Evaluation of changes in laser Doppler flowmetry indices in patients with a combined subtype of rosacea under the influence of a course of complex phototherapy

BACKGROUND: The development of new methods for the treatment of rosacea, as well as a combination of various methods of physiotherapy, is of scientific and practical interest. In this work, the assessment of changes in microcirculation indices under complex phototherapy has been carried out. AIMS: Тo assess changes in microcirculation indices in patients with a combination of rosacea subtypes according to laser Doppler flowmetry under a course of complex phototherapy. MATERIAL AND METHODS: In 20172020 a randomized controlled study of 130 patients with a combination of rosacea subtypes. All patients were divided into 4 groups. In each separate group, laser therapy and 1% metronidazole cream were used (group I); phototherapy and 1% metronidazole cream (group II); complex photolaser therapy and 1% metronidazole cream (group III); in the comparison group (group IV), patients show only 1% metronidazole cream. The treatment, the duration of which was 3 months, included 6 sessions with an interval of 2 weeks. The effectiveness of therapy was assessed according to the data of laser Doppler flowmetry, reflecting changes in the hemodynamics of the microvasculature in the affected skin areas. RESULTS: The developed complex method, including exposure to intense pulsed light (intense pulsed light, IPL) 5201100 nm in combination with submillisecond neodymium laser radiation 1064 nm (submilisecond Nd: YAG laser 1064 nm) and daily application of 1% metronidazole cream showed the most pronounced improvement in the state of microcirculation according to laser Doppler flowmetry in comparison with the rest groups. Against the background of the course of complex phototherapy for all patients with the combined subtype of rosacea, statistically significant changes were in the volume of blood flow, modulation coefficients, coefficient of variation. On the contrary, no statistically significant changes were found in the ranges corresponding to active regulatory factors endothelial, neurogenic, myogenic, and passive respiratory and cardiac, as well as in the T index. CONCLUSION: After the course of complex phototherapy in the group of patients with a combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of diseases, as well as an improvement in the main indicators of microcirculation according to laser Doppler flowmetry.

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.

Involutive changes in the vulvovaginal area

Involutional changes in the vulvovaginal area involve a series of transformations leading to vulvovaginal atrophy (VVA) during menopause. Signs and symptoms most often observed in this syndrome: vaginal dryness (54.4100%), dyspareunia (17.677.6%), burning (2.056.9%), itching (7.856.6%) and dysuria (5.936.1%). Other complaints include deformity of the vulva, irritation, and recurrent bacterial infections of the urinary tract or vagina, and yeast infection. Vaginal dryness, dyspareunia and irritation are the symptoms that most affect a woman's quality of life. The article analyzes modern ideas about the genitourinary syndrome of menopause. The questions of the mechanisms of occurrence are considered, a description of the clinical picture is given. The issues of treatment of atrophy of the vulvovaginal region are discussed in detail, in particular, special attention is paid to physiotherapeutic methods of treatment.

Variation cardiointervalometry in evaluating the efficiency of medical and psychological rehabilitation measures of military services

