CONTENTSANALYSIS OF THE REPUBLICAN REGISTRY OF CHILDREN AND ADOLESCENTS OF THE REPUBLIC OF TATARSTAN SUFFERING FROM DIABETES MELLITUS TYPE IThe data of the State Registry on diabetes mellitus, which has been compiled by experts of Children's Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, has been analyzed. It turned out that up to February 2006 in Republic of Tatarstan 301 patients were registered as suffering from type I diabetes mellitus, out of which 139 (46%) were girls and 162 (54%) were boys. The age groups, length of illness, the degree of compensation of the carbohydrate metabolism disturbance were evaluated. 60,5% of children and adolescents were in the condition of decompensation. The relationship between the degree of compensation and illness length, combination of different insulin medications and the availability of specialized medical aid was suggested. ROENTGENOLOGICAL AND DOPPLER ECHOCARDIOGRAPHY SIGNS OF LUNG CHANGES IN PATIENTS WITH DIABETES MELLITUSIn 91 patients with diabetes mellitus signs of lung angiopathy were detected. 53 patients were suffering from diabetes mellitus type I and 38 patients were suffering from diabetes mellitus type II. The changes in lung haemodynamics that were discovered by Doppler echocardiography and by multi-slice high resolution computer tomography and morphological changes of the lung parenchyma in patients with diabetes mellitus may well be considered as specific lung lesions, the basis of which is the microcirculation disorders. INSULIN RESISTANCE IN YOUTHS WITH HYPOTHALAMIC SYNDROME OF THE PUBERTY AGEThe insulin resistance in youths with hypothalamic syndrome of the puberty age has been studied. It has been shown that in the trial group there is a tendency for elevation of the insulin resistance index and for reduction of insulin sensitivity index, while in the control group - visa versa. During the evaluation of relationship between two indices of insulin resistance (HOMAR and ISI) and the obesity pattern it was shown that in the abdominal obesity pattern HOMAR is higher and ISI is lower than in gluteofemoral obesity pattern. It was found that HOMAR correlates with anthropometric signs and metabolic characteristics stronger than ISI. THE PECULIARITIES OF CARBOHYDRATE METABOLISM DISORDER IN PATIENTS WITH ACUTE STAGE OF MYOCARDIAL INFARCTION AND AFTER DISCHARGE FROM THE HOSPITAL310 patients with an acute myocardial infarction (154 with Q-wave and 156 without Q-wave) and without diabetes mellitus in anamnesis have been included in the study. During admission to hospital the glycemia level was measured, further on the glycemia profile and the glycated hemoglobin level was measured to diagnose diabetes mellitus. In 3 months time after being discharged from hospital an oral glucose tolerance test was performed. In the 3 months period of observation a carbohydrate metabolism disorder was registered in 2/3 of the observed patients. Besides the excluded 4,5% of patients with a first discovered diabetes mellitus during hospital treatment, in 3 months time in 30,9% of the patients an abnormality in glucose tolerance has been discovered and in 32,1% of patients - diabetes mellitus was discovered. Thereby patients with myocardial infarction without diabetes mellitus in anamnesis require glycemia control not only during hospital treatment, but also a glucose tolerance test after being discharged from the hospital. THE EPIDEMIOLOGY OF MYOCARDIAL INFARCTION IN PATIENTS OF AN AGRICULTURAL DISTRICTAccording to the acute myocardial infarction registry, data of the morbidity, mortality and the predisposing factors of its development have been studied throughout the 1996-2004 period in the Kurgan region, which is an agricultural district. The morbidity of acute myocardial infarction has elevated by 11% both in the urban and rural areas. The morbidity rate of males under 70 years of age is significantly higher than in women of the same age group, however in the age group older than 70 - visa versa. Amongst the predisposing factors of myocardial infarction development the most significant are: smoking, arterial hypertension, previous history of ischemic heart disease, diabetes mellitus. A big difference between the mortality from myocardial infarction in the urban and rural areas has been found. THE CLINICAL PECULIARITIES OF SUBACUTE THYROIDITIS AND ITS TREATMENT METHODSThe clinical peculiarities of subacute thyroiditis