[Medical rehabilitation for children with scoliosis]. / Meditsinskaya reabilitatsiya detei so skoliozom.

The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of scoliosis in scoliotic disease. The current classification, diagnostics features, and clinical course of the disease are addressed. Current approaches to the choice of medical rehabilitation methods for scoliotic disease in children are described: therapeutic exercise, hydrokinesiotherapy, massage, physiotherapeutic treatment, kinesiotaping, and corseting. Special consideration is given to postoperative management and stages of medical rehabilitation of children with scoliosis, including resort treatment.

[The economic analysis of the total cost of rehabilitation of the patients suffering from coronary heart disease].

OBJECTIVE: To report the results of analysis of the economic efficiency of physical rehabilitation of the patients surviving after myocardial infarction with the use of physical exercises. MATERIAL AND METHODS: The study included 110 patients (mean age 58,3±9,8 years) who were randomized into two groups: the group where the patients were treated with the use of physical training (n=53) and the control group (n=57). The physical training included natural walking over the level ground at a speed corresponding to 60% of the maximum heart rate achieved during the initial 6 minute of the walking test. RESULTS: The results of the analysis indicate that the cost of the full course of medicamental therapy for the patients of the control group was 790.043,83 rubles higher than that for the patients treated with the use of physical exercises. The expenses for the instrumental and laboratory studies in the former group proved to be 142.776,8 rubles higher than in the latter. CONCLUSION: The inclusion of controlled physical exercises in the program in the rehabilitative treatment of the patients surviving after myocardial infarction makes it possible to achieve a higher quality of their life with the more favourable cost-benefit ratio compared with use of medicamental therapy alone.

[The application of pulsed magnetic stimulation in the rehabilitation of the children operated for the treatment of grade III-IV scoliosis].

In the present paper, we for the first time provide a rationale for the application of a new physical factor, pulsed magnetic stimulation, in pediatric practice. Our observations have demonstrated positive dynanfics of the parameters characterizing the functional state of the neuro-muscular apparatus and equalization of the amplitude of M-response as appears from the results of electromyographic studies. The data obtained by electrocardiography and estimation of the external respiratory function give evidence of favourable dynamics of the cardio-respiratory system. The results of the study have been used to substantiate the application of a new method of pulsed magnetic stimulation in pediatric medicine at the early stages of rehabilitation of the children following surgical treatment of grade Ill-IV scoliosis.

[Optimization of surgical treatment of pelvic prolapse in women].

The study was aimed to improving the efficiency and reducing the incidence of complications after transvaginal pelvic reconstructive surgery with the installation of synthetic mesh prosthesis for pelvic organ prolapse. The study involved 228 patients with II-IV stage pelvic prolapse, of which 144 (63.2%) underwent surgery by the TVM (Tension-free Vaginal Mesh) method, and 84 (36.8 %)--by the original method with the installation of patented mesh implant. In the group of patients who underwent reconstruction of the pelvic floor with the implantation of mesh prosthesis, original in form and method of installation, in the postoperative period significantly less stress urinary incontinence was detected, better functional results have been found, and significantly fewer intra- and postoperative complications were diagnosed. Transvaginal pelvic floor reconstruction with the use of technology to minimize operational approaches when setting the original mesh implant allows to effectively restoring the normal anatomy of the vagina, and characterized by high safety and good functional results.

[Efficacy of combined treatment of large prostatic adenoma with doxasozine and finasteride].

Combined treatment with doxasozine and finasteride was performed for 7.26 months in 38 patients with large-size prostatic adenoma (89.54 +/- 11.64 cm3). The study group of 38 patients given the above combination benefited from the treatment (18 patients avoided surgery, TUR of shorter duration with removal of a less amount of tissue and less blood loss was conducted in 20 patients). Bladder draining with the urethral catheter was also shorter in the study group. The control group (28 patients with large prostatic adenoma) received surgical treatment alone. Long-term results were good in both the groups. Thus, combined treatment with doxasozine and finasteride can be the first-line treatment in patients with large prostatic adenoma.

[Choice of a surgical treatment of genital prolapse in women].

The trial enrolled 64 females with genital prolapse corrected in 2003-2007 with transvaginal synthetic aids. Urinary incontinence of effort was detected in 53.1% patients with cystocele. Efficacy of surgical treatment of vaginal prolapse was 73.3% in use of anterior colporaphy with implantation of prolen net and 100% in reconstruction of the pelvic fundus by PROLIFT technique. Early postoperative complications (vaginal wall erosion) occurred in 16.7 and 15% patients, respectively. Thus, reconstruction of the pelvic fundus is an operation of choice in severe and combined forms of pelvic prolapse in women.