BACKGROUND: Тhe main tasks of medical and psychological rehabilitation (MPR): accelerated restoration of the functional state and working capacity of military personnel; increase of reserve capabilities; reduction of the influence of risk factors for various diseases; secondary prevention of chronic diseases and prevention of chronization of acute processes; carrying out measures to eliminate and reduce psychopathological syndromes in order to achieve mental adaptation; restoration of professional health, correction of maladaptosis. AIMS: Is to study the informative value of variational cardiointervalometry (VCM) indicators in assessing the effectiveness of MPR of military personnel. MATERIAL AND METHODS: This study was conducted in the branch Clinical Sanatorium Volga of the Federal State Budgetary Institution Privolzhsky of the Ministry of Defense of the Russian Federation during the work of the psychotherapy room with the category of MPR for 12 months. In addition to the regulated volume of diagnostic studies, the Device for psychophysiological testing UPFT-1/30 Psychophysiologist (manufacturer of LLC NPKF Medikom MTD, Russia) was used. One of the research methods is the assessment of the functional state of the heart rhythm by the method of variational cardiointervalometry (VCM) at admission to MPR and before discharge (also referred to in the literature as heart rate variability, HRV). The study was conducted with 116 servicemen undergoing MPR for fatigue of 12 degrees for 10 days. Representatives of the Strategic Missile Forces (RVSN) ― 34 people; aerospace forces (VKS) ― 32 people; ground forces (SV) ― 50 people. The data is processed in StatSoft Statistica 10 Russian Portable 10.0.1011.0 x86. RESULTS: The average values for the entire group (116 servicemen): at admission and before discharge IN (stress index) increased statistically significantly from 284.5 to 359.7 cu; VLF-decreased from 21.1% to 16.0%; LF/HF (vagosympathetic interaction index) ― from 2.7 to 4.0 cu; Centralization index ― from 3.8 to 5.1 cu; PARS (indicator of adaptation of regulatory systems) ― from 4.6 to 5.3 cu. The result is a pronounced tension of regulatory systems, active mobilization of protective mechanisms, increased activity of the sympatho-adrenal system and the pituitary-adrenal system. CONCLUSION: VCM (HRV) is one of the practical informative methods. RVSN: an increase in the voltage of regulatory systems as a reaction to physical exertion, a post-loading energy-deficient state, the index of vagosympathetic interaction has shifted to the parameters of the norm.VCS: an increase in the voltage of regulatory systems, an increase in the activation of the sympathetic nervous system, an active mobilization of protective mechanisms. SV: a tendency to reduce the voltage of regulatory systems, a post-loading energy-deficient state, a balanced state of the autonomic nervous system (VNS). A delayed training effect is likely, changes occur in the late phases of recovery, after the end of the rehabilitation period.

Clinical efficiency of the combined application of physiotherapeutic technologies and drinking mineral waters in patients with curral skin changes under conditions of insulin resistance

BACKGROUND: One of the effective and pathogenetically substantiated methods of therapeutic action on cicatricial changes in the skin are laser technologies in combination with collagenases. However, as previous studies have shown, the presence of metabolic syndrome in patients significantly reduces the clinical efficacy of the combined use of laser therapy and phonophoresis of Fermencol. The most reasonable solution in this situation can be scientific research and experience in the practical use of drinking mineral waters, which have a high corrective efficiency in relation to metabolic processes, the course of which is significantly impaired in type II diabetes mellitus and metabolic syndrome. AIMS: Assessment of clinical indicators of cicatricial changes in the skin of patients with metabolic syndrome in the combined application of the method of phonophoresis Fermenkol, fractional photothermolysis and drinking mineral waters. MATERIAL AND METHODS: The study included 60 patients (49 men and 11 women) with cicatricial changes in the skin aged 19 to 50 years, with a confirmed diagnosis of metabolic syndrome. All patients by the method of simple fixed randomization were divided into two groups: the control group (30 people) and the main group (30 people). Both groups received treatment, which included a course of phonophoresis of 0.01% Fermencol gel in combination with the technique of fractional laser therapy. Patients of the main group, in contrast to the control group, in addition to the specified physiotherapeutic treatment received bottled sodium bicarbonate-chloride water Essentuki No. 17 (mineralization 11.8 g/l) at room temperature, 200250 ml three times a day for 1520 minutes before meals for 3 weeks. RESULTS: The addition of physiotherapeutic combined anti-scar therapy with a course of drinking mineral water Essentuki No. 17 in patients with cicatricial changes in the skin in combination with metabolic syndrome was accompanied by a significantly more pronounced clinical effect, assessed by the Vancouver scale and the Dermatological Index of Quality of Life. CONCLUSION: Additional course use of drinking mineral water Essentuki No. 17 is accompanied by a more pronounced dynamics of clinical manifestations of cicatricial deformities of the skin and an indicator of the quality of life of patients, due to the sanogenetic mechanisms of the drinking balneofactor.

