[The concept of informatics applied to Soviet public health]. / O kontseptsii informatizatsii otechestvennogo zdravooxhraneniia.

Development of integrated medical information systems (IMIS) was proposed as a main direction of health care informatization in this country. The IMIS are meant to function both on the out- and in-patient basis covering a region (city) with a population amounting to two hundred thousand. They are aimed primarily at providing information supply continuity for the prevention, diagnosis, and the treatment of diseases, and at establishing intercommunications between institutions, departments, physicians, and specialists. The IMIS may serve a data base to give objective information to higher administrative levels, and a basis for creating autonomous information systems intended to automate the work of a separate establishment (department, or physician). The IMIS may also be used to develop medical educational systems (teaching systems, biomedical data banks and data base for medical workers, reference-information service for the population), medical expert systems, and systems of scientific work provision. Expenses on the development and establishment of IMIS are estimated, and possible social sequelae of health care informatization are assessed.

[Use of automated information systems for improving and accelerating communication between hospital units]. / Ispo'lzovanie informatsionnykh sistem dlia uluchsheniia i uskoreniia vzaimodeistviia podrazdeleniia statsionara.

The article tackles the problems of interaction between the units of multidisciplinary hospitals and the feasibility of its improvement by means of introduction of a modern automated information system (AHIS). In the AHIS structure highlighted are the systems of order input and data communications ensuring more rapid interrelation of clinical departments with a pharmacy, laboratory, nutrition and other auxiliary services. The experience gained in the application of the system of order input in the central clinical hospital and abroad has been analyzed along with the role of organizational activities during the introduction of such systems. Additional functions of the order input system are pointed out. They assist not only in intensifying the curative and diagnostic process but also in raising its quality.

[Increasing effectiveness of the use of laboratory data in the therapeutic-diagnostic process through automatization]. / Povyshenie éffektivnosti ispol'zovaniia laboratornykh dannykh v lechebno-diagnosticheskom protsesse s pomoshch'iu avtomatizatsii.

Introduction of the complex computer-aided mechanization and automatization into the laboratory process and their integration with other automated information hospital systems significantly raise efficacy of laboratory data application in treatment and diagnosis, thus reducing work losses of the medical staff. The structure of biochemical research for clinical therapeutic and surgical departments is presented along with the main biochemical diagnostic programmes for some diseases.

[Use of automation potential in intensive care units of a multi-profile hospital]. / Ispol'zovanie vozmozhnostei avtomatizatsii v otdeleniiakh intensivnogo lecheniia mnogoprofil'nogo statsionara.

An example of an automated information system of a large general hospital has shown that using a sufficiently informative clinical data base (with a minimal set of parameters) on patients in intensive care departments, it is possible to provide information inquiries of diagnostic units and hospital administration without distracting staff-members on duty to report on the patients' state. The use of an automated bed turnover management system made it possible to reduce the time of patients' admission to hospital, to improve the planning of hospitalization and hospital transfers, to raise the efficacy of bed turnover, and to reduce unproductive labor of the hospital staff.

[Determination of the size of a myocardial infarct by the technic of single-photon emission computer tomography]. / Opredelenie razmerov infarkta miokarda metodom odnofotonnoi émissionnoi komp'iuternoi tomografii.

A study of 38 patients with acute myocardial infarction verified by clinical, laboratory and electrocardiographic data made use of single-photon emission computered tomography, a new radiodiagnostic method for the assessment of the extent of myocardial lesion. Its findings were compared with cardiospecific enzyme activity data and showed good correlation. The new technique was found to be more informative as compared to plane scintigraphy. Possibilities of single-photon emission computered tomography are discussed with reference to the diagnosis of acute infarction at different sites and showing different radionuclide inclusion patterns.

[Diagnosis of infectious endocarditis and the assessment of the effectiveness of its treatment]. / Diagnostika infektsionmogo éndokardita i otsenka éffektivnosti ego lecheniia.

The results of investigation and treatment of 58 patients with infectious endocarditis are presented. Changed clinical pattern of the disease, its increasing incidence among older people and the emergence of its "immunologic" variety with signs of myocarditis, vasculitis and, less commonly, glomerulonephritis have been noted over recent years. The disease has become polyetiologic. Methods of treatment for infectious endocarditis are discussed with reference to the etiology and clinical pattern of the disease. Indications for surgical treatment are outlined.

