BACKGROUND: A personalized approach to the use of therapeutic physical factors should take into account individual predictor biomarkers, which are predictive information regarding the effectiveness of the treatment, taking into account the initial state of the patient's reserve capabilities. The metabolic syndrome was defined as a model of a pathological condition characterized by reduced functional reserves. Previous studies have shown that transcranial magnetotherapy (TMT) and pulsed low-frequency exposure to an electrostatic field (INESP) have potential effectiveness in relation to the pathogenetic manifestations of the metabolic syndrome. AIM: The purpose of the study is to determine the predictors of effectiveness in the implementation of personalized combined use of TMT and INESP in patients with metabolic syndrome. MATERIALS AND METHODS: The study involved 100 patients with a diagnosis of metabolic syndrome established in accordance with clinical guidelines. All patients were divided into four groups of 25 by simple fixed randomization. The first group (control) received a placebo effect (imitation of physiotherapeutic effects with the device turned off) for 10 days of observation. Patients of the second group (comparison group 1) were exposed to a low frequency electrostatic field (INESP). The third group (comparison group 2) received transcranial magnetic therapy with a traveling magnetic field (TMT). Patients of the fourth group (main) were subjected to a combined effect of INESP and TMT. All patients before and after a course of physiotherapy underwent a comprehensive examination using functional, biochemical and hormonal methods. Statistical processing of the obtained results was carried out using the Statistica 12.6 software package using the algorithms of correlation and regression analyses. RESULTS: The analysis performed using the multiple regression algorithm made it possible to identify a cluster of independent variables in the form of an autonomic balance index, microcirculation index, body mass index and catalase activity, determined in the initial value of patients. The high efficiency of the combined use of TMT and INESP is achieved with a probability of at least 95% in patients with metabolic syndrome, the initial state of which is characterized by a level of the autonomic balance index below 1.7 conventional units. units, tissue perfusion parameter more than 14 perf. units, BMI value below 29 c.u. units and catalase activity above 90 units. аct. The results of the verification of the constructed information model convincingly prove its adequacy and objectively confirm compliance with the stated forecast requirements. CONCLUSION: It is concluded that the identified constellation of phenotypic patterns, which characterizes the state of the pathological process, reflects the main pathogenetic mechanisms that determine the severity of clinical and functional manifestations of metabolic syndrome. Evaluation of the initial values of the autonomic balance index, microcirculation index, body mass index and catalase activity in patients with metabolic syndrome makes it possible to predict the expected effectiveness of the course combined use of TMT and INESP.
The paper analyzes the dynamics of indicators characterizing the state of various functional body systems in patients with metabolic syndrome with the combined use of transcranial magnetic therapy and low-frequency electrostatic field in order to identify the main predictors of effectiveness. It was found that with such exposure, against the background of a significant increase in clinical efficacy, the degree of variation of dynamic changes increases, which is due to the difference in the initial condition of patients. It was revealed that the most pronounced therapeutic effect is observed in patients with preserved reserve and adaptive capabilities in the system of hemostasis, lipid peroxidation, micro-circulatory system and insulin regulation of glucose metabolism.
BACKGROUND: Taking into account the role of angiogenesis processes in the zone of development of immature scar tissue, it seems pathogenetically justified to use a vascular laser for the correction of hypertrophic skin scars that are at the maturation stage. In this regard, we used a pulsed dye laser, the effect of which is perceived by the patient without pronounced pain, and the technology itself is quite safe and leads to a rapid recovery of the skin after the procedure. Fermencol phonophoresis supplementation of laser therapy with pulsed dye laser has the potential to enhance the therapeutic efficacy of a vascular laser, since Fermenkol is a preparation of collagenases of hydrobiont origin that can destroy the components of the extracellular matrix, the formation of which exceeds in intensity its degradation by matrix metalloproteinases at the stage of formation scar. The use of ultrasound in this case not only accelerates the delivery of proteolytic enzymes, but also exhibits independent fibromodulatory activity.
AIM: comparative evaluation of the effectiveness of the use of physiotherapeutic factors (Fermenkol phonophoresis, pulsed dye laser therapy and their combination) in patients with immature hypertrophic skin scars, taking into account clinical research methods.
MATERIAL AND METHODS: The study was performed on 125 patients aged 19 to 50 years with immature (less than 6 months) hypertrophic skin scars. All patients were divided into 4 groups according to the simple fixed randomization procedure. The first group (control, 32 patients) received course local compression therapy using silicone plates for two months. The second group (31 patients) was treated with phonophoresis of 0.01% Fermencol gel. The third group (31 patients) was treated with pulsed dye laser. The fourth group (31 patients) received complex treatment, including a combination of two pulsed dye laser procedures and two cycles of Fermencol phonophoresis. Patients were examined twice: before the start of treatment and 2 weeks after the end of the course of treatment. The assessment of the clinical condition of patients was carried out according to the modified Vancouver scale for assessing the signs of cicatricial deformity.
