The effect of rifampicin on expression of the toll-like receptor system genes in the forebrain cortex of rats prenatally exposed to alcohol.

Ethanol causes long-term changes in the toll-like receptor (TLR) system, promoting activation of neuroinflammation pathways. Alcohol use during pregnancy causes neuroinflammatory processes in the fetus; this can lead to the development of symptoms of fetal alcohol spectrum disorder (FASD). Our study has shown that prenatal alcohol exposure (PAE) induced long-term changes in the TLR system genes (Tlr3, Tlr4, Ticam, Hmgb1, cytokine genes) in the forebrain cortex of rat pups. Administration of rifampicin (Rif), which can reduce the level of pro-inflammatory mediators in various pathological conditions of the nervous system, normalized the altered expression level of the studied TLR system genes. This suggests that Rif can prevent the development of persistent neuroinflammatory events in the forebrain cortex of rat pups caused by dysregulation in the TLR system.

[Effect of hyperoxic inhalations for athletes of different sports, including those who had COVID-19, when training in the middle altitude]. / Effekty primeneniya giperoksicheskikh ingalyatsii u sportsmenov razlichnykh vidov sporta, v tom chisle ranee perenesshikh COVID-19, pri trenirovkakh v srednegor'e.

OBJECTIVE: To identify hyperoxic inhalations on the functional state of the cardiorespiratory system of athletes of different sports, who have previously had COVID-19, when training in the middle altitude. MATERIAL AND METHODS: The study included 64 elite athletes during the preparatory period. The studies were conducted in Kislovodsk in the middle altitude (1240 meters) on the Maloe Sedlo mountain, in the conditions of training camps. We studied the parameters of heart rate variability and functional state of cardiovascular and respiratory systems. Hyperoxic inhalations were performed with the JAY-10 oxygen concentrator (LONGFIAN SCITECH CO., LTD., China). The oxygen concentration in the mixture was 93±3%, capacity - 5 l/min, exposure time - 20 min. RESULTS: Athletes specializing in sports with predominantly anaerobic lactate and mixed mechanism of energy supply, respectively experiencing hypoxia in the process of their athletic activity during training can experience hypoxia at rest as well. The state of hypoxia during exercise in the middle altitude in such athletes is shown in heart rate variability indices (high values of heart rate and stress index, low power of high frequency waves), low saturation, increased oxygen uptake from the blood microcirculation system. The use of oxygen therapy in athletes promotes positive dynamics of the functional state, consisting in a reduced stress of regulatory mechanisms, strengthened tone of the parasympathetic nervous system in the heart rate regulation, increased economization of the central hemodynamics' parameters, improved functions of the external respiratory system. CONCLUSION: Application of hyperoxic inhalations during intense exercise in the middle altitude has a favorable effect on the functional state of the cardiorespiratory system in all the studied sports, especially in athletes who have previously had COVID-19.

[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.

[Effects of the beta-stimulating training in recovery of adaptive reserves in athletes of different sports]. / Effekty beta-stimuliruyushchego treninga v vosstanovlenii adaptatsionnykh rezervov u sportsmenov s raznoi napravlennost'yu trenirovochnogo protsessa.

