[Modern approaches to developing a system of valid methods for monitoring individual health and maintaining active longevity]. / Sovremennye podkhody k razrabotke sistemy validnykh metodov monitoringa individual'nogo zdorov'ya i podderzhaniya aktivnogo dolgoletiya.

Life expectancy In Russia in 2023, according to preliminary data, exceeded 73 years, returning to the pre-pandemic level. The increase in life expectancy is associated both with an improvement in the quality of medical care In Russia and with a more responsible attitude towards the health of citizens, which is confirmed by an improvement in the quality of nutrition, a decrease in alcohol consumption and an increase in the number of people involved in sports. At the same time, there are many signs of aging, both cellular and molecular, some of the main ones are genome stability, telomere shortening, epigenetic alterations, impaired proteostasis and nutrient recognition, mitochondrial dysfunction, depletion of the stem cell pool and changes in intercellular interactions, extracellular matrix rigidity, as well as retrotransposon activation and chronic inflammation. For these reasons, in modern healthcare, the tasks of preventing premature aging and treating age-related diseases are becoming priorities. MATERIAL AND METHODS: In total, at the first stage of work (in 2023), we examined 80 people, whose average age was 59.6±0.7 years. When analyzing and assessing data, the study adopted a division into age groups (WHO). The following indicators were studied: HbA1, fructosamine, HDL cholesterol, LDL cholesterol, insulin, homocysteine, C-peptide, TSH, free T4, prolactin, total testosterone, cortisol, arginine, asymmetric dimethylarginine, leptin, TNF-a, ferritin, interleukin 1 and 6, telomere length, creatinine, uric acid and urea. RESULTS: As a result of the study, it was revealed that the aging process of the body affects many indicators, while the main markers that changed in men aged 18 to 44 years were total testosterone, leptin and telomere length; aged 44 to 60 years - HbA1, fructosamine, HDL cholesterol, homocysteine, C-peptide, total testosterone, leptin and telomere length; from 60 to 75 years - fructosamine, HDL cholesterol and telomere length and for 75-90 years - HbA1, HDL cholesterol, insulin, total testosterone, leptin and telomere length, interleukin 6 and uric acid. In women aged 18 to 44 years, only an increase in leptin was observed against the background of shortening telomere length; at the age of 44 to 60 years, the main markers that changed were total testosterone, leptin and telomere length; for the age group 60-75 years - indicators of HbA1, homocysteine, C-peptide, prolactin, total testosterone and leptin, interleukin 6 and uric acid, telomere length was shorter by only 2%; in the age group of 75-90 years, the main markers that changed were insulin, total testosterone, leptin, interleukin 6, while the indicators of uric acid, urea and telomere length differed from the reference values by 2-4%. Shortening of telomere length in all age groups, both men and women, indicates the presence of signs of premature aging. In an individual analysis, data were obtained on a more dramatic shortening of telomeres in 16 subjects in the presence of impaired glucose tolerance and insulin secretion, especially in comparison with healthy subjects, which was confirmed by the data of glycated hemoglobin (HbA1c), while, with shortening of telomere length, the HbA1 indicator was significantly higher (6.8±0.5) than in individuals with long telomeres and no chronic pathology (5.1±0.4). CONCLUSION: A system of highly valid methods and panels of markers has been developed that indicate the presence of aging processes, taking into account gender and age characteristics, which can be used to identify premature aging processes, monitor individual health and maintain active longevity, as well as for the prevention of age-associated diseases.

[The use of oscillatory respiratory therapy with positive expiratory pressure (PEP-therapy) to restore the functional state of the lungs in patients after cardiac surgery]. / Primenenie ostsillyatornoi respiratornoi terapii s polozhitel'nym davleniem na vydokhe (PEP-terapii) dlya vosstanovleniya funktsional'nogo sostoyaniya legkikh u bol'nykh posle kardiokhirurgicheskikh operatsii.

