CONTENTS
PERTUBATION OF ENDOTHELIUM THE CAUSE OF ACUTE HYPERCOAGULEMIAThe mechanism of acute hypercoagulemic reaction to response to blood loss, successively includes the following stages: 1) the reflex strengthening of vasopressin and epinephrine secretion; 2) the effect of these hormones on vasopressin V2 and a-adrenergic receptors of endotheliocytes, stimulation of their adenylate cyclase system; 3) the scramblase activation, leading to intermixing of all major lipid classes between liflets within the outside cellular membrane and egress of phosphatidilserine to the cell surface. The last event (loss of lipide asymmetry) is accompanied by the increase of procoagulant activity of endothelial lining of blood vessels, as both tenase and prothrombinase complexes of blood clotting system are formed on clusters of phosphatidilserine; 4) the appearance of microvesicles, secretion von Willebrand factor. By dynamics of hypercoagulemic response and microvesicles formation, the loss of lipid asymmetry starts earlier and lasts longer, than amplification of microvesiculation. DETERMINATION OF DIASTOLIC DISFUNCTION OF THE LEF’ VENTRICLE- THE POSSIBILITY OF EARLY DIAGNOSIS OF CARDIAC F€ILUREThe diastolic disfunction of the left ventricle and chronic heart failure is studied in patients with cardiovascular pathology. Echocardiography and tests with exertion - tredmil, bicycle ergometry, six-minute walk test are used, in 125 patients. The signs of diastolic disfunction were revealed in 119 (95,2%) patients, the same signs in combination with systolic function were found in 6 (4,8%) patients. The diastolic disfunction of hypertrophic type is revealed in 115 patients, in 3 patients - of pseudonormal type, in 1 patients - of restrictive type. The results obtained show the diagnostic importance of the diastolic disfunction criterion independent on changes due to aging of myocardium. The presence of significant prevalence of diastolic disfunction in patients with cardiovascular diseases for more than 10 years is confirmed. Examination algorythm of such patients should include the study of diastolic disfunction of the left ventricle. EFFECT OF ANTIHYPERTENSIVE THERAPY ON MICROCIRCULATION IN PATIENTS WITH ARTERIAL HYPERTENSION AND DIABETES MELLITUS OF 2-ND TYPEThe effect of taking Prestarium and Arifon combination on microcicrulation state is studied in 45 patients with arterial hypertension of II degree and diabetes mellitus of 2-nd type. All patients during 12 weeks took Prestarium (4 ml) and Arifon (2,5 ml) combination in the morning on an empty stomach. Microcirculatory hemodynamics state was estimated on conjuctival biomicroscopy data before and after treatment. The microcirculatory hemodynamics parameters improved significantly under the effect of Prestarium and Arifon combination: perivascular edema, lipoidosis, sladge-syndrome decreased. Na+-Li+-COUNTERTRANSPORT, MICROCIRCULATION AND CONTENT OF MICROELEMENTS IN COMPLEX TREATMENT OF ISCHEMIC HEART DISEASE .The dynamics of indicators of cell membrane permeability, microelement concentration in blood serum and microcirculation while including laser therapy in complex treatment of stress stenocardia is studied. A total of 129 patients with ischemic heart disease are examined. Patients were divided into two groups: 95 patients recieved laser therapy along with traditional treatment and 34 patients received only traditional treatment. The positive effect of laser therapy in complex treatment of ischemic heart disease is established: more significant decrease of cell membrane permeability, reliable increase of iron and chromium content in blood serum, improvement of microcirculation. High degree of correlation with indicators of intracardiac hemodynamics, rheological properties of blood and pulmonary function tests was found. DIAGNOSIS AND TREATMENT OF VARICOSE DISEASE RELAPSESThe causes of postoperative relapses of the varicose disease are studied, and the ways of their surgical correction are determined. The ultrasound duplex scanning method with color doppler mapping of blood flow is used to study the venous system of lower limbs. A total of 334 persons were examined. The quantitative data of the rate of deep veins valve incompetence in healhy population and in patients with