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Clinical efficacy of netilmicin was evaluated at 22 newborns (body weight from 1000 to 3600 g, delivery on pregnancy period from 28 to 41 weeks) with pneumonia caused by artificial pulmonary ventilation. Pneumonia was moderate at 13 patients and severe at 9 patients. Microorganisms isolated from tracheobronchial aspirates were mainly (in 19 cases of 22) susceptible to netilmicin. The usage of netilmicin in combination with cephalosporins was effective at the main part of the newborns and resulted with the full recovery of 11 newborns (all the patients with moderate pneumonia), in 9 cases improvement was registered (including 7 newborns with severe pneumonia). Newborns with severe pneumonia had a slow pathogens elimination.

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A total of 580 preterm babies born weighing 540-2500 g at terms less than 35 weeks were examined. The mean incidence of neonatal retinopathy under standard conditions of care in Moscow is 26%. The incidence of disease depends on body weight at birth and term of gestation. Risk factors conducive to the development of neonatal retinopathy are maternal diseases (gestosis, chronic somatic and gynecological diseases, hemorrhages in labor, detachment of placenta), and diseases of babies other than low body weight at birth and those due to preterm delivery (bronchopulmonary dysplasia, periventricular leukomalacia, intragastric hemorrhages, severe infection, early anemia, periods of hypercapnia and long oxygen therapy). The disease spontaneously regressed in 78% babies with stages I-II. In 32 (22%) babies the condition progressed to stage III. Preventive cryocoagulation was performed in 24 babies (48 eyes). The efficiency of preventive treatment is 70.4% and depends on the disease pattern. Cooperation of neonatologists and ophthalmologists essentially improves the diagnosis and prevention of severe forms of retinopathy neonatorum.

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The results of the bacteriological investigation of the secretion from the trachea, large bronchi and fauces of 36 newborns (including 27 preterms) with severe pneumonia were analyzed. 20 of them were born of women with complicating somatic, obstetric and gynecologic histories: candidiasis, herpes genitalis, chronic endometritis, adnexitis or chronic pyelonephritis that could be the risk of the fetus intranatal infection. During the acute period of pneumonia in the newborns within the first 4-8 days of life mainly Pseudomonas aeruginosa was isolated (51.3 per cent), Staphylococcus epidermidis, S. haemolyticus and Enterococcus faecalis were less frequent (18.9, 8.1 and 5.4 per cent, respectively). Klebsiella pneumoniae, Streptococcus anhaemolyticus and other organisms were extremely rare. On the whole the gramnegative microflora predominated. The study of the antibiotic susceptibility showed that the majority of the P. aeruginosa isolates were susceptible to amikacin and polymyxin B, the isolates susceptible to ceftazidime were less frequent, 20-25 per cent of the isolates were susceptible to ciprofloxacin, cefoperazone and imipenem and practically no isolates were susceptible to gentamicin. The S.epidermidis isolates were susceptible to rifampicin and vancomycin and in rare cases to fusidin and amikacin and resistant to oxacillin. When the treatment course was more than 15 days, the isolates proved to be susceptible to 1/3 of the presently available antibiotics. Because of the host low protective forces, peculiarities of the infection pathways and high frequency of the resistant strains it is valid to include netilmicin, imipenem, cefoperazone and ceftriaxone to the complex therapy of the newborns along with the substitution immunotherapy.

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The efficacies of bifacid and bifidumbacterin were studied comparatively in the correction of intestinal biocenosis in 60 newborns with infectious inflammatory diseases and intestine disfunction treated with massive doses of antibacterial drugs. The study showed that the use of bifidumbacterin was accompanied by significant disturbances in the biocenosis and by development of the intestinal syndrome. The protective action of the drug was observed after a short-term use only of one antibiotic and when the course of the bifidum therapy was continued after discontinuation of the treatment with antibacterial drugs. The use of bifacid was accompanied by a rapid (by the 2nd or the 5th day fo the treatment) and stable normalization of the stools and a marked improvement of the patient general state. The clinical efficacy of bifacid was much higher than that of bifidumbacterin. At the background of the bifacid therapy there was observed correction of the intestinal microflora composition due to normalization of the count of Bifidobacterium, Lactobacillus and Colibacillus as well as to eradication of opportunistic pathogens.

