RESUMO
Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. Purpose of the study was to assess the generalized effect power of the course of inhalations of mineral waters on the disease progress in patients with BA. A search of randomized clinical studies in data bases Pubmed, EMBASE, ELibrary, MedPilot amd CyberLeninka, according to PRISMA strategy, published between 1986 and July 2021. Standardized difference of mean values and their 95% of CI were employed for calculation using the random effects model. The meta-analysis drawing on 1266 sources included 14 studies, with 2 of them being randomized controlled clinical studies, including the results of the treatment of 525 patients. All 14 articles contain a conclusion that the inhalation of mineral water has a positive effect on the course of the disease in patients with BA. The analysis demonstrated that the group of patients after mineral water inhalations, compared with the control group, showed improvement of forced expiratory volume (FEV1), expressed both in % of the norm and in liters. The standardized difference of mean values FEV1 (%) (Hedge's g) was 8.2 (95% CI: 5.87 - 10.59; 100%), FEV1 values (liter.) (Hedge's g) was 0.69 (95% CI: -0.33-1.05). A significant heterogeneity of the results of individual studies was found (Q=124.96; tau2 = 14.55, I2 = 69.13%, p<0.0001 and Q=2.35; tau2 = 0, I2 = 0%, p<0.0001). Patients with mild, moderate, and hormone-dependent BA with a controlled and partially controlled disease course, after mineral water inhalations, compared with the control group, demonstrated a statistically significant decrease in the frequency and intensity of the cardinal symptoms of BA and improvement of FEV1.
RESUMO
Overweight and obesity is a multifactorial, multisystem disease declared a global epidemic by the World Health Organization (WHO) as early as in 1997. At least 30% of the working-age population in Russia is overweight. Only the use of physical activity as an integral (basic) part of obesity treatment and maintenance of the body weight achieved in the course of treatment can achieve durable and long-lasting treatment results as well as significant changes in the body structure (fat/non-fat body weight ratio). Terrainkur (therapeutic walking) is a method of spa treatment that combines climatotherapy and physical therapy. One of the problems in physical activity in obese people is the difficulty they experience in exercising due to the impaired walking pattern caused by imbalances in the muscle chains, including pelvic region, cervical region, which reduces endurance and commitment to physical activity. The study found that the exposure group (Terrainkur) showed lower values of "total fat", "metabolic age", "basic caloric value" compared to initial results and the control group; the exposure group (Terrainkur) showed a decrease in the deviation of the centre of body axis projection from the proper axis, the percentage of non-compliance with the proper fluctuations of the foot underextension. These changes contributed to the elimination of terrainkur restrictions and, as a result, improved the patient compliance during the terrainkur exercises.
RESUMO
The world's practice has shown the importance of medical rehabilitation, which allows increasing the effectiveness of treatment of patients with COVID-19, and also significantly reduce the risks of developing complications after COVID-19. Moreover, timely medical rehabilitation reduces the frequency of disability retirement. We developed and investigated the effectiveness of the telemedicine platform "COVIDREHAB" in order to enhance the effectiveness of the recovery period during self-isolation, as well as to provide access to rehabilitation for patients residing in remote areas or unable to undergo in-person medical rehabilitation. This pilot open clinical study includes 178 patients (108 women and 70 men) aged 32 to 82 years [mean age 50 (33-56) years] who had a moderate disease of COVID-19. We used the specialised platform COVIDREHAB for remote monitoring of the rehabilitation efficiency of patients who suffered from COVID-19. During the study, the supervising doctor assigned the patient a set of specialised questionnaires, which were filled in online. The questionnaires distributed to the patient included questions specifically designed for the COVIDREHAB remote platform as well as the mMRC (Modified Medical Research Council) questionnaire. Patients who completed the remote rehabilitation programme were found to have positive dynamics of indicators of the respiratory system functional state, and complaints.Pulmonary rehabilitation is an important part of case management for patients with respiratory diseases and plays an active role in improving lung function and general well-being of patients. Patients who completed the comprehensive medical rehabilitation program using the information and analytical system COVIDREHAB, were found to have positive dynamics of indicators of the respiratory system functional state, and complaints. Hence, at the end of the course the shortness of breath severity decreased (from 34.8% to 12.4%, as well as the feeling of lack of oxygen from 32% to 17.4%, p <0.05). We anticipate the online approach to rehabilitation will improve the functioning of the respiratory and cardiovascular systems, restore physical function, reduce anxiety and depression, and restore quality of life. An essential benefit of this program is the prevention of secondary complications and reduction of serious adverse effects of COVID-19 treatment."
RESUMO
Arterial hypertension (AH) is a burning problem in the world. Antihypertensive pharmacological therapy combined by physical exercises is well-studied in patients with mild and moderate AH. However, studies that have investigated relaxation in patients with severe AH in addition to drug therapy are lacking. Optimization of a comprehensive treatment for patients with severe AH, by using a multicomponent rational antihypertensive pharmacotherapy (PT) with subsequent application of relaxation exercise therapy (RET). The study involved 32 male patients with severe AH. Initially, clinical-instrumental and laboratory examination, blood pressure registration and daily arterial blood pressure monitoring were carried out. Suitable PT was selected for all the patients. 3 months after starting PT the patients were divided in 2 groups. The patients of the 1st group were prescribed RET in addition to PT. The 2nd group of patients continued receiving PT alone. 3 months later, average daily blood pressure (ADBP)-syst and ADBP-diast were compared in both groups. Three months after PT both groups demonstrated a significant decrease in ADBP-syst and ADBP diast, but these indicators remained higher than normal and did not reach the target level. Three months after the inclusion of RET in the comprehensive treatment, the 1st group demonstrated a significant decrease in ADBP (systolic and diastolic), not only in comparison with the initial data, but also with the data observed three months after PT. After 6 months, ADBP-syst and ADBP-diast in the 1st group were significantly lower compared with those of patients in the 2nd group. The inclusion of RET in addition to a multicomponent antihypertensive PT is a promising treatment option for severe AH.