[Arrhythmias and heart blocks in flying personnel with mitral valve prolapses]. / Aritmii i blokady serdtsa pri prolapse mitral'nogo klapana u letnogo sostava.

Investigated were 76 pilots with ECG-verified mitral valve prolapses (MVP) of the 1st and 2nd degree (w/o profound regurgitation). There were various heart blocks and ECG repolarization changes in 35 cases. Comparison of results of the cardiovascular functional investigations of flyers with MVP displayed non-specific cardiac rhythm and conductance disturbances that were registered more often during ECG-monitoring or test loading. According to the data of this study, bicycle and treadmill ergometry revealed "pseudoischemic" shifts in ECG. Literary indications of a significant loss in human endurance of physical loads due to MVP combined with the strain-induced arrhythmia received the experimental confirmation. Probably, arrhythmias in flyers with diagnosed MVP are predominantly associated with electric instability of the myocardium against the autonomous dysfunction with prevailing adrenergic effects.

[An increase in the effectiveness of outpatient care of patients with kidney diseases]. / Povyshenie éffektivnosti ambulatorno-poliklinicheskoi pomoshchi patsientam s patologiei pochek.

Organization of medical care of patients with renal diseases in a municipal health center is described. The authors demonstrate the efficacy of specialized care when it was made available for population. The detection of renal diseases improved. Use of modern methods of diagnosis and treatment, day-time hospitals, and regular check-ups permit timely comprehensive qualified care of patients with renal diseases, prevention of disease progress and chronic development, prolong the capable life of young patients, and decrease the incidence of disability.

[Clinico-functional evaluation of the significance of mitral valve prolapse in flight personnel]. / Kliniko-funktsional'naia otsenka znachimosti prolabirovaniia mitral'nogo klapana u letnogo sostava.

Mitral prolapse (MP) investigations were performed in 76 pilots. MP occurs in pilots rather frequently and in 15% may be responsible for syncope conditions resultant from cardiac arrhythmia, coronaroangiospastic and hypotonic responses to stress. MP diagnosis requires comprehensive examination combining clinical and special instrumental techniques providing more detailed picture in case of ultrasonic scanning, doppler echocardiography. Clinical complications of MP manifesting as cardiac arrhythmia and blockade, angiospasm etc. should be managed on individual basis, require expert evaluation and follow-up care.

[Cardiovascular system function in mitral valve prolapse in fighter pilots]. / Funktsional'noe sostoianie serdechno-sosudistoi sistemy pri prolapse mitral'nogo klapana u letchikov istrebitel'noi aviatsii.

Echocardiogram examination of 250 young fighter pilots has revealed that 15 aviators had mitral valve prolapse (MVP) without symptoms of pronounced regurgitation. Their functional indexes of cardiovascular system at rest or dosed physical load at veloergometer tests were normal. Only in 3 pilots were marked rare supraventricular or ventricular extrasystoles during ECG monitoring or veloergometria. Performance capability of all pilots was sufficient. 13 pilots with MVP in examination of their tolerance to +Gz hypergravity at the levels of 6 G or more for 15 s had frequent polytop or group ventricular extrasystole. There was an ordinary aggravation of extrasystole in aviators with more deep and bilateral MVP. The article makes a conclusion that on the basis of medical flight expertise a thorough selection must be made concerning possibility of every pilot with MVP to carry out flight at high manoeuvring aircraft of new generation taking into account the gravity of prolapse and tolerance to high +Gz hypergravity more than 5 G.

[The dynamics of the arterial pressure in patients with aortic coarctation before and after surgery]. / Dinamika arterial'nogo davleniia u bol'nykh s koarktatsiei do i posle operatsii.

The arterial pressure was evaluated in 841 patients before surgery and for 3-23 years after operative correction of coarctation of the aorta. It was established that the level of preoperative arterial pressure depended on the degree of congenital aortal stenosis and secondary changes of the cardiovascular system which deteriorate during the adult years. It was found that in the postoperative period even in the absence of aortal recoarctation a certain part of patients develops again the hypertensive syndrome. The number of these patients increases with increase of observation time. The efficacy of the operation depended on the age of the patient and level of hypertension by the time of surgery.

[The diagnosis of a cystic duct blockade in patients with chronic cholecystitis]. / Raspoznavanie blokady puzyrnogo protoka u bol'nykh khronicheskim kholetsistitom.

The authors describe a method of complex examination of patients with diseases of the external biliary tract with the aim of diagnosing cystic duct blocks. Intravenous cholangiography using billignost and albumin in 2:1 ratio proved highly effective. Of essential help in the diagnosis of cystic duct block was dynamic ultrasonic examination. Cystic duct block is a distinct sign of cholecystitis requiring operative intervention.