[Predicting the results of rehabilitation treatment of patients with acute myocardial infarction who underwent coronary artery stenting: focus on the rehabilitation potential]. / Prognozirovanie rezul'tatov vosstanovitel'nogo lecheniya bol'nykh s ostrym infarktom miokarda, perenesshikh stentirovanie koronarnykh arterii: fokus na reabilitatsionnyi potentsial.

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.

[Rehabilitation potential of patients with ischemic stroke: the possibility of predicting the course of the disease and the results of rehabilitation treatment]. / Reabilitatsionnyi potentsial bol'nykh s ishemicheskim insul'tom: vozmozhnosti prognozirovaniya techeniya zabolevaniya i rezul'tatov vosstanovitel'nogo lecheniya.

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.

[Physiotherapeutic service of the Irkutsk region: present status, problems, and prospect]. / Fizioterapevticheskaya sluzhba Irkutskoi oblasti: sovremennoe sostoyanie, problemy i perspektivy.

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.

Extremely heat tolerant photo-symbiosis in a shallow marine benthic foraminifera.

Bleaching, the loss of algal symbionts, occurs in marine photosymbiotic organisms at water temperatures minimally exceeding average summer SST (sea surface temperatures). Pre-adaptation allows organisms to persist under warmer conditions, providing the tolerance can be carried to new habitats. Here we provide evidence for the existence of such adaptation in the benthic foraminifera Pararotalia calcariformata. This species occurs at a thermally polluted site in the Mediterranean, where water temperatures reach a maxima daily average of 36 °C during the summer. To test whether this occurrence represents a widespread adaptation, we conducted manipulative experiments exposing this species from an unpolluted site to elevated temperatures (20-42 °C). It was kept in co-culture with the more thermally sensitive foraminifera Amphistegina lobifera in two experiments (20-36 °C). Reduced photosynthetic activity in A. lobifera occurred at 32 °C whereas photochemical stress in P. calcariformata was first observed during exposure to 36 °C. Pararotalia calcariformata survived all treatment conditions and grew under 36 °C. The photosymbiosis in P. calcariformata is unusually thermally tolerant. These observations imply that marine eukaryote-eukaryote photosymbiosis can respond to elevated temperatures by drawing on a pool of naturally occurring pre-adaptations. It also provides a perspective on the massive occurrence of symbiont-bearing foraminifera in the early Cenozoic hothouse climate.

[Complex use of naphthalane and nonselective chromotherapy in gonarthrosis treatment in rolling stock workers].

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.

[Prenosologic criteria of health disorders and cardiovascular risk factors in workers engaged into nuclear industry].

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.

[State of vegetative regulation in workers exposed to vibration at work during industrial implementation of hi-tech pneumoinstruments].

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.

[Method for the determination of the biological age and aging rate in man].

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.

Prospective cohort comparison of bioactive glass implants and conchal cartilage in reconstruction of the posterior canal wall during tympanomastoidectomy.

OBJECTIVE: To compare the effectiveness of bioactive glass implants and conchal cartilage in reconstructing the posterior canal wall during tympanomastoidectomy. STUDY DESIGN: Prospective cohort clinical study. SETTING: Teaching hospital. PATIENTS: Patients with clinically diagnosed chronic suppurative otitis media and cholesteatoma awaiting tympanomastoidectomy were recruited. INTERVENTION: All patients underwent tympanomastoidectomy by the same surgeon. A first cohort of 12 patients underwent posterior canal wall reconstruction with autogenous conchal cartilage. A second cohort of 12 patients underwent such reconstruction with prefabricated bioactive glass. MAIN OUTCOME MEASURES: Primary- All patients underwent out-patient review at 1, 3, 6 and 12 months postoperatively, after which a second-look procedure was performed. Reconstructions were inspected for evidence of epithelialization, granulation, infection, stenosis, depression and extrusion. Secondary- All patients had perioperative serial pure-tone audiometry to check for any change in hearing levels upto 1 year postoperatively. RESULTS: By 1 year postoperatively, both reconstructive graft materials showed good epithelialization, no granulation, no infection, no ear canal stenosis, no depression and no extrusion. At operative second-looks, bioactive glass particularly showed good tissue bonding, including both neovascularization and connective tissue integration. Overall clinical outcome was equivalent for both materials. Both graft materials showed no statistically significant difference in postoperative hearing levels. CONCLUSIONS: Bioactive glass and conchal cartilage showed equivalent clinical outcome in reconstructing the posterior canal wall without significantly affecting hearing levels. As bioactive glass does not require second site morbidity and thus also reduces operative time, we prefer it for reconstructing the posterior canal wall following tympanomastoidectomy.

