Life quality in patients after endoscopic microdiskectomy for intervertebral hernia of the lumbar spine

A group of 38 patients with hernia of the lumbar intravertebral disks who had undergone endoscopic microdiskectomy by DESTANDO was evaluated for life quality and compared with the control group (the patients had been operated on by the routine procedure and healthy individuals). The incidence of the postdiskectomic syndrome was studied in the compared groups of patients. It was shown that life quality in patients with lumbar pains could be evaluated, by using the general health status questionnaire and the specific lumbar pain questionnaire MiGAN. The life quality during the follow-up was considerably higher than that after endoscopic microdiskectomy, in males in particular. The use of endoscopic microdiskectomy reduced the incidence of the postdiskectomic syndrome by more than twice.     

Diagnostic value of the RR-variability indicators for mild hypertension

Experimental and clinical studies have shown that an imbalance of the cardiovascular system autonomous regulation can lead to complications. In this study we have aimed to investigate whether the vegetative control of patients with mild hypertension is disturbed and to evaluate the power of the RR-variability indicators to detect the disturbances. RR variability has been studied in two groups of individuals: normotensive and mildly hypertensive. The indicators of the heart rate variability (HRV) from the 'Cardiovit CS-100 ECG Module' electrocardiograph have been used. The HRV is known to exhibit circadian variations, therefore RR intervals were recorded in two separate sessions: morning (8-9 am) and afternoon (2-3 pm). Each session included three tests: in a resting state, with a handgrip test and with the Valsalva manoeuvre. The multivariate statistical method was applied separately to the morning and afternoon data. A number of classification algorithms were synthesized, yielding correct recognition of normotensive and mildly hypertensive subjects of 91.9% and 94.2% for the morning and afternoon sessions, respectively. We have thoroughly discussed the substantiating reasons for the high statistical significance and reliability of the discrimination obtained. The high sensitivity and specificity of the RR-variability indicators included in the classification models suggest correlative changes of the nervous system vegetative balance in mildly hypertensive patients. The results of the study show the possibility for statistically significant diagnosis of mild hypertension, for prediction of ventricular arrhythmia, left ventricular hypertrophy and ischaemic heart disease.     

Paratesticular rhabdomyosarcoma

Paratesticular rabdomyosarcoma (PR), the most frequently occurring paratesticular tumor, is encountered mostly in young and middle-aged men. PR metastasizes early and is characterized by lymphogenic dissemination of the tumor with affection of the retroperitoneal lymph nodes. Orchofuniculectomy is the first-line treatment in all the patients. If the patient is metastases-free it is followed by preventive retroperitoneal lymphadenectomy with subsequent adjuvant chemoradiotherapy. In disseminated PR, combined treatment is indicated including surgical removal of metastatic foci and adjuvant chemo- or chemoradiotherapy. If surgical removal of all the tumor foci is infeasible, patients with disseminated PR undergo chemotherapy. Radiation of metastatic retroperitoneal lymph nodes is uneffective. Prognosis of PR depends on the age, stage of the disease and treatment.     

Time-related heart autonomic balance characteristics in healthy subjects

Changes of the heart autonomic balance between morning (8-9 h) and afternoon (14-15 h) measurements were studied in 22 healthy subjects. The selection of these two daytime periods was substantiated by the established higher risk of cardiovascular incidents in the morning and the relative balance of the vegetative nervous system in the afternoon hours. The changes were analysed by RR-variability indices from ECG recordings in the resting state and with vegetative nervous system stimulation by the handgrip test and Valsalva manoeuvre. It was shown that there were no significant differences between the morning and afternoon values of the respective indices, between morning and afternoon handgrip tests and between morning and afternoon Valsalva manoeuvres. However, there were significant differences in comparison of the index values between resting state and handgrip test and resting state and Valsalva manoeuvre, both from morning and afternoon measurements. Moreover, the significantly differing indices were clustered in different groupings, when comparing resting state recordings with morning and afternoon stimulation tests. For this reason, the authors introduced an indicator for time-related autonomic balance changes. The indicator evaluates the power of each RR-variability index to respond to changes in the autonomic control, in comparisons between resting state and stimulation data in the morning and afternoon measurements. These evaluations showed low power of the frequency-domain indices to respond to time-related autonomic balance changes in stimulation, with respect to the resting state. The time-domain indices have considerably higher power to react to relative morning and afternoon changes in the two vegetative nervous system components. Based on the estimations of the RR-variability indices obtained by the introduced indicator, a profile was constructed to represent time-related heart autonomic balance changes in healthy subjects. It was established that in spite of the relative stability of the vegetative nervous system in healthy subjects, hypersympatheticotonia and relatively lower parasympathetic tone were present in the risky morning hours.     

The statistics on malignant neoplasms of the urinary and male genital organs in 1987 in the USSR

The USSR statistics on malignant neoplastic diseases of the urinary system and male sexual organs which comprised 5.7 per cent in the total mortality was presented for the first time. More than a 50 per cent increment in the death rate from these tumors was documented between 1975 and 1987. Annually, prostatic carcinoma is diagnosed in almost 10 thousand patients and cancer of the urinary bladder in 15 thousand patients. Maximal prevalence of the disease has been recorded in the Baltic republics, the Ukraine and Byelorussia. The detection rate of the aforementioned diseases, Stages I-II, is about 40 per cent. The estimate revealed that the total number of the registered oncological patients was 100 thousand persons. The problems in organization of the oncological care system, material and technical supplies and professional training should be considered.