[Some comments on the discussion about so-called functional diseases].
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Biomedical subjects
Publications and source records attributed to I P Briazgunov.
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Interpersonality relations and conflict situations were studied in patients who need psychological correction. In patients with symptomatic arterial hypertension, the degree of dissatisfaction was estimated according to the following three scales: educational ("Conflict Situations at School" including conflicts with friends); family and household ("Conflict Situations in the Family"); and "Internal Disputed Matters". The patients with symptomatic arterial hypertension of the nephrogenous and endocrine genesis may turn out more conflicting since they are trying to discover the cause of their life failures in their social surrounding rather than in their personal inability to cope with them because of the disease.
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Renal prostaglandin activity was assessed in children and adolescents with two forms of secondary (nephrogenic) arterial hypertension: vasorenal and chronic pyelonephritis-associated hypertension. Children with vasorenal hypertension showed renal PG changes, dependent on the duration of the disease. Positive correlation between arterial BP and PGF2 excretion, and negative correlation between PGE excretion and arterial BP are suggestive of the involvement of the renal PG system in vasorenal hypertension. Children and adolescents with arterial hypertension in the presence of chronic secondary pyelonephritis demonstrated a tendency to low excretion of both PG fractions, while their ratio remained unchanged. The absence of a correlation between urinary PG excretion and arterial BP indicates that renal prostaglandins make no significant pathogenetic contribution to this type of arterial hypertension.
Renin-angiotensin-aldosterone (RAA) function was studied in children with secondary hypertension of 2 varieties: vasorenal hypertension (VRH) and arterial hypertension (AH) associated with chronic pyelonephritis. Children with VRH showed RAA activation that depended on the duration of the disease for its markedness. A direct correlation found between ABP, on the one hand, and plasma renin activity and blood aldosterone level, on the other, is evidence of the latter's involvement in VRH pathogenesis. In AH that is due to chronic pyelonephritis, RAA activation was also demonstrated, however, its pathogenetic involvement was only documented in children with urinary passage disorders (vesico-renal reflux), whereas in the rest RAA activation was not a primary cause of BP elevation.
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Remote results of the surgical treatment of vasorenal hypertension in children and juveniles have been analyzed with special reference to etiology and kind of operative procedures. Good results were obtained after reconstructive operations.
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