Terapevt Arkh
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Comparative Study
[Clinico-morphological features and the course of glomerulonephritis in hemorrhagic vasculitis].
Peculiarities of a clinical course and prognosis of glomerulonephritis in Schönlein-Henoch disease (SH-nephritis) were studied in 42 adult patients. The 5- and 10-year survival rates were 87% and 72%, respectively. ⋯ SH-nephritis was characterized by a more severe course in male patients, in persons aged over 30, and in the involvement of the kidneys one year and more after the appearance of the first clinical signs of skin vasculitis. The level of blood serum IgA and the gravity of skin vasculitis had no prognostic importance.
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The paper is concerned with an analysis of the results of the method of cryoheparinoprecipitation of plasma proteins in patients with immune complex pathology. The essence of the method is that in plasma cooling cryofibrinogens, cryoglobulins, immune complexes and other components of the complement system aggregate and precipitate. The process is potentiated by adding heparin to the plasma. ⋯ Signs of the abdominal, dermal and articular syndrome were eliminated in all the patients; the urinary syndrome was retained in half of the cases necessitating other therapeutic modalities. A CIC level investigated by a method of precipitation with 3.5% polyethylene glycol was not a criterion of assessment of the gravity of diseases: in cases of its increase before therapy initiation there was a clear tendency to a decrease and normalization by the end of treatment. In hemostasis investigation hypercoagulation activation and hyperfibrinogenemia were revealed in most of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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A method of apheresis of plasma euglobulin fraction, cryoglobulins and Willebrand factor was developed. In one session of plasmapheresis 1500-1700 ml of patient's plasma were removed, fractionated and returned. The method was used in 2 patients with immune complex vasculitides. ⋯ A decrease in the content of plasma cryoglobulins, cryofibrinogen, and urine protein concentration (from 1.5 up to 0.03%) was noted in the other case. A possibility of the use of the method in other pathological conditions (DIC-syndrome, unstable angina, atherosclerotic angiopathy) accompanied by endothelial damage, was discussed. Willebrand factor multimers form complexes with low density lipoproteins therefore the removal of these complexes may be useful in the treatment of hypercholesteremia and atherosclerosis.
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Hematological "masks" of malignant tumors of the internal organs are not infrequent in clinical practice. A total of 45 patients with malignant tumors of the internal organs (stomach-12, colon-9, liver-3, lungs-9, kidneys-6, pancreas-2, thyroid-2, bladder-1, prostate-1) were under observation. Hematological signs of bone marrow metastatic involvement were as follows: anemia (mainly hypochromic), leukemoid neutrophilic reaction, leukemoid reaction of myeloid type, erythrocytosis, thrombocytosis, plasmocyte bone marrow reaction. Early cancer diagnosis, especially in obscure peripheral blood changes, requires a complete all-round investigation of a patient including an analysis of clinico-anamnestic data, the use of radiographic and endoscopic methods, sternal puncture and trephine biopsy.
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The authors analyzed 2 plasmosubstituting solutions of entirely different quantitative composition used during intensive plasmapheresis (47 procedures in 24 patients). Indices of central hemodynamics and blood oxygen-transport function served as criteria of the adequacy of plasmosubstitution. ⋯ Their lesser content (not more than 40%) revealed the development of noticeable disorder of blood oxygen-transportation function and decompensation of the blood circulation. In adequate plasmosubstitution change of the eukinetic type of blood circulation by the hyperkinetic one is a compensatory reaction of blood circulation.