[Surgical treatment of cancer of the stomach in patients over 70 years].

Surgical treatment was performed in 322 patients over 70 years with cancer of the stomach. Radical operation was made in 220 (68.3%) patients: subtotal distal resection -- in 137, subtotal proximal resection -- in 18, gastrectomy -- in 55, extirpation of the gastric stump -- in 10. Symptomatic and test surgeries were performed in 102 (31.7%) patients. Postoperative complications were seen in 16,1+/-2,1% cases, lethality was 6.8+/-1.4%. Complications after radical resections were seen in 16.4+/-2.5% patients, lethality was 5.0+/-1.5%. The rate of purulent complications was maximal (8.4%). Cardiovascular complications and coagulopathies (4.7%) were the main causes of lethal outcome (in 11 of 15 patients). Score scale of assessment of postoperative risk was developed. Five-years survival in stage I cancer of the stomach was 62.8%, stage II -- 42.6%, III -- 16.7%. Immediate and long-term results demonstrate necessity of radical surgical treatment of patients with cancer of the stomach over 70 years depending on the disease stage and risk factors.

[The parameters of life quality and the body mass index in elderly patients with essential hypertension]. / Pokazateli kachestva zhizni i indeks massy tela u bol'nykh gipertonicheskoi bolezn'iu pozhilogo vozrasta.

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.

[Diurnal arterial blood pressure monitoring in hypertensive patients treated with pulse low-frequency alternating electric field]. / Sutochnoe monitorirovanie arterial'nogo davleniia u bol'nykh gipertonicheskoi bolezn'iu pod vliianiem lecheniia pul'siruiushchim nizkochastotnym peremennym élektricheskim polem.

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.

[Adrenergic vascular reactivity in elderly hypertensive patients with orthostatic disorders]. / Osobennosti adrenergicheskoi reaktivnosti sosudov u bol'nykh gipertonicheskoi bolezn'iu pozhilogo vozrasta s ortostaticheskimi narusheniiami.

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.

[Quality of life parameters in assessment of efficacy of sanatorium treatment in elderly patients with hypertension]. / Pokazateli kachestva zhizni v otsenke éffektivnosti sanatorno-kurortnogo lecheniia u bol'nykh gipertonicheskoi bolezn'iu pozhilogo vozrasta.

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.

[Thermoregulation in hypertensive elderly patients during physiotherapy]. / Termoreguliatsiia u pozhilykh bol'nykh gipertonicheskoi bolezn'iu pri lechenii fizicheskimi faktorami.

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.

[Status of microcirculation in elderly hypertensive patients during treatment with sodium chloride baths]. / Sostoianie mikrotsirkuliatsii u bol'nykh gipertonicheskoi bolezn'iu pozhilogo vozrasta pri lechenii khloridnymi natrievymi vannami.

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.

[Human biological age, cardiovascular system, and its aging rate]. / Biologicheskii vozrast chekovek, serdechno-sosudistaia sistema i skorost' ee stareniia.

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.

First branchial cleft sinus presenting with cholesteatoma.

Disorders of the first branchial cleft are rare and often present difficulties in diagnosis. A case is reported that presented with the clinical and histological features of cholesteatoma. The embryology, diagnosis and treatment of branchial arch defects are also reviewed. The case highlights the fact that a high index of suspicion should be aroused for patients with a discharging ear in the presence of an intact tympanic membrane.

[Characteristics of microcirculation and vascular responsiveness in elderly patients with hypertension and ischemic heart disease]. / Osobennosti mikrotsirkuliatsii i sosudistoi reaktivnosti u pozhilykh bol'nykh s gipertonicheskoi bolezn'iu v sochetanii s ishemicheskoi bolezn'iu serdtsa.

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.