[Aerobic exercise and fatigue indices in rheumatoid arthritis patients in the health resort care setting]. / Aerobnye uprazhneniya i pokazateli ustalosti u bol'nykh revmatoidnym artritom v usloviyakh sanatorno-kurortnogo lecheniya.

Fatigue is one of the most common symptoms of rheumatoid arthritis (RA). There is strong evidence that physical activity is an effective way to reduce fatigue. OBJECTIVE: To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients in the health resort setting. MATERIAL AND METHODS: The study involved 102 female patients with RA (age 54.38±11.3 years, body mass index 20-29 kg/m2, DAS28-ESR ≤3.2, with severe fatigue of VAS ≥50) who received 21 days of health resort treatment. The health-improving and therapeutic complex includes dosed physical activity, aerobic exercises (walking). Visual analog scale (VAS0-100) and Bristol Rheumatoid Arthritis Fatigue Scale-Numerical Rating Scale (BRAF-NRS V2) were used to assess fatigue, and the 50-meter walking test was used to evaluate the functional status of patients. RESULTS: A correlation between walking duration and the number of steps at a distance of 50 m (p<0.001) as well as between these indices and fatigue (p<0.001) was shown. A positive effect of a standard three-week medical rehabilitation program for patients with RA on fatigue NRS severity (p=0.003) and NRS effect (p=0.037), as well as on patients' functional status (reduced time spent on the 50-meter test, p=0.01) was demonstrated. When comparing groups of RA patients with low (group 1, <5000-6000 steps per day) and optimal (group 2, ≥7000-8000 steps per day) aerobic exercise, positive results were noted in the short term (at 3 weeks) (p<0.001). CONCLUSION: Aerobic exercise is a promising intervention for treating fatigue in rheumatoid arthritis patients. Medical rehabilitation in a resort setting is the best starting point to encourage performing regular physical activity, as well as the best way to develop exercise programs tailored to rheumatoid arthritis patients.

[The influence of chronomagnetic therapy on the parameters of the quality of life in the patients presenting with the diseases of the musculoskeletal system at the balneological and health resort-based stage of the rehabilitative treatment].

UNLABELLED: The methods for the rehabilitative treatment play an important role in the management of the patients presenting with the diseases of the musculoskeletal system. One of these techniques is chronomagnetic therapy. AIM: The objective of the present study was to evaluate the influence of chronomagnetic therapy on the patient's quality of life. PATIENTS AND METHODS: The patients of the main group included 30 ones with osteoarthrosis, 30 with rheumatoid arthritis, 20 with ankylosing spondylitis, 6 with podagric arthritis, 6 with psoriatic arthritis, and 6 others with reactive arthritis. Each of these patients every day underwent 10 sessions of chronomagnetic therapy with the use of the Multimag apparatus («Kasimov Instrumental Plant¼, Ryazan). The patients of the comparison group (20 ones presenting with osteoarthrosis, 27 with rheumatoid arthritis, 15 with ankylosing spondylitis, 4 with podagric arthritis, 4 with psoriatic arthritis, and 4 subjects with reactive arthritis) received the identical chronomagnetotherapeutic treatment under the conditions of the «Vulan¼ balneological health resort located at Gelendzhik, Krasnodar Region. RESULTS: The patients of the main group presenting with osteoarthrosis were characterized by the most pronounced manifestations of the role physical and social behaviour and the associated enhancement of pain intensity. The patients with rheumatoid arthritis exhibited well apparent manifestation of role and emotional functioning as well as enhanced vitality. Positive dynamics of these characteristics (role physical and emotional functioning, vital activity) was documented in the patients of the comparison group presenting with osteoarthrosis, ankylosing spondylitis, and rheumatoid arthritis. In this group, the patients with osteoarthrosis, ankylosing spondylitis, and rheumatoid arthritis experienced the improvement of the major parameters of the quality of life characterizing the physical and mental components of the health status. CONCLUSION: The chronomagnetotherapeutic treatment at the stage of rehabilitation of the patients suffering from the diseases of the musculoskeletal system markedly improves the characteristics of physical health the disturbances of which may lead to the development of psycho-somatic disorders. Chronomagnetic therapy of the patients with the diseases of the musculoskeletal system under the conditions of a balneological health resort proved to be more effective in terms of improvement of the parameters of physical and mental health. The result of the subjective evaluation of the health status in such patients can be used as a marker of the effectiveness of chronomagnetic therapy and an indicator of remission of the disease.