Postoperative pulmonary complications in cardiac surgery patients occur in 10-35% of cases, depending on differences in their definition, patient characteristics and type of surgical intervention, most of them are associated with ineffective coughing and evacuation of bronchial secretions. OBJECTIVE: To determine the effectiveness of stimulating the evacuation of bronchial secretions with the help of oscillating PEP therapy carried out during the first three days. MATERIAL AND METHODS: A randomized prospective study of 60 adult patients after elective cardiac surgery was performed (Clinical Trials.gov. protocol number NCT05159401). Oscillatory PEP-therapy was performed in 30 patients using Acapella DHGreen device (SmithMedicalASD, USA) 10-12 hours after tracheal extubation 3 times a day for 3 days after surgery. The control group (30 patients). The inclusion criteria: age over 18 years, spontaneous breathing after tracheal extubation, clear consciousness and productive contact with the patient, the ability to maintain adequate gas exchange on the low-flow oxygen inhalation, adequate analgesia (<2 points of VAS). Exclusion criteria: the need for re-intubation and mechanical ventilation, non-invasive mask ventilation, high-flow oxygen therapy, acute cerebrovascular accident, ongoing bleeding, cardiac insufficiency (inotropic index >10), shocks syndrome of various etiologies, the use of any extracorporeal support, any neuromuscular disorders, pneumothorax, hydro-or hemothorax. Before each session and 20 minutes after its end, when breathing air, blood oxygen saturation was recorded using a pulse oximeter (SpO2), the maximum inspiratory capacity (MIC) was measured using a Coach-2 incentive spirometer from SmithsMedical and spirometry with a portable ultrasonic spirometer Spiro Scout (Schiller, Switzerland). For the purposes of this work, the total index of the spirometry maximum inspiratory capacity (SMIC) was used - the sum of the respiratory volume and the reserve volume of inspiration in ml. RESULTS: Difficulties in evacuation of sputum were noted in 90% of patients. Three-day sessions of oscillating PEP- therapy are accompanied by a significant improvement in the passage of sputum, as evidenced by a 3-fold increase in the number of patients with productive cough. The increase in MIC in the main group was 46.9% and 21.3%, respectively (p=0.042), and the number of patients with values greater than MICo. 1500 ml increased from 23.3% to 7.6% (p<0.001). The effectiveness of oscillatory PEP-therapy is confirmed by a 7-fold decrease in the frequency of radiological changes in the lungs at the end of sessions (p<0.001), while in the control group the frequency of their occurrence practically did not change and remained at a high level. The total number of patients with respiratory insufficiency (SpO2≤92%) decreased by 8.6 times after completion of all PEP- therapy sessions (p=0.001), however, without statistically significant difference with the control group. CONCLUSIONS: Oscillatory PEP- therapy in cardiac surgery patients has a positive effect on sputum passage, ventilation parameters and oxygenating lung function. The procedure was well tolerated and there were no complications associated with it.

[Reflexology in patient rehabilitation with postoperative pain. (Literature review)]. / Refleksoterapiya v reabilitatsii patsientov s posleoperatsionnoi bol'yu. (Obzor literatury).

Postoperative pain is a pressing medical problem, as it significantly reduces the quality of life of patients after surgical treatment. Chronic postoperative pain further disables patients and impairs their functional activity. Being a widespread interdisciplinary problem, postoperative pain requires the integration of various pain management methods in complex multimodal pain management in the acute period and treatment programs for its chronicity. The paper examines the possibilities of reflexology methods for the relief of acute and treatment of chronic postoperative pain. Integration of reflex effects from the first days after surgery makes it possible to more effectively and safely solve the problems of acute and chronic postoperative pain.

[The role of nutrition status correction in the rehabilitation of cancer patients]. / Rol' korrektsii nutritivnogo statusa v reabilitatsii onkologicheskikh patsientov.

Metabolic changes due to the progression of malignant neoplasms and the negative consequences of aggressive methods of its treatment lead to a decrease in food intake in patients, which contributes to the development of anorexia-cachexia syndrome in cancer patients due to complex interactions between pro-inflammatory cytokines and host metabolism. Within the framework of this article, the author analyzes the possibility of the influence of nutritional status in cancer patients. The analysis of the results of the study of a group of cancer patients with various nutritional statuses was carried out. It is concluded that the control and correction of nutritional status should become an integral part of the assessment of the quality of life and meet the needs and expectations of the patient.

[Magnetotherapy in patients with malignant tumors receiving immunotherapy]. / Opyt primeneniya reabilitatsionnoi magnitoterapii u patsientov so zlokachestvennymi opukholyami, poluchayushchikh immunoterapiyu.