have been described in 120 patients in the age from 18 to 70 years with different severity of the illness. It was shown that subacute thyroiditis etiologically is heterogenic. The functional state of the thyroid gland in the height of the disease has been specified. A high percent of thyrotoxicosis was shown at the beginning of the illness. A high incidence of recurrences has been found, especially during treatment of patients by traditional methods. A comparative evaluation of different treatment methods with the use of laser therapy has been conducted. THE RELATIONSHIP BETWEEN INDIVIDUAL YEARLY BIORHYTHMS AND THE MORTALITY RISK FROM CARDIOVASCULAR DISEASEThe mortality rate associated with cardiovascular disease has been studied in different periods of the calendar and individual years for development of effective measures of secondary prophylaxis. Based on the data of dates of birth and death of the deceased, the season and serial number of the month of the individual yearly cycle when death was registered were established. It is shown that the frequency of fatal outcomes from cardiovascular disease depends on the year season and quartal of the individual yearly cycle. THE CHANGES AND CORRELATION OF THE INDICES OF TISSUE AND CIRCULATORY COMPONENTS OF THE OXYGEN TRANSPORTATION SYSTEM IN THE NEAREST POSTOPERATIVE PERIOD AFTER AORTOCORONARY BYPASS SURGERYThe indices of tissue interchange of gases and cardiac index during 24 hours after uncomplicated aortocoronary bypass surgery in 46 middle aged patients has been studied. It has been shown that after a successful operation of aortocoronary bypass surgery with the help of artificial blood circulation practically a full recovery of the oxygen transportation system indices takes place in the first 24 hours. A positive significant correlation between the directly measured indices of tissue oxygen tension in mixed venous blood and the cardiac index was found. A COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF ENALAPRIL AND AMLODIPINE IN TREATMENT OF SYSTOLIC ARTERIAL HYPERTENSION IN ELDERLY PATIENTSThe aim of the study was to compare the effectiveness of a calcium channel blocker amlodipine with an ACE-inhibitor enalapril in treatment of isolated systolic arterial hypertension in elderly patients (60-74 years of age). Studied were patients who did not receive any treatment previously or have stopped any drug treatment no less than 1 month prior to the beginning of study. 178 patients passed randomization (92 patients received amlodipine and 86 - enalapril). The absolute value of systolic and diastolic blood pressure did not differ in the analyzed groups after 3 months of treatment. It was found that amlodipine and enalapril posses similar effectiveness in treatment of isolated systolic arterial hypertension in elderly patients. PHARMACOLOGICAL TREATMENT OF THE EARLY REPOLARIZATION SYNDROME AND PREMATURE EXCITATION OF THE VENTRICLES IN PATIENTS WITH AN ARRHYTHMIC SYNDROME150 patients with an arrhythmic syndrome have been examined. The effectiveness of the studied medications was evaluated after 3 and 6 months of therapy. The lessening of the frequency of presented complaints, registration of signs of premature repolarization of the ventricles on the ECG, registration of the late ventricular potentials and disorders in the cardiac rhythm during comparison of patient groups were statistically significant. Shown is the fact that a long-term therapy with Preductal MB and Magnerot promote stabilization of the repolarization processes and lowering of the arrhythmia incidences. DOES SMOKING EFFECT THE FORMATION OF BLOOD MICROVESICLES?Hypercoagulation mechanisms have been studied in smoking as one of the reasons of cardiovascular disease development and prethrombotic conditions. Cellular microvesicles are a procoagulant blood marker the level of which rises in acute coronary syndrome, in stokes and in arterial hypertension. A study of the dynamic of total quantity and specific ecto-5'-nucleotidase containing microvesicles in blood in smoking has been conducted. In most young volunteers no increase in microvesiculation was seen 30 and 60 minutes after smoking a cigarette. However in 19% of smokers a short-term significant elevation of blood microvesicle level containing ecto-5'-nucleotidase was registered. THE INDICES OF IMMUNE INFLAMMATION AND DISTURBANCES OF HEMOSTASIS PROCESSES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS