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read moreMain topics of the latest issue
Rehabilitation medicine and medicalrehabilitation technologies
Abstract:
Amyoplasia is the most severe form of arthrogryposis and is characterized by congenital multiple joint contractures, hypoplasia or aplasia of skeletal muscles, and limited or complete lack of self-service. The use of compensatory movements allows patients
to be partially or completely independent in daily life. The goal. Based on their own observations and literature, describe compensatory and compensatory movements in children with amyoplasia with upper limb lesions, which patients
use in performing basic self-care skills. Material and methods. From 2008 to 2019 we examined, 236 patients with amyoplasia (10 months to 16 years old) with a typical lesion of the upper extremities and limitation of self-care. Depending
on the nature of the existing anatomical and functional disorders and the level of segmental muscle damage, all patients with amyoplasia were divided into 4 groups. Compensatory movements were studied in each group of patients. Results.
The study showed that children's compensatory movements are numerous and depend on the degree of muscle function disorders of the upper and lower extremities, the rate of psychomotor development of the child. Elbow is a key joint to
determine the functional independence in daily life. In cases of extensor contracture in the elbow patients have severe functional disorders and need personal assistance. Conclusions. Compensatory movements in children with amyoplasia
are useful and help to adapt in daily life and compensate for the loss (or insufficiency) of movements in the joints. Compensatory movements in children are different. They are determined by the range of passive and active movements
in the joints of the upper and low extremities.
Keywords: arthrogryposis, amyoplasia, contractures, compensatory strategies, muscles, daily activity.
DOI: 10.38025/ 2078–1962–2020–98–4–4–13
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Abstract:
Purpоse. Detectiоn and cоrrectiоn оf vegetative deviatiоns in girls with impaired menstrual functiоn, inflammatоry diseases оf appendages, after оperative interventiоns abоut cysts at the stage оf sanatоrium treatment. Materials and methоds. Clinical-functiоnal
studies were carried оut in dynamics, including assessment оf the state оf vegetative regulatiоn by spectral analysis оf heart rhythm variability, catechоlamine urine hоrmоnes. Results. Under supervisiоn there were 126 girls between
the ages оf 9 and 15 whо arrived fоr sanatоrium treatment. Perfоrmed sanatоrium treatment: 66 girls with menstrual functiоn disоrders including pyrecetam electrоphоresis by eye-оccipital methоd against the backgrоund оf sanatоrium
regime, LFC, 32 girls with inflammatоry diseases оf pelvic оrgans receiving SMT – Phоresis оf the mud sоlutiоn оn the abdоminal bоttоm, micrоclysms with sage, 28 girls after gynaecоlоgical оperatiоns receiving laser therapy оn the
оvarian area, phоnоphоresis оn the abdоminal bоttоm and lоcal therapy in the fоrm оf micrоclysms with sage allоwed tо оbtain a favоrable effect оf the functiоnal state оf BHS, first оf all, due tо reductiоn оf the impact оn the BDR
оf the central humоral-metabоlic cоmpоnent, reductiоn оf excessive activity. Cоnclusiоns. The effectiveness оf sanatоrium and spa treatment оf girls with gynecоlоgical pathоlоgy with menstrual cycle disоrders, inflammatоry diseases
оf pelvic оrgans and after gynecоlоgical оperatiоns depends оn the individual purpоse оf the therapeutic cоmplex taking intо accоunt the expressiоn оf deviatiоns оf the state оf the vegetative nervоus system.
Keywords: girls, gynecоlоgical pathоlоgy, sanatоrium treatment.
DOI: 10.38025/ 2078–1962–2020–98–4–14–19
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Abstract:
The presence in children with bronchial asthma of disorders of bronchial patency, hypersecretion, deterioration of the drainage function of the bronchi determines the need to develop new technologies of kinesotherapy aimed at cleansing the bronchial tree
from viscous sputum, strengthening the chest muscles. In this regard, the use of high-frequency thoracic oscillation is promising. Purpose. Study of the effectiveness of high frequency chest oscillation in children with bronchial asthma.
