RESUMEN
The search for ways to assess the rehabilitation potential (RP) in patients with acute myocardial infarction (AMI) who have undergone stenting remains relevant, which will allow personalizing approaches to prescribing treatment complexes necessary for a particular patient, increasing their effectiveness and reducing the likelihood of complications. OBJECTIVE: To develop a method for assessing RP in patients in the acute period of myocardial infarction and to evaluate its role in predicting the effectiveness of therapeutic measures in the early recovery period. MATERIAL AND METHODS: The study consisted of two parts. In the first part, a method for assessing the RP of patients with AMI was created using mathematical modeling methods. For this purpose, the analysis of discharge epicrisis of 137 patients (training sample) with AMI aged from 34 to 85 years (average age 59.4±2.1 years) was carried out. In the second part of the study, the results of rehabilitation measures were analyzed in these patients who, after the intensive care unit and intensive care unit, were transferred to the cardiology department of Angara Clinical Resort JSC. At the end of the II stage of rehabilitation, a multidisciplinary team evaluated the effectiveness of treatment of patients using integral indicators characterizing the clinical condition of a patient who has undergone acute coronary syndrome and stenting. RESULTS: In the first part of the study, devoted to the development of a mathematical model for assessing the RP of patients with AMI, an algorithm of methodology was created: a formalized patient map was formed, the evidence base was represented by 109 indicators; certain indicators were assigned the values of coefficients of linear classification functions, depending on which the patient fell into one of three groups: group 1 - high RP; group 2 - medium RP; group 3 - low RP. The second part of the study was devoted to determining the value of RP for predicting the effectiveness of therapeutic measures in the early recovery period (stage II of medical rehabilitation). When testing patients at the end of treatment at the resort, it was found that the greatest effect was observed in group 1 patients with high RP. A lesser effect was observed in patients of group 2 and, especially, group 3. CONCLUSION: The use of a method for assessing RP based on mathematical modeling in AMI patients who have undergone stenting allows predicting the results of medical rehabilitation of patients at stage II in the conditions of the resort.
Asunto(s)
Síndrome Coronario Agudo , Infarto del Miocardio , Intervención Coronaria Percutánea , Humanos , Persona de Mediana Edad , Adulto , Anciano , Anciano de 80 o más Años , Vasos Coronarios , Infarto del Miocardio/complicaciones , Infarto del Miocardio/terapia , Stents , Resultado del TratamientoRESUMEN
The search for ways to assess the rehabilitation potential (RP) in patients with ischemic stroke (IS) remains relevant, which will allow personalizing approaches to prescribing the treatment complexes necessary for a particular patient, increasing their effectiveness and reducing the likelihood of complications. OBJECTIVE: To develop a method for assessing RP in patients in the acute period of IS and to evaluate its role in predicting the effectiveness of therapeutic measures in the early recovery period. MATERIAL AND METHODS: The study consisted of two parts. In the first part, using mathematical modeling methods, a method was created for assessing the RP of patients with acute IS. For this, we analyzed the discharge records of 102 patients (training sample) with IS aged 42 to 80 years (mean age 64.0±2.6 years). In the second part of the study, the results of rehabilitation measures were analyzed in these patients, who were transferred from the primary vascular department to the neurological department of Angara Clinical Resort. At the end of stage II of rehabilitation, a multidisciplinary team assessed the effectiveness of treatment of patients using integral indicators characterizing the clinical condition of a patient who had a stroke. RESULTS: In the first part of the study, devoted to the development of a mathematical model for assessing the RP of patients with IS, a methodology algorithm was created: a formalized patient card was created, the evidence base is represented by 85 indicators; certain indicators were assigned the values of the coefficients of linear classification functions, depending on which the patient fell into one of 4 groups: group 1 - satisfactory RP with limitations in rehabilitation measures; group 2 - satisfactory RP; group 3 - low RP; 4th group - high RP. The second part of the study was devoted to determining the value of RP for predicting the effectiveness of therapeutic measures in the early recovery period (stage II of medical rehabilitation). When testing patients at the end of treatment at the resort, it was found that the greatest effect was observed in patients of the 4th group with a high RP. A lesser effect was noted in patients of the 2nd group. The worst results were registered in the 1st and especially in the 3rd groups. CONCLUSION: The use of the method for assessing the RP of patients who have undergone IS, based on mathematical modeling, makes it possible to predict the results of medical rehabilitation of patients with IS at the II stage of rehabilitation in a resort.
