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"lead": "«Каротидный шум» — это неправильный звук (систолический шум) выслушиваемый стетоскопом на шее в проекции сонных артерий из-за сужения сонной артерии, или различие в пульсе между двумя сторонами шеи. Он говорит о высоком вероятности поражения сонной артерии. Каротидный шум — симптом атеросклероза. Он скорее является прогностическим признаком инфаркта миокарда, нежели инсульта. Хотя шум и указывает на повышенный риск развития инсульта, последний может произойти как на стороне каротидного шума, так и на противоположной стороне головного мозга.",
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"lead": "Наруше́ние созна́ния — состояние расстроенного сознания, синдромы его выключения (кома, сопор, оглушение) или помрачения (онейроид, делирий, сумеречное состояние сознания). Полноценное функционирование сознания предполагает состояние бодрствования, обусловленное полноценной реализацией когнитивной функции полушарий головного мозга и их взаимоотношений с пробуждающими механизмами ретикулярной формации, распространение ядер и проводящих путей которой обнаружены в диэнцефальной области, среднем мозге, варолиевом мосте и продолговатом мозге.\r\n\r\nРетикулярная активирующая система представляет собой функциональное, а не морфологическое понятие и располагается вдоль центральной оси диэнцефальной области и верхних отделов ствола мозга. Это система получает афферентные импульсы из многих соматических, висцеральных, слуховых, и зрительных сенсорных проводящих путей, направляет их в ретикулярное ядро зрительного бугра, из которого, в свою очередь, активация распространяется по всем отделам коры головного мозгаНарушение сознания является проявлением дисфункции полушарий, верхних отделов ствола головного мозга, или и той, и другой области одновременно. Так, местное поражение супратенториальных структур может носить распространенный характер, а может, вызывая отёк, смещать мозговые структуры, приводя к транстенториальной герниации, сдавлению диэнцефальных отделов головного мозга и нарушению функции диэнцефальной активирующей системы.\r\n\r\nПервичные субтенториальные процессы (ствола мозга и мозжечка) могут сдавливать или непосредственно повреждать ретикулярную активирующую систему между средними отделами варолиевого моста и диэнцефальной областью.\r\nМетаболические или инфекционные заболевания могут оказывать угнетающее воздействие на функцию полушарий и ствола головного мозга посредством патологического содержания компонентов крови или прямого токсического эффекта.\r\nНарушение сознания может наблюдаться также при нарушении мозгового кровообращения (синкопы и инфаркт) или при изменении биоэлектрической активности мозга (эпилепсия). Неадекватный мозговой кровоток и химический дисбаланс крови может также вызывать нарушение электрической активности мозга.\r\nСотрясение головного мозга и психологические расстройства вызывают нарушение сознания без видимых структурных изменений мозга.",
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"etiology": "<p>Причиной появления полипов могут стать: </p>\r\n<ul>\r\n<li>частые простудные и инфекционные заболевания, сопровождающиеся насморком </li>\r\n<li>хронические синуситы (воспаления околоносовых пазух – гайморит, фронтит, этмоидит) </li>\r\n<li>аллергический насморк, вызванный вдыханием домашней и библиотечной пыли, пыльцы растений, спор грибов, шерсти животных, частиц бытовой химии, соединений хрома </li>\r\n<li>сильное искривление носовой перегородки, вызывающее нарушения дыхания и разрастание слизистой </li>\r\n<li>наследственная склонность к образованию полипов </li>\r\n<li>патологическая реакция иммунной системы </li>\r\n</ul>\r\n<p>Повлиять на возникновение полипов может ряд заболеваний: астма, кистозный фиброз, аспириновая непереносимость и др. </p>",
"pathogenesis": "<p>Несмотря на разнородность причин, вызывающих полипы, развивается заболевание по одной схеме. Слизистой околоносовых пазух или решетчатого лабиринта приходится функционировать длительное время в условиях повышенной активности. Это необходимо, чтобы справиться с аллергией, воспалением или иным неблагоприятным фактором. Сначала эту задачу она выполняет, но постепенно резервы иссякают, а действие фактора не прекращается. </p>\r\n<p>Тогда организм старается компенсировать недостаточную эффективность работы слизистой, увеличивая ее площадь. Ткань начинает разрастаться, формируется полип. Сначала он локализован в органе, в котором он образовался, но постепенно, с увеличением своих размеров, начинает свешиваться в полость носа. Там он препятствует дыханию, со временем серьезно его затрудняя. </p>\r\n<p>Сформировавшийся полип выглядит следующим образом: это грибовидное образование на ножке, которое свисает в носовую полость своей широкой частью. Цвет полипа может варьироваться от перламутрового до красного в зависимости от того, насколько хорошо в нем развито кровоснабжение. Для него характерен умеренный рост, шарообразная или цилиндрическая форма. </p>",
