[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.

[Medical rehabilitation of children with bronchial asthma]. / Meditsinskaya reabilitatsiya detei s bronkhial'noi astmoi.

Medical rehabilitation of children suffering from bronchial asthma is based on the complex use of natural therapeutic factors, drug, non-drug therapy and other methods in order to achieve control over the disease and long-term remission. The use of non-drug technologies is necessary taking into account the pathogenesis of the bronchial asthma development and is aimed at relieving bronchospasm, reducing the activity of allergic inflammation in the bronchi, improving their drainage function, strengthening the respiratory muscles and increasing exercise tolerance. When carrying out rehabilitation measures it is important to observe the basic principles of medical rehabilitation. An individual medical rehabilitation program is drawn up taking into account the assessment of the child's clinical condition at each stage with the diagnosis of the initial rehabilitation status, the establishment of a rehabilitation diagnosis and an assessment of the rehabilitation potential. The article presents the data of the analysis of scientific publications and our own research allowing to draw up an algorithm for the formation of an individual program of medical rehabilitation for children with bronchial asthma.

[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.

[To the question of the possibility of using selective chromotherapy for allergic diseases in children]. / K voprosu o vozmozhnosti primeneniya selektivnoi khromoterapii pri allergicheskikh zabolevaniyakh u detei.

Allergic diseases are a common pathology in childhood. In the comprehensive medical rehabilitation of children with allergic pathology, non-drug methods of treatment are widely used, which help to reduce the number of drugs used, achieve and prolong the remission of the disease, favorably affect the clinical and functional indicators. THE PURPOSE OF THE STUDY: Is the scientific justification for the use of selective chromotherapy in children with bronchial asthma (BA) and atopic dermatitis (AD). MATERIAL AND METHODS: The study included 120 children with allergic diseases (BA and AD). Among 100 patients with BA, the main group included 50 children, who received exposure to monochromatic polarized green light on biologically active zones for 10 days, 50 - a comparison group that did not receive physiotherapy. The main group of children with AD included 10 patients who received selective blue chromotherapy for foci of skin lesions; the comparison group included 10 children who used only moisturizers without physiotherapy methods. In order to assess the effectiveness of the impact of physical factors in all patients, clinical and functional studies were conducted in the dynamics before and after treatment. RESULTS AND DISCUSSION: The results of clinical and functional examinations showed high therapeutic efficacy of the use of monochromatic polarized green light in children with BA (92.0%). The effectiveness of treating children with blood pressure AD using monochromatic polarized light (blue) was 80%. Indications for the use of selective chromotherapy in children with allergic diseases have been developed. For children with BA, selective chromotherapy of the green spectrum is indicated in the presence of a mild to moderate course of the disease, a period of incomplete remission, and an increased level of anxiety. It is advisable to prescribe selective chromotherapy of the blue spectrum to children with a moderate and mild course of AD. CONCLUSION: The positive effect of selective chromotherapy of the green spectrum on the clinical course of BA in children, bronchial patency, the functional state of the central nervous system and its autonomic part, and the psychoemotional status of children have been identified. The use of selective blue spectrum chromotherapy in children with AD helps to decrease the severity of objective symptoms, reduce the intensity of itching and sleep disturbance, as well as a marked decrease in the area of skin lesion.

[Contemporary potential of nonmedical treatment in ophthalmology].

The article covers treatment results of 90 patients with primary glaucoma simplex of stage 1 and 2 (137 eyes). The authors proved that using a specified magnetotherapy method, when compared to regular medical therapy, causes more fast and marked regression in clinical symptoms and improvement of vision in patients with primary glaucoma simplex of stages 1 and 2.

[Approaches to phototherapy in children with chronic dermatosis (review of literature)].

The article covers main aspects of phototherapy and photochemotherapy in treatment of skin diseases in children, risks of such methods usage, prophylactic and therapeutic measures, and precaution means for such treatment in pediatrics.

[Holter monitoring data in children with gastroesophageal reflux disease].

The aim of research is to estimate the functional state of the cardiovascular system in children with gastroesophageal reflux disease (GERD) with the help of Holter monitoring. 117 children of school age were examined: 69 children with GERD and 48 children with chronic gastroduodenitis. All children passed esophagogastroduodenoscopy, 24-hour pH-monitoring, electrocardiography and Holter monitoring. According to Holter monitoring data it was revealed that children with GERD had increased low-frequency components of frequency domain analyses, increased number of nocturnal PVCs and increased time of enhanced dispertion periods. Holter monitoring in patients with GERD can be used to detect preclinical ectopic rhythm, to evaluate autonomic dysfunction by frequency domain analyses, to predict nocturnal symptoms.

[Self-evaluation of health state in athletes].

The article covers scientific basis and elaboration of system concerning self-evaluation of athletes' health state. The study comprised 2 steps. During the first step, a group of 62 athletes (45 males and 17 females) performed methods of self-evaluation of health state through a list of changes, tests and stress testing. The second step included processing and generalization of the data obtained and specification of an integral scale of self-evaluation of athletes health state.

[The microbiocenosis of upper parts of digestive tract of children with gastroesophageal reflux disease and chronic gastroduodenitis].

The article considers the microbe specter of mucous coat of esophagus and stomach in children with gastro esophageal reflux disease and chronic gastroduodenitis. In patients with diseases of upper parts of digestive tract, the opportunistic pathogenic bacteria are isolated more often and their strains have aggression factors and cytotoxicity. In children with reflux disease the microbe landscape of esophagus is larger both in numerical and specific respect as compared to healthy adolescents and children with isolated gastroduodenitis.

GC-MS analysis of the leaf surface components of four Bulgarian grapevines grown under different conditions.