Asunto(s)
Accidente Cerebrovascular Isquémico , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Anciano , Humanos , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
INTRODUCTION: Improving the organizational forms of physiotherapy services in the context of the formation of the novel specialty of physical and rehabilitation medicine poses urgent tasks for practical public health. At the same time, ensuring the proper quality of medical care, the high level of safety, customer satisfaction from the new service presents a multifaceted and complex problem that cannot be solved without analyzing the current situation in the units of the physiotherapy network. OBJECTIVE: To study the parameters of the activity of physiotherapy units of treatment-and-prophylactic facilities in the Irkutsk Region to assess the dynamics of their development and further prospects. MATERIAL AND METHODS: The authors analyzed the data of state statistical annual reporting on the work of physiotherapy departments (PTDs) and physiotherapy rooms (PTRs), which had been submitted to the Medical Information Analysis Center, Ministry of Health of the Irkutsk Region, and information on physiotherapeutic medical care in the treatment-and-prophylactic facilities of the Irkutsk Region in the period 2010 to 2017. RESULTS: The quantitative indicators of the activities of PTD and PTR employees were investigated; the qualitative components of their activities were assessed; the problems of physiotherapeutic management were revealed and the ways of their solution were defined. Since 2014, there have been negative changes in the development of physiotherapy: the material and technical base is worsening; the number of doctors and nurses is being reduced; the specialists' qualification is decreasing, and the coverage of patients with physiotherapies is reducing. CONCLUSION: Physiotherapy is currently undergoing a period of stagnation. Along with the existing systemic economic problems of modern public health, the deepening of this negative situation in physiotherapy is promoted by the protracted period of the formation of the new specialty of physical and rehabilitation medicine physician, the absence of its legal base, federal state educational standards, which creates a number of misunderstandings of its promises and demand for physiotherapists in near future.
Asunto(s)
Modalidades de Fisioterapia , Atención a la Salud , Humanos , Modalidades de Fisioterapia/organización & administración , Salud PúblicaRESUMEN
Complex treatment using naphthalane applications with nonselective chromotherapy covered 64 engine operators of locomotive crews, aged 40-69 years, having 1-3 stage knee osteoarthrosis. Findings are that optimized treatment schedules effectively reduce intensity of pain, improve functional state of the joints involved, increase life quality of the patients, have no side effects. Comparative analysis of the treatment results showed that efficiency of combined naphthalane and nonselective chromotherapy exceeds isolated naphthalane effects.
Asunto(s)
Cromoterapia/métodos , Naftalenos/farmacología , Enfermedades Profesionales/terapia , Osteoartritis/terapia , Vías Férreas , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Naftalenos/administración & dosificación , Enfermedades Profesionales/tratamiento farmacológico , Osteoartritis/tratamiento farmacológicoRESUMEN
Prophylactic study among workers engaged into main production of Siberian chemical enterprise (Seversk city) revealed high frequency of cardiovascular risk factors (overweight, hypodynamia, dyslipidemia, arterial hypertension), low level of adaptational potential and integral somatic health parameter as prenosologic criteria of cardiovascular diseases. The results necessitate recommendations to supplement periodic medical examinations with studies aimed to reveal early criteria of health disorders, and determine priority directions to specify prophylactic measures in nuclear industry workers.
Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Industria Procesadora y de Extracción , Enfermedades Profesionales/diagnóstico , Traumatismos por Radiación/diagnóstico , Adulto , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/sangre , Enfermedades Profesionales/prevención & control , Traumatismos por Radiación/sangre , Traumatismos por Radiación/prevención & control , Factores de RiesgoRESUMEN
The study was conducted on aircraft-building enterprise during production microcycle (before working shift start, during last working hour and in an hour after the shift end)--spectral analysis covered variability of heart rhythm in 70 male assembler riveters aged 25-59, divided into 2 groups in accordance with industrial equipment used. The group 1 used standard vibroinstrument, the group 2--pneumoinstruments with low vibration velocity parameters. Triple study during the working shift revealed in group 2 an adequate reaction of vegetative nervous system to vibration, in group 1 a negative trend was seen with centralization of regulatory processes and absence of adequate recovery in an hour after work.
Asunto(s)
Aeronaves , Enfermedades del Sistema Nervioso Autónomo/diagnóstico , Industria Manufacturera , Enfermedades Profesionales/diagnóstico , Exposición Profesional/efectos adversos , Vibración/efectos adversos , Adulto , Enfermedades del Sistema Nervioso Autónomo/etiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiologíaRESUMEN
Multiple linear regression was used to develop a mathematical model of biological age in healthy subjects. Aging rate was found to slow down in elderly persons compared with young and middle-aged ones. In men below 60 years, it was lower than in women. The aging rate increased in patients with coronary heart disease and hypertensive disease.
Asunto(s)
Envejecimiento/fisiología , Sistema Cardiovascular , Modelos Biológicos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
The parameters of life quality were analyzed in 22 elderly hypertensive patients with varying body mass (BM) in relation to age and sex. Worse life quality was observed with excessive BM and obesity in males and particularly in females.
Asunto(s)
Hipertensión/epidemiología , Obesidad/epidemiología , Calidad de Vida , Anciano , Índice de Masa Corporal , Femenino , Humanos , Masculino , Índice de Severidad de la EnfermedadRESUMEN
Vascular adrenergic reactivity was studied in 100 healthy persons and 222 elderly patients with stage II essential hypertension at high risk of complications. With age, the rate of orthostatic hypotension rises. This hypotension in the elderly hypertensive patients is caused by reduced adrenergic reactivity of venous microvessels.