Application of the beta rhythm neurofeedback is mainly dealt with when considering issues related to improving attention for clinical or preventive purposes. Cognitive and autonomic interactions formed with the help of biofeedback training, changing the function of autonomic and visceral systems, qualitatively improve the efficiency of any activity, including athletic activity, the nature of which is predetermined by the type of sports. OBJECTIVE: To identify effects of the beta-stimulating training in recovery of adaptive reserves in athletes of different sports. MATERIAL AND METHODS: The study included young male athletes aged 18-22 years (n=1020), distributed according to the type of sports: group 1 - cyclic sports (n=387); group 2 - speed-strength sports (n=255); group 3 - single combat (n=31); group 4 - team sports (n=173); group 5 - complex-coordination sports (n=174). The main objective of the beta-stimulating training was to select a strategy to raise the beta rhythm level while muscles were relaxed. For each group, we identified training efficiency periods according to the lowest value of the attention index (θ/ß, c.u.), then we examined distribution of brain rhythms (α, %; ß, %; θ, %) according to EEG. The level of adaptive reserves was identified according to the heart rate variability (HRV) spectral analysis («VNS-Spektr¼, Neurosoft, Ivanovo). RESULTS: We identified following periods of the beta-stimulating training efficiency according to the attention index (θ/ß, c.u.): group 1 - 10th session (game variant); group 2 - 5th session (graphic and game variants); group 3 - 1st and 10th sessions (game variant), 5th session (graphic variant); group 4 (game variant) - 1st, 5th and 10th sessions; group 5 (game variant) - 5th and 10th sessions. The efficiency periods in the observed groups were accompanied by the following distribution of rhythms in the EEG structure: ß-rhythm - 45-60%; θ-rhythm - 20-35%, α-rhythm - 19-25%. During these periods, wave structure of the heart rhythm also changed: the activity of VLF waves increased (%); the proportion of HF waves decreased in the range of 23.3-31.59% in the groups 1, 2 and 3; the share of HF waves increased in the range of 32.3-39.8% in the group 4 at the 1st session and in the group 5 at the 10th session. The values of total power (TP, ms2) reduce at the 10th session in the groups 1, 3 and 4 and at the 5th session in the group 5. The vagosympathetic balance coefficient (LF/HF, c.u.) in the studied groups corresponds to the range of normal values; the values increased in the group 2 at the 5th session, in the groups 3 and 4 - at the 5th and 10th sessions, in the 5th group - at the 5th session. The index decreased in the groups 3 and 4 at the 1st session. The index was stable in the groups 1 and 5 at the 10th session of the training. CONCLUSION: Periods of the beta-stimulating training efficiency associated with the improvement of attention according to the lowest values of θ/ß (c.u.) are accompanied by changes in the modulation of the structure of brain rhythms and the wave structure of heart rate variability, optimizing the psychophysiological state of athletes depending on the type of sport, the number of sessions completed and the session variants chosen.

[Possibilities of physiotherapy methods for improving the microcirculation of the affected limb in patients with spasticity after acute cerebral circulation during the late recovery period]. / Vozmozhnosti metodov fizioterapii dlya uluchsheniya mikrotsirkulyatsii porazhennoi konechnosti u bol'nykh so spastichnost'yu, perenesshikh ostroe narushenie mozgovogo krovoobrashcheniya, v pozdnii vosstanovitel'nyi period.

The significant prevalence of acute cerebral circulatory disorders, the complexity and persistence of disorders of the functions of the upper and lower extremities, which are accompanied by prolonged and persistent disability, is an important medical and social problem. OBJECTIVE: Development of optimized programs of medical rehabilitation in patients after acute cerebrovascular accident in the late recovery period. MATERIAL AND METHODS: The study included 200 patients who suffered acute cerebral circulatory disorders, with increased muscle tone in the lower extremity by the type of spasticity in the late recovery period, who were divided into five groups comparable in clinical and functional characteristics and age: the 1st group (n=40) - patients who, in addition to the standard complex of therapy and rehabilitation, the same in all five groups and including therapeutic physical culture, medical massage and kinesiotherapy, received low-frequency electrostatic massage, complex multimodal effects from the Alpha-capsule apparatus, training on a multifunctional biofeedback (BFB) platform and training of the stereotype of walking on to the track by the method of imposition; the 2nd group (n=40) - patients who, in addition to the standard complex, received low-frequency electrostatic massage from the Khivamat apparatus and exposure to broadband modulation currents; the 3rd group (n=40) - patients who, in addition to the standard complex, received a complex multimodal effect from the Alpha-capsule; the 4th group (n=40) - patients who, in addition to the standard complex, received training on a multifunctional platform with barefoot and training of the stereotype of walking on the track by the method of imposition; the 5th group (n=40) - patients who received only a standard complex of therapy and rehabilitation. RESULTS: At all control points (after the course of treatment, after 6 and 12 months), in addition to general clinical and neurological studies, microcirculation parameters were evaluated by laser Doppler flowmetry. In dynamics, it was revealed that in the 1st, 2nd, and 4th groups there was a significant improvement in microcirculation in the affected limbs, to a lesser extent, this significant improvement in microcirculation was noted in the 3rd group; in patients of the 5th group, only a positive trend was noted. CONCLUSION: Inclusion in the standard rehabilitation complex of low-frequency electrostatic massage, multimodal physiotherapy and training on a multifunctional platform with BFB COBS in combination with walking stereotype training with video instruction using the system with BFB C-Mill in patients who have suffered acute cerebrovascular accident, with motor disorders in the form of hemiparesis with increased muscle tone of the lower extremity in the late recovery period causes a significant improvement in microcirculation in the arteriolar-venular bed of the affected lower extremities, which may underlie the improvement of static-locomotor indicators and contribute to the expansion of the volume of movements in the joints of the lower extremities.

