[The efficacy of «School of Health: social and psychological rehabilitation of children with renal disease¼ within the framework of comprehensive medical rehabilitation]. / Effektivnost' «Shkoly zdorov'ya: sotsial'no-psikhologicheskaya reabilitatsiya detei s zabolevaniem pochek¼ v ramkakh kompleksnoi meditsinskoi reabilitatsii.

The constantly high incidence of urinary system pathology in children, in which the pyelonephritis plays a leading role, requires to search the new approaches to the comprehensive medical rehabilitation of children, suffering from chronic pyelonephritis. OBJECTIVE: To evaluate the efficacy of comprehensive medical rehabilitation of children with chronic pyelonephritis, that includes lessons in «School of Health: social and psychological rehabilitation of children with renal disease¼ (thereafter - «School of Health¼). MATERIAL AND METHODS: A prospective monocentric controlled randomized study has been conducted. The number of children equal 61 with chronic pyelonephritis was under observation. The study group included 32 children (mean age 9.44±0.6 years), who were performed the complex of medical rehabilitation (regimen - sparing; diet - table №1; therapeutic exercises; manual massage of lumbosacral region; sapropel's applications on lumbar region; interferential current therapy by the «AIT-01¼ apparatus; oxygen cocktail), that included the education in «School of Health¼. The comparison group consisted of 29 children (mean age was 9.45±0.7 years), who were prescribed similar complex, but without education in «School of Health¼. The control group included 20 somatically healthy children (mean age was 9.41±0.6 age). Methods of work used in «School of Health¼ contained: monitoring, questionnaires; problem-oriented education of parents; evaluation of medical and pedagogical activity of family within the framework of comprehensive medical rehabilitation; either group or individual theoretical and practical classes. RESULTS: It was found, that absolute majority of children had psychological changes (more than 70% of children), unbalance of all capability components (cognitive, emotional, behavioral), low motivational component in addition to clinical and laboratory presentations of chronic pyelonephritis at the initial stage of rehabilitation. There was a positive clinical and laboratory dynamics (reduction of dysuric syndrome, toxidrome), favorable influence of education in «School of Health¼ to the childrens' psychological condition, affected by comprehensive medical rehabilitation. CONCLUSION: Comprehensive approach to the medical rehabilitation of children, suffered from chronic pyelonephritis associated with «School of Health¼ organization leads to stabilization of chronic renal inflammation, psycho-emotional condition of patients, helps to prevent the progression of chronic pyelonephritis.

[The assesment of the fragmentation rate of urinary stones during the holmium laser lithotripsy].

INTRODUCTION: For rational planning of laser lithotripsy tactics, determination of pulse settings and laser modes, considering patients condition, stone size and composition as well as for more rationale planning of operation theatre loading and the use of high-technology equipment the knowledge of the time required for complete stone fragmentation is needed. It is still assessed subjectively base on the urologists own experience. AIM: To determine the specific value of urinary stones mass decrease in order to evaluate exact time for complete fragmentation during holmium laser lithotripsy. MATERIALS AND METHODS: Fragmentation time values were derived from in vitro studies in which lithotripsy using holmium laser was compared to other lithotriptors types, as well as our own results of time and energy level measurement during urinary stones fragmentation in vivo were used. RESULTS: As baseline data for estimating of the urinary stones destruction using holmium laser lithotripsy we suggest to use not stone volume but its mass which combine in some extent the volume and density. To take into account energy level for stone fragmentation it is suggested to introduce new value, the specific decrease of the stone mass per unit of laser energy (mg/J). It is established that such a value is a constant for a given laser type and fiber size. This value is calculated using stone dimensions, its density in HU and the total laser energy delivered during complete fragmentation. Based on experimental data it is estimated that specific decrease of the stone mass per unit of holmium laser energy during fragmentation in vitro of BegoStone is 0.442+/-0,083 mg/J (p=0.05). This value, measured in real conditions in vivo during urinary stones lithotripsy using holmium laser Triple ("Medoptotech") with 600 m fiber is 0.401+/-0.12 mg/J (=0.05). CONCLUSION: The use of specific decrease of the stone mass per unit of the laser energy during lithotripsy allows to assess complete fragmentation time of the urinary stones, based on their dimensions and density in HU. The absolute error in estimating of stone fragmentation time does not exceed several minutes, which is quite acceptable for calculating the total time of using high-technologic equipment and operative time.

[The comprehensive approach to the rehabilitative treatment of junior athletes]. / Kompleksnyi podkhod k vosstanovitel'nomu lecheniyu sportsmenov-yuniorov.

AIM: The objective of the present study was the development of the comprehensive program for the medico-psychological follow-up of the male and female junior athletes (rhythmic gymnastics) with the purpose of stabilizing their hormonal and emotional status, as well as improving sport performances based on the use of modern hardware-software technologies. MATERIAL AND METHODS: The comprehensive examination of 72 female athletes at the mean age of 11.5±0.6 years attending R. Kuznetsov specialized school of rhythmic gymnastics of the Olympic reserve in the city of Seversk has been undertaken on the basis of Tomsk Research Institute of Balneology and Physiotherapy, the branch of Siberian Federal Research and Clinical Centre. RESULTS: The program of comprehensive medical psychological rehabilitation for the junior athletes of either sex engaged in sportive activities requiring precise technical actions has been elaborated. The method of the combined therapeutic treatment included physical exercises therapy, manual massage, dry carbonic bathtubs, psychological activities with the application of biological feedback trainings and cognitive trainings; it was intended for the correction of the hormonal status and the improvement of the psycho-emotional conditions of the athletes. The combined treatment based on the use of the modern hardware-software technologies was shown to promote the restoration and development of the psychophysical and psychological qualities of the male and female junior athletes indispensable for the maintenance of their high readiness for the efficient sports activities at the subsequent stages of the training cycle. In addition, such treatment enhances the adaptation resources of the athletes.