Asunto(s)
Fibras Adrenérgicas , Hipertensión/fisiopatología , Hipotensión Ortostática/etiología , Hipotensión Ortostática/fisiopatología , Capacitancia Vascular , Vénulas/fisiopatología , Adulto , Anciano , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Microcirculación , Persona de Mediana Edad , Vénulas/inervaciónRESUMEN
The effect of pulse low-frequency alternating electric field (HI-VAMAT-200 unit) on 24-h profile of arterial pressure was studied in 30 hypertensive patients. The evidence obtained at 24-h blood pressure monitoring showed that the above physiotherapy increased a nocturnal surge of arterial pressure and normalized its 24-h profile more effectively than conventional pharmacotherapy.
Asunto(s)
Presión Sanguínea/fisiología , Campos Electromagnéticos , Hipertensión/terapia , Adulto , Anciano , Presión Sanguínea/efectos de los fármacos , Monitoreo Ambulatorio de la Presión Arterial , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Questionnaires specially developed for estimation of quality of life in hypertensive elderly patients were used in 70 patients taking sanatorium treatment at Urkutsk health resort Angara. It is shown that a course of chloride sodium mineral baths normalizes quality of life of elderly patients with hypertension.
Asunto(s)
Colonias de Salud , Hipertensión/rehabilitación , Garantía de la Calidad de Atención de Salud , Calidad de Vida , Anciano , Colonias de Salud/normas , Humanos , Persona de Mediana Edad , Modalidades de Fisioterapia/métodos , Modalidades de Fisioterapia/normas , Federación de RusiaRESUMEN
Effects of therapeutic physical factors on thermoregulation and thermoreactivity of skin were studied in 222 elderly patients with hypertension. It is shown that sodium chloride half-baths, "dry" carbon dioxide baths and general magnetotherapy correct thermal asymmetry and normalize skin thermoreactivity, i.e. produce a positive effect on microcirculation.
Asunto(s)
Balneología , Regulación de la Temperatura Corporal/fisiología , Hipertensión/fisiopatología , Anciano , Femenino , Humanos , Hipertensión/terapia , Masculino , Persona de Mediana Edad , Fenómenos Fisiológicos de la Piel , Temperatura CutáneaRESUMEN
Microcirculation was studied with biomicroscopy of the eye bulbar conjunctiva's vessels in 50 patients with essential hypertension stage II aged 60-80 years. They took half baths with sodium chloride mineral water at Irkutsk health resort "Angara". The treatment resulted in improvement of perivascular and intravascular end blood flow.
Asunto(s)
Balneología , Hipertensión/terapia , Microcirculación , Anciano , Anciano de 80 o más Años , Humanos , Hipertensión/fisiopatología , Persona de Mediana EdadRESUMEN
Mathematical model of biological age of the cardiovascular system was determined by multiple linear regression analysis in 100 normal subjects aged 30-74 years on the basis of central hemodynamic, microcirculation, and vascular reactivity parameters. The rate of cardiovascular aging is decreased in elderly subjects. Before 60 years of age the rate of aging is higher in men than in women.
Asunto(s)
Envejecimiento/fisiología , Sistema Cardiovascular , Modelos Biológicos , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Microcirculation and vascular responsiveness were studied in 52 patients with arterial hypertension and ischemic heart disease versus 48 healthy elderly persons. The patients were found to have defects of the end blood flow in all links of microcirculation, longer and more severe vasoconstriction of conjunctival and skin vessels in response to norepinephrine and cold stimulation tests.
Asunto(s)
Conjuntiva/irrigación sanguínea , Hipertensión/fisiopatología , Isquemia Miocárdica/fisiopatología , Vasoconstricción/fisiología , Anciano , Anciano de 80 o más Años , Frío , Diagnóstico Diferencial , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Masculino , Microcirculación/efectos de los fármacos , Microcirculación/fisiología , Persona de Mediana Edad , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/diagnóstico , Norepinefrina , Temperatura Cutánea , Vasoconstricción/efectos de los fármacos , VasoconstrictoresRESUMEN
Effectiveness of general magnetotherapy was studied in 84 patients with essential hypertension and 36 patients with isolated systolic arterial hypertension of old age. It is thought necessary to determine biological age of the cardiovascular system in hypertensive patients over 60 years of age to specify indications and contraindications to physiotherapy.
Asunto(s)
Envejecimiento/fisiología , Hipertensión/terapia , Magnetismo , Anciano , Anciano de 80 o más Años , Hemodinámica , Humanos , Hipertensión/fisiopatologíaRESUMEN
Central hemodynamics, diastolic and pumping functions of the heart, myocardial reactivity, microcirculation and biological age of cardiovascular system were studied in 66 elderly patients suffering from hypertension and ischemic heart disease. The patients received systemic magnetotherapy which produced a geroprotective effect as shown by improved microcirculation, myocardial reactivity, central hemodynamics reducing biological age of cardiovascular system and inhibiting its ageing.