Population-based study on incidence, risk factors, clinical complications and drug utilisation associated with influenza in the United Kingdom.

This large population-based study using the UK-based General Practice Research Database was conducted to quantify influenza-related physician visits, clinical complications of and risk factors for influenza, and related drug use in all age groups from 1991 to 1996. A total of 141,293 subjects who had one or more diagnoses of influenza or influenza-like illness during the study period as well as the same number of age-, sex-, practice and calendar time-matched controls were identified. Adults aged 15-64 years had the highest influenza incidence rate. The risk of getting influenza was particularly increased for subjects with chronic respiratory conditions (asthma or chronic obstructive pulmonary disease, odds ratio 1.65, 95% confidence interval 1.60-1.70). Subjects with influenza were more likely to have a diagnosis of clinical complications than control subjects (relative risk 3.4, 95% confidence interval 3.3-3.6). The risk of developing clinical complications was highest for children and was elevated for subjects with certain underlying chronic conditions. In absolute terms, otherwise healthy adults (15-64 years) accounted for the greatest proportion of all influenza-related physician visits as well as clinical complications in this study population. Of the 141,293 subjects with influenza, 83,911 (59.4%) received drugs on prescription. The most frequently prescribed drugs were antibiotics (45.2%), followed by antipyretics/analgesics (22.5%). Influenza patients were approximately six times more likely to use drugs on prescription than controls. This analysis may lead to further analyses on the economic impact of influenza and the contribution of different population groups to that burden.

[Diagnostic potential of indirect radionuclide angiography in kidney cancer]. / Diagnosticheskie vozmozhnosti nepriamoi radionuklidnoi angiografii pri rake pochki.

Indirect radionuclide angiography was performed in 95 suspects for renal tumor. The data obtained by the said procedure were compared to those yielded by surgery, autopsy and X-ray contrast angiography. The majority of renal tumors were found to have specific angionephroscintigraphic features. The sensitivity of the method in detecting renal carcinoma was 90.2%, specificity--86.3 and diagnostic reliability--88.4%. The procedure proved functional, sparing and highly informative.

[Reasons for relaparotomies following operations on the biliary tract in nontumorous lesions]. / Prichiny relaparotomii posle operatsii na zhelchnykh putiakh pri ikh neopukholevykh porazheniiakh.

According to the authors' data the incidence of relaparotomies after 1500 operations for non-tumor diseases of bile ducts was 2.5%. Causes of relaparotomies at early and late terms of the postoperative period were different. The dependence of results of the treatment on the amount of relaparotomies and the presence of such complications as jaundice, cholangitis and pancreatitis has been established. In such complications and increased amount of relaparotomies lethality was considerably higher. General lethality after relaparotomies was 49%. Complex of prophylactic and curative measures of the complications resulting in relaparotomies has been developed.

[Indications for surgery in acute and chronic hepatitis]. / Pokazaniia k operatsii pri ostrom i khronicheskom gepatite.

The author considers that the participation of surgeons in the treatment of patients with acute and chronic hepatitis may be promising. The operation for acute hepatitis is aimed at liquidation of another disease of the patients, that for chronic hepatitic is fulfilled in order to relieve severe manifestations of the disease.

[Surgical tactics in chronic non-calculous cholecystitis]. / Khirurgicheskaia taktika pri khronicheskom beskamennom kholetsistite.

The authors have an experience with 1500 operations on bile ducts in patients with non-tumorous diseases. The operative treatment of acalculous cholecystitis was indicated only in isolated cases. After an insufficiently grounded cholecystectomy symptoms of the disease not only persisted but also made progress and new ones appeared resulting from the operation. Patients with acalculous cholecystitis must be subjected to a comprehensive examination at a specialized gastroenterological departments.

[Reconstructive and restorative surgery in impaired intactness and patency of the bile ducts in the portal fissure]. / Rekonstruktivnye i vosstanovitel'nye operatsii pri narushenii tselosti i prokhodimosti zhelchnykh protokov v vorotakh pecheni.

Results of 172 operations in 145 patients with impaired integrity and passability of bile ducts in portal hepatic fissure are analyzed. Tumorous injuries of the ducts were revealed in 90 patients, 55 patients had "benign" injuries of the ducts. Recommendations for the methods of operative interventions are given.

[Imminent changes in the preoperative diagnosis of bile duct diseases]. / Nazrevshie izmeneniia metodiki dooperatsionnoi diagnostiki zabolevanii zhelchnykh putei.

The author's views on the expedient sequence of using different diagnostic examinations in patients with bile duct diseases are presented. The author recommends instrumental methods to be predominantly used as more reliable ones.

[Surgical treatment of complicated forms of chronic pancreatitis]. / Khirurgicheskoe lechemie oslozhnennykh form khronicheskogo pankreatita.

Analysis of 96 operations in 79 patients with complicated forms of chronic pancreatitis is presented. Various changes in the pancreas itself and associated complications require an individual method of surgery. Necessary elimination of both pancreatic and bile hypertension is stressed. During operation on the pancreas the external drainage of the pancreatic duct was used.

[Ampullar choledocholithiasis]. / Ampuliarnyi kholedokholitiaz.

Under observation were 111 patients with ampullar choledocholithiasis. Variants of the clinical course of choledocholithiasis are characterized. The most rational method for the surgical treatment of ampullar choledocholithiasis is the transduodenal transpapillary extraction of concrements from the major papillar followed by papillocholedochoplasty. In a number of cases papillocholedochoplasty was accompanied with additional creation of biliodigestive anastomosis and plasty of the opening of the pancreatic duct. Remote results of the operations on the major papilla of the duodenum are dependent on the amount of preoperative complications of ampullar choledocholithiasis and first of all pancreatitis.

[Surgical treatment of primary chronic pancreatitis complicated by mechanical jaundice]. / Khirurgicheskoe lechenie pervichnogo khronicheskogo pankreatita, oslozhnennogo mekhanicheskoi zheltukhoi.

The observation of 32 cases of primary (autonomous) pancreatitis with more or less pronounced mechanical jaundice resulting from a compression of the pancreatic portion of the common bile duct is analyzed. The authors believe that it is necessary to abolish both biliary and pancreatic hypertension and to create favourable conditions for the outflow of the bile and pancreatic juice. Variants of the operations are thought to depend on the degree and extension of changes in the both systems of ducts.