OBJECTIVE: To analyze the quality of life in patients receiving immunotherapy and overall response rate in case of additional magnetotherapy. MATERIAL AND METHODS: The study included 3 cohorts of patients (n=48) with various disseminated malignancies (melanoma, lung cancer, kidney cancer) who received immunotherapy. In the study groups, all patients additionally took courses of rehabilitation based on magnetotherapy. In the control cohorts, patients underwent courses of immunotherapy without additional magnetic therapy. Treatment efficacy was assessed according to iRECIST 1.1 criteria. The Russian version of the EORTC QLQ-C30 questionnaire was used to study the quality of life. We analyzed adverse events using the CTCAE 5.0 criteria. RESULTS: In patients with melanoma, the most common response to systemic treatment was stabilization (41.7% in the study group and 30.8% in the control group). The objective response rate was higher in the study group (33.3% vs. 23.1%). There was also significant improvement in the quality of life after treatment in the study group (by 23.5%). In the control group, the indicator worsened by 4.8%. Overall health improved by 12.8% in the study group and 10.3% in the control group. In patients with lung cancer, response to systemic treatment with stabilization was achieved in 33.3% of patients in the study group and 20% of patients in the control group. The objective response rate was 33.3% and 20%, respectively. Analysis of the study group revealed improvement of overall health by 9.6% and overall quality of life by 38.6%. In the control group, overall health improved by 4.8% and quality of life remained the same. In patients with kidney cancer, the objective response rate was 40% and 42.9%, respectively. Disease stabilization was achieved in 40% and 28.6% of patients, respectively. Overall health improved by 16.7% and 6.3%, overall quality of life - by 19% and 9.1%, respectively. CONCLUSION: Magnetic therapy during the course of immunotherapy improved the overall quality of life and reduced severity of adverse events. Further study of magnetotherapy as an accompanying rehabilitation technique is required.

[Modern approaches to the rehabilitation of patients with chronic paraproctitis in the early postoperative period]. / Sovremennye podkhody k reabilitatsii bol'nykh khronicheskim paraproktitom v rannem posleoperatsionnom periode.

Along with the classical methods of surgical treatment of rectal fistulas, new minimally invasive technologies have appeared using video endoscopic support for processing the fistulous tract and closing the internal fistula opening, intrasphincter ligation of the fistulous tract LIFT, however, they do not exclude relapses in the late postoperative period. The FiLaC (Fistula Laser Closure) laser technology based on the use of a radial flexible laser light guide, which does not cause damage to the anal canal mucosa, pain in the postoperative period, rectal postoperative bleeding and strictures, is quite promising in the further development of outpatient minimally invasive surgery for anal fistulas. anal canal. However, even with this technique, complications and relapses were observed in 10-12% of cases, which dictates the need to develop not only a patient-oriented approach to the surgical treatment of patients with chronic paraproctitis, but also to develop postoperative rehabilitation programs in the early postoperative period. OBJECTIVE: To study the effect of complex rehabilitation programs used in the early postoperative period on the efficacy of the therapy in patients with pararectal fistulas. MATERIAL AND METHODS: The study included 90 patients with chronic paraproctitis, (the average age was 43±3.4 years, the average duration of the disease was 5.1±1.5 years), who underwent a surgery using the modified FiLac technology. The patients were divided into 3 groups (30 patients in each group) depending on the rehabilitation method used during the postoperative period (2 days after the surgery): 1st group underwent a 4-component rehabilitation complex (intravenous ozone therapy, rectal laser therapy, recto-tibialmyostimulation of the pelvic floor muscles and biofeedback therapy); 2nd group underwent a 2-component rehabilitation complex (intravenous ozone therapy and rectal laser therapy); 3rd group has received a standard medical complex, which served as a background in 1st group and 2nd group. Therapeutic efficacy was assessed according to the assessment of pain syndrome (on the VAS scale), the results of anal sphincterometry (the Peritron 9600 device), the incidence of postoperative complications and relapses at different follow-up periods (up to 5 years). RESULTS: A comparative analysis of the nature of the course of the postoperative period, depending on the type of postoperative rehabilitation was carried out. In multiple comparisons using the parametric ANOVA method, it was found that there were statistically significant differences between the 1st group and the 3rd group in terms of pain intensity, duration of pain, the timing of wound healing, the frequency of complications, and the timing of return to work. The results in the 2nd group were slightly lower than in the 1st group, but they also differed significantly from the data of the 3rd group. During the analysis of the early and late p/o complications and relapses in patients with chronic paraproctitis after surgery the most significant were obtained from the 1st group (only 1 case of early p/o complications and relapse within 1 to 5 years), while in the 3rd group there were 2 (6.6%) cases of early p/o complications, 2 cases (6.6%) of relapses within a period of up to 1 year and 6 (20%) cases in the period from 1 to 5 years. In patients of the 2nd group, results close to the results of the 1st group were obtained: 2 (6.6%), 2 (6.6%) and 3 (9.9%) cases respectively. CONCLUSION: The use of expanded rehabilitation complexes among the patients with chronic paraproctitis in the early postoperative period after surgery, including intravenous ozone therapy, rectal laser therapy, recto-tibialmyostimulation and bifidobac therapy, made it possible to significantly improve therapeutic efficacy, which was confirmed by faster pain relief, fewer early and late p/o complications. The data obtained indicate the need for the use of rehabilitation programs in the early postoperative period for the treatment and prevention of complications after surgery.