[Methods to restore fine motor skills in stroke patients]. / Metody vosstanovleniya tonkoi motoriki u patsientov, perenesshikh insul't.

The review article considers the problem of nonmedical post-stroke rehabilitation, in particular the restoration of fine motor skills in patients in the early period of the disease. A review and analysis of various randomized controlled trials concerning the use of various rehabilitation methods both in monotherapy and in their combined application is carried out, and modern technical devices, with the use of computer technology and biofeedback, are reviewed. Proceeding from the presented literature data and their analysis, there are certain grounds for introducing modern apparatus complexes and robotized devices for fine motor skills restoration in post-stroke patients, especially in the early period, into the multimodal rehabilitation system. However, further research in this direction is needed to achieve a sustained positive result.

[Recovery of social and everyday skills after a complex of functional spatially oriented rehabilitation in elderly patients with cerebral stroke]. / Otsenka effektivnosti vosstanovleniya sotsial'no-bytovykh navykov s ispol'zovaniem kompleksa funktsional'noi prostranstvenno-orientirovannoi reabilitatsii u pozhilykh patsientov s tserebral'nym insul'tom.

OBJECTIVE: To analyze the effectiveness of social recovery (trip to the store by bus and making purchases) in elderly patients with stroke in the right middle cerebral artery undergoing a course of specialized trainings in a complex of functional spatially oriented rehabilitation. MATERIAL AND METHODS: The study involved 44 patients with previous stroke (mean age 70.8±3.1 years) randomized into 2 equal groups: main group - basic standard of rehabilitation (exercises with instructor, mechanotherapeutic technique with cyclic simulators, massage of paretic limbs) and training of social adaptation in a complex of functional spatially oriented rehabilitation; control group - basic standard of rehabilitation alone. Duration of rehabilitation course was 14 days. To determine mean norm of timing of complex training of socially significant skill, we asked 23 volunteers without severe comorbidities to perform tasks of functional spatially oriented rehabilitation. RESULTS: After complex rehabilitation program, we found significant dynamics of time necessary for the following actions: "take a bag and hang it over shoulder", "open the pockets of the bag with a zipper (2 pockets)", "take the jacket off the hanger and put it on", "take the products from the basket and put in the pocket". Moreover, the main group was characterized by significantly lower impairment of daily activity (Barthel score 66.3±4.5 vs. baseline 45.7±4.9, p<0.05), improvement of functional independence (FIM score 76.7±1.5 vs. baseline 65.2±3.1, p>0.05). These values turned out to be significantly better than in the control group. CONCLUSION: These results indicate the effectiveness of functional spatially oriented rehabilitation in elderly patients with cerebral stroke. This approach increases personal independence in daily life and improves overall quality of life.

[Efficiency of balance training with stabilizing platform in early postoperative rehabilitation of patients after arthroplasty]. / Effektivnost' vklyucheniya balans-treninga s ispol'zovaniem stabiloplatformy v kompleksnye programmy rannei posleoperatsionnoi reabilitatsii patsientov posle endoprotezirovaniya.

OBJECTIVE: To evaluate the effectiveness of balance training on stabilizing platform (HUBER360) in early postoperative rehabilitation of patients after total knee arthroplasty. MATERIAL AND METHODS: We examined 60 patients after total knee arthroplasty. Mean age of patients was 69.1±9.8 years, mean postoperative period - 3.6±1.4 days. All patients were divided into 2 groups (main group (n=30) and control group (n=30)). All patients received a standard course of treatment, including therapeutic exercises, massage of affected lower in electro-static field limb using a drainage technique, magnetotherapy, mechanotherapy of affected limb in passive motor mode (Artromot device). Duration of rehabilitation course in a round-the-clock hospital was 7 days. In the main group, patients additionally received balance-training procedures on the HUBER 360 multiaxial platform in baseline sitting position. RESULTS: Treatment was followed by positive dynamics in all patients that correlated with significant regression of pain syndrome, edema, improvement of quality of life and 10-meter walk test with external support on crutches. However, additional balance training provided more effective regression of pain, as well as improvement of quality of life and walking after the first procedures. CONCLUSION: We can recommend balance training on stabilizing platform for early rehabilitation after total knee arthroplasty.

