Modern technologies of medical rehabilitation of children with chronic constipation

Medical rehabilitation of children with chronic constipation is a complex system of measures, including: rational nutrition, drug therapy, physiotherapy, physical therapy, massage, et. The main tasks of medical rehabilitation are: normalization of the passage of fecal masses, tone of the sphincter apparatus of the rectum and pelvic floor muscles, restoration of the defecation reflex and reduction of astheno-vegetative disorders. The article describes the methods of physiotherapy used in the treatment of chronic constipation in combination with diet, daily routine, medication, physical therapy and massage: amplipulstherapy, interference therapy, percutaneous electroneurostimulation, high-intensity magnetic therapy, transcranial electrostimulation. Balneotherapy methods are widely used: internal and external application of mineral waters, as well as heat treatment and peloid therapy. Natural and artificial physical factors are assigned differentially, taking into account the type of intestinal motility disorders. One of the promising areas of modern physiotherapy is the study of the combined and combined use of two physical factors that increase the effectiveness of the program of medical rehabilitation of children with chronic constipation. Methods of medical and psychological correction are of great importance in the medical rehabilitation of children with chronic constipation.

Therapeutic physical factors in restorative treatment of patients with nonalcoholic steatohepatitis combined with biliary sludge

Purpose of the study. To study the effectiveness of restorative treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge at the inpatient stage when low-mineralized mineral water and preformed peloid therapy are included in the basic scheme. Material and methods. A total of 119 patients with nonalcoholic steatohepatitis in combination with biliary sludge were observed and distributed into 3 randomized groups: in the main group, 39 patients received basic drug therapy in accordance with the Federal Clinical Recommendations, «Sernovodskaya» mineral water for ingestion and in the form of gallbladder cleanse, and preformed application peloid therapy; in the comparison group, 40people received only pharmacotherapy and balneotherapy, in the control group — pharmacotherapy. The control of the effectiveness of the treatment was carried out according to the dynamics of clinical, biochemical and functional studies. Results. The inclusion of medium-mineralized mineral water «Sernovodskaya» in the form of drinking treatment and cleanse and preformed peloid therapy in the complex of therapeutic measures for patients provides a significant decrease in the intensity of clinical manifestations by 54.4% versus 40% with the use of pharmaco- and balneotherapy and 28,8% — with only drug therapy; cytolysis and cholestasis syndromes — by 46,2; 39,8 and 28.9%, respectively. Restoration of the contractile function of the gallbladder is observed in 78,8% of cases versus 65.6% when using only pharmacotherapy. The duration of hospitalization in the main group was reduced by 3 days, and in the comparison group — by 1,5 days, compared with the indicators in the control group. Conclusion. The developed new medical technology for the treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge with the combined use of mineral waters and preformed peloid preparations against the background of basic pharmacotherapy at the inpatient stage provides a significant increase in the efficiency of therapeutic measures.

Characteristics of Techirghiol Sludge and Different Methods of Peloid Therapy

The paper highlights the physical, chemical and biochemical composition of the sludge and systematizes the beneficial effects obtained by applying Techirghiol sludge through specific procedures. Techirghiol sludge is a well hydrated sapropelic sludge, with a high content of minerals and organic compounds. Following the application of sludge on the skin, a series of processes take place: stimulation of sensitive endings, energy and substance exchanges, general thermoregulation, vitamin D synthesis, regulation of homeostasis balance by immune, endocrine and neurovegetative mechanisms, better tissue oxygenation. The use of Techirghiol sludge in medical therapies is often alternative and complementary treatments in the treatment of diseases that can be good solutions for amelioration various diseases.