IMMUNOPHENOTYPICAL CHARACTERISTICS OF CELLULAR COMPOSITION IN BREAST MILK.

The morphology and immunophenotype of female colostrum adherent cells with the help of CD3, CD31, CD34, CD45, CD68, vimentin, and osteocalcin antibodies panel was studied in short-term (6­7 days) culture in vitro. Approximately equal (1 : 1) ratio of fibroblast-like and rounded cells was observed in 20 % of cultural flasks. The cells with regular shape mixed with single fibroblasts were noted in 80 % of cultural flasks. The diameter of spreaded cells varied within 10­100 mm. All cells adhered to plastics did not express CD3 and interacted slightly (sl) with antibodies to CD31, CD34, and CD45. At the same time, adherent cells with intensive CD68, vimentin and osteocalcin staining have been revealed. Literature data allows to interpret CD68+CD3­CD31slCD34slCD45sl immunophenotype of significant part of mother colostrum adherent cells as belonging to monocyte-macrophage lineage. Marked expression of stromal antigens (vimentin, osteocalcin) in 40­45 % adherent cells in cultural medium without osteogenic supplements (beta-glycerophosphate, ascorbic acid, dexamethasone) proposes an existence of osteoblasts fraction differentiated in colostrum from mesenchymal stem cells under an action of breast milk humoral factors.

[The rehabilitative treatment of the frequently ill children presenting with chronic infectious foci in the nasopharynx].

AIM: The objective of the present study was to elucidate the influence of the combined physiotherapeutic remedial treatment on the effectiveness of rehabilitation of the frequently ill children (FIC) and children presenting with chronic infectious foci inthe nasopharynx taking into consideration their microelemental and immunological status. MATERIALS AND METHODS: A total of 80 frequently ill children and children presenting with chronic infectious foci inthe nasopharynx were available for the observation with special reference to dynamics of clinical conditions, immunological processes, and microelement composition. CONCLUSION: The combined treatment including the intake of "Asonovklyuch" mineral water enhanced the resistance of the children to the causative factors of respiratory infections and increased selenium content in their body. It is concluded that the treatment of the children presenting with chronic infectious foci inthe nasopharynx with the use of the specialized dietary product "Clinutren Junior" produces an anti-inflammatory and immunoregulatory effect and thereby promotes the correction of disorders of microelement nutrition.

[The medical and psychological support for the child athletes during different periods of the training cycle].

OBJECTIVE: To study dynamics of the indicators of the hormonal and psychological status as well as psychological features of significance for the sportive performance under conditions of rehabilitative treatment during training and post-training periods in the child athlete engaged in rhythmic gymnastics. MATERIAL AND METHODS: The study included 42 child athletes at the age from 8 to 15 years engaged in rhythmic gymnastics. The children of the study group (group 1, n=17) received the combined restorative treatment under conditions of regular training while those comprising group 2 group (n=25) were given a similar treatment in the absence of the training load. All athletes underwent clinical and laboratory examination before and after the treatment for the assessment of their psychological status. RESULTS: The study has demonstrated that additional physical activities were responsible for the development of negative changes in the hormonal and psychological spheres of the child athletes. As a result, they experienced the impairment of certain qualities significant for their sportive performance. CONCLUSION: The rehabilitative measures during different periods of the training cycle promote normalization of all parameters of the hormonal, psychological, and physical status of the child athletes; moreover, they improve the adaptive capacity of the children.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

[Peculiar features of the clinical and metabolic status and its variations under the influence of rehabilitative treatment in the children with obesity and diffuse non-toxic goiter].

A total of 120 children at the age of 10-15 years presenting with class I-II obesity were available for observation. Fifty two of them suffered diffuse non-toxic goiter. The combination of obesity and diffuse non-toxic goiter was associated with excessive body weight, insulin resistance, disturbances of lipid metabolism, and impaired tolerance of physical exercises. Differential therapeutic complexes have been proposed for the treatment of the children with diffuse nontoxic goiter. Their application was shown to induce positive dynamics of clinical conditions and laboratory characteristics of the patients.

[A chronobiological approach to the treatment of obesity in children based at a sanatorium and spa facility].

The objective of the study was to evaluate results of non-medicamental treatment of 167 children with obesity taking into account dynamics of annual rhythms of their clinical, hormonal, metabolic, and psychological characteristics. The period from August till November was shown to be especially favourable in terms of body weight loss, improvement of hormonal, metabolic, and psychic status. Analysis of these changes permitted to correct the proposed mode of combined therapy of obesity during the period from December till July.

[Possibilities of respiratory exercises in medical rehabilitation of preschool age children with respiratory organs pathology].

The purpose of the work is to study efficiency of a new medical technology in rehabilitation of children with respiratory organs pathology. 177 children at the age from 2 to 7 years were randomized into two groups: 90 children of the main group performed the complexes of physical and respiratory exercises according to developed medical technology, 87 children of the control group performed standard physical exercises on physical training classes. The results of the study revealed decrease in frequency of acute respiratory disease in 1.83 times, exacerbation of bronchial asthma in 1.86 times in children of the main group. Improvement in development of physical qualities and spirography indices against the background of physical and respiratory exercises according to developed medical technology was detected. Significant cytoprotective action to nasal mucous tunic in preschool age children with respiratory organs pathology was registered.