"diagnostics": "<p>Как правило, полипы легко обнаруживаются в ходе риноскопии. Важной задачей специалиста является дифференциальная диагностика от доброкачественных, злокачественных опухолей и иных заболеваний. Для этого проводя исследования: </p>\r\n<ul>\r\n<li>Компьютерную томографию носовых пазух. Ее проводят, как правило, перед операцией, для того, чтобы точно выявить локализацию полипа. </li>\r\n<li>Биопсия. Кусочек ткани, составляющей полип, подвергают всестороннему исследованию, изучают под микроскопом его структуру, величину и форму клеток. </li>\r\n<li>Серологическое исследование. Оно позволяет при отсутствии в крови определенных антител исключить склерому, туберкулез, сифилис, проказа. Данные заболевания иногда дают похожие уплотнения ткани (гранулемы), которые можно принять за полипы. </li>\r\n</ul>",
"treatment": "<p>Консервативное лечение включает в себя: терапия инфекционных недугов; иммунокорригирующая терапия; </p>\r\n<ul>\r\n<li>устранение факторов, которые провоцируют более интенсивный рост полипов; </li>\r\n<li>местное лечение антивоспалительными, антигистаминными, антибактериальными препаратами; </li>\r\n<li>специфическая иммунотерапия с применением бактериальных и не бактериальных аллергенов; </li>\r\n<li>возможно назначение различных народных средств. </li>\r\n</ul>\r\n<p>Если консервативные методики не приносят должных результатов, то прибегают к операции по удалению полипа. </p>",
"prevention": "<p>Профилактика полипов носа заключается в своевременном выявлении аллергических заболеваний, устранении их причин и назначении корректного лечения; ранней диагностике инфекционно-воспалительных процессов в носоглотке и их ликвидации; не допущении перехода заболеваний носоглотки в хроническую форму. </p>",
"clinical_picture": "<p>При полипозе носа возникают такие симптомы: </p>\r\n<ul>\r\n<li>Длительное затрудненное носовое дыхание, чувство заложенности носа. Это вызвано тем, что разросшаяся слизистая частично или полностью перекрывает просвет носового хода. </li>\r\n<li>Насморк, выделения слизистые или слизисто-гнойные. Это признаки присоединения вторичной инфекции и интенсивной работы слизистых желез. </li>\r\n<li>Чихание при полипах в носу возникает из-за того, что вырост слизистой оболочки касается ресничек, и они воспринимают его как инородный предмет. А чихание – это защитная реакция, которая позволяет от него избавиться. </li>\r\n<li>Нарушения обоняния, вплоть до полной потери чувствительности к запахам. При разрастании соединительной ткани, в полипе нарушается работа клеток-рецепторов, которые воспринимают запахи. </li>\r\n<li>Головная боль является следствием сдавливания разросшейся тканью нервных окончаний. Недостаток кислорода, вызванный полипами, вызывает кислородное голодание мозга. Часто болевые ощущения связаны с воспалением придаточных пазух носа. </li>\r\n<li>Нарушения голоса, гнусавость. Нос является органом, который берет участие в образовании голоса. При полипозе прохождение воздуха нарушается и это становится причиной того, что человек говорит «в нос». </li>\r\n</ul>",
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"lead": "Нарушение здоровья, относящееся к группе симптомы и признаки, относящиеся к мочевой системе",
"description": " Полиурия — состояние организма, при котором в результате нарушения водного баланса происходит увеличение выработки мочи и частоты мочеиспускания. ",
"etiology": "<p>Все причины возникновения делятся на 2 большие группы: патологическую и физиологическую. </p>\r\n<p>К физиологическим причинам заболевания относят: </p>\r\n<ul>\r\n<li>прием лекарств, способствующих увеличению выработки мочи; </li>\r\n<li>большое количество выпитой воды; </li>\r\n<li>переохлаждение; </li>\r\n<li>добавление в рацион продукции, содержащей глюкозу и ведущей к ухудшению обратного всасывания первично выработанной урины. </li>\r\n</ul>\r\n<p>К патологической группе относят такие факторы, как: </p>\r\n<ul>\r\n<li>наличие камней в почках; </li>\r\n<li>воспалительные процессы в мочевом пузыре; </li>\r\n<li>заболевания простаты; </li>\r\n<li>раковые образования в мочевом пузыре; </li>\r\n<li>почечную кисту; </li>\r\n<li>острой формы пиелонефрита; </li>\r\n<li>хронического типа пиелонефрита у беременных женщин; </li>\r\n<li>сердечной недостаточности; </li>\r\n<li>одного из типов диабета; </li>\r\n<li>неврологические заболевания; </li>\r\n<li>бессимптомного пиелонефрита, появляющегося у женщин, у которых последний триместр беременности. </li>\r\n</ul>",
