[Peculiarities of ulcerous and erosive lesions of gastroduodenal zone in patients with arterial hypertension].

The aim of the research was to evaluate peculiarities of ulcerous and erosive lesions of gastroduodenal zone (UELGDZ) in patients with arterial hypertension (AH). The authors studied clinical and endoscopic parameters in 442 patients with UELGDZ and AH, and 160 patients without AH (control group). The feature of the AH group was more frequent HP-invasion, aggravation of ulcerous process, development of complicated and atypical forms of the disease. In the patients with AH the clinical manifestations of chronic erosive gastritis were more diverse and severe; unfavorable clinical course prevailed. Risk of cardiovascular complications varied from low to very high, correlating with the severety of AH and UELGDZ.

[Diagnosis of aspiration pneumonia complicated by acute purulent destruction in persons having risk factors].

OBJECTIVE: To analyze the causes of development of aspiration pneumonia (AP) complicated by acute purulent pulmonary destruction (APPD) and to optimize approaches to its diagnosis, by examining the clinical picture and features of its development in patients having risk factors. SUBJECTS AND METHODS: 431 patients with purulent pulmonary diseases, including 314 (72.8%) patients with abscessed pneumonia and 117 (27.2%) with lung abscesses. The aspiration mechanism of development of the diseases was established in 96 (22.3%) of the 431 patients. The patients' age ranged from 38 to 73 years. There were 87 males and 9 females. The episodes of massive aspiration of the contents of the stomach [45 (46.9%)], and oropharynx [15 (15.6%] and those of foreign body aspiration [36 (37.5%)] were analyzed. RESULTS: The aspiration mechanism of development of the diseases was established in 96 (22%) of the 431 patients with APPD, which accounted for 22.3%. Alcoholic disease was the underlying background disease in most (89.85%) patients, which permits alcoholism to be considered to be one of the major risk factors of the aspiration syndrome. Aspiration with the gastric food contents from the oral cavity was predominant, which makes it possible to consider dysphagia to be one of the most potent predictors of AP. Foreign body aspiration was established in 36 patients, among them 17 patients were found to have aspiration of fragments of teeth, dental fillings, and dentures. The aspiration mechanism of the disease was supported by history data, as established a documented episode of aspiration, by clinical, X-ray (esophageal and gastric roentgenoscopy and roentgenography) and endoscopic (fibrobronchoscopy, esophagogastroscopy) findings, as well as by the conclusions of an ENT specialist, a dentist, a neurologist, a narcological psychiatrist. The algorithm of the pathogenesis of AP and purulent lung diseases was proposed. CONCLUSION: Chronic alcoholism associated with peptic ulcer, chronic gastritis, and hepatic lesion (hepatitis/cirrhosis) is the most important predictor of AP and APPD. Complex clinical and X-ray examination including fibrobronchoscopy, esophagogastroscopy, 24-hour gastric juice pH-metry, and consultations of particular specialists are indicated to support the fact of aspiration.

[The characteristics of the social psychological status of patients with chronic ischemic heart disease]. / Osobennosti sotsial'no-psikhologicheskogo statusa bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa.

The multifactorial rating scale, interpersonal relation test and methods for examining lifestyle were used to study the psychosocial status of 168 patients with chronic coronary heart disease. As compared with normal psychoemotional persons, the patients with these disorders were found to show a significantly higher degree of their dissatisfaction with occupational and financial status, working conditions, extra-familiar relations. With progressive neurotic disorders, their dissatisfaction with relations at home and work significantly increased and their work motivation decreased. Moreover, psychoemotional disorders were accompanied by higher conflicts with all those present and lower lifestyle.

[Possibilities of correction of mental disorders and dyslipoproteinemia in patients with neurocirculatory asthenia]. / Vozmozhnosti korrektsii narushenii psikhiki i dislipoproteinemii u bol'nykh neirotsirkuliatornoi distoniei.

A total of 230 patients with neurocirculatory dystonia (NCD) were investigated. Different mental disorders associated with the atherogenic nature of dyslipoproteinemia were revealed in the majority of patients using the clinical scale and MMPI test. Psychotropic agents used for a period of 2-4 mos improved the mental status of these patients, increased exercise tolerance, and decreased blood levels of free fatty acids (FFA). A course of exercise training (graded walking) for 4-6 mos. helped to enhance exercise tolerance, to lower the blood levels of cholesterol, triglycerides, FFA, the total fraction of low- and very low-density lipoproteins, to reduce manifestations of hypochondriasis, depression, and neurasthenia . The results obtained can be used for developing programs of NCD patients' rehabilitation.

[Post-puncture headache and patients' personality characteristics]. / Postpunktsionnaia golovnaia bol' i lichnostnye osobennosti bol'nykh.

Diagnostic lumbar punctures were performed in 60 patients suffering from different organic diseases of the central and peripheral nervous systems. Out of 60 persons, 30 developed postpuncture headache. Comparison of the personality traits in patients with and without postpuncture headache, made according to the MMPI technique, has shown significant differences in scales 1, 3 and 7 of the MMPI profile (scales of hypochondria, hysteria and psychasthenia). A conclusion is drawn that the patients' personality traits are of undoubtful importance in the pathogenesis of postpuncture headache. This circumstance should be taken into consideration in carrying out proper psychological and medicamentous preparation of the patients before lumbar punctures.

[Blood lipid levels in patients with neurocirculatory asthenia of the cardiac type]. / Soderzhanie lipidov krovi u bo'lnykh neirotsirkuliatornoi distoniei kardia'lnogo tipa.

A larger proportion of patients with neurocirculatory dystonia of the cardiac type was found to show atherogenic disturbances of lipid metabolism, the most changes being observed in subjects with the moderate and severe cardiac pain symptom, decreased exercise tolerance, mental disorders and being associated with the traits of a personality. Hypercholesterolemia and hypertriglyceridemia were present in about half of the patients. As for blood lipids, free fatty acids showed higher concentrations to the greatest extent.

[The clinical and psychological aspects of permanent and temporary loss of work capacity in patients with postinfarct cardiosclerosis]. / Klinicheskie i psikhologicheskie aspekty stoiki i vremennoi utraty trudosposobnosti bol'nykh postinfarktnym kardiosklerozom.

Stable and temporary disability was studied in 333 patients after myocardial infarction. Peculiarities of a clinical course of the postinfarction period, physical exercise tolerance and psychoemotional factors were shown to influence disability indices. A painful course of postinfarction cardiosclerosis, particularly anginal pains combined with cardialgia, low working capacity indices and psychic changes were the main causes of stable and temporary disability.

[Characterologic personality traits, premorbid and current mental status of patients with ischemic heart disease]. / Kharakterologicheskie osobennosti lichnosti, premorbidnoe i aktual'noe sostoianie psikhiki u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Personality characteristics, and premorbid and actual mental states were studied in 130 male coronary patients suffering from anginal attacks. Psychasthenic, stenotic and rigid personalities prevailed in the examined sample. At the same time, 69.6% of patients showed unbalanced personality manifested in character accentuation (58.2%) and psychopathy (11.4%). Mental changes (neurotic reactions and neuroses) were first recorded well in advance of coronary symptoms in 72.4% of the patients. They were usually found in unbalanced personalities and grew worse after the onset of first signs of coronary insufficiency.