[Patient-oriented medical rehabilitation after stroke in long-term recovery period]. / Patsientoorientirovannaya meditsinskaya reabilitatsiya bol'nykh posle ostrogo narusheniya mozgovogo krovoobrashcheniya v pozdnem vosstanovitel'nom periode.

OBJECTIVE: To evaluate the effectiveness of patient-oriented medical rehabilitation on microcirculation, motions in affected limbs and quality of life in patients with previous stroke in long-term recovery period. MATERIAL AND METHODS: The study included 120 patients with previous stroke, hemiparesis and spastic disorders in late recovery period. All patients received standard drug therapy and medical rehabilitation (exercise therapy and medical massage). All patients were divided into 3 groups depending on additional measures: group 1 (n=40) - massage in a pulsed low-frequency electrostatic field in addition to standard complex of rehabilitation; group 2 (n=40) - course of multimodal physiotherapeutic effects (Alpha LED Oxy Light-Spa) in addition to standard complex; group 3 (n=40) - standard drug therapy and medical rehabilitation only (exercise therapy and medical massage). Patients were examined immediately after treatment, 3 and 6 months later. We analyzed effectiveness of rehabilitation using laser Doppler flowmetry (LAKK-01, Russia) and goniometry. Subjective indicators of quality of life were assessed according to the EQ-5D questionnaire (European Quality of Life Questionnaire). RESULTS: At baseline, all patients showed a decrease in microcirculation, motions in affected limbs and subjective decrease in the quality of life. In the 1st group, rehabilitation program improved microcirculatory processes that was confirmed by increment of capillary blood flow by 24% and total vasomotor activity of capillaries by 26.8%. There was a significant decrease in EQ-5D score by 37% in the 1st and 2nd groups after treatment that indicated increase in the quality of life. In the 3rd group, we observed mild increase of microcirculation parameters, range of motions and quality of life. CONCLUSION. P: Ersonalized methods of complex rehabilitation contribute to improvement of microcirculation, range of motions in affected limbs and quality of life in patients with spasticity in long-term recovery period after stroke.

[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.

[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.

[Evaluation of the effectiveness of using broadband modulation currents in medical rehabilitation of patients after acute cerebrovascular accident]. / Otsenka effektivnosti primeneniya tokov shirokopolosnoi modulyatsii v meditsinskoi reabilitatsii patsientov posle ostrogo narusheniya mozgovogo krovoobrashcheniya.

Every year in the world more than 15 million patients suffer from acute cerebrovascular accident. A special role in the organization of medical care for patients after acute cerebrovascular accident should be assigned to measures to improve the prevention of clinical manifestations and comprehensive rehabilitation. OBJECTIVE: To study the effect of broadband modulation currents on the manifestations of spasticity and on cognitive functions in patients after an ischemic stroke in the late recovery period. MATERIAL AND METHODS: The article presents data on the effectiveness of the use of broadband modulation currents in the late recovery period of medical rehabilitation of patients with ischemic stroke. The study included 80 patients who underwent ischemic stroke with movement disorders in the form of hemiparesis and increased muscle tone by the type of spasticity in the late recovery period. Control group patients (40 people) underwent standard drug therapy and medical rehabilitation, patients of the main group (40 people) received broadband modulation currents against the background of standard drug therapy and medical rehabilitation. The severity of spasticity and impaired motor function of the arm and leg was assessed according to the modified Ashfort Spasticity Scale (MAS) and goniometry parameters; the analysis of indicators of impairment of cognitive functions according to the data of the Montreal Cognitive Assessment Scale (MoCA) was carried out. RESULTS: After the course of treatment in patients of the main group, at all control points, there was a statistically significant positive dynamics of a decrease in spasticity, both in the proximal and in the distal parts of the upper limb, according to the modified Ashforth Spasticity Scale (MAS), while in the patients of the control group, only positive trend. After the course of treatment, a significant advantage of the influence of the developed method on cognitive impairment of functions in patients of the main group, who received broadband modulation currents, was revealed. This was confirmed by the increase in the total indicator of the MoCA scale to 26.7±0.6 points, which corresponded to the reference values. In patients of the control group, less pronounced results were obtained, the total indicator of the MoCA scale was 25.1±1.0 points, which was below the norm. CONCLUSION: The data obtained indicate that the inclusion of broadband modulation currents in the medical rehabilitation program contributes to a significant decrease in the severity of spasticity, increases the range of motion in the affected limb, and has a positive effect on the cognitive functions of patients.

