[Rehabilitation of patients after spinal surgery: effectiveness of nonthermal techniques of peloidotherapy]. / Reabilitatsiya patsientov posle operatsii na pozvonochnike: effektivnost' neteplovykh metodik peloidoterapii.

The problem of patients' rehabilitation after spinal surgery remains relevant. The use of therapeutic physical factors, both preformed and natural, including pelotherapy, is very important. The application of the latter requires to develop new techniques in this pathology, one of which is low temperature exposure. OBJECTIVE: To study the possibility and to assess the effectiveness of resource-saving nonthermal pelotherapy techniques in patients' rehabilitation, who underwent surgeries for intervertebral discs' herniation. MATERIAL AND METHODS: The number of patients equal 88, including 39 males and 49 females, after lumbar microdiscectomy, was examined in this study. The patients were divided into 3 groups. Control group (28 patients) received a basic rehabilitation complex (therapeutic gymnastics, massage, low-frequency magnetotherapy); the 1st study group (30 patients) - basic complex and procedures of thin layer applications with peat muds preparation (Tomed-applikat) at 20-24 °C; the 2nd study group (30 patients) - basic complex and procedures of fluctuoresis of 2% solution of peat mud Tomed-aqua preparation. RESULTS: There was a significant reduction of pain syndrome, recovery of sensitivity and motor activity, decrease of Oswestry index, characterizing the degree of vital activity disturbance, in patients of the study group compared to the control group after treatment. CONCLUSION: The inclusion of nonthermal resource-saving techniques of pelotherapy in rehabilitation complex of patients who underwent spinal surgery is effective and pathogenetically justified.

[Prospects for the use of ozone therapy and low-intensity laser therapy in the treatment of atrophic pharyngitis]. / Perspektivy primeneniya ozonoterapii i nizkointensivnoi lazeroterapii pri lechenii atroficheskogo faringita.

Chronic pharyngitis (CP) is one of the most common diseases of the oropharynx. The number of referrals from patients with CP reaches 70% of the total number of referrals to an otorhinolaryngologist. The development of this disease is facilitated by the neuro-reflex factor and a violation of trophic and metabolic processes. It should be noted that of all forms of CP, the greatest impact on the quality of life is noted precisely in atrophic pharyngitis (AP), due to the presence of pronounced subjective sensations from the oropharynx. Many of the modern methods of treatment do not provide a lasting effect due only to the application, superficial local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes caused by a violation of trophic processes in the tissue. A promising direction in the treatment of atrophic pharyngitis is the use of a combined technique - ozone therapy and low-intensity laser therapy. The article presents the results of the application of fine-drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil in combination with low-intensity laser radiation on the projection of vessels supplying blood to the middle parts of the oropharynx. OBJECTIVE: Improving the effectiveness of treatment of patients with atrophic pharyngitis through the use of ozone therapy and low-intensity laser therapy. MATERIAL AND METHODS: A single-center experimental controlled randomized open-label study of 90 patients with AP aged 18 and over was conducted. All patients were randomly divided into three groups depending on the treatment performed: group I - traditional treatment method (rinsing the oropharynx with antiseptic solutions, the use of tablets for resorption), group II - treatment with ozone therapy (fine drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil), group III - treatment with ozone therapy and laser therapy. During the examination of patients, anamnesis collection, examination of ENT organs, cytological and microbiological examination of the mucous membrane of the posterior pharyngeal wall, contact endoscopy of the mucous membrane of the posterior pharyngeal wall were performed. 5-point visual analogue scales (VAS) were used to assess complaints and pharyngoscopic signs. RESULTS: Our results showed a statistically significant improvement in the quality of life of patients with AP (p=0.012), an improvement in the pharyngoscopic picture (p=0.003). The results obtained by us indicate an improvement in microcirculation under the influence of ozone therapy and low-intensity laser radiation. The technique using ozone therapy and low-intensity laser therapy is characterized by a bactericidal and fungicidal effect. There is a decrease in the total contamination of the posterior wall of the oropharynx with pathogenic and saprophytic microflora (there is a decrease in the contamination of the posterior wall of the pharynx with saprophytic and pathogenic microflora (p≤0.05), the differences are statistically significant). The technique using ozone therapy and low-intensity laser therapy has a pronounced anti-inflammatory effect, which was expressed in a decrease in the severity of dyskeratosis and hyperkeratosis. Thus, the use of ozone therapy in combination with laser therapy opens up new prospects for pathogenetically sound and effective treatment of AP.