Transdermal electroneurostimulation in patients with diabetic neuropathy

BACKGROUND: The dynamics of pain syndrome determined using various algic tests in the treatment of patients with diabetic neuropathic pain syndrome using tansdermal electroneurostimulation has been little studied. AIMS: To study the dynamics of projection zones of neuropathic pain syndrome in patients with diabetic polyneuropathy while using TENS. MATERIAL AND METHODS: 75 patients with diabetic polyneuropathy were examined. The control group (n=25; 33.3%) received a course of standard pharmacotherapy. The main group consisted of 2 groups. The first group (n=25; 33.3%) underwent a course of high-frequency low-amplitude (HL TENS) transdermal electroneurostimulation, and the second group (n=25; 33.3%) underwent a course of low-frequency high-amplitude (LH TENS) therapy. Pain syndrome was determined using a visual analogue scale (VAS) and a body diagram before, after treatment and in the long-term period. RESULTS: Using a visual analogue scale (VAS), the dynamics of pain syndrome after the use of LF TENS was lower than after the use of HFTENS by an average of 35% (p 0.05). The data obtained indicate that the regression of pain syndrome after physiotherapeutic treatment of TENS in patients from the main comparison groups exceeds similar indicators in patients from the control group by an average of 63% (p 0.05) both immediately after the course of exposure and in the distant the observation period by 23%. Against the background of TENS, the area of pain syndrome according to the body pattern significantly decreased by 53% after treatment (p 0.05) and by 65.6% in the long-term period (p 0.05), compared with a decrease in the area of pain syndrome in the control group. CONCLUSION: There were revealed significant differences between the quantitative and projection forms of pain measurement. The use of TENS enhances the analgesic effect of drug therapy in the treatment of diabetic neuropathic pain syndrome by 1.37 times while maintaining this effect without negative dynamics for 2 months after the end of the course of non-drug therapy. The developed technique for assessing pain syndrome using a body diagram in combination with a visual analogue scale (VAS) in patients with diabetic polyneuropathy provides a more reliable assessment of pain syndrome.

Rehabilitation program for acute poisoning in a toxicological hospital

BACKGROUND: Diagnostics and treatment of acute poisoning, as well as the rehabilitation measures carried out in relation to them, including the stationary stage, are aimed at the most complete restoration of the lost capabilities of the body. AIMS: Increasing the efficiency of medical rehabilitation of acute poisoning (AP) in a toxicological hospital through a combination of drug therapy and non-drug treatment with preformed physical factors. MATERIAL AND METHODS: Of 1,207 patients with AP psychopharmacological agents (pPFA), neurotoxicants (pNT), cauterizing agents (pCA) and snake bites (SB), who were in the toxicology department of the N.V. Sklifosovsky, 421 patients with an unfavorable course of AP were subjected to an in-depth examination. Intravenous laser hemotherapy (LGT), hyperbaric oxygenation (HBO), mesodiencephalic modulation (MDM), wave biomechanotherapy (WBMT) and ethylmethylhydroxypyridine succinate (EP) were used in cases of 291 patients of the main groups. RESULTS: The unfavorable course of AP was accompanied by an increase in the duration of treatment by 2.26.8 times due to the addition of pneumonia (pPFA), toxicohypoxic encephalopathy (pNT), severe burns of the gastrointestinal tract (pCA) and local edematous-inflammatory changes (SB). There was a syndrome of high blood viscosity and moderate endotoxicosis. The best clinical and laboratory results were obtained with a combination of LHT (90 minutes) with EP (pPFA), HBO and EP (pCA), HBO, MDM, EP (heavy pNT), HBO, EP (moderate pNT) and WBMT (SB). The adaptive capabilities of the organism, the state of the autonomic nervous system (pNT), neuropsychological indicators and electrical activity of the brain (pNT) improved. CONCLUSION: Programmed rehabilitation made it possible to achieve a noticeable reduction in the incidence of symptoms of the studied poisoning (by 54.693.4%), the time to resolve their manifestations (by 9.175%), as well as inpatient treatment (by 16.159.3%), improving functional performance.

