2008, volume 4

The article is devoted to some aspects of influence of digestive apparatus diseases (chronic gastritis, a stomach ulcer, chronic cholecystitis) on clinical course ofischemic heart disease. It is revealed, thatthe patients with clinical symptomatology are typically to have extra cardiac hue of painful heart attacks. The patients with influence ofischemic heartdisease and digestive apparatus disorders have sympathetic overbalance of the vegetative one against the background of the parasympathotonia.

The team of the first medico sanitary aid for population has examined the patients with ‘cardiac pain' (heavy heart) in the district of general practitioner. The physical diagnosis, parameters of psychological and social status were determined. The authors developed clinical recommendations to organization of diagnostics and interference.

The immobilization of broken fragments by two-jaw anchor splints in patients with the mandibular fractures in a combination with inflammatory diseases ofperiodontium usually causes the exacerbation and progression of the diseases and growing progressively worsening ofperiodontium status. The intensity of these conditions depends on an initial status ofperiodontal tissue. The posttraumatic suppurative inflammatory complications of the mandibular fractures frequency depending on the initial stage of periodontal disease are marked.

Smolensk State Medical Academy1 Saratov State Medical Univercity2
As the result of carried out investigation itwas revealed by the authors thatthe method oftreatment ofexacerbations of destructive form of chronic periodontitis based on active medicinal therapy with the use of combination of "Mepacyl” (Pierre Rolland) and “Nise"(nimesulide) allows to control inflammatory signs quickly and to reduce the number of visits to the dentist.

The authors of this article discuss advantages of conservative treatment’s complex of patients with serious malleolar fractures. Improvement oftreatment quality and reduction of labor disability period by means ofworked out new complex approach are revealed. All this is confirmed by tests of evident medicine using mathematical analysis and modelling.

The scientific research deals with the analysis of direct results of urgent operations of 81 patients with combined complications of ulcerous disease of stomach and duodenum. On the base of this research work it is possible to define the criteria which letto choose the optimal way of the operation in case of acute combined complications.

The investigation is dedicated to surgical treatment of patients with peritoneal process of abdominal cavity. Authors elaborated the complex clinical classification of peritoneal process and its clinical manifestations in the form of peritoneal commissures, taking into account principal demands of practical surgery, as well as therapeutic-diagnostic algorithm of surgeon’s actions in the abdominal commissures. According to clinical cases it was demonstrated that laparoscopic adhesiolysis as compared with the traditional open method allows to reduce complications considerably and to avoid the development of lethal outcomes.

The results of prophylaxis of acute impairment of a cerebral circulation with the help of carotid endarterectomy (CEAE) are considered. There are examined 324 patients with cerebrovascular pathology 132 of them have transferred CEAEand 156 received only conservative therapy. The results of Wyears observation of operated and non operated patients show, that in patients, who were operated, in mostcases the marked signs of impairment of cerebral circulation in ipsilateral hemisphere were not developed. The results of observation over group of patients who were not operated coincide with the average data according to which the patients who have suffered an ischemic insult, have the riskof development of the subsequent insult at a level of 5-9% in a year, and approximately 25-45% of them have a repeated insult during 5 years period after the first insult. The best clinical effect had CEAE, performed in patients with transitional ischemic attacks. CEAE is the main preventive measure in treatment of patients with an atherosclerotic stenosis of carotids. The analysis of the results of the research testifies to the stable and long-term effect of operation.

The questions of diagnostics and classification of cognitive disturbances in 112 patients with hypertensive encephalopathy are considered. The diagnosis of cognitive frustration was based on results of expanded neuropsychological examination with a qualitative and quantitative estimation of the received results. 56 % of the examined patients had the moderate cognitive disturbance syndrome. Neurodinamical-disregulation and primary-dismnestical types have been revealed. Taking into account, that opportunities of treatment and rehabilitation of patients with dementia noware rather limited, the study of predementical forms of cognitive disturbances when therapeutic actions are considered to be the most effective and of great importance.

Aim: to study dynamics of the 0,1Hz-componentofthe heart rate variability(HRV) spectrum in patients with arterial hypertension taking fosinopril and atenolol. 49 patients with hypertension were enrolled (age - 46+/-7 years). Fosinopril and atenolol were administered consequently. The power of 0,1 Hz-component of the HRV spectrum was assessed during a passive orthostatic test. Results: In patients taking fosinopril and atenolol comparable decrease of blood pressure was observed. Atenolol caused reliable decrease of a heart rate during orthostatic test. The power dynamics of 0,1Hz-componentwas comparable in patients taking fosinopril and atenolol. Conclusion: fosinopril and atenolol influenced similar on 0,1-Hz mechanisms of vegetative heart control system.