Materials and methods. 60 children with bronchial asthma aged 6 to 17 years were examined. The main group was 30 children who received exposure to high frequency chest oscillation, the comparison group included 30 children who received
only basic therapy, including basic anti-asthma therapy and respiratory gymnastics. Results. In the course of the study, positive dynamics of clinical-functional indicators was revealed, characterized by a decrease in the frequency
of wet and dry seizure cough and its disappearance, increased sputum discharge, normalization of the auscultal picture in the lungs against the background of improving the performance of external breathing and respiratory excursion
of the chest. More pronounced dynamics were observed in children with a moderate disease course, who were in incomplete remission and had initially lower computer flowmetry rates. Conclusion. Based on the studies, the possibility of
using high-frequency chest oscillation in the comprehensive medical rehabilitation of children with bronchial asthma was scientifically substantiated. Peculiarities of action of high-frequency thoracic oscillation on clinical course
of bronchial asthma characterized by improvement of bronchial patency, enhancement of sputum withdrawal, improvement of mobility of ribs, diaphragm, and biomechanics of respiration are studied. High therapeutic effectiveness of high-frequency
chest oscillation in the treatment of bronchial asthma in children was established – 93.3%, which is significantly higher than in the comparison group (73.3%, p
< 0.05).
Keywords: children, bronchial asthma, medical rehabilitation, kinesotherapy, high frequency chest oscill.
DOI: 10.38025/ 2078–1962–2020–98–4–20–25
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Abstract:
Introduction. Postural disorders are significant in severe forms of cerebral palsy (CP). The aim of the work was to study the effect of locomotor training in combination with transcutaneous electrical stimulation of the spinal cord and functional electrical
stimulation (FES) of the muscles of the lower extremities on the restoration of the function of maintaining a vertical posture in children with III level of limitation of motor activity according to the GMFCS classification. Materials
and methods. 20 patients with CP at the age from 8 to 12 years old were examined. Patients of the main group (10 children) received 15 sessions of 45 minutes rehabilitation in the ≪Lokomat≫ robotic simulator in the sequence: 1) ≪Lokomat≫
in combination with FES, 2) ≪Lokomat≫ in combination with transcutaneous electrical stimulation of the spinal cord, 3) ≪Lokomat≫ in combination with FES and transcutaneous electrical stimulation of the spinal cord. The intervals between
courses were 6 months. Patients from the control group (10 children) underwent only locomotor training. Results. The dynamics of regaining control of the upright posture in children was evaluated by the method of stabilometry, which
revealed the active response of the musculoskeletal system in patients of the main group only in the case of combined robotic mechanotherapy and FES. This was manifested in a significant increase in the amplitude of oscillations A
of the pressure center, a clear increase in the variance of the parameters of the LFS parameter, and a decrease in the strength of the correlation between the parameters LFS and A towards normalization. However, with a combination
of locomotor training with FES and transcutaneous electrical stimulation of the spinal cord, there were no convincing signs of improving the regulation of the vertical posture. Conclusion. It is suggested that multilevel neurostimulation
of patients with CP is necessary, which may be more effective, since it will affect the central components of motor activity.
Keywords: cerebral palsy, Lokomat, muscle functional electrical stimulation, transcutaneous spinal cord electrical stimulation, stabilometry.
DOI: 10.38025/ 2078–1962–2020–98–4–26–34
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Abstract:
This article reviews the methods of medical rehabilitation used in the complex treatment of children with chronic constipation. Medical rehabilitation of children with chronic constipation is a complex system of measures that include rational nutrition,
medication therapy, physiotherapy, kinesotherapy, massage, etc. The main objectives of the medical rehabilitation of children with chronic constipation are normalization of the passage through the intestines, improvement of tone of
the pelvic floor muscles, restoration of the defecation reflex. The article describes the methods of physiotherapy used in the treatment of chronic constipation in children in combination with diet, daily regimen, drug treatment, physiotherapy
exercises and massage: amplipulse therapy, interference therapy, ultrasound therapy, percutaneous electroneurostimulation, fluctotuorization, high-intensity magnetic therapy, transient transduction. The methods of balneotherapy are
widely used: the internal and external use of mineral waters, as well as heat therapy and peloidotherapy. Natural and artificial physical factors are assigned differentially, taking into account the type of intestinal motility disorder.
One of the promising directions of modern physiotherapy is to study the combined and combined use of two physical factors that increase the effectiveness of the medical rehabilitation program for children with chronic constipation.
Methods of medical and psychological correction are of great importance in the medical rehabilitation of children with chronic constipation. The medical rehabilitation of children with chronic constipation is carried out taking into
account the individual program of medical rehabilitation of the child, which makes it possible to increase the efficiency of medical rehabilitation and the patient’s quality of life.
Keywords: chronic constipation, children, medical rehabilitation, physiotherapy, electrotherapy, balneotherapy.
