[Complex characterization of the quality of hospital care provided patients with glomerulonephritis (as per a regional nephrology department)]. / Kompleksna kharakterystyka iakosti statsionarnoï dopomogy khvorym na glomerulonefryt (na prykladi oblasnogo nefrologichnogo viddilennia).

Based on expert examination of 296 histories of 145 patients with glomerulonephritis the frequency of errors being made in examining of patients at the prehospital stage, in hospital, has been estimated. Kinds of errors include diagnostic errors (primarily in defining forms and variants of the disease), errors in administering treatments to patients. This necessitated raising the level of the primary link in the nephrological educational program for medical men and warrants development of alternative forms of the in-patient medical care delivery to patients with glomerulonephritis.

[Prognosis of pretreatment outcome in patients with acute glomerulonephritis after an immunological review]. / Prognozuvannia bezposeredn'oï klinichnoï efektyvnosti likuvannia khvorykh na gostryi glomerulonefryt.

Expediency has been shown for the immunological investigation to be done in those patients with acute glomerulonephritis in the nephrosis stage before the start of treatment to find out relevant approaches to such patients. The most informative parameters characterizing immunity include the peripheral blood absolute content T-lymphocytes, relative and absolute content of B-lymphocytes in the peripheral blood, IgA, IgG in blood plasma. However, to prognosticate near term clinical efficiency of treatment with immunodepressive drugs it is essential that all basic indices for the cell-bound and humoral immunity be taken account of.

[The prognosis and control of the efficacy of heparin therapy in patients with diabetic glomerulosclerosis]. / Prognozirovanie i kontrol' éffektivnosti geparinoterapii u bol'nykh diabeticheskim glomerulosklerozom.

3-week heparin treatment (25000 U/day) of 38 patients with diabetic glomerulosclerosis (DGS) produced positive results in 31 of them, was ineffective in 5 patients and induced complications in 2 cases. Prognostic criteria of heparin treatment efficacy basing on hemostatic changes on day 7 have been developed. Hemostasis was controlled most effectively in patients receiving heparin by a new graphic turbidimetric method capable of objective registration of clotting and fibrinolysis in one plasma portion. Because individual sensitivity to heparin widely varies and this variability manifests as early as first days of treatment, control over hemostasis system in heparin day dose 25000 U/day is advisable before treatment, on treatment day 3, 7 and on aftertreatment day 2.

[The morphological characteristics of the nephrotic form of glomerulonephritis in children at puberty]. / Morfologicheskaia kharakteristika nefroticheskoi formy glomerulonefrita u detei pubertatnogo vozrasta.

67 children (from 3 to 18 years of age) and 26 adults (19-30-year-olds) with nephrotic or mixed forms of glomerulonephritis (GN) are studied. The most severe and pleiomorphic forms of GN are found in children of 12 to 15 years of age: mesangio-capillary, mesangial proliferative, extracapillary proliferative GN with "half-moon" structures, sclerosing GN. Pronounced disturbances of the vimentine content and distribution in the basal lamina, of i.v. type collagen, fibronectin in combination with its damage under the influence of various immune deposits (particularly subepithelial ones) are found in these patients.

[The dynamics of the urinary glycosaminoglycan indices in the pathogenetic therapy of glomerulonephritis]. / Dinamika pokazatelei glikozaminoglikanov mochi pri patogeneticheskoi terapii glomerulonefrita.

A positive dynamics of the course of glomerulonephritis under the effect of pathogenetic therapy evaluated in 140 patients was accompanied by a statistically valid reduction of glycoseaminoglycanes in the urine. This allows to use these indices as adjunctive criteria of treatment efficiency, especially in patients with chronic forms of the disease.

[The dispensary care of pregnant women with kidney diseases]. / Dispanserizatsiia beremennykh s zabolevaniiami pochek.

The authors evaluated data of expertise of the quality of observations on 1056 pregnant women with renal diseases (primary nephropathy, chronic glomerulonephritis, acute and chronic pyelonephritis, acute and chronic pyelonephritis, associated nephropathies) as well as data on the dynamic observation of 300 patients carried out according to special methods. On the basis of these findings the authors worked out the strategy, tactics and individual program of dispensarization with consideration of regularities of evolution of renal diseases, risk factors in the course of onset and progression of the disease. An organizational model was worked out of graded dispensarization with the participation of obstetricians, nephrologists, therapists, urologists.

[Lipid metabolism in primary and combined lesions of the kidneys in pregnant women]. / Obmen lipidov pri pervichnykh i sochetannykh porazheniiakh pochek u beremennykh.

