were not observed. Both treatment methods improved indices of test Lee, HAQ, role physical, emotional functioning and pain. Indices of physical functioning, HAQ-AS and psychological health improved only in patients treated with prospidine combination. ON THE EFFECTS OF SOCIAL AND ECONOMIC CONDITIONS OF LIFE ON ARTERIAL HYPERTENSION INDICES IN THE WORKERS OF ROAD-PATROL SERVICESThe clinical and social evaluation of the effects of social and economic conditions of life on arterial hypertension indices in 1017 workers of road-patrol services of the Ministry of internal affairs of the Republic of Tatarstan was carried out. The contribution of social and economic factors into the development of arterial hypertension was studied with the help of mono-factor dispersion analysis. It was concluded that social and economic conditions of life contribute significantly to the development of arterial hypertension in the workers of road-patrol services. On the basis of the data on the strength of influence of negative social economic risk factors on the arterial hypertension indices the author recommends the development of measures directed on the minimisation of these factors together with the pharmacotherapy of the disease. EVALUATION OF CHEMICAL SAFETY OF FOODSTUFFSThe estimation of pollution of foodstuffs by heavy metals in the Republic of Tatarstan in the years of 2000-2002 is presented. The number of substandard samples varies insignificantly with general tendency to their decrease. It was established that the vegetables were the most important source of heavy metals as assessed by the real entry into the organisms of population of the Republic of Tatarstan (by cadmium and lead), followed by milk and dairy products (by lead) and by eggs and bread ( by mercury). The average daily entry of cadmium, lead and mercury into the organisms of population of Kazan with actual food allowances did not exceed permissible values. PROBLEMS OF SOMATIC HEALTH OF YOUNG WOMEN IN GENERAL PRACTICEThe examination of the cohort of 1317 young women belonging to three general practices was carried out by the primary health care delivery team. The key problems of patients, physical examination diagnoses and parameters of psychological and social status were determined. The most common somatic diseases and/or their combinations were revealed. The clinical guidelines on organisation of diagnostics and intervention programs in the sub-population of young women in general practice were developed. MANAGEMENT OF DIABETES MELLITUS IN CHILDREN AND ADOLESCENTSManagement of diabetes mellitus in the Republic of Tatarstan includes specialised medical care and prophylactic examinations of children and adolescents with severe chronic diseases at the specialised children's republican clinical hospital, rehabilitation and organisation of patients' schools for the diabetic children and their parents. The effectiveness of this approach proves the need of its introduction into general practice. |