[Modern surgical technologies in the treatment of patients with chronic paraproctitis]. / Sovremennye khirurgicheskie tekhnologii v lechenii bol'nykh khronicheskim paraproktitom.

The development of minimally invasive surgical technologies in the treatment of chronic paraproctitis is a promising young trend in coloproctology. Increasingly, in clinical practice, coloproctologists use laser technologies in the outpatient treatment of extra- and transsphincteric pararectal fistulas, in particular, laser technology FiLaC (Fistula Laser Closure). OBJECTIVE: Conducting a comparative retrospective and prospective cohort study of immediate and long-term results of treatment of complicated transsphincteric and extrasphincteric fistulas using the developed modified FiLaC technology with the «traditional¼ FiLaC technology, and standard excision of the fistulous tract with plasty of the internal fistula opening with a full-thickness flap of the rectal wall. MATERIAL AND METHODS: The study included 270 patients with trans- and extrasphincter pararectal fistulas, which were divided into three groups. In group 1 (n=90) the traditional FiLaC technology was used for the treatment of fistulas, in group 2 (n=90) the modified FiLaC technology was used, providing for the opening of purulent streaks and laser coagulation (FiLaC) of the intrasphincter part of the fistula with a Biolitec laser, 12 W, 100 J/cm, in group 3 (n=90), excision of the fistula tract with plastic surgery of the internal fistula opening with a full-thickness flap of the rectal wall was used. RESULTS: The results of treatment in patients of the three groups were monitored for 19-36 months. after surgery (median 31 months). The analysis of the results showed that in group 2 (modified FiLaC technology) healing of fistulas occurred faster (7.3±0.5 weeks versus 12.6±0.7 weeks) compared to group 3 (excision of the fistula with plasty of the internal fistula opening). The indicators of sphincterometry in the long-term period in patients of the 2nd group were restored in relation to the initial ones, and in the th group 3 they were reduced compared to the initial values. Postoperative complications were most common in patients of group 3 (32.2%), and least often in patients of group 2 - 8.9%. At the same time, late postoperative complications were most common (24.4%) in patients of group 1. None of the patients in group 2 had late postoperative complications, while 11.1% of postoperative complications were recorded in group 3. In patients who underwent excision of the AC (group 3), relapses were most common: early - 15.6%, late - in 21.1%. The least frequent relapses were observed in patients who underwent modified FiLaC technology (Group 2): 6.7% - early relapses and 11.1% - late relapses. CONCLUSION: The use of the modified FiLaC technology in the treatment of trans- and extrasphincteric fistulas of the rectum made it possible to minimize postoperative complications, fully preserve the function of anal holding, and achieve healing of fistulas in 82.5% of cases with a median follow-up of 31 months.

[Regenerative effect of comprehensive physiotherapeutic programs in the early postoperative period in patients with chronic paraproctitis]. / Regenerativnyi effekt primeneniya kompleksnykh fizioterapevticheskikh programm v rannem posleoperatsionnom periode u bol'nykh khronicheskim paraproktitom.