[On the Draft Regulations on Districts of Sanitary (Mountain Sanitary) Protection of Natural Medicinal Resources: Comments, Suggestions]. / O proekte Polozheniya ob okrugakh sanitarnoi (gorno-sanitarnoi) okhrany prirodnykh lechebnykh resursov: zamechaniya, predlozheniya.

The purpose of the article is to attract the attention of specialists in the resort business in the document being developed - the Decree of the Government of the Russian Federation «On Approval of the Regulations on the Districts of Sanitary (Mining and Sanitary) Protection of Natural Medicinal Resources¼, the draft of which is proposed for discussion. The article presents all the comments on the discussed draft Regulation and proposals for making appropriate changes with their reasoned justification. The proposals put forward to change the wording of specific paragraphs of the Regulation are aimed at protecting and preserving the wealth of our country - natural healing factors that form the basis of sanatorium treatment. The proposals made to edit the paragraphs of the Regulation will undoubtedly guarantee the preservation of Russia's natural healing resources in order to use them for the prevention, treatment and rehabilitation of the population of our country and the successful development of the resort industry.

[Questionnaire of the Ryzhikh National Medical Research Centre for Coloproctology is a new tool for assessing chronic pelvic pain and pelvic organ dysfunction]. / Oprosnik NMITs koloproktologii imeni A.N. Ryzhikh ­ novyi instrument otsenki khronicheskoi tazovoi boli i narusheniya funktsii tazovykh organov.

The article presents the work of a multidisciplinary team of experts from various fields of medicine to optimize the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ for use in clinical practice. The survey of respondents was conducted from June 28 to September 28, 2021. As a result of this survey, by repeatedly making edits and clarifications during communication with respondents, the final version was obtained, which allows assessing the patient's subjective sensations by the nature and localization of pelvic pain, sensitivity disorders and pelvic organ function. The main objective of this Questionnaire is to differentiate patients with neurogenic pain from a huge number of patients with chronic pelvic pain. This aspect will allow a more targeted approach to the diagnosis and pathogenetically justified treatment of patients, including after appropriate instrumental examinations. The work of a multidisciplinary team implies a higher degree of objectification and terminological accuracy of the Questionnaire under discussion. The presented version of the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ will be primarily used in coloproctological patients with pelvic pain problems and anal incontinence and obstructive defecation. Further studies will be directed to the clinical evaluation of the results of the work carried out.

[Particularities of thermoregulation in Parkinson's disease]. / Osobennosti termoregulyatsii u patsientov s bolezn'yu Parkinsona.

OBJECTIVE: To evaluate the topography of thermographic characteristics and compliance with the degree of asymmetry of motor and thermometric characteristics of patients with Parkinson's disease (PD). MATERIAL AND METHODS: The study enrolled 45 patients with PD (stage 1-3) according to the Hoehn and Yahr scale. The patients were divided into two groups: a right-sided group (n=27) and a left-sided one (n=18). The groups were matched for age, disease type and duration, and symptom severity. All the patients in the study group underwent thermography investigation. RESULTS: Lower temperature values were noted on the more affected side (p<0.05) only in patients with left-sided predominance of symptoms (p<0.05). CONCLUSION: This result may suggest that left-sided PD patients have more frequent thermoregulation dysfunction, but further research is needed to investigate the relationship between thermoregulation and motor asymmetry.

[Drinking mineral waters: problematic issues and prospects of use in treatment and rehabilitation]. / Pit'evye mineral'nye vody: problemnye voprosy i perspektivy ispol'zovaniya v lechenii i reabilitatsii.