DOI: 10.38025/ 2078–1962–2020–98–4–35–41
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Abstract:
The relevance of the problem of children with upper limb trauma medical rehabilitation is determined by the high frequency elbow joint fractures; the risk of complications development, disabilityc of the patient. A comprehensive medical rehabilitation
program assumes a personalized approach and a differentiated prescription of physical factors, depending on the time period of rehabilitation. Early physical rehabilitation is a key link in the complete recovery of the function of
a patient’s limb with damage to the elbow joint. The purpose of this work is to analyze literature and summarize the results of our own research to determine the optimal approaches and methods for medical rehabilitation of children
with upper limb injury. The medical rehabilitation program includes various methods of kinesiotherapy, robotic mechanotherapy, massage, a wide range of apparatus physiotherapy to improve the trophism of the periarticular tissues, to
maintain mobility in joints free from immobilization; gain of the full range of motion in the damaged joint; normalizing tone and strengthening the muscles of the upper limb. Medical rehabilitation of children with elbow joint injury
is carried out from the earliest stage, in stationary conditions, during the period of immobilization. The rehabilitation measures continue in outpatient and polyclinic conditions, during the entire period of immobilization (2–4 weeks)
and then in the post-immobilization period until the limb function is fully restored. It is necessary to monitor the main indicators of the function of the upper limb during the entire period of rehabilitation to assess the effectiveness
of rehabilitation measures, objectify the course of the rehabilitation process and the continuity of rehabilitation programs. Definition of the tasks of medical rehabilitation, differentiated for each stage; the choice of modern, pathogenetically
grounded rehabilitation technologies with an assessment of their effectiveness contribute to a significant increase in the effectiveness of comprehensive rehabilitation programs for children with upper limb trauma.
Keywords: children, trauma, elbow joint, kinesitherapy, robotic mechanoterapy, selective electrostimulation of lymph dynamic and venous outflow, magnetotherapy, selective chromotherapy, biofeedback.
DOI: 10.38025/ 2078–1962–2020–98–4–42–47
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Abstract:
The aim of the study was to study the effect of bishovite baths on the dynamics of plasma S100B protein in children with autism spectrum disorders (ASD). Material and methods. 45 children with autism (F84) aged from 6 to 15 years were examined – general
croup (GG). The control group (KG) consisted of 25 healthy children. I group – 22 children who received the health research therapy (HRT); II group – 23 children who received a course of the baths with bishophite. The examination included
examination by specialists, an assessment of the severity of the disease using the CARS scale (Children’s Rating Scale of Autism), evaluation in blood serum of protein S100B. Results. The content of S100B in children with autism was
significantly higher in comparison with KG. The level of S100B in children with ASD with abnormal development of brain structures (MRI) was significantly higher in comparison with KG and with a group of children without signs of violation
of brain structures. With hard ASD the S100B indicators were higher, and at medium severity did not differ significantly from the KG. After the treatment only in the II group, there was a significant decrease in S100B in GG in children
with abnormalities in the development of the brain and with severe severity. Conclusions. The majority of children with ASD with anomalies of brain structures, there are signs of hypoxia of the brain and violation of the blood-brain
barrier. A positive effect of bischophite baths was revealed in children with ASD, having antioxidant, antitoxic, and neuroprotective effects.
Keywords: autism, children, CARS (Children’s Rating Scale of Autism), S100B protein, violation of the blood-brain barrier, bath with bishophite, the health research therapy.
DOI: 10.38025/ 2078–1962–2020–98–4–48–54
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Abstract:
Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial
hypertension. The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors. The use of non-medicinal agents to reduce blood pressure
is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy. Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment
of hypertension in children. Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically
justified and can be used at all stages of arterial hypertension development. Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis
of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system. Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic
drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods. Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative
corrective method. Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics,
normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes. The use of hardware
physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.
Keywords: children, arterial hypertension, medical rehabilitation, hardware physiotherapy.
DOI: 10.38025/ 2078–1962–2020–98–4–55–61
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Abstract:
The purpose of this article is systematization and analysis of the results of studies on the effectiveness of using dry carbon dioxide baths in the medical rehabilitation of children with various diseases. Dry carbon dioxide baths allow to dose carbon
dioxide during the procedure. The method eliminates the hydrostatic component and excludes the penetration of carbon dioxide into the respiratory tract during the procedure. The article presents the main aspects of the formation of
the mechanism of the therapeutic action of dry carbon dioxide baths in bronchial asthma, atopic dermatitis, vegetative dystonia syndrome, health improvement of children who often suffer from acute respiratory diseases. The use of dry
carbon dioxide bath in medical rehabilitation of children with bronchial asthma helps to reduce the intensity of allergic inflammation, bronchial obstruction, the frequency of exacerbations of the disease. The use of SUV in atopic
dermatitis in children allows you to stop or reduce the manifestations of the main clinical symptoms of the disease, improves the psycho-emotional state of the child. The effectiveness of dry carbonic bath in the vegetative dystonia
is shown (mainly in the sympathicotonic type). The improvement of autonomic regulation and the reduction of tension in the work of the sympathetic department of the autonomic nervous system have been established. The application of
dry carbon dioxide bath in sickly children helps to reduce clinical symptoms of acute respiratory infections, improves mucosal immunity, and reduces the frequency of recurrent infections throughout the year.