"pathogenesis": "<p>Механизм возникновения патологии связан с нарушением процесса обратного всасывания воды при прохождении первичной мочи через систему почечных канальцев. В норме из первичной мочи отфильтровываются лишь токсины и вредные вещества, которые в дальнейшем поступают в мочевой пузырь, а нужные компоненты и вода остаются в организме. При полиурии этот процесс нарушается — организм теряет жидкость в повышенных объемах. </p>\r\n<p> </p>",
"diagnostics": "<p>Ведущий метод выявления полиурии — проба Зимницкого — сбор мочи, выделенной за сутки, с определением объема каждой порции и последующим изучением в лабораторных условиях. Исследованию подлежит литраж выведенной мочи и ее удельный вес. </p>\r\n<p>Специальная проба с лишением жидкости позволяет достоверно выявить основное заболевание, ставшее причиной полиурии. Суть метода — в сознательном введении организма в состояние обезвоживания на период от 4 до 18 часов. В течение этого времени у пациента контролируют осмоляльность — особый показатель, характеризующий концентрационную способность почек. Одновременно оценивают баланс жидкости в плазме крови. </p>\r\n<p>Дополнительными методами исследования являются: </p>\r\n<ul>\r\n<li>анализ мочи с микроскопическим исследованием осадка; </li>\r\n<li>биохимия крови; </li>\r\n<li>коагулограмма — исследование на свертываемость; </li>\r\n<li>цитоскопия; </li>\r\n<li>УЗИ почек и органов брюшины; </li>\r\n<li>экскреторная урография почек; </li>\r\n<li>КТ и МРТ. </li>\r\n</ul>\r\n<p>При подозрении на заболевания эндокринного характера назначают: </p>\r\n<ul>\r\n<li>исследование крови на сахар и гормоны; </li>\r\n<li>УЗИ щитовидной железы; </li>\r\n<li>рентген костей; </li>\r\n<li>глюкозотолерантный тест. </li>\r\n</ul>",
"treatment": "<p>Терапия полиурии сводится к лечению основного заболевания. При ярко выраженной дегидратации имеет смысл регидратационная терапия. В зависимости от степени обезвоживания применяют оральную или парентеральную регидратацию. <br class=\"SCXW242796711\" /> <br class=\"SCXW242796711\" />Оральная регидратация применяется при легкой и средней степени обезвоживания и заключается в приеме готовых растворов, содержащих определенную пропорцию углеводов и электролитов: Регидрон, Оралит. <br class=\"SCXW242796711\" /> <br class=\"SCXW242796711\" />Парентеральная регидратация назначается при тяжелых степенях дегидратации. Чаще всего внутривенно вводят физиологический раствор. Необходимое количество рассчитывают исходя из массы тела человека и предполагаемых потерь жидкости. <br class=\"SCXW242796711\" /> </p>",
"prevention": "<p>Профилактические мероприятия полиурии включают в себя: </p>\r\n<ul>\r\n<li>нормализацию режима питания; </li>\r\n<li>употребление в малых количествах продуктов, которые могут повышать выработку организмом мочи — содержащие кофеин напитки, шоколад, приправы; </li>\r\n<li>контроль за суточным употреблением жидкости. Норма должна составлять полтора или два литра; </li>\r\n<li>полный отказ от спиртных напитков; </li>\r\n<li>своевременная диагностика и лечение заболеваний, которые могут вызвать полиурию; </li>\r\n<li>прохождение полного врачебного обследования два раза в год. </li>\r\n</ul>",
"clinical_picture": "<p>Наиболее часто встречаемым в медицинской практике симптомом полиурии является чрезмерное мочеиспускание с регулярными интервалами в течение дня и ночи.. В зависимости от этиологии, признаками синдрома также являются колебания артериального давления, потеря веса и общая усталость. <br class=\"SCXW14445518\" /> <br class=\"SCXW14445518\" />Полиурия всегда сопровождается жаждой, которая возникает вследствие снижения объема плазмы. Чтобы восполнить объем, человек, иногда сам того не замечая, увеличивает количество выпиваемой воды. Длительное повышенное потребление жидкости называется полидипсией. <br class=\"SCXW14445518\" /> <br class=\"SCXW14445518\" />Частое мочеиспускание в больших объемах становится причиной дегидратации или обезвоживания. Это проявляется сухостью слизистых оболочек и кожи, общей слабостью и утомляемостью. <br class=\"SCXW14445518\" /> <br class=\"SCXW14445518\" />Возможен такой вариант, как ночная полиурия или никтурия — преобладание ночного диуреза над дневным. Больному часто приходится просыпаться, чтобы опорожнить мочевой пузырь, что приводит к недосыпанию. <br class=\"SCXW14445518\" /> <br class=\"SCXW14445518\" />Так как полиурия не является патологией, а только симптомом, то кроме нее проявляются признаки основного заболевания. </p>",
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