The modern lifestyle is often associated with low physical activity and blood stasis in the pelvic organs, which leads to increased incidence of proctological diseases, and increasingly in people of young working age. Chronic paraproctitis is the third most common proctological disorder that requires surgical treatment. The disease occurs commonly in the age group of 30-50 years, predominantly in men, which determines its socio-economic significance. It indicates the urgent need for advanced comprehensive physiotherapeutic programs for early rehabilitation of patients after surgery for chronic paraproctitis, and the application of new diagnostic technologies for assessment of surgery effectiveness and postoperative changes to provide adequate and effective medical rehabilitation. One of the main goals in the early postoperative period is the acceleration of adequate scar formation and reduction of the postoperative wound healing time; therefore, it seems reasonable to assess regeneration processes using transrectal ultrasound examination and sonoelastography of the scar tissue, which have great potential for use in coloproctology. OBJECTIVE: To study the role of the medical rehabilitation program in the early postoperative period on the adequate scar formation and postoperative wound healing processes (by transrectal ultrasound investigation and scar tissue sonoelastography) as well as postoperative complications rate and long-term (up to 12 months) treatment outcomes in patients with chronic paraproctitis. MATERIAL AND METHODS: The study included 60 patients 20-69 years with chronic pararectal fistulas (ICD-10: K60.4). The patients were assigned into two groups. The control group consisted of 30 patients who received standard of care in the early postoperative period, including analgesics, local antibacterial ointments (Levomekol, etc.), and rectal suppositories (Relief Pro, etc.). The main group also consisted of 30 patients who received standard of care and a 5-day comprehensive physiotherapeutic program starting the second day after the surgery. Effectiveness was assessed by complex transrectal ultrasound investigation with color Doppler mapping, Doppler sonography, and sonoelastography at various post-surgery time points. RESULTS: The higher efficacy of the rehabilitation program, including intravenous ozone therapy, rectal laser therapy, recto-tibial myostimulation, and biofeedback therapy in the early postoperative period, versus the standard of care, was shown. CONCLUSION: The introduction of rehabilitation program including intravenous ozone therapy, rectal laser therapy, recto-tibial myostimulation, and biofeedback therapy in the early postoperative period significantly reduced the average postoperative wound healing time by accelerating the formation of an adequate scar (according to transrectal ultrasound investigation and scar tissue sonoelastography) and the incidence of postoperative complications and improved the long-term treatment outcomes (up to 12 months) in patients with chronic paraproctitis.

[Non-drug technologies in early rehabilitation of patients after hemorrhoidectomy]. / Nemedikamentoznye tekhnologii v rannei reabilitatsii bol'nykh posle gemorroidektomii.

Among all coloproctological diseases, hemorrhoids rank first among the reasons for visiting a proctologist. Its prevalence is 130-145 per 1.000 adults, and its proportion in the structure of colorectal diseases ranges from 34 to 41%. After hemorrhoidectomy, a long period of rehabilitation is necessary. There are long periods of incapacity for work (at least two weeks) and quite high complications rate, which generally leads to economic burden. Therefore, an urgent problem of current coloproctology and physiotherapy is the development of new approaches to medical rehabilitation of the patients after surgery for their fast recovery and prevention of complications. OBJECTIVE: To study effectiveness of comprehensive postoperative rehabilitation program including ozone therapy, laser therapy, recto-tibial myostimulation and biofeedback therapy in patients after hemorrhoidectomy. MATERIAL AND METHODS: The study included 90 patients 20-65 years of age (mean age 41.4±2.1years) with chronic stage III hemorrhoids with prominent external nodules (ICD-10 code: K64.2). All patients underwent Milligan-Morgan hemorrhoidectomy using an ultrasound scalpel by the same coloproctologist to exclude the influence of personality factors. The patients were assigned into two groups by random sampling. The main group consisted of 45 patients who received standard of care and the rehabilitation program, including intravenous ozone therapy, rectal laser therapy, recto-tibial myostimulation, and biofeedback therapy starting from the second day after the surgery. The control group consisted of 45 patients who received the same standard of care in the early postoperative period, including analgesics, local antibacterial ointments (Levomekol, etc.), and rectal suppositories (Relief Pro, etc.). RESULTS: In the early postoperative period, in the patients who received non-drug rehabilitation program, the pain was significantly less intensive, and it relieved faster after surgery, which indicated a strong analgesic effect of the rehabilitation program. Patients in the control group received analgesics (including narcotic drugs) for pain control in 68.9% of cases. Duration of postoperative incapacity for work in the main group patients was 12.9±2.4 days vs. 24.1±2.3 days in the control group patients (p<0.001). The analysis of the quality of life in the early and the late postoperative period by SF-36 scale showed a significant difference between the groups according to the physical health component and psychological component both in the early and in the late postoperative period (after six months), which indicates the higher quality of life in the main group patients. Assessment of the late period quality of life using the I. Yu. Alimzhanova and Yu.M. Sheptunov questionnaire showed good results in 43 (95.6%) patients of the main group. Only in 2 (4.4%) main group patients, anal stenosis was observed. Good results were shown in 38 (84.58%) control group patients. Seven patients had complications: cicatricial anal stenosis (5 [11.1%] patients) and pararectal fistulas (2 [4.4%] patients); in 3 (42.9%) of these 7 patients a persistent pain syndrome was developed. CONCLUSIONS: Introduction of the rehabilitation program in the early postoperative period after hemorrhoidectomy contributes to faster relief of pain and other signs and symptoms, a significant decrease of average postoperative wound healing time due to acceleration of adequate scar formation (according to ultrasound sonoelastography), improvement of life quality, reduction of hospital stay, a decrease of incapacity for work duration, and prevention of postoperative complications.