Аpplication of rehabilitation technologies to improve cognitive functions in patients with ischemic stroke

BACKGROUND: Currently, the development and implementation of new effective comprehensive programs for medical rehabilitation of patients who have undergone acute cerebrovascular accident is an important and urgent medical problem. AIMS: To study the effect of combined methods of medical rehabilitation in patients with post-stroke spasticity on cognitive functions and psychoemotional status. MATERIAL AND METHODS: The study involved 60 patients who underwent ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the long-term period. Patients of the control group (30 people) underwent standard drug therapy and medical rehabilitation, patients of the main group (30 people), against the background of standard drug therapy and medical rehabilitation, used combined physiotherapy methods from the Alpha LED Oxy Light Spa apparatus. Subjective indicators of cognitive impairment (Montreal Cognitive Assessment Scale) and psychoemotional defects (Hospital Anxiety and Depression Scale) were assessed. RESULTS: Immediately after treatment on day 14, cognitive functions significantly improved and the degree of psychoemotional defect decreased, which was confirmed by the MOCA and HADS scales. CONCLUSION: The inclusion of combined physiotherapy methods in the standard complex of medical rehabilitation and treatment of patients after ischemic stroke with movement disorders in the form of hemiparesis contributes to a significant improvement in cognitive functions and a decrease in the degree of psychoemotional impairment.

Psychoemotional motivation of motor act development (pilot study)

BACKGROUND: In clinical practice, video motion analysis is widely used. It is known that such a higher mental function as creative thinking manifests itself in the motor activity of the body, as a result of which the movement becomes expressive. Since the quality of the images presented affects the organization of movement, it is presumably possible to characterize this psychosomatic connection through an assessment of the expressiveness of movement. AIMS: fixation in graphic and digital format of expressive movement, as well as the identification of spatio-temporal criteria for the quantitative assessment of expressiveness. MATERIAL AND METHODS: The experiment involved 3 healthy volunteers with different levels of acting training. The structure of expressive movement was presented in a graphic and digital format, which made it possible to calculate spatio-temporal indicators and give an objective quantitative assessment of the quality of expressiveness of movements of the participants in the experiment. RESULTS: It has been established that expressive movements arise with the integration of the following components: motor abilities and motor experience, movement image, plastically expressive structure of movement construction. In addition, expressive movements affect deep psychological functions: imagination, creative thinking, emotional control, etc. CONCLUSION: The inclusion in the course of medical rehabilitation of patients with various pathologies of the direction of ergotherapy, based on the analysis and assessment of the expressiveness of movement, will contribute to the complex restoration of the connection between consciousness and movement, correction of psychosomatic deviations, the expansion of movement patterns, improvement of body feeling and movement control.

Features of medical rehabilitation of patients who have suffered an ischemic stroke and have a history of obstructive chronic disorders of the respiratory system without exacerbation.

Background. To date, the study of respiratory function in the clinic is limited, as a rule, to the determination of bronchial conduction indicators, as well as bronchodilation tests, which at the present stage is insufficient for a deep assessment of the functional state of patients with chronic obstructive pulmonary disease. Aims. The development of personalized medical rehabilitation programs for patients who have undergone ischemic stroke at various stages of rehabilitation, including spa. Materials and methods. The article considers the effectiveness of the new method of treating neurological disorders in patients suffering from acute cerebral circulation disorder and having respiratory system function disorder at different stages of rehabilitation, based on the complex application of physiobalneotherapy, LFC and mechanotherapy in sanatorium and resort conditions. Results. After the course of using physical methods of treatment, patients with comorbid pathology showed improvement in health, relief of breathing, reduction of shortness of breath, cough, sputum production, disappearance of wheezing in the lungs. Conclusion. Patients in the early and late recovery period after acute cerebral circulation disorder with accompanying clinical-functional manifestations of respiratory pathology are shown to include in the rehabilitation complex general gasair carbon dioxide baths, nebulizer inhalations of broncho- and mucolytic preparations, as well as classes on a rowing simulator (rowing) against the background of standard drug therapy and therapeutic exercise in the hall.