[Outpatient care of young invalids with locomotor defects]. / Opyt dispanserizatsii invalidov molodogo vozrasta s narusheniiami oporno-dvigatel'nogo apparata.

AIM: The study of somatic health in patients with locomotor defects (infantile cerebral paralysis, meningoencephalocele, myodystrophy) to reveal abnormalities in function of the principal systems and organs of these patients. MATERIALS AND METHODS: The examination covered 93 students of Moscow institute for invalids suffering from locomotor defects (mean age 18.2 +/- 0.1 years). Clinical, laboratory, instrumental tests, ultrasound investigation of the viscera and heart, gynecological functional tests were made. RESULTS: Defects were found almost in all the essential systems of the body in the majority of the invalids. The changes revealed were both functional and organic. Relevant correction was needed. Affection of the somatic organs impaired adaptation, resulted in still worse conditions for learning. Attendant somatic diseases aggravated the underlying disease. CONCLUSION: Visceral affections in patients with locomotor defects aggravate the underlying disease and provoke more severe disability. Poor rehabilitation results lead to defective social adaptation. The authors propose introduction of special therapeutic programs for primary and secondary prophylaxis of somatic lesions in invalids with locomotor affections. Further study of somatic status of invalids is thought valid.

[Detection of risk factors for hemodynamic dysadaptation under physical loading based on data from genetic studies (Part 1)]. / Vyiavleniie faktorov riska gemodinamicheskoi dezadaptatsii pri fizicheskoi nagruzke po dannym geneticheskikh issledovanii (soobshchenie 1).

Twenty-eight pairs of unisexual healthy twins were examined during exercise, on anapriline or their combination. The twin technique of calculating the additive component of blood pressure and catecholamine levels was used in each of the terms of the examination. beta-adrenoceptor blockade was found to be a highly potent environmental factor under whose influence both resting and exercise blood pressures were not provided by inheritable regulatory mechanisms. The latter resulted in tense synthetic function of the sympathoadrenal system and in disadaptation of the cardiovascular system when anapriline and exercise were used, which might serve an individual prognostic criterion of exercise tolerance.

[Detection of risk factors for hemodynamic dysadaptation under physical loading by data of genetic studies (echocardiography data) (Part 2)]. / Vyiavlenie faktorov riska gemodinamicheskoi dezadaptatsii pri fizicheskoi nagruzke po dannym geneticheskikh issledovanii (dannye ékhokardiografii) (soobshchenie 2).

Examination in 28 pairs of twins who were studied by echocardiography just after their performance of exercise (Stage I) and at the peak of effects produced by oral anapriline (Stage II) have shown that at rest such parameters as end-systolic volume, ejection fraction, relative changes in the internal dimension of the left ventricular cavity during a cardiac cycle, show moderate-to-high genetic predisposition. At the same time, a persistent contribution of heredity to myocardial contractility is found only for end-systolic volume when the conditions of the examination were changed. The lesser extent to which contractility parameters had hereditable signs, the more intensively they varied under different conditions. It is assumed that the contraction rate of circulatory myocardial fibers is less resistant to environmental factors. A significant decrease in this parameter during anapriline administration allows one to suppose that cardiac decompensation in patients with coronary heart disease starts with damages to the very myocardial circulatory muscles.

[Detection of risk factors for hemodynamic dysadaptation under physical loading by data of genetic studies (the beta-adrenoreceptor blockade test) (Part 3)]. / Vyiavlenie faktorov riska gemodinamicheskoi disadaptatsii pri fizicheskoi nagruzke po dannym geneticheskikh issledovanii (proba s blokadoi beta-adrenoretseptorov) (soobshchenie 3).

Examinations in 28 pairs of twins who were studied by bicycle ergometry during a "pure" graded exercise and an exercise during oral administration of anapriline have shown that the functional features of the heart make some contribution to cardiovascular implementation of the "pure" graded exercise. When given exercise and anapriline, energy processes play a role in its implementation. It is suggested that exercise + anapriline will cause substantial metabolic changes which can be essential in cardiac decompensation if exercise is not limited in the use of beta-blockers.

[The effect of anaprilin on the reaction of the sympathetic-adrenal system to graded physical loading in healthy subjects and patients with ischemic heart disease]. / Vliianie anaprilina na reaktsiiu simpatiko-adrenalovoi sistemy pri dozirovannoi fizicheskoi nagruzke u zdorovoykh liudei i bol'nykh ishemicheskoi bolezn'iu serdtsa.

The specific features of responses of the sympathoadrenal system during its activation by graded exercise (E), including that along with anaprilin induced blockade of beta-adrenoceptors, were determined from the urinary excretion of norepinephrine, epinephrine, dopamine, and dioxyphenylalanine in 54 healthy males and 22 patients with postinfarction cardiosclerosis concurrent with Functional Class I-II angina pectoris on effort. E caused hyperreactivity of the sympathoadrenal system, as appeared as significantly greater increases in the levels of catecholamines and their precursors in the patients than in the healthy persons. A single anaprilin dose of 40 mg abolished the responsiveness to exercise and improved its tolerance. The revealed features of sympathoadrenal responsiveness to exercise with and without anaprilin suggest that the patients with coronary heart disease have sympathoadrenal dysfunction, which shows one of the possible mechanisms responsible for the cardioprotective effect of beta-adrenoblockers in this disease.