DEPENDING ON THE PRESENCE OF ANTIPHOSPHOLIPID SYNDROMEAn evaluation of interaction processes of inflammation and hemostasis based on the interrelation between production of tumor necrosis factor alpha, interleukin-4, C-reactive protein and the indices of platelet-vascular and coagulatory hemostasis in patients with systemic lupus erythematosus depending on the presence of antiphospholipid syndrome was conducted. It is shown that the indices of tumor necrosis factor alpha, C-reactive protein and interleukin-4 positively correlated with the activity of inflammation, with the increasing quantity of desquamated epithelial cells and with the parameters of platelet-vascular and coagulatory hemostasis. It is proven that the increase of tumor necrosis factor alpha and C-reactive protein concentrations reflects the activation of inflammation processes and makes it possible to use them as additional predictors of endothelial damage and potential risk of thrombotic complications development in patients with systemic lupus erythematosus in the presence of antiphospholipid syndrome. AN INTESTINAL ENDOTOXIN AS AN IMPORTANT PATHOGENESIS FACTOR OF IRIDOCYCLITIS AND ENDOPHTHALMITIS OF UNKNOWN ETIOLOGYThe role of intestinal endotoxin aggression in the pathogenesis of inflammatory pathology of the eye was studied. The test subject was not chosen randomly, as iridocyclitis (in 59 patients) and endophthalmitis (in 16 patients) of unknown etiology a priori did not have any interrelation with different etiological factors, which made the result interpretation much easier. A double decrease in bacterial liposaccharide concentration in the general blood flow and a normalization of studied serological indices were found, which testify the involvement of endotoxin aggression of intestinal origin in the pathogenesis of uveitis and endophthalmitis of unknown etiology. THE EFFECTIVES OF SINUS-TRABECULECTOMY WITH INTRASCLERAL MICRO-DRAINAGE USING A CARBON BASED IMPLANT IN TREATMENT OF OPEN-ANGLE GLAUCOMAThe aim of this study was to increase the effec-tiveness of surgical treatment of open-angle glaucoma by using a pure carbon based implant. 200 sinus-trabe-culectomy operations were carried out for treatment of open-angle glaucoma. The main trial group included 100 patients (100 eyes) operated using the carbon based implant. 100 patients (100 eyes) of the control group were operated by the traditional method. The carbon based implant showed to be very biocompa-tible and an optimal material for micro-drainage, which due to its structure enables formation and long-term function of the humor microfiltration through the new outflow paths. The proposed method of surgical treatment of glaucoma makes it possible to achieve a much more evident hypotensive effect with preser-vation of the visual function in comparison with a classical sinus-trabeculectomy. DEFINING THE DEGREE OF PATIENT ADAPTATION TO NON-REMOVABLE ORTHODONTIC MATERIALSIn order to evaluate the degree of patient adaptation to non-removable orthodontic materials a questionnaire "Adaptation to orthodontic treatment" has been designed. The degree of patient adaptation to non-removable orthodontic materials was evaluated in 181 patients of 15 years and older. The most severe period of orthodontic treatment is the initial period. An orthodontic construction gives a feeling of discomfort, while the appearing anxiety makes it psychologically difficult to adapt to it. THE EFFECT OF AEROIONOTHERAPY ON THE ALVEOLAR SOCKET CONDITION AFTER DENTAL EXTRACTIONThe effect of aeroionotherapy on the alveolar socket condition after dental extraction has been studied in 15 patients. The effectiveness of the therapy was evaluated by clinical investigation results, by microscopic evaluations of smears from the alveolar socket after dental extraction in patients at different stages of treatment and by using microbiological control. It was swon that aeroionotherapy possesses an antiseptic action and promotes reduction of the inflammatory process, acceleration of the mucosa regeneration of the alveolar socket of the removed tooth. SIMULTANEOUS OPERATIONS DURING TREATMENT OF THE DIAPHRAGM ESOPHAGEAL OPENING HERNIASFor the purpose of removal of the diaphragm esophageal opening hernias and of the gastroesophageal reflux disease a modified Rampal operation with a compulsory posterior cruro- raffia was proposed. Good and satisfactory