The status of the SNS external antenna ion source and spare RFQ test facility.

The Oak Ridge National Laboratory operates the Spallation Neutron Source, consisting of a H(-) ion source, a 1 GeV linac and an accumulator ring. The accumulated <1 µs-long, ∼35 A beam pulses are extracted from the ring at 60 Hz and directed onto a liquid Hg target. Spalled neutrons are directed to ∼20 world class instruments. Currently, the facility operates routinely with ∼1.2 MW of average beam power, which soon will be raised to 1.4 MW. A future upgrade with a second target station calls for raising the power to 2.8 MW. This paper describes the status of two accelerator components expected to play important roles in achieving these goals: a recently acquired RFQ accelerator and the external antenna ion source. Currently, the RFQ is being conditioned in a newly constructed 2.5 MeV Integrated Test Facility (ITF) and the external antenna source is also being tested on a separate test stand. This paper presents the results of experiments and the testing of these systems.

[The influence of general magnetic therapy on the psychological status of the patients presenting with osteoarthrosis].

The present study was designed to estimate the influence of general magnetic therapy on the psychical conditions of 151 patients presenting with degenerative joint diseases including osteoarthritis (OA). It was shown that the application of general magnetic therapy for the rehabilitative treatment of osteoarthrosis promotes the improvement of the psycho-emotional state of the patients. It is concluded that prescription of general magnetic therapy to the patients with OA suffering from serious psycho-emotional disorders brings about beneficial changes in their anxiety- and depression-related personality traits.

[Rheumatoid arthritis: psychosomatic aspects].

The review considers the results of studies of the psychosomatic aspects of rheumatoid arthritis (RA), which have been published in the past 5 years. In particular, there is evidence for the impact of chronic pain on the psychological status of patients with RA, for that of the disease on quality of life in the patients, their sociopsychological and interpersonal relationships; trials of the efficiency of additional treatment options for RA are given.

[Normalizing effect of rehabilitative techniques on the psychoemotional status of patients with inflammatory and degenerative joint diseases].

120 subjects with a verified diagnosis of rheumatoid arthritis (RA) and 94 ones with osteoarthrosis (OA) were examined to evaluate the influence of structural electromagnetic resonance therapy (SEMRT) on psychological status of patients suffering from both inflammatory and dystrophic joint diseases. Spielberger test for situational and personal anxiety and Beck test for depression were used to detect and assess changes in the patients' psychological condition. Comparative studies demonstrated advantages of incorporation of SEMRT in combined RA and OA treatment. Wide spectrum of SEMRT therapeutic actions accounts for its beneficial action in patients presenting with anxiety and depressive disorders associated with inflammatory and dystrophic joint diseases highly refractory to routine treatment.

[Kinematic characteristics of the voluntary cyclic trunk movements in patients at the early stage of Parkinson's disease].

Patients with the initial stage of Parkinson disease (PD) and matched controls performed repetitive bendings and turnings in standing position. Tasks included trunk movements in each of the anatomical planes: sagittal, frontal and axial. Electromagnetic system Flock of Birds was used for movement registration. Sensors were fixed at different segments of subject's body. Joint angles in the ankle, hip and torso as well as coordinates of the center of pressure served as output parameters. The amplitudes of joint angles were found to be lower in PD patients. Performance of the axial rotation revealed most pronounced differences. Thus, the amplitudes of joint angles of trunk movements in different anatomical planes reliably discriminate between PD patients and healthy subjects.

[Psychosomatic relationships in patients with primary fibromyalgia syndrome].