Four grapevine seedlings were propagated and planted both in a greenhouse and in an experimental field. Surface components of their fresh leaves were easily obtained and analysed by gas chromatography-mass spectrometry. In total, 21 surface metabolites were identified. Unlike the greenhouse samples, the field ones possessed semiochemicals and compounds contributing to their survival under environmental stress. This study shows that the leaf surface of the grapevine possesses compounds indicating the conditions of breeding.

[Clinical and instrumental characteristics of the gastroesophageal reflux in children with bronchial asthma, possibilities of therapy].

The group of 141 school-year children with bronchial asthma was examined. The condition of upper gastrointestinal tract was assessed. Gastroesophageal reflux disease was revealed in 94 children (66.7%). Dyspepsia, mucosal damage and changes of 24-hour pH monitoring data were more intensive in acute period of asthma and in children with severe asthma. Acid supression in the complex therapy of gastroesophageal reflux disease permited to minimise symptoms of dyspepsia and improve the pH monitoring data.

[Serine proteinase from the archaebacterium Halobacterium mediterranei--an analog of eubacterium subtilisin]. / Serinovaia proteinaza arkhebakterii Halobacterium mediterranei--analog subtilizina éubakterii.

A homogeneous serine proteinase was isolated from cultural filtrates of the extreme halophilic bacteria Halobacterium mediterranei 1538 using affinity chromatography on bacitracin-Sepharose, ultrafiltration and gel filtration on Sephadex G-75, with a 48% yield and 260-fold purification. The enzyme was completely inactivated by specific inhibitors of serine proteinases, PMSF and DFP, as well as by Hg2+ and PCMB. The enzyme activity was strongly dependent of NaCl concentration, the enzyme being inactivated below 0.75 M NaCl. Inactivation of the enzyme was also seen in the presence of 2-7% organic solvents. The pH optimum for Glp-Ala-Ala-Leu-pNA hydrolysis is 8.0-8.5; Km is 0.14 mM, kcat is 36.9 s-1. The stability optimum lies at pH 5.5-8.0, temperature optimum is at 55 degrees C. The enzyme molecular weight is 41,000 Da; pI is 7.5. The substrate specificity of the enzyme is comparable to that of secretory subtilisins; the extent of protein substrate hydrolysis is similar to that of proteinase K. The N-terminal sequence of Halobacterium mediterranei serine proteinase, Asp-Thr-Ala-Asn-Asp-Pro-Lys-Tyr-Gly-Ser-Gln-Tyr-Ala-Pro-Gln-Lys-Val-Asn- Ala- Asp-, reveals a 50% homology with the aminoterminal sequence of Thermoactinomyces vulgaris serine proteinase. Hence, the serine proteinase secreted by halophilic bacteria may be considered as a structural and functional analog of eubacterial enzymes.

A serine proteinase of an archaebacterium, Halobacterium mediterranei. A homologue of eubacterial subtilisins.

A homogeneous serine proteinase secreted by the extreme halophilic bacterium Halobacterium mediterranei 1538 was isolated by affinity chromatography on bacitracin-Sepharose with a yield of 48% (260-fold purification). The enzyme reveals an optimum for pyroglutamyl-Ala-Ala-Leu p-nitroanilide hydrolysis at pH 8.0-8.5 (Km 0.14 mM; k(cat). 36.9 s-1). Its activity increases linearly with NaCl concentration over the range 2-5 M. The substrate specificity of the enzyme is comparable with that of secretory subtilisins, the extent of protein degradation approaching that attained with proteinase K. The enzyme has a molecular mass of 41 kDa and a pI of 7.5. The N-terminal sequence of H. mediterranei serine proteinase reveals a 50% identity with that of Thermoactinomyces vulgaris serine proteinases, indicating that the enzyme belongs to the subtilisin family. Hence the serine proteinase secreted by the halophilic bacterium should be considered as a functional analogue, and a structural homologue, of eubacterial serine proteinases (subtilisins).

[Compensatory ovarian hypertrophy during alloxan diabetes and adrenoreceptor blockade]. / Kompensatornaia gipertrofiia iaichnika v usloviiakh alloksanovogo diabeta i blokady adrenoretseptorov.

The sexual cycle ceases in rats with alloxan diabetes. Chronic administration of phentolamine promoted interruption of the sexual cycle while obsidan was conducive to its preservation in part of the animals. Most diabetic rats both given and not given adrenoblockers showed the complete absence of compensatory hypertrophy of the ovary (CHO). As shown by the analysis, the content of gonadotropins in the pituitary glands of diabetic rats was increased, with the response to chorionic gonadotropin being close to normal. It is suggested that the absence of CHO in most diabetic rats can be accounted for by the fact that after removal of one ovary the hypothalamohypophyseal system does not secrete gonadotropins in adequate amounts.

[Effect of an adrenoreceptor block on ovarian function and hypophyseal gonadotropic function in rats]. / Vliianie blokady adrenoretseptorov na funktsiiu iaichnika i gonadotropnuiu aktivnost' gipofizov krys.

Experiments were conducted on rats. Sexual cycle, the state of the sexual system, and the gonadotropic activity of the hypophysis were studied in chronic administration of phentholamine and obsidan. Sexual cycle was found to be disturbed in 60% of rats given phentholamine and in 25% of animals to which obsidan was administered. There was no change in weight of the ovaries or of the uteri in rats treated with adrenoblockers. At the same time the height of the uterine epithelium was diminished, and also a distinct elevation of gonadotropin activity of the hypophysis was seln. It is suggested that chronic administration of adrenoblockers was accompanied by inhibition of gonadotropins secretion from the hypophysis; reduction of the hormonal function of the ovaries ensued.