Terapevt Arkh
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Cryoglobulins were studied in the sera of 40 unselected pSS patients. The nature of the cryoglobulins was defined using a very fast and sensitive resolution electrophoresis technique combined with immunofixation. Thirty-five per cent of SS patients were shown to have circulating IgMk mixed monoclonal cryoglobulins. ⋯ Patients with cryoglobulins had lower serum C4 levels compared to patients without cryoglobulins. These findings suggest that SS in addition to polyclonal B-cell hyperreactivity expresses a monoclonal process preceding the development of lymphoid neoplasia. Extraglandular manifestations of the syndrome may be associated with an immune complex mediated pathology.
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A 2-year study of all lethal outcomes in active tuberculosis in the Russian Federation has shown that 64.2% of patients died from progression of the specific process or its complications, 35.8%--from other diseases. A distinctive feature was that 42.8% of these were aged 20 to 49. The number of men exceeded that of women 5.8-fold. The negative factors were as follows: primary detection on consultation (47.9%), late diagnosis of far advanced forms of tuberculosis (23.4%), violation of the principles of chemotherapy by undisciplined patients, alcohol abuse and alcoholism among men (63.5%) and women (31.7%), concomitant diseases (58%).
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The paper is concerned with the results of many year-old clinical studies on workers of vibration-risk and "noisy" professions. The authors consider occupational and biomedical risk factors contributing to the development of vibratory disorders and noisy cochlear neuritis, the main clinical syndromes of this occupational pathology, modern methods of their preclinical and early clinical diagnosis. The basic principles of differentiated follow-up and combined prevention as well as problems of therapy, medical labor examination and rehabilitation of patients with vibratory disease and occupational cochlear neuritis are described.
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An attempt was made to outline a program of intensive care on the basis of experience with 396 patients with hematologic diseases admitted in a critical condition (shock of various genesis, mainly bacterial, acute liver and renal insufficiency, spontaneous hemorrhage, etc.) taking into account the characteristic signs of such patients. The percentage of patients transferred to the hematology department rose from 36.2 to 47.9% as a result of 14-year experience. A conclusion was made of the appropriateness of such a department in each major inpatient hematologic clinic.