The article is devoted to the use of drinking mineral waters in the treatment and rehabilitation of patients with various pathologies. The results of numerous studies carried out in previous years have proven the ability of mineral waters to positively influence the functional state of the digestive system, eliminate various metabolic disorders, and affect the processes of hormonal and immune regulation. However, due to the current lack of educational programs for the training of doctors at medical universities, as well as further training in the basics of balneology, medical workers often encounter difficulties in determining the most suitable schemes for the use of mineral waters for a specific pathology. It is known that today there are quite a lot of bottled waters on the market that do not have a healing effect, but are quite suitable for use as table waters. The latter circumstance, combined with not always correct information about the real healing properties of waters, creates certain difficulties even for doctors. In addition, there is a need for a certain clarification of the methods of prescribing mineral waters, taking into account the magnitude of mineralization, the main cation-anionic composition, the nature of the disease and the phase of its course. Taking into account the fact that drinking mineral waters are actively used in the treatment of many diseases, including in children and the elderly, the task of fully and competently informing doctors of different specialties, and with their help, patients, about the features of specific mineral waters available in different regions of the Russian Federation, their unique capabilities, optimal methods of therapeutic use.

[The effectiveness of local and general magnetotherapy in early rehabilitation of women after surgical treatment of breast cancer]. / Effektivnost' lokal'noi i obshchei magnitoterapii pri rannei reabilitatsii zhenshchin posle operativnogo lecheniya raka molochnoi zhelezy.

OBJECTIVE: Effectiveness comparison of local and general magneto-therapy for determining differentiated indications in order to prescribe the techniques for early rehabilitation of patients after surgical treatment of breast cancer (BC). MATERIAL AND METHODS: It was examined 114 women after radical mastectomy for breast cancer. The patients were divided into 3 groups by the method of simple randomization: the control group (37 women) received therapeutic exercises without additional prescription of physiotherapeutic procedures; 1st main group (38 women) - in addition to exercises a course of local magneto-therapy; 2nd main group (39 women) - general magneto-therapy. The results were assessed using a visual analogue pain scale, goniometry results, remote infrared thermography, hospital anxiety and depression scale (HADS). RESULTS: The inclusion of magneto-therapy in the rehabilitation complex reduced local hyperemia and edema in the area of the postoperative suture on the 7th-8th day in 73.7 and 76.9% of patients of the 1st and 2nd groups, respectively, while in the control group a similar result was observed by 10-14 days. Both methods of magneto-therapy eliminated temperature asymmetry and restored the normal thermographic pattern of the skin surface in the area of the surgical field, reduced the severity of pain, and increased the range of motion in the shoulder joint on the side of the operation. When studying the possibility of eliminating the manifestations of asthenic syndrome a comparison of the two studied methods showed the undoubted advantage of the general exposure to a magnetic field. In addition, it has also caused a statistically significant decrease in indicators of anxiety and depression on the HADS scale, while local exposure to a magnetic field did not have a similar effect. CONCLUSION: The choice of exposure to a magnetic field at the stage of early rehabilitation of women after surgery for breast cancer is determined by the intensity of the pain syndrome, the degree of activity of aseptic inflammation in the area of the postoperative suture, the level of anxiety and depression, and the severity of asthenic syndrome.

Synchrotron radiation diffraction in a single crystal of paratellurite investigated with a new experimental scheme.

First results are presented for synchrotron radiation diffraction in a paratellurite (TeO2) single crystal investigated with a new experimental scheme consisting of a standard monochromator and a relatively narrow slit for collimation and monochromatization of an incident beam. The Bragg case reflection geometry is used. The monochromator, a pair of Si crystals, maintains the initial direction of the beam propagation. The theory is developed for a precise description of the instrumental function in such a scheme. A new rocking curve registration technique with use of an adaptive bending piezoactuator is applied for the first time with the aim to record the narrow diffraction peaks with high accuracy. A sample is attached to one edge of the bidomain lithium niobate single crystal piezoactuator used. The piezoactuator is bent under the influence of an electric field and it changes the angular position of the sample with a very small step. The experimental curves are compared with the calculated diffraction rocking curves of a perfect paratellurite crystal, both the theoretical one and the one calculated taking into account the instrumental function. An instrumental function account allows a complete coincidence of the simulated curves with the experimental results to be obtained if the experimental curve does not coincide with the theoretical rocking curve. A small discrepancy between the theory and the experimental data has been discovered in cases where the incident beam is sufficiently collimated and monochromated. This indicates the presence of a certain number of lattice defects in the sample under study.