This clinical and psychological study involved 100 patients aged 24-51 years with primary fibromyalgia syndrome (PFS). The patents exhibited clinical manifestations of neurotic disorders, low level of subjective control, dysadaptive attitude toward the disease, and an intense spectrum of protective psychological mechanisms. The main clinical manifestations of PFS correlated with psychological status of the patients. It is concluded that objective evaluation of clinical conditions of PFS patients requires integrated psychosomatic assessment of their health status.

[Thyroid hormone antibodies in rheumatoid arthritis].

The goal of the study was to investigate thyroid functional activity in rheumatoid arthritis (RA) and to identify the specific features of the generation of thyroid hormone antibodies in RA patients depending on the activity of the disease. Seventy-five patients with RA (61 (81.4%) females and 14(18.6%) males; mean age 54.1±11.6years) were examined. Physical examination and measurements of the level of thyroid hormones (free T4 and free TJ and the number of their antibodies were made. Thirty healthy individuals were examined as controls. The sera from RA patients showed antibodies to T4 and T3 in 45 and 39% of cases. There was a rise in thyroxine levels and T4 antibody concentrations with the higher activity of RA. Along with the routine clinical and laboratory parameters, the values of T3 and T4 antibodies may be used as an additional tool to characterize the activity of RA genesis.

[Prospects for using antigenic nanosystems in the diagnosis and treatment of inflammatory rheumatic diseases].

AIM: To study whether immobilized antigenic nanosystems (ANS) may be designed on the basis of antigens of varying chemical nature to identify and to remove specific antibodies (Ab) from the blood of patients with systemic lupus erythematosus (SLE). SUBJECTS AND METHODS: Sixty patients with the diagnosis of SLE verified by the 1997 American College of Rheumatology criteria and 30 apparently healthy individuals were followed up. The levels of Ab to catalase (Cat), xanthine oxidase (XO), and cardiolipin (CL) were measured by enzyme immunoassay, by applying the respective ANS as an antigenic matrix. RESULTS: There was a significant relationship of the levels of Ab to Cat and XO to the activity of SLE. It was shown that Ab to Cat and XO could affect the functional activity of serum enzymes. The level of Ab to CL in patients with SLE was found to depend on two parameters - the intensity of the disease and the presence of antiphospholipid syndrome; acute cerebral circulatory disorder and thrombocytopenia were observed to have a significant unidirectional impact on the level of Ab to CL. Immobilized CL-based ANSs were effective in eliminating Ab to CL from the whole blood of patients with SLE, without resulting in a significant hemolysis of blood corpuscles and in a reduction of total protein concentrations. CONCLUSION: The development and introduction of preventive methods for the early diagnosis of SLE may be extended, by using ANS based on Cat, XO, and CL antigen. The designing and putting into practice novel ANS-based hemosorbents may allow immunosorption to occupy a prominent place in the pathogenetic therapy of inflammatory autoimmune diseases.

[Use of life quality indices in the rehabilitation therapy of inflammatory and degenerative rheumatic diseases].

AIM: To study whether life quality (LQ) indices may be used to evaluate the efficiency of structural resonance electromagnetic therapy (SREMT) and its correction in patients with rheumatoid arthritis (RA) and in those with osteoarthrosis (OA). SUBJECTS AND METHODS: One hundred and twenty patients with significant RA and 94 patients diagnosed as having OA were followed up. The SF-36 questionnaire was used to detect and assess objective data on health problems and changes. The patients with RA and those with OA were randomized to the groups matched for gender, age, and disease duration: a study group (n = 80) and a control one (n = 40) for RA; a study group (n = 56) and a control one (n = 38) for OA. Both group patients received the same medical and physiotherapeutic treatment (within each nosological entity, respectively). Furthermore, in the study groups, the patients with RA and those with OA had additionally 10-12 daily (43-min) sessions of SREMT on a Rematerp apparatus. RESULTS: The inclusion of SREMT into the multimodality treatment of patients with RA and those with OA has shown significant benefits. A wide spectrum of therapeutic action of SREMT exerts a positive impact on the basic LQ indices (the indicators of physical and role physical performance, somatic pain, general condition, and social and role emotional performance). CONCLUSION: SREMT may be recommended for use in rheumatological care as a technique that enhances the efficiency of performed therapy and medical rehabilitative measures in inflammatory and degenerative rheumatic diseases.

