Atherosclerosis and Its Treatment

Atherosclerosis is one of the diseases of the cardiovascular system which is due to many causes. There is a number of factors which may determine its de­velopment.

Atherosclerosis of the blood vessels results from metabolic disturbances and particularly from disturbances of cholesterol exchange. These disturbances begin long before there is any external evidence of the disease. Therefore the doctor must prevent its appearance beginning preventive measures and treat­ment as early as possible.

Vitamins are widely used in the treatment of atherosclerosis because some of them improve the metabolic processes and others dilate the vessels, particu­larly the peripheral ones.

Other drugs administered in treating atherosclerosis are the so-called lipo-tropic substances, which prevent fat from accumulating in the organism.

Since the nervous system affects the metabolic processes in the human body the patients with atherosclerosis are prescribed such drugs as bromide and vale­rian to improve its general condition.

Gastric and Duodenal Ulcers

.The Soviet scientists N. Burdenko, L. Koreisha, A. Speransky and B. Mogilnitsky proved the existence of an association between a lesion of the central and peripheral nervous systems and the development of ulcer.

The neurogenous theory of the pathogenesis of ulcer was developed further into the corticovisceral theory by K. Bykov and I. Kurtsin. According to this theory gastric and duodenal ulcers were found to result from disturbances in the central nervous system, i.e. the brain cortex.

Gastric and duodenal ulcers are found to develop more frequently in men than in women, mainly at ages of 25 to 40 years. This disease is characterized by pains, haemorrhages, nausea, vomiting, etc[At the onset of the disease pain is usually dull in character. In gastric ulcers pain is found to grow worse after meals. Acute pain in the stomach is known to be characteristic of perforated ulcers. Pain due to ulcer is well known to occur periodically and be intermittent in occurrence.

The course of ulcer has proved to vary with age and sex, location of ulcers, etc. At a young age its course has no characteristic clinical manifestations. In old persons the incidence of ulcers is known to be rare. But they are often com­plicated by considerable haemorrhage resulting from sclerotic changes in the stomach.

Ulcers are known to have a chronic, cyclic course, with remissions from 6 to 12 months. Exacerbation (обострение) of ulcers, particularly that of duode­nal ulcers, has been found to occur in spring and autumn.

Cancer of the Stomach

Gastric carcinoma is a frequent form of cancer causing about 35-40% of all deaths from malignant tumours.

This disease is more common in men than in women. The highest incidence is noted at ages of 50 to 60. Gastric carcinoma is known to have a more malig­nant course in young persons than in old age. The duration of gastric cancer from the appearance of its first manifestations to death is not longer than 1-2years.

The aetiology of cancer is unknown. But such pathologic conditions as be­nign tumours, ulcer of the stomach, gastritis and stomach polyps have been determined to contribute considerably to its development.

According to certain data the use of too hot or too cold food, smoking and alcohol are considered to be responsible for the development of stomach carci­noma.

In the past few years a virus theory of cancer has been suggested. Though this theory is supported by many it has not yet been proved. For a long time many scientists have been discussing the importance of hereditary factors in the development of cancer. The hereditary theory has not yet been confirmed either .

The clinical manifestations of gastric carcinoma vary with the stage of its development, location and spread through the lymphatic nodes and other inner organs. The main symptoms of gastric carcinoma are known to be disturbance in gastric digestion, epigastric pains, loss of weight and sometimes vomiting of blood. A prolonged, usually external, profuse bleeding results in severe anaemia. The appetite is usually reduced.

Botkin's Disease

Botkin's disease, or the so-called epidemic or infectious hepatitis, is an acute viral disease affecting hepatic cells and bile ducts.

The prominent German scientist Virchow believing it to be due to obstruc­tion of the common bile duct with mucus during inflammatory processes in the duodenum, the disease was called catarrhal jaundice.But in 1880 the prominent Russian scientist S. Botkin having advanced the idea of an infectious origin of this disease, proved his suggestions by such facts as the involvement in this pathologic process not only of the liver but also of the nervous system, the kidneys, the enlargement of the spleen, etc.

But it was not before 1940 that the term "Botkin's disease" was introduced into medicine due to the efforts of the well-known Soviet physician M. Konchalovsky.

Botkin's disease occurs in epidemic form. This disease more commonly affects children, adults as well as elderly persons suffering from it frequently too.

Botkin's disease is known to be due to a filterable virus present in the blood, liver and found in stool and urine. The virus is infective only for man. As this virus cannot be seen under a usual microscope, it is revealed only by an elec­tronic one. Being highly virulent the virus survives in water, food, and on hands for days and weeks.

Acute Cholecystitis

Among inflammatory diseases of bile ducts the most frequent is cholecysti­tis or the inflammation of the gallbladder. Cholecystitis is known to occur rarely in isolated condition, inflammatory processes both in the intrahepatic and extra-hepatic ducts, sometimes with the involvement of the liver being associated with it. The main forms of cholecystitis are the following: catarrhal, purulent and gangrenous.

The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area. An attack of pain is usually preceded by physical and mental overstrain, sharp physical move­ments or abnormalities in diet, fatty food and alcohol being responsible for the onset of pain. But sometimes pain is observed to appear suddenly in quite healthy persons. Pain may radiate to the right shoulder, right arm, sternum, and lumbar area, its intensity depending on the form of cholecystitis and the patient's sensi­tivity. The pain grows much worse when the patient is lying on his right side.

Dryness in the mouth, vomiting, nausea, and constipation are the character­istic clinical manifestations of the dise'ase.

During the attack of pain the face is moist with cold perspiration, the skin is pale, the tongue and lips are dry. Even a slight palpation reveals severe tender­ness, it being due to irritation of the peritoneum. Approximately in 40-50% of cases there is slight jaundice of sclerae.jThe biochemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

Purulent form of cholecystitis is highly dangerous to life and requires an emergency operation. An even more severe course is observed in gangrenous cholecystitis. Recovery is achieved by surgical treatment, it being followed by prolonged antibiotic therapy and chemotherapy.

Peritonitis

Peritonitis is known to be general or localized, acute or chronic, primary or secondary.

Acute general purulent peritonitis is believed to be due to perforation of one of the hollow abdominal organs. The most frequent causes are perforating appendicitis, inflammatory conditions of the female sex organs and perforating gastric or duodenal ulcers.

The main symptoms of this condition are vomiting, pain and tenderness in the abdomen, it being considerably enlarged due to the presence of fluid there. The temperature is known to be moderately elevated, the pulse rate being con­siderably changed. The blood analysis usually reveals leucocytosis.

This condition is extremely dangerous to the patient's life, an emergency surgery being performed to save the patient. During the operation the primary focus of peritonitis is to be removed, the danger for the patient being elimi­nated.

Emergency operative treatment is known to be followed by a course of antibiotic treatment, which greatly contributes to the recovery.