[Advanced regenerative rehabilitation technologies. Successful use of autologous adipose tissue in a patient with cutaneous tracheal fistula]. / Sovremennye tekhnologii regenerativnoi reabilitatsii patsientov. Opyt uspeshnogo ispol'zovaniya autologichnoi zhirovoi tkani u patsienta s kozhno-trakheal'nym svishchom.

According to the published data, the rate of fistula formation in the postoperative period ranges from 0.3% to 29%. Currently, due to the high risk of suture failure in the postoperative period and tracheal and esophageal fistulas formation, the options for fistulas treatment by the regenerative rehabilitation methods are under consideration. The frequency of fistula healing and reduction of scar deformities after adipose tissue autografting ranges from 43% to 55%. OBJECTIVE: To develop the minimally invasive technology for postoperative fistulas treatment and describe the real-world experience of its use in terms of hospital stay reduction and patients' quality of life improvement. MATERIAL AND METHODS: Patients were selected as part of a pilot research project (Development of Personalized Approaches to Regenerative Rehabilitation for Surgical Patients, # 0394-2020-0011). Patients' quality of life was assessed using the Russian version of the EQ-5D-5L questionnaire (Russian version for Russia). This article presents a clinical example of successful repair of a cutaneous tracheal fistula by autografting of adipose tissue three months after fistula formation. RESULTS: In one month after autografting of adipose tissue, the tracheobronchial secretion through the fistula has stopped. According to the follow-up computed tomography of the neck and tracheobronchoscopy, the fistulous passage is not observed. CONCLUSION: The presence of a fistula worsens the patient's quality of life and increases the risk of secondary infection. When treating patients with tracheal fistulas of high and extremely high surgical risk, the method of autografting of adipose tissue can be a safe and effective alternative to conventional surgery. Further study of this method of regenerative rehabilitation is required.

[Prospects of drinking mineral water in the rehabilitation of patients with coronavirus (COVID-19) infection: analysis of the main sanogenetic mechanisms]. / Perspektivy primeneniya pit'evykh mineral'nykh vod v reabilitatsii patsientov s koronavirusnoi (COVID-19) infektsiei: analiz osnovnykh sanogeneticheskikh mekhanizmov.

This review provides an analysis of the main mechanisms of the therapeutic and prophylactic effects of drinking mineral water concerning the rehabilitation of new coronavirus infection convalescents. When considering the sanogenetic potential of mineral water for drinking, it was noted that in the mechanisms of their systemic effects, a major role belongs to the nonspecific hormone-stimulating effect in the form of a pronounced activation of the gastroenteropancreatic endocrine system, capable of integrating substance and energy exchange following the current needs of the body and excrete vasoactive factors modulating the vital functional systems activity. The maximum effect of this system is promoted by the intake of mineral water with a high content of hydrocarbonate ions, magnesium, and sodium, as well as carbon dioxide saturation, but with general mineralization of water within the range from 5-6 to 11-13 g/L. The observed stimulating effect of mineral water on the adaptation processes allowed us to theoretically substantiate and convincingly prove the benefits of using this natural healing factor for the primary prevention of disorders in various functional systems and their hormonal regulation. The effects of drinking mineral water on various inflammatory states, resistance to hypoxia, microcirculatory tissue perfusion, and the state of the cardiovascular system were shown. It is concluded that the potential effectiveness of drinking mineral water as a part of comprehensive programs of medical rehabilitation of new coronavirus infection convalescents.

[Influence of complex rehabilitation programs on the uterine blood flow in patients of different age after plastic surgery for rectocele]. / Vliyanie reabilitatsionnykh kompleksnykh programm na pokazateli matochnogo krovotoka po dannym 3D-ekhodopplerografii u patsientok raznykh vozrastnykh grupp posle plasticheskoi operatsii po povodu rektotsele.