[Detection of serum catalase antibodies in patients with inflammatory rheumatic diseases by immobilized magnetic sorbents].

Sixty patients with systemic lupus erythematosus, 48 patients with rheumatoid arthritis, and 30 healthy individuals (a control group) were examined. Modified procedures for enzyme immunoassay (EIA) and immunofluorescence (IF) assays with an immobilized magnetic sorbent (MS) based on catalase as an antigenic matrix were used to detect catalase antibodies (Ab). The application of immobilized MSs and a photoelectric digital display attachment to a fluorescence microscope permits measurements of Ab to soluble antigens (catalase) in the IF assay. Nevertheless, for detection of catalase Ab in laboratory practice, preference should be given to EIA using a MS as a more sensitive procedure.

[The evaluation of the quality of life as a criterion of the efficiency of rehabilitating treatment in rheumatoid arthritis].

Under observation there were 120 patients with rheumatoid arthritis (RA), which were divided into basic (n = 80) and control group matched by gender, age and duration of the disease. The all patients received the similar drug and physiotherapeutic treatment. Furthermore additional sessions of structural resonance electromagnetic therapy (SREMT were performed) in patients from basic group. The comparative studies showed significant benefit of inclusion of SREMT in complex management of RA patients. The wide spectrum of therapeutic action of SREMT has positive influence on basic parameters of the quality of life of RA patients: the general indices of physical and role physical functioning, somatic pain, overall health, social and role emotional functioning. SREMT may be recommended for using in rheumatologic clinic as a method of increasing the efficacy of conducted treatment and therapeutic and rehabilitation measures in RA.

[Preoperative care and surgical treatment of small-intestinal fistulas in children]. / Predoperatsionnaia podgotovka i khirurgicheskoe lechenie tonkokishechnykh svishchei u detei.

Experience in using complex treatment in 42 children with unformed small-intestinal fistulas, generalized defects of the anterior abdominal wall and severe disorders of alimentary status is presented. Their preoperative preparation included parenteral alimentation, enteral probe feeding with special elementary milk formulas, correction of metabolic disorders. Intestinoplication during surgery was carried out with the medicinal glue MK-7 to prevent intestinal obstruction and formation of interloop abscesses. The use of portions of the tendinous part of the musculus tensor fasciale late was one the simple and effective methods for plasty of anterior abdominal wall defects.

Somatosensory evoked potentials during natural and learning rearrangements of posture accompanied by limb elevation in dogs.

Changes in the functional state of the sensorimotor cortex associated with reorganization of the natural pattern of postural rearrangement before limb elevation (the "diagonal" patten and of an artificial rearrangement (the "unilateral" pattern) were studied in dogs. The state of cortical structures on postural rearrangement was assessed in terms of the pattern of somatosensory evoked potentials produced in response to stimulation of the forelimb during postural preparation of the animal for elevating the hindlimb (acquired avoidance response to a sound signal). Evoked potentials during the natural postural preparation (the "diagonal" pattern) were compared with those during the altered pattern of postural preparation (the "unilateral" pattern), this preparation taking place prior to elevation of the limb. Controls consisted of evoked potentials in the resting state. Decreases were seen in the latencies and amplitudes of most components of evoked potentials during postural rearrangement. In general, changes in evoked potentials were less marked in the "unilateral" pattern than in the "diagonal" pattern, though the differences were significant only for the amplitude of the first negative component. Changes in evoked potentials were similar regardless of whether the supporting forces of the limb to which the test stimulus was applied increased or decreased during postural rearrangement. It is suggested that differences in evoked potentials may reflect changes in the interaction between neuronal populations within the sensorimotor cortex during reorganization of the pattern of postural rearrangement associated with learning.

