Obesity, being a global epidemic of the 21st century, increases the likelihood of various diseases and conditions that are associated with increased mortality. Given the risks associated with obesity throughout life, identifying early predictors of its development is a priority task of prevention. Assessment of the prognostic significance of laboratory parameters, functional tests and instrumental examination data for the early diagnosis of obesity and associated metabolic disorders. The studies were conducted at the Scientific and Clinical Center 1 of the B.V. Petrovsky Russian Scientific Center of Surgery with the participation of 77 patients (43 men and 34 women) aged 33 to 65 years. After signing voluntary informed consent for a special study with the processing of their personal data, all patients underwent a comprehensive clinical, laboratory and functional examination. The study design provided for a three-time examination of patients with an interval of 6 and 12 months. To search for predictors of early diagnosis of obesity and metabolic disorders, we used an algorithm for constructing a mathematical model of multiple regression. The dynamics of the body mass index and the insulin resistance index served as the resulting feature. To build a mathematical predictive model, a matrix of independent variables was formed, including parameters characterizing the biochemical status of patients, the severity of systemic inflammation, body composition, as well as arterial stiffness and vascular condition based on the results of ultrasound duplex scanning of the brachiocephalic arteries. The choice of the most informative set of independent variables that act as predictors provides for achieving the maximum additive effect in explaining the variance of the resulting feature. The construction of the actual mathematical multiple regression model was based on the results of the selection of independent factors carried out using the method of sequential hypothesis testing. As a result of applying the algorithm of sequential hypothesis testing, three independent variables (predictors) were identified to predict the degree of BMI increase and four variables to predict the development of metabolic disorders. The accuracy of the developed model, verified at the final stage of the study, showed its high information content. Two clusters of predictors were identified: the cluster of predictors for the risk of obesity development includes the systemic inflammatory response index, the triglyceride-glucose index and the blood leptin level. The cluster of biomarkers of metabolic disorders consists of the atherogenicity coefficient, the blood malondialdehyde level, the systemic inflammation index and the body roundness index.
The article analyzes the role of lipid peroxidation processes in the pathogenesis of cicatricial skin changes, including in patients with metabolic syndrome. Baseline indices of LPO processes and antioxidant enzymes in patients with metabolic syndrome indicate the development of oxidative stress and accumulation of cytotoxic carbonyl products. The course use of a combination of fermenkol phonophoresis, fractional photothermolysis and mineral water «Essentuki №17» in patients with cicatricial changes in the skin and metabolic syndrome is accompanied by a decrease in the severity of insulin resistance and lipid peroxidation processes. The use of a complex of physiotherapeutic factors and drinking mineral water contributes to an increase in the coefficient of antioxidant protection by 54%. The revealed dynamics of the assessed parameters is realized due to the elimination of molecular inhibitors of antioxidant enzymes in conditions of an increase in the receptor sensitivity of tissues to insulin and a decrease in the level of glycemia. The manifestation of antioxidant activity in the combined use of physiotherapeutic methods and mineral waters for drinking purposes allows this technology to be considered as an effective means of pathogenetic therapy of cicatricial deformities of the skin in combination with metabolic syndrome.
This study is devoted to assessing the effect of a single simultaneous exposure to a low-frequency electrostatic field and transcranial magnetic therapy on non-specific systemic adaptation mechanisms. Objective: to evaluate the effect of a single combined exposure to a low-frequency electrostatic field and transcranial magnetic therapy on the stress-realizing and stress-limiting systems of the human body. Material and methods of research. The study involved 83 male volunteers aged 25 to 38 years (the average age was 31,4±0,33 years), who did not have any chronic diseases and risk factors for their development (the first health group), who were divided into four groups by simple fixed randomization. The first group (control group, 21 people) received placebo treatment (imitation of physiotherapy treatment with the device turned off). In the second group (main group 1, 20 people), the volunteers were singly exposed to transcranial magnetic therapy with traveling magnetic field (TMT TMF) using the device «Amo-Atos» with the attachment «Headband» (RU from 18.11.2011 №FSR 2011/12325). In the third group (main group 2, 21 people), the volunteers were singly exposed to low-frequency electrostatic field (LFESF) using the multifunctional therapeutic system «Khivamat-200» (RU from 12.04.2017 №RZN 2017/5597). To assess the stress-realizing and stress-limiting systems of the body, an analysis of heart rate variability (HRV) was performed, which allows determining the tone of the sympathetic and parasympathetic parts of the autonomic nervous system (ANS). Blood levels of ACTH, cortisol, glucagon, LPO products (malondialdehyde (MDA) and Schiff base (SB)), as well as insulin and the activity of antioxidant enzymes (SOD and catalase) were measured. The study was carried out three times: in the initial state, after 30 minutes, and a day after the end of the single exposure to the complex of physiofactors. The results obtained allow concluding that the criteria for the optimality of a combined single exposure to physiotherapeutic factors is a stable activation of stress-limiting mechanisms against the background of an initial moderate increase and gradual diminishment of stress-realizing manifestations. The dynamics of the estimated indicators observed a day after the exposure indicates the increasing adaptive capabilities of the body to minimize stress-damaging effects. A single simultaneous application of physiotherapy factors demonstrated the possibility of targeted implementation of the strategy of adaptation and control of the severity of physiological, hormonal and metabolic changes within the framework of a non-specific stress response, which opens up new opportunities for optimizing the treatment process.
