Validation and approaches to correction of hemorheologic disorders in patients with gastrointestinal cancer]

A total of 237 patients were examined: 127 with gastric cancer and 110 with colonic cancer, 99 women and 138 men, mean age 57.5 years. Erythrocyte deformability and aggregation were studied by original methods. Red blood, protein metabolism, and endogenous intoxication parameters were evaluated by routine laboratory tests. Increased aggregation and volume of erythrocytes and decrease of their deformability and hemoglobin content in parallel with hypo- and dysproteinemia and increased level of endogenous intoxication were observed in all patients with gastrointestinal cancer. Correction of these disorders by intravenous laser exposure of the blood essentially improved the erythron status and protein metabolism and decreased endotoxicosis. Infusion/transfusion therapy also notably improved the erythron function and decreased endogenous intoxication. Analysis of the results of surgery showed decreased incidence of complications and lethal outcomes, which was due to methods of corrective therapy.     

Homeostasis and its correction in burn patients with gastrointestinal erosive-ulcerative diseases

Acute erosive ulcerative hemorrhage (EUH) is one of the most grave complications of burn disease, caused by impaired blood rheology, clotting, and protein status. Twenty-three patients with burns of 12-70% body surface were examined, 17-25% of burns being deep. The most pronounced changes in blood rheology and clotting with formation of erythrocyte aggregations, fibrin precipitation and imbalance of visceral proteins were observed during the shock stage (days 1-3), particularly pronounced in patients with acute EUH. Development of septicotoxemia favored secondary increase in blood clotting and rheological parameters, which led to thrombotic complications. The data helped improve the complex of infusion-transfusion therapy for preventing and treating ulcerative and erosive lesions.     

Psychosomatic factors in gastrointestinal disorders

Gastrointestinal functions such as food intake, propulsive peristalsis, inhibition of reflux, secretion, digestion and defecation are controlled by a complex autonomous neurohumoral system, which is influenced by higher cortical impulses. Life stress may modulate these impulses and in this way cause two types of gastrointestinal reactions. Psychophysiological reactions involve accentuations, inhibition or distortion of the pattern of function of gastrointestinal organs without changes in their structure. Examples of this type of reaction are often painful accentuation of bowel movements in patients with the irritable bowel syndrome, and increased gastric secretion elicited by emotional stress. Psychosomatic reactions lead to morphological changes in the end organ, e.g. activation of peptic ulcer or ulcerative colitis. Psychophysiological reactions may be important in the onset of symptoms in some functional diseases, e.g. in the irritable bowel syndrome. These patients need support from the physician, but specific psychiatric therapy is required only in cases with severe psychopathology, e.g. in patients with anorexia nervosa. The role of psychosomatic reactions in the development of organic gastrointestinal diseases is still unclear, as is the value of specific psychiatric therapy in the treatment of diseases such as peptic ulcer or ulcerative colitis. If this kind of therapy has some effect, it may be directed mainly towards subjective symptoms.     

Renal disorders in patients with collagen vascular diseases

Membranous nephropathy, mesangial proliferative glomerulonephritis and renal amyloidosis are common renal pathology in RA patients. However, IgA nephropathy and diffuse thinning of glomerular basement membrane are described as common and characteristic renal lesions in Japanese RA patients. Glomerular filtration rate may decrease significantly in active lupus nephritis, but renal plasma flow does not change or even increase. These findings seem to be characteristic of SLE patients with active renal disorders. Therefore, filtration fraction may be a useful clinical parameter to evaluate SLE patients. Scleroderma renal crisis(SRC) has been believed to be the most serious renal disorder in systemic sclerosis (SSc). Recently, the presence of an antibody to RNA polymerase has been associated with a high prevalence of SRC.     

Psychosomatic disorders in patients with neurocirculatory dystonia and their correction in the day hospital]

Clinical and psychological tests were used to examine 77, 31 and 32 patients with normotonic, hypertonic and hypotonic neurocirculatory asthenia, respectively. Compared to control subjects, 80% of the patients responded to stress with psychic and social dysadaptation (psychic asthenia, frustration, emotional lability, hypothymism) as well as depression with visceral manifestations: cardialgia, extrasystole, lability of arterial pressure. Chemotherapy, physical and psychological treatment in day hospital produced a response in 89.2% of neurocirculatory asthenia sufferers.     

Immunological and metabolic disorders and the means for their correction in patients with chronic bronchitis]

A study was made of certain immunity characteristics and of the activity of lipid peroxidation (LPO) in patients of two groups with frequent exacerbations of chronic bronchitis in the phase of lingering exacerbation. The patients of one of the groups received intravenous infusions of piracetam (30 mg/kg bw, 10-12 injections per course) in addition to the common therapy; the other group patients were administered aminalon (1.5-3 g/day for 18-20 days). Activation of LPO was found to be associated with inhibition of the T cell component of the immune system, since cell metabolites exerted a toxic action on lymphocytes. Piracetam and aminalon not only produce the beneficial clinical effects but also favour immunity normalization due to the regulative influence on LPO as well as via the hypothalamo-hypophyseo-adrenal system.     

Social support and change in vascular risk factors in patients with clinical manifestations of vascular diseases

Background and aims

Vascular risk can be reduced by adequate medical treatment of vascular risk factors and by adopting a healthy lifestyle, a behavioral change that is influenced by social support. We investigated whether social support is associated with change in vascular risk factors in patients with vascular diseases during 1 year.

Methods

140 patients who had 2 modifiable vascular risk factors participated. Social support was measured with a questionnaire about the patient's perception of active involvement, protective buffering, and overprotection.

Results

Most types of social support were not associated with a change in vascular risk factors over 1 year. Having a partner was associated with a reduction in BMI of 1.4 kg/m² (95%CI − 2.2 to − 0.5), less protective buffering was associated with a decrease in blood glucose of 0.47 mmol/l (95%CI 0.09-0.84), and less active involvement was associated with an increase in BMI of 0.42 kg/m² (95%CI 0.05-0.78).

Conclusion

Having a partner and active involvement are only associated with a decrease in BMI but not with changes in other vascular risk factors. Protective buffering is only associated with blood glucose whereas overprotection is not associated with changes in vascular risk factors.