[New lines of activity of health centres in the Russian Federation].

The first data illustrating work efficiency of health centres in this country are presented. They suggest the necessity to change both the strategy of activities and the patient population. Studies on variability of cardiac rhythms and characteristics of vegetative status in adolescents showed that the equipment used is poorly adapted to the purpose.

[Contemporary approaches to evaluation of psychosomatic status in patients with alimentary tract diseases].

The authors present the results of psychosomatic status evaluation performed in 159 patients with biliary dyskinesia, chronic gastritis, and somatoform disturbances. The examination was done using questionnaires, scales, and computer methods. Computer diagnostic methods were proved to be most effective and allowed for quantitative evaluation of psychosomatic disturbances in patients with gastrointestinal diseases.

[Antioxidant effects of vetoron in flying personnel with arterial hypertension]. / Antioksidantnaia éffektivnost' vetorona u lits letnogo sostava s arterial'noi gipertenziei.

The purpose of the investigation was to assess the possibility to control free radical oxidation in patients with cardiovascular pathologies with the help of vetoron. This was the first attempt to study effects of a beta-carotene (vetoron) on lipid peroxidation and the activity of antioxidant defense enzymes in flying personnel with cardiovascular pathologies (hypertension and neurocirculatory dystonia). Therapeutic effect of the medicament was evaluated by its action on peroxide metabolism (malonic dialdehyde, acyl hydroperoxides and trien conjugates, Schiff bases) and stimulation of the antioxidant defense enzymes (catalase and glutathione reductase). Results of the investigation pointed to the inhibition of lipid peroxidation against activation of the antioxidant defense enzymes in patients with hypertension who had been given the course of vetoron; however, in patients with neurocirculatory dystonia.

[Contemporary approaches to the treatment of the irritable bowel syndrome in pilots]. / Sovremennye podkhody k lecheniiu syndroma razdrazhennoi tolstoi kishki u pilotov.

Reported are results of treating 53 pilots with the irritated large intestine syndrome verified by endoscopic and morphologic investigations. Salozinal proved to be highly helpful to young patients. One of the therapeutic mechanisms is blocking of the cycloxygenase path circumstantially confirmed by normalization of lipid peroxidation and AOS owing to salozinal.

[Current approaches to the diagnosis, treatment and expertise of cholelithiasis in pilots]. / Sovremennye podkhody k diagnostike, lecheniiu i ékspertize kholelitiaza u pilotov.

Data on the modern mechanisms of forming the cholelithiasis and the new methods of its treatment are presented. There have been examined 337 pilots of the helicopter aviation with the professional length of service of 10 year and more, the cholelithiasis has been revealed in 107 cases. In the course of treatment there have been used the preparations of ursodeoxycholic acid (urosan), remote shock-wave lithotripsy and laparoscopic cholecystectomy. There is demonstrated the high efficiency of these methods during examination of 106 patients who after passing the air-force medical board are pronounced for proceeding their flying activity.

[Salozinal in the treatment of the irritable bowel syndrome in young persons]. / Salozinal pri lechenii sindroma razdrazhennoi tolstoi kishki u lits molodogo vozrasta.

AIM: To ascertain whether salozinal improves short- and long-term treatment outcomes in young patients. MATERIALS AND METHODS: Salozinal was given in a daily dose 4-6 g to 32 patients depending on the length of the colon lesion. All the patients were subjected to colonofibroscopy with obligatory spot biopsy and morphological examination, evaluation of lipid peroxidation (LPO), antioxidant defense (AOD) and immunological indices. RESULTS: The endoscopic picture improved in 27, histologic one in 26, stool in 28 patients. Negative results were absent. A positive trend was observed in LPO and AOD. CONCLUSION: A high response rate to salozinal in young patients with irritable colon syndrome is achieved, among other mechanisms, through block of the cyclooxigenase pathway indirectly confirmed by normalization of LPO and AOD.

[Development of vibration-induced intrahepatic cholestasis in pilots and new ways of correcting these disorders]. / Formirovanie vnutripechenochnogo kholestaza u pilotov pod vliianiem vibratsii i novye vozmozhnosti korrektsii étikh narushenii.

Data of analysis of the role of vibration in the development of hepatobiliary pathology in helicopter pilots are reported. Vibration was found to drastically deteriorate colloid-osmotic qualities of the bile and increase the lithogenesis risk. Exposure to vibration over 10 and more years of the flying career may instigate cholelithiasis. Dynamic USI with functional testing for early diagnostics and correction with ursodeoxycholic acid (ursosan) of disorders in the colloid-osmotic properties of the bile and can be proposed as one of the methods to prevent cholelithiasis.

[Current approaches to the diagnosis and treatment of pilots with combined polyposis of the stomach and large intestine]. / Sovremennye podkhody k diagnostike i lecheniiu pilotov s sochetannym polipozom zheludka i tolstoi kishki.

Findings of diagnostics and treatment of 198 pilots suffering from combined polyposis in the stomach and large intestine are presented. Different therapeutic tactics should be chosen for these patients. Annual dynamic evaluation should be made in case of a benign course and without an upward tendency, whereas diagnosed villus polyps, villus-tubular adenoma with the second or third phase of dysplasia, adenomatous polyps with regional 2nd or 3d phase dysplasia will require early polypectomy to be followed by yearly dynamic endoscopy. The proposed tactics is angled at early diagnostics of stomach and large intestine cancers. This tactics allows considerable prolongation of the flight career of pilots with the diagnosis of combined polypous lesions.

