[Syndrome of ventricular preexcitation].
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Biomedical subjects
Publications and source records attributed to L I Kovaleva.
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ECG, echo-CG and poly-CG examination of 61 workers with vibration disease revealed in most subjects hyperkinetic type of blood circulation, reduced variability of cardiac rhythm in orthostatic test and increased weight of left ventricle myocardium in 60.3% of the subjects. The authors consider the changes functional.
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Examination in occupational clinic covered 60 male sufferers from vibration disease caused by local vibration (28 patients with I and I-II stages, 26 with II stage, 6 with residual signs). Nearly 36% of examinees demonstrated moderate disorders of bioelectric myocardial activity in left ventricle. Hyperkinetic type of central hemodynamics was diagnosed in 75% of the subjects, hypokinetic one-in 8.3%, eukinetic one-in 16.7%. The hyperkinetic type may promote arterial hypertension during vibration disease.
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Examination of 42 liquidators of Chernobyl power station accident consequences, which was conducted in 5-6 years after the work in Chernobyl, proved 66.7% of examinees to have hypervolemia of hepatic circulation. These changes are due to hyperkinetic type of central hemodynamics. The data obtained prove absence of sclerotic lesions in liver.
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Investigations of the central haemodynamics and myocardial contractility in 73 men, who took part in repairing after the Chernobyl accident in 1986, in 4 years after the accident have shown the hyperkinetic type of circulation in 60.2%, eukinetic in 23.2%, hypokinetic in 15.6% of the examinees. Such changes of the central haemodynamics, increased frequency of the hyperkinetic type are due to the regulatory disorders decreasing the vascular tone in the major and minor circles, amplifying the venous return to heart and increasing the myocardial contractility.
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Examination of 102 patients who developed bronchitis due to exposure to cotton dust running a complicated or noncomplicated course recognized a moderate hyperkininemia in 40% of cases (4.46 +/- 0.43 against the normal 2.90 +/- 0.42) and apparent hypokininemia in 60-63% of cases (0.52 +/- 0.03 against 2.90 +/- 0.42). Hypokininemia appeared in association with pathological shifts in external respiration and central hemodynamics. It is an unfavourable factor contributing to formation of occupation complications of chronic bronchitis: pulmonary emphysema, pulmonary hypertension and cor pulmonale.
The article deals with current issues and quality of the medical labour examinations (MLE) performed by MLE commissions, reveals the reasons accounting for discrepancies in MLE based on the data of the commissions and those of specialized clinics. A clinico-functional examination of 243 in-patient dust bronchitis cases established a late primary diagnosing of dust bronchitis as one of the reasons for invalidism. 3-rd group invalids were mostly workers with lengthy professional background but still before the retirement age, who needed social and labour rehabilitation. The main reason for the discrepancies lies in inadequate examination prior to the MLE commissions decision and prescription of invalidism to the patients with the initial stage of the disease basing on the social criterion.
122 persons who had participated in the Chernobyl nuclear power station disaster control were passed through ECG examinations, as a result of which susceptibility to bradycardia was revealed. To exclude a marked vagal influence on the myocardium, orthostatic, atropine and ephedrine tests were performed. Weakened reactions to atropine and ephedrine indicated a secondary vagotomy caused by the lowered sensitivity of beta-adrenoreceptors.
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