Keywords: children, physiotherapy, dry carbon dioxide baths, medical rehabilitation, bronchial asthma, acute respiratory diseases, atopic dermatitis, vegetative dystonia syndrome.
DOI: 10.38025/ 2078–1962–2020–98–4–62–70
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Abstract:
The article is devoted to the medical rehabilitation of children with neurogenic bladder dysfunction. Medical rehabilitation of children with neurogenic bladder dysfunction includes behavioral therapy, medication, biofeedback, and physical therapy. The
popularity of physiotherapy methods is explained by the influence on the main links of pathogenesis, the absence of side effects and the possibility of use in young children. The aim of the study was to study the effectiveness of complex
application of laser radiation and interference currents in the medical rehabilitation of children with PDMP. Materials and methods. Clinical observations and special studies were conducted in 40 children with hyperactive bladder aged
3 to 10 years. The main group consisted of 20 children who received laser therapy and interference currents, 20-a comparison group (without physical therapy). Results. Positive dynamics was observed by the middle of the course of medical
rehabilitation, a third of patients showed a decrease in urgency and urgent urinary incontinence, there was a tendency to normalize the number of urinations per day, by the end of the course of medical rehabilitation, the dynamics
of clinical symptoms was more pronounced and reliable. The favorable influence of interference currents and laser radiation on the clinical course of neurogenic bladder dysfunction, the state of urodynamics and speed characteristics
of the act of urination was revealed. The feasibility of including interference currents and laser radiation in the medical rehabilitation of children with neurogenic bladder dysfunction is scientifically proved. Conclusion. Medical
rehabilitation of children with neurogenic bladder dysfunction with the inclusion of laser radiation and interference currents has a favorable effect on the symptoms of hyperactivity of the bladder, indicators of uroflowmetry, cystometry
and helps restore the normal rhythm of urination. As a result of the research, the effectiveness of medical rehabilitation with the inclusion of laser radiation and interference currents was 85.0 %, in the comparison group only 60.0
% (p
< 0.05).
Keywords: neurogenic bladder dysfunction, overactive bladder, medical rehabilitation, interference currents, laser radiation.
DOI: 10.38025/ 2078–1962–2020–98–4–71–76
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Abstract:
Introduction. Currently, sulfide silt mud of Lake Saka has been widely used in both adult and pediatric practice, which has a positive effect in the treatment of various diseases. The effectiveness of peloidotherapy in the rehabilitation treatment of
children with a number of chronic and disabling diseases has been established. The purpose of the review is to summarize and analyze the accumulated experience of applying peloidotherapy in children with various diseases. In order
to achieve a targeted effect, it is necessary to study previously carried out scientific studies on the in-depth study of the mechanism of therapeutic action of natural factors. Data on methodology of application of peloidotherapy
based on highly mineralized silt sulphide mud of Black Sea resorts are presented. It is necessary to take into account the response of the child body to peloidotherapy, which depend on the individual capabilities of the body, in connection
with which the parameters of mud treatment methods in pediatrics should be justified. Indications for peloidotherapy for diseases of the cardiovascular system have been developed. The purpose of application method of peloidotherapy
in the complex of sanatorium treatment of children with chronic bronchitis, pneumonia and other bronchopulmonary diseases is recognized in order to provide reparative and regenerative, anti-inflammatory, trophostimulating, anti-inflammatory,
resolving effect, to improve bronchial permeability, ventilation function.. The dynamics of endothelial dysfunction indices in children with rheumatoid arthritis under the influence of spa treatment using mud applications, the results
of complex spa treatment of children with different forms of pyelonephritis in clinical-laboratory remission against the background of application of Saki silt mud were studied. In children with celiac disease the efficiency of therapeutic
complex of physical factors influence on pathogenetic links of the disease is shown. Extensive experience has been gained in mud treatment of children with cerebral palsy. Conclusion. In peloidotherapy, individual approaches to comprehensive
rehabilitation are applied depending on the clinical picture of the disease with repeated treatment courses.
