[Peculiarities of diagnosis and treatment for diabetic feet]. / Osobennosti diagnostiki i lecheniia diabeticheskikh porazhenii stop.

Multifactorial pathogenesis of the "diabetic foot" syndrome suggests advisability to single out some clinical pathogenetic forms, depending on basic causes of the lesions: due to neuropathy, osteoarthropathy, neuro-ischemic factors. The authors has developed the algorithm which enables to diagnose various forms of the syndrome and differentiate the treatment. The most important treatment modalities include unloading and podiatric measures as well as surgery, systemic antibacterial and glucolytic therapy. Conservative or surgical antiischemic measures are indicated only in demonstration of the degree of the ischemic damage in the lower extremities by Doppler ultrasonography and measurement of local oxygenation of the skin. The combined differentiated treatment in 142 patients with diabetic lesions of the feet has resulted 97.2% favourable outcomes in neuropathy and 86.5% successful outcomes in neuroischemic damages. Local oxygenation of dorsal skin of the foot (< 20 mm Hg) indicates that amputation above the ankle is highly probable.

[Anesthesia in surgical treatment of pyo-necrotic forms of diabetic foot]. / Obezbolivanie pri khirurgicheskom lechenii gnoino-nekroticheskikh form "diabeticheski stopy".

Examinations of 48 patients with the syndrome of "diabetic foot" (IV-V degree according to Wagner classification), have shown advantages of prolonged epidural anesthesia (EA) carried out during pre-, intra-, and postoperative (6-7 days) period. This method has relieved pain during postoperative period with minimal impact on carbohydrate metabolism and central hemodynamics. Moreover prolonged EA is a basic prophylactic method against the development of phantom painful syndrome in patients with amputated extremity. The prolonged postoperative EA is a reliable method for modification of surgical stress-response, being especially important in patient, afflicted with a severe form of diabetes mellitus who represent a high surgical and anesthesiological risk group.

[Role of diabetic neuropathy in development of diabetic foot syndrome]. / Rol' diabeticheskoi neropatii v razvitii sindroma diabeticheskoi stopy.

A known complication of diabetes mellitus is diabetic foot syndrome (DFS) arising in the presence of peripheral nervous system disorders and affection of the major vessels of the legs. Various foot defects with characteristic clinical functional features develop depending on the prevailing factor. Peripheral neuropathy is essential in DFS onset. The study of sensomotor and autonomic neuropathic disturbances can be used for prognostic analysis of foot defects in diabetes mellitus.

[The characteristics of the myocardial morphofunctional status of hypothyroidism patients]. / Osobennosti morfofunktsional'nogo sostoianiia miokarda u bol'nykh gipotireozom.

Electro- and echocardiography were used to examine the morphofunctional state of the heart in 19 patients with hypothyrosis during disease decompensation and after therapy with thyroid hormones. The hormonal blood content was measured by RIA. Nonspecific alterations of the electro- and echocardiographic readings characterizing hypothyroid myocardiodystrophy were discovered. Almost half of the cases manifested hydropericardium. The discovered myocardial alterations were marked by a slow positive dynamics. In patients over 45 years, they appeared irreversible in nature. The pericardial exudate resolved shortly after the euthyroid status was attained.

[Central hemodynamics in patients with hypothyroidism]. / Tsentral'naia gemodinamika u bol'nykh gipotireozom.

A study was made of the parameters of central hemodynamics in 48 patients with hypothyroidism in various degrees of its compensation. Tetrapolar chest rheography was used for this purpose. The content of the blood thyroid hormones was determined by radioimmunoassay. The patients developed a hypokinetic blood circulation, correlating to a degree of severity of hypothyroidism. Significant correlation between the levels of the thyroid hormones and indices of central hemodynamics was found. The method of tetrapolar chest rheography was shown to be a reliable and noninvasive test for assessment of the adequacy of substitution therapy in hypothyroidism and myocardial sensitivity to the thyroid hormones.

[Carbohydrate antigen (CA-19-9) in the blood serum of patients with benign and malignant liver diseases]. / Uglevodnyi antigen (CA-19-9) v syvorotke krovi bol'nykh s dobrokachestvennymi i zlokachestvennymi zabolevaniiami pecheni.

The concentration of a new tumor marker CA-19-9 was determined in the blood serum of 51 patients with different diseases and in 38 healthy persons. In 95% of the examined persons, the concentration of CA-19-9 in the blood serum did not exceed 15 Units/ml in health. In the patients with benign focal and diffuse liver diseases and in the patients with rectal cancer without metastases to the liver, the level and frequency of the elevated CA-19-9 content in the blood serum did not practically differ from those in health. In primary and metastatic liver cancer, the CA-19-9 content was considerably elevated in all the patients. The combination of the CA-19-9 and CEA tests did not add to the efficacy of differential diagnosis between benign and malignant liver lesions.