[Optimization of the treatment of patients with osteoarthrosis using hyperbaric gaseous cryotherapy].

The authors report the results of combined rehabilitative treatment of patients presenting with gonarthrosis and coxarthrosis by means of hyperbaric cryotherapy using carbon dioxide at -78 degrees C. Estimation of the data obtained based on the internationally accepted Lequesne, WOMA, and Likert indices made it possible to objectively evaluate the clinical efficiency of this technology. Moreover, the approach employed permitted to elucidate various aspects of the mechanism of action of the physical factor, identify predictors of the possible outcome of hyperbaric gaseous cryotherapy, and improve by 33% the efficacy of rehabilitative treatment of patients with arthrosis affecting the large joints.

[Current evaluation of efficacy of radon baths of various concentrations during rehabilitation of patients with seronegative spondylarthritis].

141 patients with seronegative spondylarthritis including ankylosing spondylarthritis (n = 90), reactive arthritis and Reiter's disease (n = 51) took water radon baths (concentration 1.5, 3.0 and 4.5 kB/l). The baths proved similarly effective in patients with seronegative spondylarthritis. They produced analgetic, anti-inflammatory actions, raised quality of life for such patients.

[Influence of combined rehabilitation treatment including novel non-pharmacological technologies on immune system of patients with seronegetive spondylarthritis].

The immune system was studied in 90 patients with seronegative spondylarthritis (SNSA). Of them, 60 patients had ankylosing spondylarthritis (30 patients with central and 30 patients with peripheral forms) and 30 patients with reactive arthritis. SNSA patients were found to have secondary immunodeficiency. Cellular immunity was characterized by a decreased count of T mu (helper cells), an increased count of T gamma (cytotoxic/suppressors) and suppressed functional activity of lymphocytes, humoral immunity--by a high concentration of circulating immune complexes in an increased concentration of serum immunoglobulins. Integral assessment of the changes in the immune system and clinical data in SNSA patients leads to the conclusion that water radon baths and decimetric wave therapy reach the highest efficacy in ankylosing spondylarthritis while water radon baths and low frequency ultrasound--in reactive arthritis, a complex of water radon baths and ultraphonophoresis of hydrocortisone--in ankylosing spondylarthritis and reactive arthritis.

[Combined rehabilitation treatment for seronegative spondylarthritis including novel non-pharmacological technologies]. / Kompleksnoe vosstanovitel'noe lechenie bol'nykh seronegativnymi spondiloartritami s vkliucheniem novykh nemedikamentoznykh tekhnologii.

The trial included 90 patients with seronegative spondylarthritis (SA): 60 ones with ankylosing spondylarthritis (30 with central and 30 with peripheral forms) and 30 patients with reactive arthritis (RA). RA patients with affection of the peripheral joints, periarticular tissues and the spine are effectively treated with a complex of water radon baths and low frequency ultrasound but in affection of the peripheral joints and tendon-ligament system water radon baths and ultraphonophoresis of hydrocortisone are recommended. Water radon baths and decimetric therapy are good for patients with central ankylosing spondylarthritis having a dominant lesion of the spine. In involvement of the joints and tendon-ligament system it is recommended to use a complex of water radon baths and ultraphonophoresis of hydrocortisone.

[Laser Doppler flowmetry in evaluating the effectiveness of magnetolaser exposure in patients with gonarthrosis]. / Lazernaia dopplerovskaia floumetriia v otsenke éffektivnosti magnitolazernykh vozdeistvii u bol'nykh gonartrozom.

The aim of the study was estimation of the effects of laser therapy on microcirculation in osteoarthritis with application of laser doppler flowmetry (LDF). A total of 20 patients were treated. 10 procedures of the laser therapy were performed (Mlada unit, 0.85 micron, 15 mV, 5 min). LDF proved informative in complex estimation of blood microcirculation and efficiency of laser therapy in patients with osteoarthritis.

[Gout: current views. Stage oriented treatment]. / Podagra: sovrenennye predstavleniia. Lechenie na raznykh étapakh razvitiia zabolevaniia.

Gout is a common disease arising due to abnormal purin metabolism and excessive accumulation of uric acid in the blood (hyperuricemia) and manifesting with attacks of acute gouty arthritis. In long duration of gout uric acids accumulate in the bones and periarticular tissues as tophuses. Repeat attacks lead to development of chronic gouty arthritis. Purins restriction diet is an important component of gout treatment. Treatment of acute arthritis should be started early, in initial pains before the development of the attacks. Gouty arthritis in the presence of continuous hyperuricemia, tophyses and urolithiasis is treated with allopurinol. Its intake should be long and controlled by the blood level of uric acid. Balneotherapy is recommended for patients with chronic gouty arthritis associated with cardiovascular diseases, urolithiasis.