varicose disease are obtained. Particular attention is given to the valvar incompetence of deep veins as the cause of operative treatment of the varicose disease. The results of its operative correction are given. TREATMENT OF SYSTEMIC SCLEROSIS WITH XIMEDONEThe efficiency of the pyrimidine series drug - ximedone in design of double blind placebo-controlled study in 67 patients with systemic sclerosis is shown. The use of ximedone 0,5 three times per day during 5 weeks improves the state of 76% of patients with systemic sclerosis. It improves microhemocirculation, increases local temperature in 64% of patients, promotes healing of ulcerations of finger tips, decreases induration in 52% of patients, skin lesion area by 11,2%, decreases laboratory indices of pathologic process activity. ACTIVITY OF g-GLUTAMILTRANSPEPTIDASE AND 5'-NUCLEOTIDASE IN NEWBORNS WITH JAUNDICE SYNDROMEActivity of g-glutamiltranspeptidase and 5'-nuc- leotidase is studied in blood serum of 84 newborns. In 20 newborns enzymes are studied in umbilical blood serum, in 64 children aged 5 to 28 days - in peripheric blood serum. The lowest level of enzymes is found in umbilical blood serum and in children without jaundice in neonatal period. The development of conjugational jaundice in neonatal period can be predicted by activity of g-glutamiltranspeptidase in umbilical blood. AMBULATORY CHARACTERISTICS OF PATIENTS WITH SARCOIDOSISThe results of complex examination of 84 patients with sarcoidosis aged 20 to 72 are presented. It is established that functional disorders (obstruction of small bronchi and reduction of diffusion capacity of lungs) were found more often in II roentgenologic stage of sarcoidosis than in I stage. Functional and radiation parallels are more expressed in using roentgen computer tomography of high permission. Dyspnea symptom in patients with sarcoidosis of I-II stage was to a greater extent connected with reduction of expiration rate at the level 75% of the forced vital capacity of lungs than with limitation of diffusion capacity of lungs. The necessity of complex examination of patients with sarcoidosis in current diagnostic centers is concluded. LAPAROSCOPY IN URGENT ABDOMINAL SURGERYAs many as 385 case records of patients with abdominal cavity pathology admitted urgently are analyzed to improve the diagnostic tactics of acute surgical pathology of abdominal cavity organs using laparoscopy. The analysis of laparoscopic examination showed the high resolving capacity of 93,1-96,8%. depending on nature of the disease. COURSE OF BRONCHIAL ASTHMA IN WOMEN IN GESTATION PERIODEpidemiologic investigations among 1500 pregnants are performed, the course of pregnancy and labor outcome among 127 patients suffering from bronchial asthma are analyzed. Noncontrolled course of bronchial asthma was observed in 69 patients (1-st group), controlled course of asthma - in 58 patients (2-nd group). The comparative analysis was performed with 100 pregnants without extragenital pathology in the past (3-d group). The incidence of bronchial asthma was 4,5%. Mild bronchial asthma was observed in 67,7% of cases, moderate bronchial asthma in 24,3% of cases, severe bronchial asthma - in 8,1% of cases. The level of total IgE in the 2-nd group was the same as in normal pregnancy - 38,7+3,3 ME/ml, in the 1-st group in mild bronchial asthma it was 271+48 ME/ml, in moderate ly severe bronchial asthma it was 354+71 ME/ml. The constant clinical monitoring in all periods of pregnancy is quite necessary to achieve the effective asthma control in pregnancy for decreasing the risk of pathology of the mother and the fetus. It turned out that in controlled bronchial asthma and in adequate antiinflammatory treatment the level of IgE is decreased, the number of threatened abortions, cesarean section rate are significautly lower, the indices of newborns are higher. VAGINAL MICROBIOCENOSIS AND LOCAL IMMUNITY IN WOMEN USING NORPLANTThe possibilities of wide use of contraceptive implanted drug norplant on the basis of studying vaginal microbiocenosis and local immunity in women are studied. It is established that progesteron included in this drug causes the increase of phagocytosis indices and IgG and IgA level. Vagina microflora in women with implanted norplant is largely