[Single-photon emission computed tomography with 201Tl in the diagnosis of ischemic heart disease]. / Odnoprotonnaia émissionnaia komp'iuternaia tomografiia s 201Tl v diagnostike ishemicheskoi bolezni serdtsa.

One hundred and thirty-six patients with CHD were examined by plane scintigraphy and single-photon emission computer-aided tomography (SPECT). The control group comprised 26 healthy persons. Two SPECT techniques were compared (gamma-chamber rotation at 360 and 180 degrees). In acute myocardial infarction, focal defects of perfusion were detected by SPECT in 36 out of 39 patients, those by plane scintigraphy in 30 patients. In angina pectoris patients, perfusion alterations were detected by SPECT and scintigraphy in 91.6 and 75% of cases, respectively. During tomographic examination of patients with postinfarction cardiosclerosis, the perfusion defects were revealed in 38 out of 42 patients, whereas during plane scintigraphy, such alterations were detected but in 31 patients. The advantages of SPECT and its high importance for diagnosing different patterns of CHD are discussed. It is recommended that SPECT and plane scintigraphy can be used combined in clinical practice.

[Information value of computed tomography in diagnosing pericardial diseases]. / Informativnost' komp'iuternoi tomografii v diagnostike zabolevanii perikarda.

The authors present the results of examination of 38 patients with various diseases of the pericardium using the CT method. It possesses a high sensitivity and permits one to reveal pericardial effusions as well as tumor lesions of the pericardium. CT has a high resolving power and provides for visualization of of the unchanges pericardium and adjoining structures. It also allows for densitometric measurements of pericardial effusion. The results obtained make it possible to attribute this method to one of the most informative in the diagnosis of pericardial diseases.

[Stage-by-stage rehabilitation of patients with myocardial infarct]. / Primenenie poetapnoi reabilitatsii u bol'nykh infarktom miokarda

Continuous stage-wise rehabilitation was used in 102 patients who survived acute macrofocal myocardial infarction that was of a transmural type in nearly 60% of them. While hospitalized in a clinic, the patients underwent a 5-week physical activization course. Depending on the severity of the lesion the average duration of their hospitalization ranged from 34.2 to 43.1 days. Seventy patients (68.8%) were referred to the local cardiological sanatorium directly from the hospital. Subsequently all these patients were followed-up (up to 2 1/2 years) and treated on an out-patient basis in the cardiological service of the clinic. Among 88 patients who had worked before infarction, 72 persons (81.8%) returned to their professional activities after 4.9 months, on the average, following the development of myocardial infarction. Professional rehabilitation proved more effective in those who had received the sanatorium treatment after hospital, 87.1% of them returning to their jobs, and nearly 1 month sooner than those who had had no sanatorium treatment. Among the main clinical and instrumental methods of control of the state of myocardial infarction cases during the rehabilitation period the test with portioned physical exercises was also used. The examinations were repeated in 80 patients, in 50 of them -- on the 30th--35th day of the disease. The obtained data indicate that the threshold tolerance of the patients increases due to the stage-wise rehabilitation measures.

[Physical exertion tests in patients with acute myocardial infarct at the hospital stage of rehabilitation]. / Proby s fizicheskoi nagruzkoi u bol'nykh ostrym infarktom miokarda na gospital'nom etape reabilitatsii

The aim of the work is to clarify the part of physical exertion tests applied to patients early after myocardial infarction, i.e. on the 30--35th day of the affection and also to appraise the reserves of the coronary circulation with a definite threshold tolerance to physical efforts. Tests with a graded physical loading were set up in 50 patients with acute macrofocal (including 34 transmural) myocardial infarction at the time of completion of the intrahospital rehabilitation program that included the regimen of an early activation. A continually-rising type of loading with an initial rating of 150 kgm/min was used. At the instant of effort the ECG was being registered in 4 chest leads. The threshold load-rating was found to average 315 kgm/min and the sum-total of the work performed equaled 2190 kgm. Tests with graded physical loading are of great importance for elaboration of concrete recommendations for rehabilitation and prophylactic measures in patients with acute myocardial infarction.