[Application of modern non-drug technologies to improve the quality of life of patients with hemiparesis]. / Primenenie sovremennykh nemedikamentoznykh tekhnologii dlya povysheniya kachestva zhizni bol'nykh s gemiparezom.

In recent years, the improvement of the system of medical rehabilitation of patients with acute cerebrovascular accident has acquired special social significance due to the high morbidity. OBJECTIVE: To study the effect of the combined use of a multifunctional platform and massage with a pulsed low-frequency electrostatic field on the motor functions of the lower limb, coordination and balance, as well as on the psychoemotional status and quality of life of patients after an ischemic stroke with hemiparesis in the late recovery period. MATERIAL AND METHODS: The article presents data on the treatment of 120 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with an increase in muscle tone by the type of spasticity in the late recovery period. All patients received standard drug therapy and underwent medical rehabilitation. The patients were divided into 3 groups: the main group - 40 patients who received massage with a pulsed low-frequency electrostatic field and training on a multifunctional platform with biofeedback (BFB) - COBS (mtd-Systems, Germany), a comparison group - 40 patients who received training on a multifunctional platform with biofeedback (BFB), control group - 40 patients. RESULTS: In the initial state, all patients included in the study showed an uneven distribution of the load in the protocols «normal standing position¼ and «standing balance¼ with an advantage towards the healthy leg. After the course of treatment in the patients of the main group, all the evaluated indices were normalized, in the patients of the comparison group statistically significant less pronounced results were obtained, and in the patients of the control group only a positive trend was noted. When studying the quality of life and the effectiveness of treatment according to the EQ-5D questionnaire in the examined patients in the initial state, the indicator averaged 7.8±0.8 points. After the course of treatment, the patients of the main group showed a statistically significant decrease in the indicators of the EQ-5D questionnaire from 7.8±0.8 points in the initial state to 5.1±1.1 (p<0.001), which lasted up to 6 months. In patients of the comparison group in all periods of observation, a decrease in the indicator was also noted, but less pronounced, in patients in the control group, only a positive trend. The data were supported by the Hospital Anxiety and Depression Scale (HADS) score. CONCLUSION: The use of complex rehabilitation with the inclusion of a multifunctional platform with biofeedback and electrostatic massage contributes to a pronounced improvement in the functional state of muscle tone, coordination and balance, a significant decrease in the level of anxiety and depression and has a pronounced positive effect on the quality of life and assessment of the health status of patients with hemiparesis in late recovery period after ischemic stroke.

[The use of transdermal electroneurostimulation in the rehabilitation of patients after surgical decompression of the carpal tunnel]. / Primenenie transdermal'noi elektroneirostimulyatsii pri reabilitatsii patsientov posle khirurgicheskoi dekompressii karpal'nogo kanala.

Most of the clinical and neurophysiological disorders of the median nerve that persisted in patients after surgical decompression of the carpal tunnel (DCT) are associated not with acute compression of the nerve, but with myelinoaxonopathic disorders in the structure of the nerve that developed as a result of prolonged compression. OBJECTIVE: To study the effectiveness of transdermal electroneurostimulation (TENS) in the rehabilitation of patients with residual neurological deficit after surgical DCT. MATERIAL AND METHODS: We observed 45 patients after DCT (6-12 months), aged 30 to 50 years (mean age 42±3 years). All patients were diagnosed with primary carpal tunnel syndrome with a lesion of the dominant hand, of which 15 patients received pharmacotherapy; 15 patients - in addition to pharmacotherapy, received a course of low-frequency high-amplitude TENS (NTENS) and 15 patients - a course of high-frequency low-amplitude TENS (VTENS). RESULTS: The regression of positive sensory symptoms was more pronounced against the background of VTENS and NTENS than after the use of pharmacotherapy, on average 6.6 times (p<0.01). At the same time, VTENS turned out to be more effective than NTENS by 28.5% (p<0.05). In the long-term follow-up period (2 months), the severity of positive sensory symptoms decreased in patients who received VTENS and NTENS, by an average of 58.1% compared with the baseline values before treatment (p<0.05). The severity of Tinel's symptom in patients who received a course of VTENS decreased by 44%, after a course of NTENS - by 67%, and after pharmacotherapy - by 14%. It was found that NTENS compared with VTENS was 51% more effective in reducing Tinel's symptom (p<0.05) and by 64% - Falen's symptom (p<0.05). The decrease in the time to perform the Jebsen-Taylor test (JTT) after the use of pharmacotherapy was on average 9% (p>1.00), and after TENS - 23% (p<0.05). When comparing VTENS and NTENS among themselves, NTENS turned out to be more effective on average by 68% (p<0.05). An improvement in electro-kymographic parameters was revealed only after the use of VTENS. At the same time, the decrease in the residual latency was 21.3% and the increase in the amplitude of the M-response was 14.3%. CONCLUSION: Transdermal electroneurostimulation is a highly effective method used in the complex treatment of patients with residual neurological disorders after undergoing surgical decompression of the carpal tunnel. The maximum regression of positive sensory symptoms develops against the background of high-frequency low-amplitude transcutaneous electroneurostimulation, and the maximum anti-inflammatory effect, the greatest improvement in the function of small hand muscles and statistically significant neurophysiological restoration of the function of the median nerve are revealed after the application of a course of low-frequency high-amplitude transcutaneous electroneurostimulation. At the same time, positive dynamics after low-frequency high-amplitude transcutaneous electroneurostimulation and high-frequency low-amplitude transcutaneous electroneurostimulation persists in the long-term period.