Keywords: peloidotherapy, balneo-mud health resort, spa treatment, children.
DOI: 10.38025/ 2078–1962–2020–98–4–77–81
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Abstract:
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.
Keywords: juvenile rheumatoid arthritis, peloid therapy, adjuvant arthritis, pituitary gland, thyroid gland, gonads, laboratory animals.
DOI: 10.38025/ 2078–1962–2020–98–4–82–89
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COVID-19: New methods, relevant recommendations
Abstract:
Models of pathogenetic effects of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the new coronavirus infection 2019 (COVID-19) on the brain indicate the possibility of both direct and indirect damage. Objective of the research.
to study the features of the course of ischemic stroke in patients with COVID-19 disease. Methods. A retrospective analysis of 5 cases of acute ischaemic stroke in patients with COVID 19 who underwent inpatient treatment in march –
April 2020 in one of the multi-specialty hospitals in Saint Petersburg, which was re-designated to receive patients with COVID-19 infection and has a primary vascular department. Results. Among 5 patients COVID-19 (3 men, 2 women;
average age 76.8Ѓ}12.0 years), 3 registered in-hospital ischemic stroke (IHS), 2 patients were hospitalized with suspected cerebral stroke by ambulance. In vivo, COVID-19 was diagnosed in 3 patients; in 2 cases, the SARS-COV 2 virus
was detected in the sectional material. All patients had high comorbidity: a history of stroke and/or myocardial infarction; 3 patients had diabetes mellitus; 2 had atrial fibrillation. Patients with IHS at the time of stroke development
received secondary prevention of vascular events. The severity of ischemic stroke was 21.4Ѓ}4.3 on the NIHSS scale. According to the TOAST classification, the stroke was atherothrombotic (n=2), cardioembolic (n=1) and unspecified subtypes
(n=2). Adverse outcome was registered in all cases on 5–11 day of stroke development (the average life expectancy after a stroke = 7,4 days). Conclusion. Experience in treating patients with COVID-19 indicates the need for monitoring
the coagulation system and active prevention of thrombosis. Providing care to patients with ischemic stroke on the background of COVID-19 is associated with additional organizational difficulties associated with the need to comply
with strict anti-epidemic measures, which affect the intra- hospital logistics and quality of care.
Keywords: new COVID-19 coronavirus infection, acute ischemic stroke, in-hospital ischemic stroke, hypercoagulation.
DOI: 10.38025/ 2078–1962–2020–98–4–90–98
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Abstract:
In addition to physical mortality, the COVID-19 pandemic has a broad psychosocial and emotional impact on all population groups. Medical workers in the hospitals are experiencing unprecedented physical and psychological difficulties. Guided
by the principles of providing professional psychological assistance to health care workers and based on the analysis of international experience, the “FCBN” of the FMBA of Russia organized several forms of psychological support. The
purpose of this study was to investigate the methods and results of psychological support to health care workers during the period of re-profiling hospital for patients with COVID-19. The study sample includes 578 employees of the
“FCBN” of the FMBA of Russia, covered during a weekly call; 25 of them participated in "social questionnaire"; 33 people completed the MBI and GAD-7 questionnaires; more than 30 people received personal or distant consultations. The
results of questionnaires show that employees reacted to the new conditions adequately. The average values of indicators on the scales "emotional exhaustion" and "depersonalization" for the group fell within the normal range for medical
workers in Russia. Investigation of effectiveness of different psychological methods shows that for supporting health care workers in the new condition, the most effective were personal consultations, and to identify the actual problems
of work organization and building vertical communication between staff and management – weekly calls and ≪social questionnaire≫. In conclusion, our experience has shown the importance of maintaining the functioning of psychological
service to help health care workers in an emergency situation for the health system.
Keywords: COVID-19, coronavirus, psychological support of health care workers, psychological distress, re-profiling.
DOI: 10.38025/ 2078–1962–2020–98–4–99–108
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Abstract:
Acute Respiratory Distress Syndrome (ARDS) is a well-recognized clinical problem first described in the late sixties. However, its relevance seems to have increased since the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) outbreak, as 14%
(CI 95% 2% to 59%) of patients admitted to the hospital present with this syndrome. Conceptually, a syndrome is a group of symptoms and signs that correspond to several diseases. Although defining disease is much harder than may appear
at first glance, we can view it as the association between a syndrome and a pathology pattern. Diffuse alveolar damage (DAD) is the morphological hallmark of ARDS, although studies performed in autopsies and patients have demonstrated
that it is present in only half of ARDS patients. The SARS-CoV-2 outbreak and the high incidence of ARDS associated with this infection have triggered a natural question: is the lung pathology similar in patients with ARDS associated
with traditional risk factors than to SARS-CoV-2 infection? This review aims to analyze the lung pathology results of patients infected with the novel SARS Cov-2. As this article targets non-intensive care physicians, we will first
describe the main characteristics of the novel SARS-Cov-2 and the ARDS definition, and then the lung pathology results from the UCI in this group of patients.