RESULTS: Conducting a course of treatment of patients with immature hypertrophic skin scars made it possible to establish a good tolerability of the effects of physiotherapeutic factors. At the same time, the positive dynamics of clinical manifestations of cicatricial changes in the skin, assessed by Vancouver scar scale, in the control and main groups was not the same and increased in the following order: Control Fermencol phonophoresis pulsed dye laser pulsed dye laser + Fermencol phonophoresis. The use of the correlation adaptometry technique, which makes it possible to objectify the obtained clinical data, evaluating them using the category of functional reserves of the body, confirmed that the best clinical result was achieved in the group recieved combined use of pulsed dye laser and Fermencol phonophoresis.
CONCLUSION: The conclusion was made about the maximum therapeutic effect in the group of complex use of pulsed dye laser and ultrasound administration of an enzyme preparation, which manifested itself due to the synergistic type of interaction between two physiotherapeutic factors that have different modalities, points of application and mechanisms for implementing their therapeutic activity.
Biochemical effects of phytoinhalation and oral administration of biologically active additives containing beta-carotene (e.g. vetoron) are evaluated with special reference to changes in lipid peroxidation. Systemic analysis of the mechanisms of antioxidative effects of phytotherapy demonstrated the leading role of activation of vegetative homeostasis-regulating centres and central stress-limiting systems as well as direct action of antioxidative ingredients comprising the formulation. The study showed that combination of phytotherapy and vetoron allowed the overall antioxidative efficiency of these treatments to be considerably increased due to their action on different targets. It is concluded that the proposed method promotes effectiveness of combined rehabilitative treatment in patients with arterial hypertension due to correction of disturbed lipid peroxidation.
BACKGROUND: One of the effective and pathogenetically substantiated methods of therapeutic action on cicatricial changes in the skin are laser technologies in combination with collagenases. However, as previous studies have shown, the presence of metabolic syndrome in patients significantly reduces the clinical efficacy of the combined use of laser therapy and phonophoresis of Fermencol. The most reasonable solution in this situation can be scientific research and experience in the practical use of drinking mineral waters, which have a high corrective efficiency in relation to metabolic processes, the course of which is significantly impaired in type II diabetes mellitus and metabolic syndrome. AIMS: Assessment of clinical indicators of cicatricial changes in the skin of patients with metabolic syndrome in the combined application of the method of phonophoresis Fermenkol, fractional photothermolysis and drinking mineral waters. MATERIAL AND METHODS: The study included 60 patients (49 men and 11 women) with cicatricial changes in the skin aged 19 to 50 years, with a confirmed diagnosis of metabolic syndrome. All patients by the method of simple fixed randomization were divided into two groups: the control group (30 people) and the main group (30 people). Both groups received treatment, which included a course of phonophoresis of 0.01% Fermencol gel in combination with the technique of fractional laser therapy. Patients of the main group, in contrast to the control group, in addition to the specified physiotherapeutic treatment received bottled sodium bicarbonate-chloride water Essentuki No. 17 (mineralization 11.8 g/l) at room temperature, 200250 ml three times a day for 1520 minutes before meals for 3 weeks. RESULTS: The addition of physiotherapeutic combined anti-scar therapy with a course of drinking mineral water Essentuki No. 17 in patients with cicatricial changes in the skin in combination with metabolic syndrome was accompanied by a significantly more pronounced clinical effect, assessed by the Vancouver scale and the Dermatological Index of Quality of Life. CONCLUSION: Additional course use of drinking mineral water Essentuki No. 17 is accompanied by a more pronounced dynamics of clinical manifestations of cicatricial deformities of the skin and an indicator of the quality of life of patients, due to the sanogenetic mechanisms of the drinking balneofactor.
The performed study is devoted to the analysis of the initial clinical and functional state of patients with post-COVID syndrome and to the evaluation of the effectiveness of rehabilitation measures, supplemented by the course use of MDM therapy and interval hypoxic training. It is shown that, despite the various clinical manifestations of post-COVID syndrome, the severity of complaints and indicators of the objective status of patients are largely determined by the presence of concomitant pathology that reduces the functional reserves of the body. The results obtained allow us to conclude that the additional course use of MDM therapy and the technique of interval hypoxic training increases the effectiveness of patients» rehabilitation. The complex application of these factors makes it possible to speak about the formation of functional potentiation, which determines the strategy for achieving high final efficiency of directed rehabilitation, opening up new opportunities for optimizing the recovery process. The basis of the supra-additive type of synergistic interaction of physiofactors is the complementation of subeffective shifts in the estimated parameters induced by each of the factors, as well as the formation of functional cumulation, in which the cumulative corrective effect is the result of epigenetic regulation of adaptation process.
The article analyzes the effect of chronic generalized periodontitis and the methods of its treatment on the life quality of patients which has been assessed by using the Oral Health Impact Profile (OHIP-14) as an oral health questionnaire validated in Russia. It was shown that the initial state of patients with chronic generalized parodontitis was characterized by a marked decrease in the life quality and its criteria in comparison with the indices of healthy individuals. It has been established that the course application of ozone in combination with transcranial magnetotherapy in patients with chronic generalized periodontitis in comparison with traditional treatment is a more effective therapeutic method that provides reliable positive dynamics of subjective signs and basic dental indices. The combination of the revealed positive dependences between the indicators of the dental status and the domains of the life quality proves the informative use of the "OНIP-14" questionnaire as a criterion for choosing the method of therapy and evaluating the clinical effectiveness of the ongoing treatment of chronic generalized periodontitis.