AB0589 STUDY OF THE EFFECTIVENESS OF PELOID THERAPY IN THE TREATMENT OF OSTEOARTHRITIS OF THE KNEE JOINTS IN THE CONDITIONS OF THE SANATORIUM “ CHUVASHIYAKURORT»

Background:Peloids are successfully used in the treatment of various diseases. The sapropel mud-silt deposits of freshwater reservoirs are the most widely used for joint diseases. The sapropel mud from the freshwater lake «Kogoyar» (Russia, Cheboksary) has unique properties. The right to extract and use sapropel belongs to the sanatorium “Chuvashiyakurort” (Russia) [1]. The organic biostimulants of the sapropel mud (bitumen, fatty and humic acids, amino acids, hormones, lipids) have a pronounced anti-inflammatory effect on cartilage. High humidity (87%) provides sapropel high thermal qualities.Objectives:The aim of the research was to study the effectiveness of peloid therapy in patients with osteoarthritis of the knee joints at the II X-ray stage using the sapropel mud of Lake «Kogoyar».Methods:The object of the study was 150 patients of the sanatorium “Chuvashiyakurort” aged from 55 to 62 years (89 women and 61 men). The patients were randomly divided into 2 groups. The first group (75 people) received basic therapy - chondroprotectors (Teraflex) and nonsteroidal anti-inflammatory drugs (NSAIDs) on demand. The second group (75 people) received basic therapy with the addition of peloid application. The peloid was used in the natural, minimally modified, undiluted form. The peloid therapy protocol: the peloid was heated to 50 °C before use and applied to the affected joint with a layer of 4-5 cm thick and wrapped with a warm cloth on top. The procedure took 30 minutes. Five three-day cycles of applications with one-day breaks were performed. At the end of the procedure, a patient was unraveled, the mud was removed from him and he took a warm shower. Then he had a rest for 30 to 40 minutes in the recreation room. Before the start of treatment and after its completion, a survey of patients was conducted with the fixation of pain on the VAS scale, the duration of morning stiffness, fatigue and decreased performance, general discomfort, dependence on taking NSAIDs.Results:The analysis of the survey results revealed a decrease in VAS pain and morning stiffness in both groups. However, patients in the second group had a more pronounced reduction in the average VAS pain score (26% lower compared to the first group) and the duration of morning stiffness (20% lower compared to the first group). In addition, the number of patients who indicated a decrease in dependence on taking NSAIDs was 28% higher than in the group that received only standard therapy.Conclusion:Peloid therapy enabled to reduce the pain on the back, reduce the frequency of the need for NSAIDs, improve the condition of patients, which is the reflection of the positive clinical dynamics in patients with osteoarthritis of the knee joints, and contributed to the effectiveness of treatment.References:[1]Sakharova A.S. Modern methods of medical rehabilitation in the practice of doctors of various specialties. Cheboksary: Publishing House of Chuvash State University, 2019: 110-115.Disclosure of Interests:None declared.

The parameters of regional hemodynamics in patients with chronic pelvic pain syndrome against the background of magnetic stimulation and peloid therapy

The study of Doppler parameters of hemodynamics of internal genital organs was carried out in 102 patients with chronic pelvic pain syndrome, 54 men and 48 women. It was found that against the background of extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor and peloid therapy in patients of the main group, there is an improvement in the Doppler parameters of the hemodynamics of the internal genital organs in the form of a decrease in angle-independent indices: systolic-diastolic ratio, resistance and pulsation index, an increase in blood flow velocity on average by 36,2% in men and 42,1% in women from the initial values with the results being preserved for 6 months. In patients of the control group, Doppler measurements of the arteries of the prostate and ovaries showed no significant dynamics of vascular indices and blood flow velocities in the presence of a tendency to unidirectional shifts in parameters with the main group.

Sanatory therapy of chronic prostatitis with the use of physiobalneotherapy

The purpose of the study. Evaluation of the effectiveness of sanatory therapy in patients with chronic prostatitis using peloid therapy and extracorporeal magnetic stimulation. Materials and methods. The efficiency of sanatory therapy was studied in 86 patients with chronic prostatitis without exacerbation; the control group received a basic sanatory complex; the main group was additionally prescribed procedures for applying pelloids and extracorporeal magnetic stimulation. Results. In most patients of the main group, it was revealed that the course of sanatory therapy can reduce the severity of the clinical symptoms of chronic prostatitis against the background of improved bacteriological, immunological, and ultrasound indicators with the preservation of treatment results over 12 months, in contrast to the control group against the background of basic sanatory treatment, where the treatment effect remained up to 6 months. Conclusions. Sanatory therapy of patients with chronic prostatitis with the inclusion of peloid therapy and extracorporeal magnetic stimulation procedures has a high clinical effectiveness with the preservation of the results for a year.