Keywords: coronavirus, SARS-Cov-2 infection, lung pathology, acute respiratory distress syndrome.
DOI: 10.38025/ 2078–1962–2020–98–4–109–113
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Health-resort treatment
Abstract:
The treatment of mineral water with silver allows to significantly extend its shelf life without deteriorating its organoleptic properties, which makes it possible to use mineral water away from the natural deposit and is critical for business and the
end consumer. However, possible changes in the physiological properties of mineral waters when treated with silver have not been studied until now. We have carried out a preclinical double-blind randomized placebo-controlled, experimental
study, during which the effect of treatment with silver sulfate at a dose of 0.02 mg / liter (according to the EAEU tR 044–2017 regulation) of natural mineral water of sulphate-hydrocarbonate calcium-sodium (Russia, Stavropol territory,
deposit “Slavyanovskaya”, well No. 69 bis) for cellular metabolism, microcirculation and micro-lymphocyte when applied externally to the area of the inner surface of the forearm. A comparison of the effect on cell metabolism and microcirculation
has been made for applications with native mineral water “Slavyanovskaya”, “Slavyanovskaya, enriched with silver sulfate” and placebo (tap water) after 30 minutes and after 24 hours. Number of patients: 15. Number of studies by location:
45. the results were monitored using the LAZMA St device. the study carried out simultaneous registration of diagnostic parameters of blood microcirculation, lymph microcirculation, as well as fluorescence amplitudes of coenzymes participating
in oxidative metabolism - reduced nicotinamide adenine dinucleotide (NADH) and oxidized flavin adenine dinucleotide (FAD). It was revealed that the mineral water “Slavyanovskaya enriched with silver” differs in its physiological effect
on cellular metabolism, microcirculation and micro-lymph flow from the physiological effect of the mineral water “Slavyanovskaya”, namely that, compared to “Slavyanovskaya”, the mineral water “Slavyanovskaya enriched with silver” has
a more pronounced positive effect on cellular metabolism, metabolic reserves of the cell, promotes the activation of microcirculation and micro-lymphatic flow. Mineral water “Slavyanovskaya, enriched with silver” has a longer effect
on cellular metabolism, microcirculation and micro-lymphatic flow than mineral water “Slavyanovskaya”. A statistically significant positive effect of cell metabolism activation was detected both 30 minutes and 24 hours after exposure.
Thus, this method of processing mineral water with silver sulfate not only does not decrease its positive physiological effect, but also improves it, prolonging its action, which makes further use of silver preparations in the processing
of mineral water justified.
Keywords: mineral water, spa treatment, prevention, cell metabolism, microcirculation, laser fluorimetry.
DOI: 10.38025/ 2078–1962–2020–98–4–114-123
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Reviews. Lectures. Report. Historical sketches
Abstract:
In 2021 the National medical research center of rehabilitation and balneology (NMIC RK) marks one hundred years. This is one of the specialized scientific institutions created in the country in the first years of the existence of Soviet
power. From the first months of the reign of Soviet power, it became obvious that the resort business was at a new stage of development. Under Nicholas II, as with his predecessors, resort business was treated as something secondary,
philanthropic. Only with the advent of socialism was a resort business in the USSR of the 1920s. acquired important state significance. First of all, it was decided to create in a short time the necessary number of specialized research
institutes. Within a few years, a network of special institutions for the scientific support of resort business was created. One of the first was the NMIC RK. The history of this Center is unique, but still little studied. The purpose
of the study is to, based on archival materials and publications, characterize the history of the Center, identify its role in the development of balneology. Resortology of the USSR has become an independent multi-industry sphere.
the Centre has made a significant contribution to this through its scientific achievements and high efficiency. Scientists of the NMIC RK tried to keep up with the demands of the authorities and worked for the benefit of the population
and economy of the country. the center faced a number of problems after the change of the country's political structure in the 1990s, but this did not prevent it from maintaining the scientific potential and professionalism of its
employees, modernizing the logistics, improving the quality of work and introducing the results of research into the practice of the country's resort business.
Keywords: resort business, balneology, scientific support, natural healing factors, clinic, institute, center.