[Choice of surgery in the treatment of recurrent varicocele].

The article presents the results of examination and surgical treatment of 48 patients with varicocele recurrence after Ivanisevich operations. Ultrasound dopplerography revealed principal causes of the recurrences: unperformed ligation of vein-satellites, undetected renospermatic reflux with hypertension in the renal vein, undetected ileospermatic or mixed reflux. Depending on the detected hemodynamic disorders, we made microsurgical ligation of veins-satellites, created proximal vein-veinous testiculosafic or distal testiculosafic anastomoses with good clinical results and correction of pathospermia. Ultrasound dopplerographic control of anastomoses after 1 year of their creation showed satisfactory function of anastomoses in 80.1% cases. Thus, choice of surgical method in varicocele recurrence must be based on assessment of hemodynamic disorders in the territory of genital veins.

[MRT assessment of metabolic and thrombolytic therapy effects on postinfarction left ventricular remodeling].

AIM: To examine effects of trimetasidine on morphofunctional indices of the left ventricle (LV) in myocardial infarction (MI) patients on combined treatment. MATERIALS AND METHODS: Seventy five patients with primary macrofocal MI were randomized into 2 groups. Patients of group 1 (n = 38) received a combination of bisoprolol (beta-blocker) with enalapril (ACE inhibitor) in individual doses under control of blood pressure and blood creatinine level. Group 2 (n = 37) patients received the same combination of drugs and, in addition, trimetasidine in a dose 70 mg/day from postmyocardial day 7-10 for 6 months. Two subgroups from the groups were given systemic thrombolytic therapy (STLT) with streptokinase. MRT and cine-MRT of the heart were made for measurement of LV morphofunctional parameters. RESULTS: Low-field MRT of the heart in MI patients treated with adjuvant STLT (1500000 U within 6 hours after MI onset) and trimetasidine (preductal MB) in a dose 70 mg/day from the disease day 7-10 registered a significant inhibition of pathological LV postinfarction remodeling: a decrease of body surface indexed LV end diastolic volume by 10.3%, systolic volume--by 15.4%, LV myocardial tension--by 14.0%, sphericity index--by 7.1%; an increase in the index of relative wall thickness by 5.3%, cardiac index--by 9.2% compared to the group treated without trimetasidine. CONCLUSION: 6-month therapy with trimetasidine of MI patients leads to a significant regress of morphofunctional changes accompanying LV remodeling. Pathological LV postinfarction remodeling inhibits significantly in MI patients combined treatment of whom included STLT (streptokinase in a dose 1500,000 U within 6 hours after acute MI onset and trimetasidine in a dose 70 mg/day on postmyocardial infarction day 7-10).

[Sildenafil citrate in diagnosis of erectile dysfunction].

We examined 86 patients: 24 with functional and 62 with organic erectile dysfunction (EDF). In functional EDF, sildenafil citrate (SC) in a dose 25-50 mg or intracavernous injection of 2% solution of papaverin always resulted in satisfactory erection. In EDF, SC, papaverin injection and LOD test results were compared. Morphological examinations of cavernous tissue and tunical albuginea of the penis. Correlations were found between clinical findings, results of SC and intracavernous papaverin solution administration, LOD-test, morphological evidence. This provides objective data for classification of EDF into three stages (I, II and III). Stages I and II were defined as compensated, stage III--as a decompensated stage of organic erectile dysfunction. SC has some advantages over other tests, therefore it is recommended as a monomethod for diagnosis of functional forms, indirect staging of organic EDF.

Experimental and clinical study of the demineralized bone allografts manufactured in the tissue bank of CITO.

The technology for producing demineralized bone allografts (DBA) with definable degree of demineralization and sterilization by high energy electron bean was developed in the tissue bank of Central Institute of Traumatology and Orthopaedics (CITO). The authors consider the technology to be one of the ways of producing demineralized bones. The results of the experiments show that time of demineralization process as well as the absorption dose of radioactive high energy electron beam change substantially mechanical toughness and osteoinductive properties of DBA. Mechanical properties of DBA were tested by the universal testing machine 'Zwick 1464'. Quantitative assessment of DBA osteoinductive properties resulted from the investigation of DBA samples in the culture of stromal precursor bone marrow cells and in the culture of human skin fibroblasts. Cloning efficiency of fibroblasts was considered as indecies of proliferative potential of stromal bone marrow cells, i.e. osteogenic precursor cells. The growth of the cell mass after definite time as well as the index of 3H-timidin marked cells within biological inductor were considered as indecies of proliferative potential of skin fibroblasts. The obtained results showed, that inductive properties of allografts improve when the degree of their demineralization increases whereas the dose of high energy electron radiation decreases. Mechanical toughness of DBA deteriorates when both degree of their demineralization and radiation doses increase. This emphasizes the importance of optimizing technological stages in DBA producing. Since 1998 DBA have been used in Russian clinics for bone plasty in traumatology and orthopaedics, maxilla-facial surgery, ophthalmology, and neurosurgery. The resulting analysis is based on case histories of 257 patients operated from March 1998 to July 2002. The majority of patients were children and teenagers of 3-18 years old with prime tumors, tumor-like and systemic inherited diseases of skeleton, post-traumatic complications. Observation periods were from 1.5 to 5 years and 10 months. Good and satisfactory results were obtained in 93.4% cases.