Methodological aspects of the medical examination of special contingents in the All-Russian Service of Disaster Medicine.

The tasks required for the preservation of the health of rescuers can be accomplished with the creation of a system for medical examinations and rehabilitation that functions with commonly used methodological and organizational principles. Absence of such a common methodological platform often results in the disqualification of members of the special contingent and a mistake in the evaluation process that gives birth to serious medical and social problems. The specific character of the rescuers' activities during conditions associated with extraordinary situations necessitates the development of criteria-based evaluation systems for determining the prognosis, and the clinical, diagnostic, normative, and legal, medical, and social criteria that include methodological approaches that define the criteria to be used in the examinations. We propose that the concept of the professional health examinations becomes the methodological basis used for the medical examinations and rehabilitation of the rescuers.

[Contemporary approaches to diagnosis and treatment of chronic duodenitis among flying personnel]. / Sovremennye podkhody k diagnostike i lecheniiu khronicheskogo duodenita u letnogo sostava.

Causes for increased gastric and duodenal morbidity were analyzed in 435 patients. Chelibacteriosis was shown to be one of the key factors of development and recurrence of chronic duodenitis which which, in its turn, leads to physical disability retirement of flying personnel. The role of determining the immune status in dynamics in predicting recurrence, and effectiveness of therapy was confirmed. Results of the investigation indicate that "triple therapy" (Tribemol, Doxacyclin, Trichopol) of chronic duodenitis on the background of chelibacteria is most effective as it reduces length of treatment, decreases the recurrence rate and improves the clinical and certification-important indices in flying personnel.

[Efficacy of ursodeoxycholic acid (UDCA) in the treatment of chronic alcoholic hepatitis]. / Effektivnosyt' ursodezoksikholevoi kisloty v lechenii khronicheskogo alkogol'nogo gepatita.

Treatment for chronic alcoholic hepatitis with UDCA drug was performed in 76 patients. In development of this kind of hepatitis an essential role belongs to defects in the systems of lipid peroxidation and antioxidant defense. The UDCA drug produced stabilization of cell membranes, changed bile composition by effects on bile acids pool and micellar complex. Clinicomorphological remission was available in 88% of cases.

[Current medical technologies in the treatment of cholelithiasis]. / Sovremennye meditsinskie tekhnologii v lechenii kholelitiaza.

AIM: Assessment of different approaches to treatment of cholelithiasis (CL). MATERIALS AND METHODS: 245 CL patients were given a long-term treatment with ursosan, laser lithotripsy and combined modalities. RESULTS: Ursosan promoted dissolving of the stones in 56% of the patients. Laser lithotripsy destroyed the stones in 74 from 91 patients. Ursosan and laser lithotripsy eliminated the concrements in 59 of 67 patients. CONCLUSION: Efficacy of laser lithotripsy in CL depends on valid selection of the patients. The combined therapy of CL is preferable in patients who reject operative intervention and in those with severe somatic complications.

[New approaches to diagnosis and treatment of cholelithiasis in young occupational groups]. / Novye podkhody k diagnostike i lecheniiu kholelitiaza v professional'nykh gruppakh molodogo vozrasta.

Cholelithiasis was treated in 107 pilots. Cholesterol choleliths were effectively treated with ursosan. In bilirubin or calcium stones ursosan combination with shock-wave lithotripsy is more effective. Promising is dissolving of the stones in the gall bladder by chemical solvents delivered through special drainage or catheters. In lithogenic bile it is recommended to conduct early prophylaxis of the stones with ursodeoxycholic acid compounds.

[Beta-carotenoids and their potential use in diseases of the digestive tract]. / Beta-karotinoidy i vozmozhnost' ikh ispol'zovaniia v lechenii zabolevanii organov pishchevareniia.

Flying personal with chronic hepatitis received beta-caratinoid vetoron. The latter proved to be an effective immunomodulator improving lipid peroxidation, clinical and morphological characteristics in the personnel with chronic persistent hepatitis. Follow-up gives proves on longer physical fitness for service of those pilots who have taken beta-caratinoids.

[The efficacy of high-intensity laser irradiation in the combined treatment of patients with esophageal candidiasis]. / Effektivnost' vysokointensivnogo lazernogo oblucheniia v kompleksnom lechenii bol'nykh kandidozom pishchevoda.

High-intensity impulse laser radiation proved effective in 23 patients with esophageal candidiasis. The highest effect was achieved in its use with nistatin. In low laser efficacy radiation should be combined with transendoscopic administration of granulocytes concentrate. This produced clinico-endoscopic remission in 98.3% of the cases.

[Current approaches to using beta-carotenoids in chronic hepatitis in flight personnel]. / Sovremennye podkhody k primeneniiu B-karatinoidov pri khronicheskikh gepatitakh u letnogo sostava.

48 patients from flying personnel with chronic diseases of the liver have been studied. Considering poor effectiveness of the available hepatotropic drugs, a new B-caratinoid, veteron, was used at different daily doses. Findings of this study allowed us to draw inferences not only about more efficient clinical effect of this preparation beginning from a daily dose of 160 mg/day but also about its immunomodulating and pro-oxidant action. Thus, veteron is optimal for patients with chronic disorders of the immunologic and antioxidant systems and can be effectively used in treatment of these diseases.