Adverse conditions in the Arctic North provoke the development of various diseases, primarily cardiovascular and respiratory systems, metabolism. The main etiological factors are hypoxia, low temperatures, geomagnetic storms, desynchronosis, stress, impaired microcirculation, pathogenetic changes in hormonal regulation of metabolic reactions. To develop effective methods of treating diseases provoked by adverse environmental conditions and activities in the Arctic North, as well as their prevention, it is necessary to develop a new strategy for medical support of this problem. As an alternative, it is proposed to use methods of restorative medicine, based on the use of non-drug factors (natural origin and physiotherapy), which have a systemic effect on various functional systems of the body. In this regard, of particular interest are mineral waters used internally, in the form of baths and inhalations, controlled hypoxia, physical activity, reflexology.
Despite the long history of studying the influence of meteo- and heliogeophysical factors on the human body, the mechanisms of this influence remain unclear. The inability to influence weather conditions makes it necessary to develop new, experimental approaches to such research. To analyze the effect of the ambient air temperature, atmospheric pressure, moisture and other meteorological indices on the human body, and to identify the mechanisms of such impact, there is proposed a new approach using an appropriate experimental stand (weather experimental stand). The basis of such stand can be composed of a climatic chamber, the technical characteristics of which allow carrying out research with human participation. In such studies, various physiological and biochemical indices can be monitored, as well as psychological tests can be administered. Such studies are of particular relevance in relation to the intensive development of the Arctic since in high latitudes the influence of heliogeophysical and meteorological factors is very pronounced. The climate of the Arctic is characterized by a combination of significant temperature fluctuations, atmospheric pressure, low absolute and high relative humidity, strong winds, significant changes in the geomagnetic field and atmospheric electricity, a pronounced deficit of UV radiation and light aperiodicity. Features of the natural conditions of the North, apparently, cause a high incidence of the diseases of the circulatory and respiratory system in the alien population (in comparison with the indigenous one). In addition, the article draws attention to the fact that the only weather factor, whose mechanisms of influence are sufficiently well studied, is the change in ambient air temperature, and these mechanisms were studied through research done under experimental conditions.
BACKGROUND: In the pathogenesis of true eczema, an important place is occupied by stress, under the influence of which stimulation of the hypothalamus and brain stem occurs, as well as activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Stress-induced secretion of neurotransmitters impairs the barrier function of the epidermis, slows wound healing, increases itching and inflammation, and suppresses immunity by changing the immune response of T-helper cells. AIM: Assessment of the severity of the corrective effect of a course of application of supravenous laser irradiation of blood and broadband medium-wave phototherapy on the blood levels of adrenocorticotropin, cortisol and beta-endorphin in patients with true eczema with a moderate form of the course. MATERIALS AND METHODS: The study was carried out with the participation of 120 patients with a moderate form of true eczema. Using simple fixed randomization, all patients were divided into 4 groups. The first group (control, n=30) received only basic drug therapy, including the use of detoxification, hyposensitizing, antihistamines and topical glucocorticosteroids. Patients of the second group (comparison group 1, n=30) additionally underwent a course of supravenous laser irradiation of blood. In the third group (comparison group 2, n=30), broadband medium-wave phototherapy was performed against the background of basic therapy. Patients of the fourth group (main group, n=30) in addition to basic therapy received a course of combined exposure to supravenous laser blood irradiation and phototherapy. The concentrations of adrenocorticotropin, cortisol and beta-endorphin were determined in the blood of patients twice (before the start of treatment and 1 month after the start of therapy) using ELISA. The clinical condition of patients in the groups was assessed by changes in the EASI index. Additionally, we studied the dynamics of the level of reactive and personal anxiety using the Spielberger–Khanin questionnaire. RESULTS: Positive dynamics of adrenocorticotropin, cortisol and beta-endorphin were noted only in the comparison groups and the main group, which proves the high efficiency of correction of the neurohumoral status of patients through a course of complex use of supravenous laser blood irradiation and broadband mid-wave phototherapy. Quantitative changes in the assessed parameters during complex therapy with therapeutic physical factors indicate a supra-additive version of their interaction, realized through different modalities, points of application and mechanisms for realizing the biological potential of physiotherapeutic effects. CONCLUSION: The results obtained convincingly prove the effectiveness of an additional course of use of supravenous laser irradiation of blood in combination with broadband medium-wave phototherapy when correcting the neuroendocrine status in patients with true eczema. The close correlation between neurohumoral indicators and clinical and psychological patterns of the disease proves the pathogenetic significance of the studied neuroendocrine indicators, which allows us to consider their dynamics as informative criteria for the effectiveness of the treatment.