[Dynamics of lipid peroxidation and antioxidant defense in response to dalteparin therapy in acute coronary syndrome]. / Dinamika protsessov prerekisnogo okisleniia lipidov i antioksidantnoi zashchity pod vliianiem terapii dal'teparinom pri ostrom koronarnom sindrome.

The aim of the study was examination of lipid peroxidation (LPO) and antioxidant system (AOS) in patients with acute coronary syndrome (ACS); evaluation of the effect of dalteparin therapy on LPO and ACS. Fifty one patients (mean age 57.5 +/- 1.5 years) were randomized into two groups: group 1 (n = 31) received low-molecular heparin dalteparin, group 2 (n = 17) was given non-fractionated heparin. The course of the anticoagulant therapy lasted 8 days. LPO and antioxidant defense in plasm and blood red cells were investigated on day 1 and 9. ACS patients appeared to have elevated LPO products production both in plasm and blood red cells, low plasm antioxidant activity (AOA). Dalteparin therapy lowered content of malonic dialdehyde (MD) in red cells and plasm, AOA enhanced. Heparin activity was lower: MDA in plasm decreased in a lesser degree while MDA in red cells continued to rise in lowering AOA in plasm and inhibition of catalase.

[Impact of transrectal microwave hyperthermia on hemodynamics and prostatic cell membranes in chronic prostatitis]. / Vliianie transrektal'noi mikrovolnovoi gipertermii na gemodinamiku i sostoianie kletochnykh membran predstatel'noi zhelezy pri khronicheskom prostatite.

An Aden-Ch apparatus programming complex made in our country was used for transrectal microwave hyperthermia in 75 patients with chronic prostatitis. In addition to its good clinical results achieved in most patients, the complex restored hemodynamics and stabilized the status of prostatic cell membranes. The complex described in the paper may be recommended for the treatment of chronic prostatitis.

[Immunologic assessment of the risk of developing infectious-inflammatory complications after percutaneous operations for nephrolithiasis]. / Immunologicheskaia otsenka riska razvitiia infektsionno-voxpalitel'nykh osloznenii posle perkutannyklh operatsii pri nefrolitiaze.

A retrospective comparison of the evidence obtained at preoperative examination of 68 patients with urolithiasis operated with the use of percutaneous technologies has demonstrated that the risk of postoperative infectious-inflammatory complications depends much on the immune status of the patient. Patients with initially different states of phagocytic immunity and antibody production had different courses of the postoperative period. An algorithm of immunological prediction of an acute pyelonephritis attack after percutaneous operations for nephrolithiasis is proposed.

[State of lipid peroxidation, blood antioxidant defense in patients with myocardial infarction aggravated by circulatory insufficiency]. / Sostoianie perekisnogo okisleniia lipidov, antioksidantnoi zashchity krovi u bol'nykh infarktom miokarda, otiagoshchennym nedostatochnost'iu krovoobrashcheniia.

AIM: To study free radical processes in patients with myocardial infarction (MI) aggravated by heart failure. MATERIAL AND METHODS: Forty seven patients taken to the clinic within the first 5 hours of MI were examined. The patients were divided into 2 groups: 1) those with left ventricular failure-complicated IM (n = 25); 2) those with uncomplicated MI (n = 22). A control group included 17 apparently healthy males. The activity of lipid peroxidation (LPO) and blood antioxidative defense was determined in the patients' red blood cells prewashed off the plasma with saline solution at a temperature of 4 degrees C. RESULTS: The tension of free radical lipid oxidation mechanisms in patients with MI aggravated by circulatory insufficiency is followed by an increased antiradical activity. In patients with uncomplicated higher LPO activity is attended the less marked activation of antioxidative enzymes. The examinees were found to show a correlation of the global systolic function of the left ventricle with the concentration of LPO products and with the activity of antioxidative enzymes. CONCLUSION: More significant LP activation coupled with left ventricular systolic dysfunction was noted in patients with MI aggravated by acute heart failure.

