Atrial fibrillation: choice of the method of pharmacological cardioversion

The paper considers circumstances under which it is expedient or not expedient to perform cardioversion in patients with paroxysmal or persistent atrial fibrillation. It contains discussion of benefits, limitations and drawbacks of electrical and pharmacological methods of cardioversion. American College of Cardiology/American Heart Association/European Society of Cardiology Guidelines for the Management of Patients With Atrial Fibrillation are presented. These guidelines suggest amiodarone, dofetilide, ibutilide, propafenone, flecainide, and quinidine as first line therapy because of their proven efficacy. Efficacy of intravenous disopyramide and procainamide in some patients with recent onset atrial fibrillation is recognized with certain reservations. The use of azimilide and dronedarone is considered promising. In Russia nibentan and ethacizine can be also used. Special emphasis is made on the possibility of wide use (including self-administration) of loading doses of oral propafenone for cardioversion in some categories of patients with atrial fibrillation of recent onset.     

Criteria of functional operability and indications for intraoperative volumetric monitoring of patients during extensive surgical procedures on the lung

The investigation included 32 patients after extensive operative interventions on the lungs: pneumonectomy with circular resection of the trachea bifurcation and different kinds of combined pneumonectomies. Methods of Doppler echocardiography and thermal dilution were used for studying the parameters of lesser circulation before, during and after operation. Patients with the initially impaired hemodynamics had more pronounced functional changes after surgical procedures. The shift limits of the main ultrasonic indices of the right ventricle function were determined in order to form a group of the higher prognostic risk.     

Histological validation of diagnoses of thyroid cancer among adults in the registries of Belarus and the Ukraine

In order to evaluate the diagnostic reliability of the thyroid cancers listed in adult registries from the Ukraine and Belarus, a histological review was organised of 327 randomly selected thyroid carcinoma cases diagnosed between 1980 and 1999. A final diagnosis was reached at a 5-day consensus conference by six pathologists who met around a multiheaded microscope. The study concluded with a comparison between the final diagnosis and the initial diagnosis. The pathologists agreed with the initial diagnosis of malignancy in 286 cases (88%). A final diagnosis of papillary, follicular or medullary thyroid carcinoma was reached in 86, 4, and 6% of the cases respectively. In 2.8% of the cases reviewed, diagnostic discrepancies persisted. The percentage of agreement between the final diagnosis and the initial diagnosis was 93%, with a weighted kappa-statistic of 0.61 (confidence interval 95% (CI(95%)): [0.45-0.77]). In all, 89% of the 286 confirmed cancer cases were in agreement for the type of cancer, with a kappa-statistic of 0.56 (CI(95%): [0.43-0.69]). The level of agreement differed according to cancer categories, with concordance rates of 94, 40 and 33% for papillary, follicular and medullary thyroid carcinomas respectively. The low prevalence of follicular thyroid carcinomas in the adult population studied calls for further exploration. The discrepancies and classification difficulties encountered were analysed.     

Psychosocial dysadaptation in students with chronic somatic diseases

To reveal the specific features of psychosocial adaptation in students having chronic somatic diseases, 114 students from the humanitarian faculties of the Pomor State University of Arkhangelsk were examined. Among them, 65.79% of the students had chronic somatic diseases, 34.21% had no diseases or complaints. The examination was made at the session interval. The students with chronic somatic diseases had a more significant psychosocial dysadaptation, which is indicative of higher depression and anxiety, timidity, reticence, lower activity, understated self-assessment, lower self-esteem, noticeable discord of personal relations. The paper shows it necessary to follow up emotional features of health within the framework of the regional programme "Students' Health" that includes the development of therapeutical, rehabilitative, and preventive measures.     

Glutamic acid in treatment of alcohol intoxication aggravated by ecologically unfavorable factors

Alcohol intoxication aggravated by exposure to ecologically unfavorable factors (methanol and furfural vapors) induced pronounced desynchronization of hematologic processes, dramatic disturbance of carbohydrate metabolism, and considerable structural changes in internal organs. Treatment with glutamic acid reduced pathological manifestations and increased the adaptive capacities of the organism. Functional and morphological changes observed in laboratory animals after treatment with the neurometabolic compound glutamic acid could be classified as reversible. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 129, No. 3, pp. 321–325, March, 2000     

Isolation of human serum lipoproteins using a sedimentation method and the determination of their lipid composition]

A method for separation of human blood serum lipoproteins into 3 fractions (low- and high-density lipoproteins, subfractions 2 and 3) is described in detail. The method may be used to rapidly obtain information on the status of lipid metabolism in humans and animals. The results of lipid composition analysis of individual lipoprotein fractions are presented. These data were obtained in a series of experiments and EC-1052 computer-processed with the use of a COM applied program pack. Basing on the results of investigation of individual fractions' lipid composition, the authors make a conclusion on the characteristic features of each fraction, which in future may be helpful in the diagnosis of pathologic process and in detection of lipid metabolism disorders in the body.     

Means of improving the diagnosis of cancer of the large intestine

Problems of perfecting diagnosis of colorectal cancers are discussed with a view to identification of follow-up groups and improvement in methods for X-ray examination and subsequent diagnostic procedures. Double-contrast enema examination should be preferred in those at high risk for cancer of the large bowel. Follow-up groups were identified on the basis of risk factors. Patients' preparation for double-contrast enema including saline and contact purgatives, residue-free diet and hydration is described. The composition of a high-contrast barium suspension is given. The method of primary double-contrast enema, the required projections and other roentgenologic technicalities, which ensure the diagnostic value of the procedure are discussed. Complex syndrome-based roentgeno-endoscopic examination programs are suggested.