results were obtained in 86,6% of the operated patients. The advantage of the proposed method is the simultaneous correction of the pathogenetically interconnected disease, elimination of recurrent operation risk and the decrease in hospital treatment period. STOMACH RESECTION IN URGENT SURGICAL TREATMENT OF COMPLICATED PYLORODUODENAL ULCERSThe results of stomach resection in emergency surgery in 210 patients combined with complicated pyloroduodenal ulcers by using an individualized surgical tactic were analysed. This tactic included intraoperative diagnosis and a reasonable correction of chronic disorders of duodenal passability, choice of gastric resection method depending on the presence of these disorders, evaluation of difficulty category for mobilization of the pyloroduodenal zone for choosing the gastric resection type and an optimal method of duodenal stump formation. Usage of the proposed tactic made it possible to decrease the amount of early postoperative complications twice, decrease postoperative mortality by 3,7 times and to raise the life quality of the patients in the long run in comparison with the traditional treatment tactic. GASTRECTOMY RESULTS IN GASTRIC CANCER CARRIED OUT IN SPECIALIZED ONCOLOGY AND NON-SPECIALIZED HOSPITALS OF PENZA CITYThe results of gastrectomies carried out in 588 patients with gastric cancer in specialized oncology and non-specialized hospitals of Penza city were analysed. A comparative analysis of operation results shows that less complications and a lower mortality rate was seen in specialized oncology centers. The effectiveness of gastrectomies in treatment of gastric cancer in a specialized oncology center was higher than in any other surgical department, which was due to the presence of all necessary conditions and equipment for diagnosing and treating patients with such an illness in specialized hospitals. THE ROLE OF MAGNETIC RESONANCE IMAGING IN DIAGNOSIS OF LESIONS OF THE KNEE JOINT IN CHILDREN WITH HEMARTHROSISMagnetic resonance imaging of knee joint of 51 children revealed that in 31.4% of the cases the causes of haemarthrosis were isolated lesion of joint cartilage with formation of osteo-cartilage fragments, lesion of meniscus and Goff's disease. In 68.6% of the cases there was combined lesion of intra-joint structures. It is proposed that magnetic resonance imaging is a more informative and non-invasive methods for the diagnosis of joint disorders in children, comparing with other methods. KINEMATIC STABILITY OF THE KNEE JOINT IN OSTEOARTHRITISThe definition of kinematic stability of the knee joint is given in osteoarthritis and diagnostic methods are proposed. Defining the kinematic stability of the knee joint in osteoarthritis and shown objective functional criteria made it possible to activate and control the effectiveness of the treatment and rehabilitation protocol, finding an optimal and individual for each patient vertical position balance. OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH COMPLEX EXTRASPHINCTERIC AND INTERSPHINCTERIC PARARECTAL FISTULASThe experience in treatment of 902 patients with rectal fistulas was described. In 304 of the patients a severe form of chronic paraproctitis has been diagnosed. Developed is an algorithm of examining and treating patients with severe forms of chronic paraproctitis. A method of complex therapy has been proposed which includes preoperative photodynamic therapy, segmental rectal plasty using polypropylene graft and a special complex of gymnastic exercise. In the main group (n=63) the proposed method of complex treatment has been used. In the control group (n=241) traditional methods of treatment have been used. A decrease from 21,6% to 14,3% of early postoperative complications has been established. Good and satisfactory long term results of treatment were seen in 96,2% of the operated patients of the main group and in 86,3% of the control group. THE PECULIARITIES OF DETECTION AND REMOVAL OF BENIGN TUMORS OF THE COLON IN PATIENTS OF THE OLDER AGE GROUP4378 medical documents of patients who had undergone a planned colonoscopy in the Endoscopic Department of the Veteran's Hospital throughout 2000-2005 have been analyzed. Established is the fact that benign new formations make up 75% in the structure of the tumors, and cancer - 19%. The frequency of polyp detection depends on the age of the patients. The portion of colon cancer increases