[Doppler ultrasonography of penile vessels in combination with various methods of erectile stimulation in diagnosis of erectile dysfunction]. / Ul'trazvukovaia dopplerografiia sosudov polovogo chlena v sochetanii s razlichnymi sposobami stimuliatsii érektsii v diagnostike érektil'noi disfunktsii.

Ultrasonic dopplerographic investigation (Ultramark-9, USA) was made in 227 males. 50 males with normal erection served controls. Stimulation of erection with an individual LOD-device is a low-invasive, convenient to standardize technique in ultrasonic dopplerographic examination of penile vessels for diagnosis of erectile dysfunction. Erection stimulation by different methods in the same patient during penile vessel dopplerography raises diagnostic value of this method.

[The role of intracardiac hemodynamic parameters in prognosis of cardiac failure in myocardial infarction patients]. / Znachenie pokazatelei vnutriserdechnoi gemodinamiki u bol'nykh infarktom miokarda v prognozirovanii razvitiia serdechnoi nedostatochnosti.

Two-dimensional echocardiography was used to study intracardiac hemodynamics (end systolic, end diastolic volumes and left atrial ejection fraction; end systolic, end diastolic volumes and left ventricular fraction; mean pressure in the pulmonary artery; myocardial mass of the left ventricle) in 49 patients 2, 10 and 30 days after onset of macrofocal myocardial infarction (MI). It was found that patients with and without cardiac failure after one year of the diseases significantly differed by volume and function of the left ventricle and atrium registered since MI day 2. Probability of cardiac failure in the postinfarction period may be estimated since the disease day 2 by an increase in the end-systolic and end-diastolic volumes and left ventricular ejection fraction. A restrictive type of left ventricular diastolic dysfunction is one of the early prognostic criteria of cardiac failure in postinfarction period.

[Changes in serum levels of lipid peroxidation products and ceruloplasmin in patients with benign prostatic hyperplasia in uncomplicated and complicated periods after transurethral electro-resection]. / Dinamika soderzhaniia pereokislennykh lipidov i tseruloplazmina v syvorotke krovi bol'nykh s neoslozhnennym i oslozhnennym posleoperatsionnym periodom transuretral'noi élelktrorezektsii dobrokachestvennoi giperplazii predstatel'noi zhelezy.

Lipid peroxidation products and ceruloplasmin in the serum were measured in 78 patients with benign prostatic hyperplasia (BPH) in uncomplicated or complicated period after transurethral resection of the prostate (TUR) and before it. In uncomplicated period, a short rise in lipid peroxidation activity and lowering of ceruloplasmin concentrations were followed by normalisation by day 6. In the complicated postoperative period by day 6 these indices were higher. The authors propose that these indices are used in assessment of antioxidants efficacy after TUR for BPH.

[Surgical treatment of erectile dysfunction in Peyronie's disease]. / Operativnoe lechenie érektil'noi disfunktsii pri bolezni Peironi.

Methods of surgical treatment of fibroplastic induration of the penis are briefly reviewed. Supplements to classification of Peyronie's disease are proposed regarding the degree of erectile dysfunction and the angle of the penis deformity in erection. The authors analyse the results of operations performed from 1987 to 2000: Nesbit's operation (n = 13), intracavernous penis prosthesis (n = 48), dissection of the fibrous plaque, the defect repair with preserved dura mater followed by intracavernous prosthesis (n = 10). Indications for various surgical procedures in Peyronie's disease are described.

[Clinical and prognostic significance of the degree of delayed ventricular function and vegetative regulation of cardiac rhythm in myocardial infarction patients]. / Klinicheskaia i prognosticheskaia znachimost' pokazatelei zamedlennoi zheludochkovoi aktivnosti i vegetativnoi reguliatsii ritma serdtsa u bol'nykh infarktom miokarda.

Ventricular tachyarrhythmias (VT) are responsible for many sudden deaths in postmyocardial infarction (PMI) patients. The aim of the study was to investigate clinical and prognostic significance for such patients of delayed ventricular activity and vegetative regulation of cardiac rhythm. Signal-averaged ECG, mathematical analysis of cardiac rhythm with measurement of variation range, mode, index of regulatory systems tension, 24-h ECG monitoring were made in 90 patients with acute large-focal myocardial infarction (MI) on the disease day 1, 15, 40 and 365. Signal-averaged ECG registered on MI day 15 was found most informative for identifying the risk to develop VT. Combined application of diagnostic techniques brings more information than each of them alone.