The epidemic of overweight and obesity, which has reached the proportions of a total crisis in health care in recent years, affects more than 1 billion people worldwide, of whom 2.8 million die annually. The polymodal nature of the pathogenesis of obesity, manifested by the participation of multiple pathological processes, allows us to consider the complex use of physiotherapeutic effects as the most effective therapeutic strategy, the implementation of which allows us to achieve a high clinical result due to the synergistic interaction of therapeutic physical factors. Development and evaluation of the effectiveness of preventive and personalized technologies based on the predominant use of therapeutic physical factors that have a pathogenetic effect on key patterns of metabolically unhealthy obesity. The studies were conducted at the Scientific and Clinical Center 1 of the Russian Scientific Center of Surgery named after academician B.V. Petrovsky with the participation of 157 patients (89 men and 68 women) aged 30 to 70 years. A prospective, controlled, comparative, randomized study was performed. Using the simple fixed randomization method, all patients were divided into 2 groups: control (77 patients) and experimental (80 patients). In the main group, patients received a course of complex exposure to therapeutic physical factors aimed at correcting their metabolic profile (thermotherapy, oxygen and aromatherapy, vibration massage of the back and lower extremities, relaxation music therapy, pressotherapy, dry carbon dioxide baths and general air cryotherapy). The course of complex physiotherapeutic exposure was carried out twice with an interval of 6-8 months. Patients in the control group did not undergo correction of the metabolic profile. The design of the study provided for a three-fold examination of patients in the main and control groups: before the complex program of physiotherapeutic correction of the metabolic profile, after the first and second courses. Conducting a complex course of physiotherapy had a reliable corrective effect on the parameters of the metabolic profile of patients with obesity, including a reliable decrease in anthropometric indices, improvement of the lipid spectrum of the blood, a decrease in insulin resistance, a decrease in the level of leptin and the severity of sluggish systemic inflammation. Conducting a comparative assessment of the effectiveness of a course of complex physiotherapeutic intervention in the main group compared to the control group, performed using the correlation adaptometry algorithm, made it possible to establish a reliable decrease in the weight of the correlation graph in the main group, which indicates an increase in functional reserves. To implement a personalized approach to the use of a complex of physiotherapeutic interventions, an algorithm for identifying predictor biomarkers that allow predicting the expected clinical effectiveness was used. As a result, informative indicators were identified for predicting the effectiveness of using the developed physiotherapeutic complex to reduce body mass index and insulin resistance. Using the correlation adaptometry method, the effectiveness of using the developed technologies based on the complex use of therapeutic physical factors affecting the main clinical and metabolic manifestations of obesity was proven. The identified predictors of the effectiveness of physiotherapeutic correction of obesity have criterion significance for forming a prognosis of the expected clinical effect at the initial stage (before the start of therapy).
In article the main achievements in a problem of studying of mechanisms of treatment-and-prophylactic use of drinking mineral waters are analysed. The important role of their nonspecific influence due to existence of a stressorny component, activation of digestive organs and increase in products of gastrointestpnalny and pancreatic hormones is proved. Increase in activity of enteroinsulyarny interrelations at intake of mineral waters provides optimization of the broken metabolic reactions. It is revealed that against the background of course intake of mineral waters the resistance to insulin due to optimization of hormonal and receptor interaction decreases. The role of activization of pro-oxidatic reactions in improvement of sensitivity of fabrics to insulin is discussed. Various methods of increase in medical potential of mineral waters due to change of algorithms of their use, enrichment are analyzed by vitamins and phytodrugs, nanoparticles of metals. The scheme of realization of biological potential of mineral water at its internal reception is offered.
BACKGROUND: The information-predictive approach can be used for determining biomarkers as predictors that allow predicting the effectiveness of the treatment of chronic generalized periodontitis using the combined use of ozone and transcranial magnetotherapy.
AIMS: Determination of the set of initial morphometric parameters that have predictive significance, as well as the development of a method for the integral assessment of the clinical effectiveness of the combined use of ozone and transcranial magnetotherapy in patients with chronic generalized periodontitis.
MATERIALS AND METHODS: A multiple regression model was built, which establishes the relationship between the dependent variable (effective sign treatment effectiveness) and the value of independent variables (factors characterizing the initial state of patients).
RESULTS: It has been established that the technology of combined use of ozone and transcranial magnetotherapy is most effective in the initial clinical manifestations of chronic generalized periodontitis and minimal values of other pathogenetically significant parameters (microcirculation, oxygen metabolism, lipid peroxidation disorders) in the initial state.
CONCLUSION: The clinical and laboratory cluster identified as a result of mathematical analysis the index of bleeding of the gingival sulcus, the volume of nutritive blood flow, the fluorescent indicator of oxygen consumption, the quality of life according to the Daily Life domain generalized periodontitis, determining the indications and contraindications for the use of this treatment regimen for inflammatory periodontal diseases.
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