[Impact of rhythmic transcranial magnetic stimulation on the dynamics of motor and non-motor manifestations of Parkinson's disease]. / Vliianie ritmicheskoi transkranial'noi magnitnoi stimuliatsii na dinamiku motornykh i nemotornykh proiavlenii bolezni Parkinsona.

BACKGROUND: Parkinson's disease is a neurodegenerative disease manifested by a whole group of motor, cognitive, affective, and other disorders. Many of them cannot be controlled by modern pharmacotherapy in full measure. New treatments, including nondrug ones, are needed. OBJECTIVE: To evaluate the impact of rhythmic transcranial magnetic stimulation on motor, cognitive, and affective disorders in Parkinson's disease. MATERIAL AND METHODS: The investigation enrolled 55 patients with Stage III Parkinson's disease according to the Hoehn and Yahr scale. The patients were randomly divided into 2 groups: a study group (n=35) and a control one (n=20). The groups were matched for age, disease type and duration, and symptom severity. The basic therapy for Parkinson's disease included Levodopa in combination with dopamine receptor agonists and monoamine oxidase B inhibitors. All the patients in the study group underwent a cycle of therapeutic transcranial magnetic stimulation. Both patient groups underwent clinical and neurological examinations and tests using various scales. All the patients were followed up for 6 months. RESULTS: The patients who had undergone a cycle of magnetic stimulation showed a significant improvement in motor functions. There was a decrease in the total MDS-UPDRS-III scores by an average of 6.4 (p<0.05) and that in the GABS scores by 5.9 (p<0.05). CONCLUSION: Rhythmic transcranial magnetic stimulation can be considered as an additional treatment for Parkinson's disease. No significant side effects were noted during and after stimulation.

[Gonarthrosis concurrent with chronic venous insufficiency: a new look at therapy]. / Gonartroz v sochetanii s khronicheskoi venoznoi nedostatochnost'iu: novyi vzgliad na terapiiu.

AIM: To study the possibility and feasibility of using terahertz-modulated infrared radiation in the treatment of patients with gonarthrosis, including those with concomitant chronic lower limb venous insufficiency and to develop a specific treatment procedure. SUBJECTS AND METHODS: A total of 92 patients were examined and treated. The patients matched for age, gender, and main clinical manifestations were divided into a study group and a control one. All the patients received disease-modifying anti-rheumatic drugs, therapeutic exercises, including those in a swimming pool. In addition to the basic treatment, the patients in the study group had terahertz-modulated infrared radiotherapy. Before and after treatment, all the patients underwent a physical examination; their complaints were studied; pain severity was assessed by a visual analog scale (VAS) for pain; lower limb temperature was measured by infrared beam thermography; and microcirculation in the affected knee joint area was analyzed by laser Doppler flowmetry. RESULTS: Analysis of posttreatment changes in clinical manifestations in the study group revealed a significant reversion of clinical manifestations, such as knee joint pain occurring at the end of the day or in the first half of the night (from 42.6 to 15.3%), as well as pain occurring after mechanical load and reducing at rest (from 72.3 to 25.5%). The changes in mean VAS scores in the study group (from 6.1±0.7 to 2.1±0.6) were significantly pronounced (p<0.01) compared with those in the controls (from 6.6±0.7 to 4.3±0.4). Infrared beam thermography established that the study group had a decrease in the thermal asymmetry value between varicose veins and adjacent tissues, indicating a hemodynamic improvement in the lower extremity vessels (by 1.57±0.07 °C in the study group (p<0.05) versus 0.91±0.04 °C in the control group (p<0.05). The ongoing package of rehabilitation measures assisted in reducing the temperature difference between the affected vein area and adjacent tissues. CONCLUSION: The incorporation of terahertz-modulated infrared radiation into a therapeutic complex was found to have a positive impact on the clinical symptoms of the disease, the state of local hemodynamics and microcirculation, which substantially enhances the efficiency of therapy.