presented by corinebacteria, staphylococci, lactobacilli and more rarely by streptococci. Bacilliform and mixed flora with bacilli prevailed in the control group. Candida fungi were found in the control group and in the test group. The bacterial vaginosis signs were less often revealed in the group where norplant was used comparing with the control group. OPTIMIZATION OF CHILDREN NOURISHMENTThe structure, quality of actual nourishment and antioxidant status of children of preschool age in various regions of Russia are studied. Based on the obtained results, the hygienic optimization model of nourishment was developed, making it possible to resolve the nutrient provision ptoblem and to reduce the negative tendencies of some health indicators. HEALTH OF YOUTHS OF CALL-UP AGE IN TATARSTAN REPUBLICHealth of youths in Tatarstan Republic is studied. The special approach is required. The important role belongs to the organizers of public health services. The research has been performed in 1995-1999. The youths of 1981 year of birth were studied. The considerable aggravation of health of youths is noted. The respiration organ diseases occupy the first place. Traumas and poisonings occupy the second place. Youths are distributed on groups of health. The call-up resource is reduced twice. HEALTH STATE OF PUPILS ACCUSTOMED TO USING PSYCHOACTIVE AGENTSThe disease rate, functional state of different systems of the organism and psychologic functions in children and teenagers accustomed to using psychoactive agents are studied. The extremely fatal effect of psychoactive agents on their health state is shown. ECONOMIC ESTIMATION OF MEDICODEMOGRAPHIC SITUATION IN TATARSTAN REPUBLIC IN 1995-1999The true losses of Tatarstan Republic connected with health state of population able to work as well as by the causes not related with health loss are determined. When calculating economic expenses due to medicodemographic situation, it was established that nearly half of labour potential and the whole of internal regional product made in Tatarstan (in 1999 - 43,0%) is lost as a result of premature mortality, as well as due to tho causes not connected with health loss. Loss increase rate was 17,8% for 5 years. The necessity of urgent and comprehensive study of the problem and the creation of complex measures directed to decrease the labour potential losses of economically active population is stressed. MEASURES ON LOCALIZATION AND CONTROL OF CHOLERA OUTBREAK IN TATARSTAN REPUBLICThe cholera outbreak was recorded within 16 July to 5 August 2001 in Tatarstan Republic. As many as 52 persons proved to be sick and 18 persons - carriers. The cause of cholera focus was swimming in lake (reservoir) of Azino-1 microregion where sewage got as a result of the sewer-pipe damage. The epidemiologic analysis by age, social and professional signs as well as by ways of spreading of cholera pathogene shows their relation and causal conditionality. The complex of organizational, antiepidemic, treatment and prophylactic and sanitary and hygienic measures made it possible to localize and control the cholera outbreak. RABIES CONTROL IN TATARSTAN REPUBLICThe epizootologic and epidemiologic situation on rabies in Tatarstan Republic for last years is analyzed. The existing system of forced and partial vaccination results only in short-term inprovement in rabies control. The complex plans of antiepizootologic measures and rabies prevention program in Republic are developed. SONOGRAPHY OF VASCULARIZATION IN FRACTURE ZONE OF TUBULAR BONESThe principal scheme of examining patients with fractures of long tubular bones is developed. The observations were carried out to control the reparative process course in the primary osteogenesis zone of the injured bone immobilized by plaster: as well as after transbone osteosynthesis by Elizarov on the injured bone. Scanning in real time made it possible to obtain picture of all studied objects. Information on correctness of constituting osteal fragments on the whole bone parameter was obtained by examining the whole circle of the traumatized limb. The sonography makes it possible to study blood circulation in the bone fracture zone as well as to observe blood flow at the osteogenesis stages. © 1995-2008 Kazan State University |