[Phenotype characteristics of skin dendritic cells in patients with psoriatic arthritis during the treatment with deresinated naphthalan]. / Fenotipicheskie osobennosti dendriticheskikh kletok kozhi u bol'nykh psoriaticheskim artritom pod vliianiem lecheniia obessmolennym naftalainom.

The study of the phenotype of immunocompetent dendritic cells of the skin in patients with psoriatic arthritis in the course of treatment with deresinated naphthalan (DRN) has revealed some aspects of the mechanism of therapeutic action of DRN. Use of the complex of monoclonal antibodies allowed the authors to determine membrane markers of various cells belonging to the system of mononuclear phagocytes and participating in development of immunoinflammation in the skin. The active stage of the disease is characterized by a fall in the number of CDIa+ cells. HLA-DR+ cells are more resistant. DRN therapy led to prevalence of CDIa+ cells.

[Low-temperature peloids in rehabilitating osteoarthritis patients]. / Peloidy nizkikh temperatur v reabilitatsii bol'nykh osteoartrozom.

A comparative trial was made of a therapeutic effect of low-temperature (10-24 degrees C) and hot (37 degrees C) applications of mud in osteoarthrosis (OA) patients. Hot applications are highly effective in OA but are contraindicated for patients with synovitis because of the risk of exacerbations. Low-temperature peloids have advantages over standard hot peloids in the treatment of synovitis, in concomitant lymphovenous insufficiency, cardiovascular diseases.

[Keratinocyte immunophenotypes in patients with psoriatic arthritis and their changes after treatment with deresinated naphthalan]. / Immunofenotipicheskie osobennosti keratinotsitov u bol'nykh psoriaticheskim artritom i ikh izmenenie pod vliianiem obessmolennogo naftalana.

The study of phenotyping features, membrane markers of epidermic keratinocytes, their production of adhesive molecules has established structural basis of favourable effect of deresinated naphthalan on the skin and articular syndromes in patients with psoriatic adtheritis. The immunohistochemical examination of the skin biopsies using monoclonal antibodies in the test of indirect immunofluorescence has found that deresinated naphthalan in patients suppresses immunoinflammatory reactions in the skin. Monitoring of expression of molecules HLA--on keratinocytes may be helpful for prediction of the skin and joint manifestation.

[New approaches to the use of physical factors in the practice of the medical rehabilitation of osteoarthritis patients]. / Novye podkhody k primeneniiu fizicheskikh faktorov v praktike meditsinskoi reabilitatsii bol'nykh osteoartritom.

The authors propose new approaches to medical rehabilitation of osteoarthrosis patients, i.e. cryotherapy, its combinations with other therapeutic physical factors. A trial performed in 328 patients with osteoarthrosis has shown effectiveness of the proposed treatment. Relevant indications and contraindications have been determined.

[The comparative efficacy of methods for the cryo-electropulse therapy of osteoarthrosis patients]. / Sravnitel'naia éffektivnost' metodov krioélektroimpul'snoi terapii bol'nykh osteoartrozom.

Comparative trials of two methods of cryoelectroimpulse therapy in combination with kinesitherapy and massage performed in 132 patients with osteoarthritis (OA) demonstrated that both methods relieve pain syndrome, improve peripheral circulation, condition of the neuromuscular system. Overall course effectiveness of parallel use of cryotherapy and transcutaneous electroneurostimulation (cryo-TCENS) combined with exercise and massage was found less than that of cryotherapy and sinusoidal modulated currents (cryoamplipulsetherapy). However, the effect of a single cryo-TCENS procedure was rather high. This may be explained by a labile technique which allows impact on the most painful (trigger) zones in OA patients. Thus, cryo-TCENS should be applied in short courses (maximum 6 procedures) or in single impacts in severe OA pain while cryoamplipulstherapy is more effective in courses consisting of 10-12 procedures.

[The effect of carbon dioxide baths and applications of low-temperature peloids on the immune function of patients with psoriatic arthritis]. / Vliianie gazovykh uglekislykh vann i applikatsii peloidov nizkikh temperatur na immunnoe sostoianie bol'nykh psoriaticheskim artritom.

A trial of dry air effervescent baths and low-temperature peloid applications was made in 109 patients with psoriatic arthritis (PA). Marked response was achieved in patients who had received combined therapy with the above two modalities. The effect presented with lower articular index, weaker skin involvement, improvement of blood picture. These positive changes correlated with normalization of immune indices. The benefit persisted for 6-9 months.

[The use of dry-air radon baths in the treatment of patients with reactive arthritis]. / Primenenie sukhovozdushnykh radonovykh vann v lechenii bol'nykh reaktivnym artritom.

66 patients with reactive arthritis took dry air radon baths. Radon concentration was 1.5 kBq/l (40 nCi/l), temperature regimens 27 +/- 3 and 37 +/- 3 degrees C. The procedures produced analgetic, anti-inflammatory and immunocorrective effects.