DOI: 10.38025/ 2078–1962–2020–98–4–124–130
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Abstract:
Introduction. Oncological diseases take the second place in the world in mortality rate after cardiovascular pathology. The development of the tumor is accompanied by the appearance and accumulation of a number of pathological metabolites. At the same
time, it is worth noting that the expansion of indications for the use of surgical methods of treatment, as well as an increase in the range of medicated antitumor drugs, especially against the background of combination therapy, is
still accompanied by aggressive effects on the patient's body. Thus, the consequences of radiation and chemotherapy are quite significant and consist of the cumulation of cytotoxic drugs that are toxic not only for tumor cells, but
also for other tissue structures of the body. In this connection, intensive therapy of endogenous intoxication in case of tumor lesions is one of the complex interdisciplinary problems, in which should participate surgeons, resuscitators,
pathophysiologists, transfusiologists. Purpose. Analysis of literature data on the use of plasmapheresis as an effective component of rehabilitation measures from the point of view of pathophysiology in cancer patients. Conclusion.
Considering the possibility of using extracorporeal detoxification methods in the treatment and rehabilitation of cancer patients, it should be noted that, against the background of chemotherapy and / or radiation therapy, plasmapheresis
is one of the most common indications for use. Positive responses after plasmapheresis have been reported in patients with carcinoma of the lung, colon and breast. In addition, there are reports of the effectiveness of the method in
patients with melanoma, head and neck tumors, lymphomas, leukemia and Kaposi’s sarcoma with acquired immunodeficiency. However, there is currently a limited number of studies aimed at the effectiveness of the use of extracorporeal
detoxification in the complex treatment of cancer patients.
Keywords: plasmapheresis, oncology, cancer rehabilitation.
DOI: 10.38025/ 2078–1962–2020–98–4–131–134
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Abstract:
This chapter reviews current knowledge about the health effects of several environmental conditions on home fuel poverty, including physiological and epidemiological aspects of cold and heat related illness, and epidemiological studies on excess morbidity
and mortality. the inadequate home concept has been addressed with further contributions that have on mental health, asthma (dampness and mould), noise, CO poisoning and lung cancer for radon exposure. Measures for reducing cold and
heat related mortality and morbidity related to poor energy housing include appropriate urban planning and housing design. this contributes confirm that poor housing quality is a significant public health issue. However, to realize
a large health potential associated with adequate, safe and healthy homes, joint action on health and nonhealth sectors is required. the development of specific guidelines for general and healthcare practitioners to better manage information
on patients living in bad situations of fuel poverty is desirable.
Keywords: fuel poverty; indoor environments; public health; risk factors, bioclimatology; vulnerability; preventive medicine; healthcare practitioners.
DOI: 10.38025/ 2078–1962–2020–98–4–135–143
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Dissertation orbit
Abstract:
Introduction. the low-back pain is a challenging medical issue. the disorder polymorphism requires ongoing search for new treatment solutions based on up-to-date technologies, including these related to rehabilitation and preventive treatment
of pathological conditions. However, our findings have shown, most studies are narrowly focused on one or several pathogenesis components only. the dedicated publications do not fully highlight the role, which the basic physical characteristics
(BPC) have in building movement patterns. Purpose of the study. Our research was aimed at working out an isometric exercising program for dorsopathy patients to develop the above characteristics. Material and research methods. We analyzed
findings of the clinical and functional examination methods as well as treatment results of 150 patients. the design included the pre-randomization into treatment and control groups, clinical study techniques, questionnaire-based surveys,
use of genuine FSSD diagnostic profile and tension dynamometry to assess both initial BPC values and their dynamics at the adjustment stage. Results. According to the further result analysis, within the treatment group of patients
suffering from pain-associated dorsopahies, the proposed exercising program allowed the add-on of BPC like tone, strength and endurance of main posture- dependent muscle groups as to static and dynamic loads. At that, comparing to
the control group, where patients exercised to mobilize a vertebral motor region and have general restorative effect, no positive impact on the indicators was acquired. Conclusion. The study proved the deviation of dorsopathy patients’
BPC from the age-appropriate norms. In addition, complex functional assessment of spine and myofascial system was described based on functional muscle testing and movement tasks.
Keywords: isometric exercises, dorsopathy, pain syndrome, muscle tone, static endurance, dynamic endurance, functionalassessment.
