Dynamics of thyroid cancer incidence in Russia following the Chernobyl accident.

This paper presents an analysis of thyroid cancer incidence in the territories of Russia most contaminated after the Chernobyl accident. In the work, data on incidence in the Bryansk, Kaluga, Orel and Tula regions (5298000 persons) are used. Altogether, 2599 cases of thyroid cancer are considered from 1982 to 1995. Of them, 143 cases were among the population who were children and adolescents at the time of the accident in 1986. The work uses the approach based on comparison of distributions of thyroid cancer cases by age at diagnosis and age at exposure. It has been shown that since 1991 the age structure of the incidence has changed significantly with a growing proportion of cases among children and adolescents. The change in the structure occurred due to the radiation factor, specifically as a result of exposure of thyroid to incorporated 131I. It has been shown that the standardised incidence ratio (SIR) of thyroid cancer among children who were 0-4 years at exposure in 1991-6 was 6 to 10 times higher than among adults. On the average, SIR for children and adolescents at the time of exposure is about three times higher than in adults.     

Eye Coordination and Vestibular Testing in Electroconvulsive Therapy

Nine depressive patients were examined before bilateral electroconvulsive therapy (ECT), immediately after ECT, and 2 days later with saccadic, pursuit tracking, and Hallpike caloric vestibular tests. Before ECT, all tests showed normal results. Immediately after ECT, the saccadic test displayed dysmetria of the fast eye movements in six of nine patients. The pursuit tracking test showed decreased gain of the slow eye movements with compensatory saccades in seven of nine patients. These findings were for both directions in the horizontal plane. In the caloric vestibular test, the changes were not significant. Two days after ECT, the eye coordination and vestibular testing showed normal function. We conclude that the eye coordination and vestibular function disturbances induced by ECT are transient.     

The formation and developmental outlook of medical rehabilitation in the Armed Forces of the Russian Federation

In medical service system of AF RF rehabilitation means combination of medical, military and professional, social and economic and pedagogical measures directed to recovery of health, fighting efficiency (ability to work) which were disturbed or lost by servicemen because of disease or trauma. In the article the main landmarks of rehabilitation development in Russian military medicine are pointed out, today's state of system on the whole and stages in particular is analyzed, perspectives of development are determined. The authors have noted considerable contribution made by Central Military Clinical Hospital N 6 to development of medical rehabilitation. Arsenal of modern rehabilitation and restorative measures is indicated. Methodological principles of rehabilitation conduction are shown. The main ways in further improvement of medical rehabilitation are development of its specialization, rise in economic and social efficiency of rehabilitation measures at the expense of significant unloading of hospital urgent beds and decrease in periods of patient return to military service who will be ready to perform their duties in whole volume. Introduction of modern methodological and organizational principles of medical rehabilitation into the practice of medical support of the Armed Forces' personnel will contribute to achievement of success in this area.     

Surgical correction of incomplete form of open atrioventricular canal in adults

Clinical and anatomo-hemodynamic features of adult patients with incomplete form of the open atrioventricular canal are presented, policy of surgical treatment and optimal degree of surgical intervention on mitral valve are determined. The study of variant anatomy of the defect, revealed two variants of left atrioventricular valve formation (with "functional" and with "anatomical" septal commissure). In the first anatomic variant the mitral insufficiency was hemodynamically important and required surgical correction. In the second variant, the mitral valve had good closure function, that permitted to avoid the routine suturing of anterior velum's splitting.     

Risk factors for the development of acute lung injury in patients with infectious pneumonia

ABSTRACT: INTRODUCTION: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia. METHODS: A retrospective cohort study of adult patients with microbiologically positive pneumonia, hospitalized at two Mayo Clinic Rochester hospitals between January 1, 2005, and December 31, 2007. In a subsequent nested case-control analysis, we evaluated the differences in prehospital and intrahospital exposures between patients with and without ALI/acute respiratory distress syndrome (ARDS) matched by specific pathogen, isolation site, gender, and closest age in a 1:1 manner. RESULTS: The study included 596 patients; 365 (61.2%) were men. The median age was 65 (IQR, 53 to 75) years. In total, 171 patients (28.7%) were diagnosed with ALI. The occurrence of ALI was less frequent in bacterial (n = 99 of 412, 24%) compared with viral (n = 19 of 55, 35%), fungal (n = 39 of 95, 41%), and mixed isolates pneumonias (n = 14 of 34, 41%; P = 0.002). After adjusting for baseline severity of illness and comorbidities, patients in whom ALI developed had a markedly increased risk of hospital death (ORadj 9.7; 95% CI, 6.0 to 15.9). In a nested case-control study, presence of shock (OR, 8.9; 95% CI, 2.8 to 45.9), inappropriate initial antimicrobial treatment (OR, 3.2; 95% CI, 1.3 to 8.5), and transfusions (OR, 4.8; 95% CI, 1.5 to 19.6) independently predicted ALI development. CONCLUSIONS: The development of ALI among patients hospitalized with infectious pneumonia varied among pulmonary pathogens and was associated with increased mortality. Inappropriate initial antimicrobial treatment and transfusion predict the development of ALI independent of pathogen.