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To study tolerance of two nonionic X-ray contrasting agents Omnipaque and the iso-osmolar dimer Visipaque, changes in central hemodynamic, myocardial electrophysiological, renal nitrogen-excretory parameters were studied in 50 patients undergoing coronary angiography and ventriculography. The two contrasting agents were found to provide slight negative side effects; however, Visipaque showed better subjective tolerance and less frequently caused adverse reactions and complications. The beneficial properties of Visipaque allows the authors to recommend that it should be used in angiographic studies in high-risk patients.

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To evaluate the tolerance of ionic versus nonionic CM, a double-blind randomized study was performed in 90 pts undergoing cardiac angiography. Nonionic CM caused fewer adverse reactions. These were no different in tolerance of two nonionic CM. Selective injections of urografin induced significant prolongation of RR, QT, PQ intervals on standard ECG of A-H and H-V intervals on intracardiac ECG. Nonionic CM induced the minimal electrophysiological disturbances. During left ventriculography urografin induced a significant decreased in left ventricular systolic pressure, -dp/dt value and increase in both end-diastolic pressure and heart rate. Nonionic CM produced less hemodynamics adverse effects. Urografin administration produced insignificant increasing of creatinine and urea blood levels. Minimal hemodynamics and ECG alterations caused by nonionic CM and low risk of complications determine the preferable using of nonionic CM in cardiac angiography.

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Coronary angiography and left ventriculography was performed in 45 coronary patients with stable angina using triombrast and in 45 similar patients using omnipaque. Omnipaque was better tolerated than triombrast. The negative electrocardiographic and hemodynamic side effects were less marked with omnipaque than triombrast. The incidence of complication was lower in patients with omnipaque.

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Angiography of the coronary arteries with iohexol was carried out in 45 coronary patients with stable angina pectoris and that with diatrizoate in another group of 45 similar patients. Iohexol was tolerated better that diatrizoate. Physiological and hemodynamic side effects of iohexol were less marked than those of diatrizoate.

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A study of the correlation between electrophysiologic effects of intracoronary injections of radiopaque agents and anatomical features of blood supply of cardiac conduction was carried out in 60 patients with intact coronary arteries. Coronary angiography was performed in all the patients. Disorders in cardiac conduction and repolarization in the myocardium were observed in intracoronary injection of radiopaque agents, which was accompanied by the development of S-A bradycardia. A bradyarrhythmic reaction type depends on prevalence of the left or right coronary artery in the atrial blood supply and cardiac conduction. The bradyarrhythmic effect was more pronounced in injection of a radiopaque agent in the right artery than in the left one.

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Coronary angiography (CAG) was performed in the acute period of myocardial infarction in 41 patients using verografin and in 38 patients using omnipack. In a high risk of CAG performance the tolerance of omnipack was better than that of verografin. Omnipack causes allergic reactions less frequently, disturbs less azote excretory function of the kidneys and myocardial bioelectric activity.

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Altogether 30 patients with unstable angina (UA) were examined. In 15 patients omnipaque was used during coronography and ventriculography (VG), in the rest of 15 patients--verografin at common dosages. A study was made of the changes in the indices of central hemodynamics and myocardial contractility resulting from the action of these radiopaque media during VG, and of ECG changes during coronography. VG with verografin was accompanied by more noticeable disorders of left ventricular contractility, an increase in myocardial oxygen consumption; coronography with omnipaque was characterized by later ECG changes, less noticeable disorders of intraventricular conductivity. It is advisable that coronaroventriculography in patients with UA should be performed using a new group of radiopaque media, in particular omnipaque.

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To improve the efficiency of electrocardiographic diagnosis of coronary heart disease, a search for new meaningful ECG parameters has been carried out, using precordial mapping and automated analysis of the maps. The study included 95 coronary patients, whose diagnosis was verified by visual techniques (coronaroangiography and left ventriculography). ECG-12 showed no signs of past focal/scarry lesions in any of the patients, and detected ischemic changes in 23% only. A group of 95 normal subjects was taken as controls. A classifying function was constructed, using mathematical procedures, stepwise discriminant analysis in particular. Used for the diagnosis of coronary disease, it yielded an 83% sensitivity and an 85% specificity.

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Selective coronary radiography was performed in 100 patients with chronic CHD. Three indices of total affection of the coronary arteries including that modified by the authors, were analyzed with regard to assessment of relationships between the main clinical characteristics and indicators of left ventricular functions. A higher sensitivity of Califf's index modified by the authors was noted.

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