Comprehensive studies of the influence of binaural beats on the effectiveness of the treatment of patients with post-traumatic stress disorders have been carried out. It has been established that this physiotherapeutic factor contributes to a decrease in the activity of stress-initiating systems, including the normalization of heart rate variability and the regression of hormonal and biochemical stress markers with an improvement of psychophysiological parameters. It has been revealed that bioacoustic impact on the brain has an antinociceptive effect. It has been proven that post-traumatic stress disorders initiate the formation of pathological correlation pleiades, which are destroyed when binaural beats are applied. The development of more effective rehabilitation programs for patients suffering from post-traumatic stress disorder, taking into account the complex mechanism of the formation of this disease, should be based on highly informative technologies of digital medicine and the construction of multifactorial prognostic information models with the selection of predictor biomarkers.
BACKGROUND: Previous studies on the comparative evaluation of the effectiveness of the course application of therapeutic physical factors during the complex medical rehabilitation of patients with polypous rhinosinusitis showed a rather high efficiency of the additional use of complex physiotherapy (alternating magnetic field and low-intensity laser therapy) in enhancing the regression of the main clinical manifestations of polypous rhinosinusitis and improving the quality of life (QoL) of patients. Considering the chronic and often recurrent nature of polypous rhinosinusitis, along with the relief of the main clinical manifestations of the disease and improvement in the quality of life of patients after treatment, medical rehabilitation of patients should also cover the long-term period.
AIM: Evaluation of the results of complex medical rehabilitation of patients with polyposis rhinosinusitis in the long-term period (after 6, 12 and 18 months) and determination of the optimal time parameters for a repeated course of physiotherapy aimed at maintaining the achieved clinical effect and the level of quality of life of patients.
MATERIALS AND METHODS: The study was performed with the participation of 120 patients with moderate to severe polypous rhinosinusitis and uncontrolled course. All patients were divided into 4 groups by simple fixed randomization. The first group (control, 30 patients) received only basic therapy, including endonasal application of Nasonex 2 doses 2 times a day and daily twice daily lavage of the nasal mucosa. Patients of the second group (comparison group 1, 30 patients) were additionally injected subcutaneously with dupilumab at a dose of 300 μg once every two weeks. In the third group (comparison group 2, 30 patients), against the background of the administration of dupilumab, exposure to an alternating magnetic field was performed. using the apparatus MAGNIT Med TeCo. Patients of the fourth group (main group, 30 patients), in addition to the volume of treatment of patients of the third group, received low-intensity laser radiation of the red spectrum (633 nm) using the AZOR-2K-02 apparatus.
RESULTS: Positive dynamics in terms of assessed clinical indicators throughout the entire observation period was noted only in the comparison groups and the main group. The maximum severity of positive changes was determined in the main group after 6 and 12 months of rehabilitation, exceeding the achieved values in the group with dupilumab. The follow-up period made it possible to establish that 18 months after the start of rehabilitation, there were no significant differences between these groups. The dynamics of the parameters of the microcirculatory tissue system in the comparison groups and the main group in the long-term period indicated the formation of compensatory-adaptive processes aimed at eliminating congestion in the nasal mucosa and associated hypoxia, as well as the normalization of oxygen metabolism and trophism of tissues prone to chronic inflammation.
CONCLUSION: The results obtained convincingly prove the effectiveness of additional course use of an alternating magnetic field in combination with low-intensity laser therapy. The use of this technology, implemented against the background of ongoing biological therapy, shows its increased efficiency up to 12 months after the start of medical rehabilitation. It is advisable to conduct a second course of physiotherapy based on the complex use of an alternating magnetic field and low-intensity laser radiation 9–12 months after the start of medical rehabilitation.
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