Skin care in children with atopic dermatitis

In this article, we described specific features of baby skin and care for it (washing baby's face, bottom; cleaning ears, nose, and eyes; baby's bathing). We also assessed the efficacy of cream-balm ‘Tamba-PS’ (‘Adonis’ LLC, Russia) for the treatment of atopic dermatitis. ‘Tamba-PS’ contains only natural ingredients, including oil extract of native peloids from Lake Tambukan, plant extracts and essential oils, propolis, mumiyo, beeswax, honey, olive oil, sea buckthorn oil, coconut oil, and lecithin. We demonstrated its efficacy in infants and children aged 3 months to 3 years with both focal skin lesions and advanced lesions. Treatment improved children's quality of life, which was evaluated using the Dermatology Life Quality Index (DLQI) for children (from 22.8 ± 3.1 to 10.1 ± 2.0, р < 0.01); ‘socialization’ (according to the ‘KID-questionnaire,’ p ≤ 0.05) and the dynamics of clinical manifestations according to the SCORAD index (from 33.1 ± 2.9 to 14.2 ± 1.8 after therapy, p < 0.01). The unique composition of ‘Tamba-PS’ allows its daily use for problematic, irritated skin of children, as well as to protect normal skin from adverse effects, and as the external therapy for atopic dermatitis (the minimum course is 2 weeks (twice a day); the courses can be repeated if necessary). Key words: atopic dermatitis, Lake Tambukan mud, peloid therapy, skin care

Influence of Peloid Therapy on the Condition and Functional Activity of the Glands of Internal Secretion in Juvenile Rheumatoid Arthritis (Clinical and Experimental Study)

The aim of the study was to assess the dynamics of hormones of the pituitary-gonadal-thyroid axis in patients with juvenile rheumatoid arthritis under the influence of peloid therapy and to establish the corresponding morphological changes in the pituitary gland, gonads and the thyroid gland of white Wistar rats with induced adjuvant arthritis during peloid therapy. Material and methods. 46 patients with juvenile rheumatoid arthritis were examined during their rehabilitation at sanatoria. The effect of peloid therapy on the pituitary-gonadal-thyroid axis was evaluated based on the changes in the levels of the main hormones LH, FSH, estradiol, testosterone, TSH, T3, T4. The control group consisted of 15 healthy age-mates. Morphological changes in the pituitary, testes, ovaries and thyroid gland were studied in 24 white Wistar rats with adjuvant arthritis. Results. In juvenile rheumatoid arthritis, the pituitary-gonad-thyroid axis is activated, which is manifested by a decrease in the production of FSH, LH, TSH, testosterone in boys of all age groups and estradiol both in girls regardless of their age and in boys 12–17 years of age. At the same time, an increase in secretion of T3, T4 was observed. The most pronounced deviations were noted in patients with a systemic form of the disease, with a high degree of severity and duration of the disease. The inclusion of mud therapy into the program of sanatorium rehabilitation leads to positive changes in the levels of the studied hormones. The experiment with induced adjuvant arthritis revealed reversible ultrastructural and tinctorial changes in the thyrotropocytes and gonadotropocytes of the pituitary gland, as well as impaired differentiation and partial destruction of the structural elements in the thyroid gland and gonads. The course of peloid therapy had a positive effect on the condition of the thyroid gland and gonads in the experimental animals, which was manifested by the restoration of structural and functional organization. Conclusion. Peloid therapy has a positive effect on the functional activity of the pituitary-gonadal thyroid axis in patients with juvenile rheumatoid arthritis, which has been confirmed by experimental data.