OBJECTIVE: To develop the optimized complex programs, including general magnetotherapy, fractional microablative therapy with a CO2 laser, electromyostimulation with biofeedback of the pelvic floor muscles, and a special exercise therapy complex in late rehabilitation programs for women of different age after reconstructive plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 women of childbearing, peri- and menopausal age with rectocele grade II-III and 20 healthy women of comparable age. All patients were divided into 4 groups by 50 womes: main group, two comparison groups and control group. Surgical treatment of rectocele was followed by long-term postoperative rehabilitation including symptomatic therapy, general magnetotherapy, and electromyostimulation with biofeedback of the pelvic floor muscles, intra-vaginal fractional microablative therapy with a CO2 laser and special complex of therapeutic physical education. RESULTS: General magnetotherapy in early (1 day) postoperative period and complex rehabilitation in long-term postoperative period (within a month after surgery) including 2 procedures of intra-vaginal microablative fractional therapy with carbon dioxide laser, electromyostimulation with biological connection of the pelvic floor muscles and special complex of therapeutic physical education ensured more significant improvement of uterine blood flow regardless age and baseline disorders in the uterine arteries in patients with rectocele. In our opinion, this is primarily due to vasoactive effects of general magnetotherapy, recovery of circulation via relief of spasm in the arteries and arterioles, improved vein contractility and venous outflow. These processes combined with electrical stimulation and therapeutic exercises of pelvic floor muscle followed by their reinforcement, as well as fractional microablative therapy ensured significant vascular effect.

[Myostimulating effect of comprehensive application of general magnetotherapy, fractional CO2 laser, electro-myostimulation and special complex of exercise in patients with rectoceleal after open-peconstructure]. / Miostimuliruyushchii effekt kompleksnogo primeneniya obshchei magnitoterapii, fraktsionnogo CO2-lazera, elektromiostimulyatsii i spetsial'nogo kompleksa LFK u patsientok s rektotsele posle rekonstruktivno-plasticheskikh operatsii.

The article presents data on the treatment of 200 women of childbearing, peri - and menopausal age with rectocele of II-III degree, which were divided into 4 groups comparable in clinical and functional characteristics: 1-50 patients who, after surgical treatment of rectocele, underwent a complex consisting of a course of General magnetic therapy, 2 intra-vascular procedures of fractional microablative CO2 laser therapy, electromyostimulation with the pelvic floor muscles and a special complex of therapeutic physical education; comparison 1, which included 50 patients who underwent the above-mentioned complex of rehabilitation measures without General magnetotherapy; comparison of 2-50 patients after surgical treatment of rectocele, who in the late postoperative period (one month after the operation) underwent a set of rehabilitation measures, including a course of electromyostimulation with the biological connection of the pelvic floor muscles, consisting of 10 daily procedures and a special complex of physical therapy and a control group - 50 patients after surgical treatment of rectocele, who in the late postoperative period were treated with symptomatic therapy, including painkillers and antispasmodics, which served as a background for all other groups. As a result of the research, it was found that the developed rehabilitation complexes have a pronounced myostimulating effect, and can be recommended for wide use in rehabilitation programs for postoperative management of patients with rectocele.

Physical therapy methods for treatment and rehabilitation of oncologic patients (review of literature).

Oncologic morbidity has a tendency to steady rise. Treatment of oncologic patients, aimed to remove or cease malignant cells growth and prevent metastases, has considerable side effects and is conducted on psychologic stress background. Rehabilitation measures hence get crucial importance. Rehabilitation of oncologic patients in complex treatment is a multi-stage continuous recovery process that includes various influences. Correct implementation of physical therapy factors in rehabilitation program causes no tumor growth and metastases, and sometimes inhibits tumor cells growth. On recommendations of sanatorium-and-spa treatment for oncologic patients, the complex promotes rapid recovery of disordered functions, activation of adaptive responses, psychologic and social adjustment.

Efficiency of controlled halotherapy in rehabilitation of patients with occupational lung diseases.

The study was aimed at features and efficiency of controlled halotherapy method in patients with occupational chronic obstructive lung disease (COLD). Examination covered 73 patients with occupational mild and moderate stages of COLD, aged 45 to 64. All the patients were randomized to 2 comparable groups - main and reference (37 and 36 examinees respectively). The main group in addition to conventional medical therapy received courses of controlled halotherapy (10 procedures with certain concentration of sodium chloride dry aerosol in accordance to methodic recommendations). Based on complex evaluation of clinical, functional and laboratory methods, the authors assessed efficiency of controlled halotherapy in patients with occupational COLD. Considerable improvement was seen: for mild COLD-- in 40% of cases, for moderate COLD - in 30%, with general efficiency for these patients of 90 and 85% respectively. Analysis of the results obtained enables to evaluate controlled halotherapy as an effective method of rehabilitation and prevention in occupational COLD patients.