on the age group 61 and older. Adenomas with a villiferous component which significantly increase the malignancy potential, occur significantly more frequently in patients older than 70. THE ENZYMATIC ACTIVITY OF THE UREA AND BLOOD IN BENIGN AND MALIGNANT TUMORS OF THE URINARY BLADDERThe activity of lactate dehydrogenase in blood serum and urine was studied in 102 patients (71 males and 31 females) with benign (10) and malignant (92) tumors of the urinary bladder and in 118 persons of the control group. In malignant tumors of the urinary bladder established was a statistically significant increase in enzymatic activity of lactate dehydrogenase in blood serum and urine. In males the increase of serum lactate dehydrogenase concentration has been shown in 1st, 2nd and 3rd stages and in the urine - at all stages. Prevailing was the increase of lactate dehydrogenase level in blood serum in patients of 40-49 and 60-69 years of age and in a higher degree in urine in age group of 39 years and older. In females a significant rise in enzymatic activity was found only in urine at the 3rd stage of disease and in groups of patients 70 and older. ENURESIS AMONG TEENAGERS CALLED UP FOR MILITARY SERVICE: SPREAD, RISK FACTORS AND CLINICAL FEATURESEnuresis prevalence for military service called up young men has been analysed for 1996-2005 period. Complex clinical-neurological and urological examination of 170 teenagers at the age of 17-22 years of age has been carried out. Abnormalities of autonomic and hormonal regulation in the enuretic teenagers were characterized. The patterns of neurological and urological symptoms were described. The main risk factors of enuresis which are hereditary and perinatal traumas were determined. THE POSSIBILITIES OF PREDICTING URINARY INCONTINENCE IN FEMALE OF REPRODUCTIVE AGEThe data of obstetrical, gynecological and somatic anamnesis have been analyzed in a group of women of reproductive age with a manifestation of urinary incontinence after childbirth. The content of magnesium in blood serum of healthy females and women with symptoms of urinary incontinence after childbirth has been studied and a significant decrease of its level has been established. The results show a possibility to predict the development of urinary incontinence after childbirth with an aim of taking possible precautions. ULTRASONOGRAPHIC AND MORPHOLOGICAL PECULIARITIES OF THE RETROVAGINAL SEPTUM WITH ANTERIOR RECTOCELE OF THE III STAGE AND JUSTIFICATION OF THE SURGICAL TACTIC CHOICEA comparative study of ultrasonographic and morphological changes of the levator muscles in women with anterior rectocele of the III stage has been conducted. Introduction of the endorectal ultrasonography in the preoperative examination complex made it possible to reveal two categories of patients: with a magistral and resistive types of blood flow. A comparative study of the morphological changes in levator muscles in women with rectocele of the III stage showed a significant decrease of collagen and elastic fibers, a depletion of the vascular bed in resistive blood flow type. Taking into consideration the characteristics of degenerative changes of the levator muscles and of the blood flow type in them, 66 women have been operated. The operation of choice was an anterior levator plasty. THE PECULIARITIES OF DEVELOPMENT OF OVARIAN INSUFFICIENCY SYNDROME IN FEMALES OF REPRODUCTIVE AGE AFTER HYSTERECTOMYDuring evaluation of the postoperative period in females with a combination of a hysterectomy and tubectomy with preserved ovaries, a development of ovarian insufficiency syndrome has been established. This syndrome is accompanied by haemodynamic and hormonal disorders, which is combined with clinical manifestations of hypoestrogenemia - an increase of neurovegetative, metabolic and endocrinal and psychoemotional disturbances. THE SATISFACTION OF THE POPULATION OF ORENBURG CITY BY THE QUALITY OF EMERGENCY MEDICAL CARESatisfaction of patients by the quality of emergency medical care was studied in the city of Orenburg. Most of interviewed patients were at the age of 65 and older. In general, satisfaction was rather high (77,8%), however the significant part of the patients was satisfied only partly. Factors having impact on patient's satisfaction were dependent on organization of emergency call service, as well as on functioning of outpatient clinics. © 1995-2008 Kazan State University |