[Modern technologies of regenerative rehabilitation in the treatment of patients with abnormal scars]. / Sovremennye tekhnologii regenerativnoi reabilitatsii v lechenii patsientov s patologicheskimi rubtsovymi izmeneniyami.

OBJECTIVE: To evaluate an efficacy of lipoaspirate-based products in pathologic scarring management. MATERIAL AND METHODS: There were 118 patients with external scars. Depending on scar type, localization and need for soft tissue augmentation, three different methods were used for lipoaspirate-based product preparation: 15-minute sedimentation, centrifugation at 1200 g for 3 minutes and emulsification with a channel diameter of 1.2 mm. Results were assessed using the Manchester Scar Scale (MSS) and photographing. RESULTS: According to MSS analysis, the following results were obtained: before treatment - 11.6 (9.3-13.3) scores, 3 months after treatment - 6.5 (5.1-7.2) scores, 6 months after treatment - 5.2 (4.5-6.1) scores. Significant differences were obtained for baseline values and both control points. Stable results were obtained in long-term follow-up period (12-24 months). No major adverse effects were observed. Minor complications were registered in 10.1% of patients. CONCLUSION: Injections of lipoaspirate-based products is an effective option for the treatment of patients with pathologic scarring. This approach is intermediate between conservative and conventional surgical treatment.

[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.

Temperament differences between institution- and family-reared toddlers.

The goal of this study was to compare the temperamental properties (i.e. Surgency/extraversion, Negative affectivity, Effortful control) of institution-reared (IR) and family-reared (FR) toddlers, aged between 17 and 37 months, living in Simferopol, Crimea. The results demonstrated significantly lower Surgency and higher Negative affectivity scores in the institution-reared toddlers. At the same time, in IR children Surgency scores depended on children's age, the older the children were, the higher scores they were assigned. No such relation was found for FR toddlers. Further, level of Negative affectivity in IR group depended significantly on amount of time that children spent at the institution; more time resulted in higher Negative affectivity scores. We could not find any differences between IR and FR children in Effortful control. The study results suggest different developmental patterns for Surgency and Negative affectivity in IR and FR children and are discussed in terms of potential impact it may have on further personality development.

[Complementary methods of rehabilitation in borderline mental disorders].

The article covers treatment results of 417 patients (186 males and 231 females) aged 18 to 71 years, with borderline mental disorders. Findings are that using specified complementary methods, more when treatment complex is applied, causes better psycho-emotional state in patients with borderline mental disorders, that is supported by results of medical diagnostic tests including psychometry tests (abridged minnesota multiphasic personality inventory, Beck depression inventory, Spielberger-Hanin, test "feeling, activity, mood").

[Extracorporeal shock wave therapy in athletes with degenerative and dystrophic disorders of locomotory system].

Degenerative and dystrophic changes of joints and ligaments are among the most prevalent disorders in professional athletes. Specification of a complex system for these diseases is an important task in sports medicine. Extracorporeal shock wave therapy is a modern and highly effective method of rehabilitation.

[Increased functional resources in athletes of cyclic sports].

The article covers individual coaching program specified by specialists in Sports Medicine and Rehabilitation Center in Bournazian FMBC of the FMBA of Russia, to improve functional durability of highly qualified athletes.