[Slow Formation and Degradation of γH2AX Foci in Human Skin Fibroblasts Exposed to Low-Dose X-Ray Radiation].

It was shown that the kinetics of changes of γH2AX foci number (marker of DNA double-strand breaks) in human skin fibroblasts after exposure to low doses of X-ray radiation (20, 40 and 80 mGy) differs from that observed after exposure to medium-low doses (160 and 240 mGy). After exposure to 160 and 240 mGy the highest number of γH2AX foci was detected at 30 min after exposure (first experimental point) and further their decrease was observed. At the same time we observed a fast phase of repair (upto 4 h), in which there was a decrease of the foci amount to ~50-60% and a slow phase of repair (from 4 h to 24 h). After 24 h only ~3-5% of the foci amount observed at 30 min after irradiation was left. After exposure to low doses, the foci number did not decrease during 2 h and even 24 h after exposure their amount was ~25% from that observed at maximum points (1 h after irradiation at 40 and 80 mGy and 2 h after irradiation at 20 mGy).

Estimation of the contribution of short-lived radioiodines to the thyroid dose for the public in case of inhalation intake following the Fukushima accident.

The purpose of this paper is to present (1) the method of assessing the contribution of short-lived radioiodines to the thyroid for members of the public in Fukushima and neighbouring prefectures based on available data and (2) the results of a realistic assessment of such a contribution. The estimates of that contribution for the inhalation intake that occurred on the day of the main fallout (15 March 2011) are within 15 % of the dose to the thyroid from (131)I. The contribution to the thyroid dose from intake of (132)Te is higher than that from the intake of (133)I by a factor of ∼3. The contribution of short-lived radioiodines to the thyroid dose for the public in the case of inhalation intake occurring as early as March 12 might be as great as 30-40 %.

[Prediction of the acute pancreatitis after surgery on the pancreas].

RESEARCH OBJECTIVE: Study preoperative and intraoperative risk factors for acute postoperative pancreatitis after surgical treatment of the pancreatic diseases. MATERIAL AND METHODS: Predictive value of the probable preoperative and intraoperative risk factors of the acute postoperative pancreatitis after surgical treatment of the proximal and distal pancreatic cancer were explored and evaluated. Patients were divided at the high risk group and mild risk group using a specially developed formula. RESULTS: Preoperative and intraoperative risk factors of the acute postoperative pancreatitis were detected and had predictive value. Much of the identified preoperative risk factors indirectly or objectively showed morphology and function of the pancreas. The importance at the development of the acute postoperative pancreatitis playing the conditions of sur gical intervention, its volume and features of technology, results of the intraoperative research of the pathological focus and status of the pancreatic tissue. Its risk factors have been ranked to intraoperative risk factors. The Identification of the intraoperative risk factors of the acute postoperative pancreatitis allowed to make correction of the risk of complications determined at the preoperative stage. CONCLUSION: The data on the effect of various technological solutions and surgical tactics to the possibility of the development of the acute postoperative pancreatitis should be considered in predicting the development of complications and in develop the most effective and safe technologies of the surgical treatment of the pancreatic diseases, as well as in optimization of the prevention of the acute postoperative pancreatitis and postoperative complications.

[Experimental model of severe local radiation injuries of the skin after X-rays].

The experimental model of severe local radiation injuries skin under the influence of a relatively soft X-rays on a modified device RAP 100-10 produced by "Diagnostica-M" (Russia) was proposed. The model can be used as pre-clinical studies in small experimental animals in order to improve the treatment of local radiation injuries, especially in the conditions of application of cellular therapy.

[Early medical consequences of the radiation accidents in the former USSR Territory].

The paper sums up the information on radiation incidents at the former USSR territory, which incidents are related to the human exposure of clinically significant effects. Within more than 60 years (since 1949), at least 356 radiation incidents accompanied by the clinically significant human exposure have happened at the former USSR territory, which has resulted to clinically significant health effects in 765 victims. This exposed cohort includes 348 acute radiation sickness (ARS) patients including cases aggravated by local radiation injuries (LRI). 407 victims were affected by local radiation injuries only. Totally, 71 radiation induced fatalities were observed within first 3-4 months after the irradiation. The maximum adverse effects as a result of accidental exposure of radiation incidents in the former USSR territory, had a place for professional workers whose work is associated with sources of ionizing