[Natural coordination of the head and limb movements and its transformation by learning in dogs]. / Estestvennaia koordinatsiia dvizhenii golovy i lapy u sobak i ee peredelka v protsesse obucheniia.

Kinematic analysis of the head and the forelimb movements in dogs has been done during elaboration the instrumental tonic forelimb flexion when the head was bent down to foodwell. It was found, that in naive dogs the forelimb flexion was accompanied by anticipatory lifting of the head, the head lowering evoked extension of the flexed forelimb. Therefore simultaneous holding of the lifted limb and the lowered head was impossible and could be achieved only by learning. Studying of the dynamics of transformation of the innate (natural) head-forelimb coordination during learning has shown that innate relationship between phasic head-forelimb movements, which was lost at the early stage could spontaneously restore for a short time in trained dogs. It was found between low-amplitude head-forelimb oscillations which did not disturb the learnt tonic forelimb flexion, when the head was bent down. The innate coordination is supposed to be an inborn and in the given conditions the only possible way of the forelimb lifting, in which the anticipatory lifting of the head might facilitate the limb flexion. That's why lowering of the head provoked extension of the flexed limb. Contrary to the known hypothesis [4] that the mechanism of elaboration of the novel coordination is connected with suppression of the interfering innate coordination, it is proposed to consider the elaborated coordination as the novel way of the forelimb lifting in the forced posture of the lowered head. The novel flexion of the forelimb, as supposed, became possible by changing its innate organization (muscular pattern).

[Somatosensory evoked potentials during natural and learned patterns of postural adjustment, accompanying limb movements in dogs]. / Somatosensornye vyzvannye potentsialy vo vremia natural'noi i vyuchennoi perestroiki pozy, soprovozhdaiushchei pod''em konechnosti u sobak.

A goal of the study was to investigate cortical reorganization corresponding to inhibition of innate motor patterns during motor learning. Functional changes in the sensorimotor cortex during learned rearrangement of the natural diagonal pattern of postural adjustment (PA) accompanying a hindlimb movement into a new one, the so-called unilateral pattern, were studied in dogs by testing somatosensory evoked potentials (SEP) in response to stimulation of a forelimb during PA immediately before the limb movement onset. During PA the latency and the amplitude of several SEP components decreased. In general, changes in SEP were less pronounced in the learned unilateral pattern of postural adjustment in comparison with the innate diagonal pattern, but the difference was significant only for some SEP components. The SEP late positivity in the learned postural pattern was replaced by a negativity. The SEP changes were similar independently of whether the test stimulus was applied on the forelimb loaded or unloaded during postural adjustment. The data suggest that changes in interrelations between different neuronal populations in the sensorimotor cortex during formation and realization of a learned motor program can be reflected in SEP changes.

Certain methods of biomechanical description of various postural adjustment patterns during motoric learning in dogs.

Methods for the biomechanical description of spatial displacements of the center of mass of quadruped animal (dog), developed by the authors on the basis of an assessment of the vertical constituents of support pressures, as well as methods for the assessment of the postural adjustment pattern (coefficient of diagonality), are presented in this paper. The results are presented of an investigation of the role of the motor cortex in the accomplishment of the postural adjustment pattern of dogs, reorganized during learning, in the performance of an instrumental movement.

[New approaches to the diagnosis of carbohydrate metabolic disorders]. / Novye podkhody k diagnostike narushenii uglevodnogo obmena.

A bioenergetic conception of insulin-independent diabetes mellitus (IIDM) is put forward. Molecular mechanisms of carbohydrate and fat metabolism are discussed which result in a vicious regulatory cycle to provoke a transition to stable pathology. Previously unknown role of human saliva in oral cavity in this regulatory cycle is revealed. New diagnostic tests are developed on the basis of the conception on IIDM pathogenesis. The results of clinical trials are presented which have been obtained during population screening.