DOI: 10.38025/ 2078–1962–2020–98–4–144–148
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Abstract:
The aim. to optimize the treatment of children with ADHD who often suffer from recurrent infections by justifying the effectiveness of a therapeutic and physiotherapy complex that includes a BOS-bioacoustic effect on the head area and
NILI on the projection of the cubital area and thymus. Method of research. In children (140 people) with a verified diagnosis of ADHD, often suffering from recurrent infection, humoral-cellular immunity indicators (immunoglobulins:
IgA; IgG; IgM); T-and B-lymphocytes; cytokines) were studied in the dynamics of the use of therapeutic measures. Depending on the applied physiotherapy method of treatment, the children were divided into 3 groups: the 1st group-received
NILI on the projection of the cubital area and thymus, the 2nd – received BOS-bioacoustic effect on the head area, the 3rd – developed physiotherapy complex, including BOS-bioacoustic effect on the head area and NILI on the projection
of the cubital area and thymus. Conclusion. the developed physiotherapy complex, including BOS-bioacoustic effect on the head area and NILI on the projection of the cubital area and thymus, can be considered as a therapeutic and preventive
model of respiratory viral attacks in children with SSDVNS, since it reduces the number of recurrent viral attacks by 3.7 times, correcting the activity of circulating cytokines, T-lymphocytes (CD3+), T-helpers (CD4+) and T-suppressors
(CD8+) in the population white blood cells.
Keywords: children 7–12 years old; somatoform vegetative dysfunction; physiotherapy complex; recurrent infection; frequently ill children (CBD); laser therapy; bioacoustic treatment complex BOS-BAC.
DOI: 10.38025/ 2078–1962–2020–98–4–149–157
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Professional space. Chronicle of life. People
С глубокой скорбью сообщаем, что на 59 году жизни скоропостижно закончил свой земной путь Игорь Иосифович Драпей (20 ноября 1961 года – 27 апреля 2020 года), генерал-майор в отставке с 2018 г. Игорь Иосифович – выпускник Ульяновского высшего военно-технического училища им. Б. Х мельницкого. Служил в вооружённых силах СССР и РФ с 1979 по 2018 гг. После выхода в отставку (апрель 2018 г. – март 2019 г.) работал заместителем главы управы района Соколиная гора г. Москвы; специалистом по комплексной безопасности и администратором в Первом Московском кадетском корпусе (март 2019 г. – март 2020 г.). Последним местом работы (2020 г.) являлось Федеральное государственное бюджетное учреждение "Национальный медицинский исследовательский центр реабилитации и курортологии" Министерства здравоохранения Российской Федерации, где Игорь Иосифович проработал в должности руководителя управления делами и кадрами. В любой должности и в любое время Игорь Иосифович запомнился коллегам надежным, внимательным, доброжелательным человеком. Память об Игоре Иосифовиче Драпее сохранится в сердцах всех, кто его знал. Редакционная коллегия журнала, коллектив ФГБУ «НМИЦ РК» Минздрава России
Сердечно поздравляем с замечательным юбилеем Иванову Галину Евгеньевну, доктора медицинских наук, профессора, главного внештатного специалиста по медицинской реабилитации Министерства здравоохранения Российской Федерации, руководителя отдела медицинской реабилитации ФГБУ "Федеральный центр мозга и нейротехнологий" ФМБА России, заведующую кафедрой медицинской реабилитации факультета дополнительного профессионального образования ФГБУ "Российский национальный исследовательский медицинский университет им. Н.И. Пирогова" Минздрава России, председателя президиума общероссийской общественной организации содействия развитию медицинской реабилитологии "Союз реабилитологов России". В 1991 г. Галина Евгеньевна защитила кандидатскую диссертацию на тему "Комплексная коррекция состояния дизадаптации студентов в процессе физического воспитания", в 2003 г. – докторскую диссертацию на тему "Комплексная дифференцированная физическая реабилитация больных с мозговым инсультом". Г.Е. Ивановой опубликовано более 300 научных трудов, в том числе 8 монографий и 13 учебно-методический пособий. Богатый опыт, правительственные и ведомственные награды за трудовые успехи Г.Е. Ивановой говорят о ее огромном трудолюбии, а защищенные кандидатская и докторские диссертации, присвоение ученого звания "профессор" являются свидетельством постоянного стремления к новым знаниям. Она как высокопрофессиональный врач, организатор и опытный руководитель научно-практических исследований по медицинской реабилитации с успехом решает задачи, стоящие перед российским здравоохранением, умело сочетая научную, преподавательскую работу и организаторскую деятельность. От имени редакционной коллегии журнала «Вестник восстановительной медицины» поздравляем Г.Е. Иванову с юбилеем, желаем крепкого здоровья и новых творческих успехов!