Urinary and blood lipid metabolism was examined during pregnancy complicated by different forms of nephropathies. The pregnant with primary nephropathy and with chronic pyelonephritis showed a significant increase of lipid peroxidation products in erythrocytes while the pregnant with chronic glomerulonephritis showed high-molecular lipoproteids in the urine. A relationship was found of metabolic disorders and indices characterizing the degree of renal lesions in the pregnant.

[Dynamics of Mycoplasma infection in patients with glomerulo- nephritis during pathogenetic therapy]. / Dinamika mikoplazmennoi infektsii u bo'lnykh glomerulonefritom pod vliianiem patogeneticheskoi terapii.

Among bacterial infections arising in glomerulonephritis and complicating its course Mycoplasma infection (M. hominis) is not a rare finding as shown by microbiological and serological examinations. Good therapeutic results achieved in patients treated with prednisolone and cyclophosphamide suggest inhibiting action of glucocorticoids on Mycoplasma infection.

[Drug sensitivity of Candida in patients with kidney diseases receiving immunosuppressive therapy]. / Lekarstvennaia chuvstvite'lnos't gribov roda Candida u bo'lnykh s zabolevaniiami pochek, poluchaiushchikh immunodepressivnuiu terapiiu.

It was shown that prednisolone and its combination with azathioprine++ increased contamination of the patients with yeast-like fungi and promoted development of candidiasis in them to a greater extent than cyclophosphamide. In the patients treated with the immunodepressants there was observed a carrier state in regard to various yeast-like fungi: 12 species belonging to 6 genera were isolated from the pathological materials. Determination of sensitivity to antifungal drugs in 200 Candida strains revealed that amphotericin B was the most active agent. Then followed mycoheptin, nystatin and nitroxolin. Levorin was the least active drug. The MICs of the drugs for the majority of the cultures were 0.5, 4-8, 8-16 and 32-64 micrograms/ml respectively. Candida resistant strains (mainly to levorin and mycoheptin) were isolated only from recipients of kidney transplants during the early postoperative period when the patients were subjected to intensive immunodepressive and prophylactic antifungal therapy. Among the fungi of the Candida genus C. guillermondii and C. parapsilosis proved to be the most resistant. Under the hospital conditions and in vitro studies it was found that cyclophosphamide and combinations of prednisolone with cytostatics increased resistance of Candida to the antifungal drugs. Rapid increasing of the fungi resistance to levorin and mycoheptin was observed. The increase in the resistance to amphotericin B was somewhat lower and that to nitroxolin and nystatin was extremely low. The study of the combined effect of the immunodepressants and antifungal drugs demonstrated that the immunodepressants increased the antifungal activity of amphotericin B, levorin and nitroxolin.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effectiveness of sanitorium treatment of patients with chronic glomerulonephritis depending on their permanent residence]. / Effektivnost' sanatornogo lecheniia bol'nykh khronicheskim glomerulonefritom v zavisimosti ot mesta ikh postoiannogo zhitel'stva.

The authors analyze the immediate and long-term results of 48-day health resort treatment at the Southern Coast of the Crimea of three groups of patients with chronic glomerulonephritis (150 patients in each) depending on the place of their permanent residency: "north", "middle" and "south" climatic zones. Treatment efficacy was higher in the group of patient inhabiting the "middle zone" (latitude 57.5 degrees-42.5 degrees North). These findings make it possible to improve the organization of selection of this contingent of patients for climatotherapy as well as to study the processes of their adaptation to new climatic conditions.

[Principles of clinical morphology in nephrology]. / O printsipakh klinicheskoi morfologii v nefrologii.

Causes of the numerous changes found in kidney biopsy specimens and the absence of their commonly accepted classification are revealed. Principles of clinical morphology underlying nephrology have been formulated which emphasize the need to study the qualitative and quantitative characteristics of all renal structures, maintenance of the nosological independence of primary glomerulonephritis whose diagnosis must be supplemented by the morphological characteristics of kidney biopsy specimens. Kidney affection in different diseases should be designated by the term "nephropathy" specifying the causative factor and the character of affection of renal structures.

Methodology of functional studies in nephrologic clinic.

Authors have worked out the methodology of functional diagnosis in nephrologic clinic--strategy, tactics and individual programme--on the basis of their own experience. The strategy is based on the natural functions of excretory and incretory renal function and quantitative and qualitative characteristics of indices. The tactics is based on the natural functions of evolution of renal diseases and probable exogenic and endogenic influences. The individual program involves standardization of conditions, complex usage of methods and integration of the results obtained. The interrelation between the methodologic foundations and their components is presented.