[The integral estimation of health problems and effectiveness of stage rehabilitation in patients after ischemic stroke]. / Integral'naia otsenka narushenii zdorov'ia i éffektivnosti étapnoi reabilitatsii bol'nykh posle ishemicheskogo insul'ta.

The multidisciplinary assessment of health problems after stroke should take into account not only motor, speech disorders, disability, but also postural balance, type and level of mental disorders, degree of working hand dysfunctions, cortical motor neuron functional indicators, and risk factors for recurrent stroke. OBJECTIVE: To develop a methodology for the integrated assessment of health problems and the effectiveness of stage rehabilitation in patients after ischemic stroke (IS) and risk factors for recurrent stroke. MATERIAL AND METHODS: Examinations were made in 101 patients (mean age 59.78±8.63 years) after IS in the middle cerebral arterial bed in the early recovery period. Of them, 62 patients were examined in the early and late recovery periods of stroke. The investigators assessed neurological disorders using National Institutes of Health Stroke Scale (NIHSS), Ashworth Spasticity Scale, dysarthria scale, Medical Research Council Scale and wrist dynamometry, Frenchay Arm Test), Self-Care Rating Scale (Barthel index) and social and living activities (Rehabilitation Activities Profile Scale), psychological status (procedures of Memory for Pictures and Ten Words, Schulte-Platonov Tables, Luscher Color Test, Hospital Anxiety and Depression Scale (HADS), Recovery Locus of Control Scale) questionnaire, functional (stabilography, transcranial magnetic stimulation) and laboratory (lipid profile test) results. The integrated assessment of health problems was defined as the sum of ranks of the signs studied; the effectiveness of stage rehabilitation in patients was defined as the coefficient of the dynamics of the sum of ranks of informative indicator. RESULTS: There was a preponderance of moderate motor impairments; the high incidence of cognitive impairment and paretic hand dysfunctions; a change in the temporal parameters of the nerve impulse through the corticospinal tract; obvious balance dysfunctions; and the relationship between equilibrium and the visual analyzer. The integral indicator of the level of health correlated with clinical and functional findings. After the rehabilitation, severe arm/hand paresis was not detected; paretic arm/hand function improved; the number of patients with moderate paresis declined; impaired vital and social activities reduced significantly; the proportion of patients with low dependence on others was as much as 86%; balance and psychological functions improved; the mean blood pressure reached the target values. An integrated effectiveness evaluation showed that 33, 58, and 9% of patients were discharged with a significant improvement, improvement, and a slight improvement, respectively. CONCLUSION: The integrated approach to evaluating health problems and the effectiveness of rehabilitation makes it possible to comprehensively estimate (taking into account neurological, psychological, functional disorders, risk factors for recurrent stroke) the harm to a patient's health and activity, which is associated with prior stroke and its reversal due to rehabilitation.

[The comprehensive approach to the rehabilitative treatment of junior athletes]. / Kompleksnyi podkhod k vosstanovitel'nomu lecheniyu sportsmenov-yuniorov.

AIM: The objective of the present study was the development of the comprehensive program for the medico-psychological follow-up of the male and female junior athletes (rhythmic gymnastics) with the purpose of stabilizing their hormonal and emotional status, as well as improving sport performances based on the use of modern hardware-software technologies. MATERIAL AND METHODS: The comprehensive examination of 72 female athletes at the mean age of 11.5±0.6 years attending R. Kuznetsov specialized school of rhythmic gymnastics of the Olympic reserve in the city of Seversk has been undertaken on the basis of Tomsk Research Institute of Balneology and Physiotherapy, the branch of Siberian Federal Research and Clinical Centre. RESULTS: The program of comprehensive medical psychological rehabilitation for the junior athletes of either sex engaged in sportive activities requiring precise technical actions has been elaborated. The method of the combined therapeutic treatment included physical exercises therapy, manual massage, dry carbonic bathtubs, psychological activities with the application of biological feedback trainings and cognitive trainings; it was intended for the correction of the hormonal status and the improvement of the psycho-emotional conditions of the athletes. The combined treatment based on the use of the modern hardware-software technologies was shown to promote the restoration and development of the psychophysical and psychological qualities of the male and female junior athletes indispensable for the maintenance of their high readiness for the efficient sports activities at the subsequent stages of the training cycle. In addition, such treatment enhances the adaptation resources of the athletes.

[The medical and psychological support for the child athletes during different periods of the training cycle].

OBJECTIVE: To study dynamics of the indicators of the hormonal and psychological status as well as psychological features of significance for the sportive performance under conditions of rehabilitative treatment during training and post-training periods in the child athlete engaged in rhythmic gymnastics. MATERIAL AND METHODS: The study included 42 child athletes at the age from 8 to 15 years engaged in rhythmic gymnastics. The children of the study group (group 1, n=17) received the combined restorative treatment under conditions of regular training while those comprising group 2 group (n=25) were given a similar treatment in the absence of the training load. All athletes underwent clinical and laboratory examination before and after the treatment for the assessment of their psychological status. RESULTS: The study has demonstrated that additional physical activities were responsible for the development of negative changes in the hormonal and psychological spheres of the child athletes. As a result, they experienced the impairment of certain qualities significant for their sportive performance. CONCLUSION: The rehabilitative measures during different periods of the training cycle promote normalization of all parameters of the hormonal, psychological, and physical status of the child athletes; moreover, they improve the adaptive capacity of the children.

[Influence of frozen-dried antlers of Siberian stags on humoral homeostasis in athletes of cyclic sports].

The authors evaluated effects of antlers of Siberian stags on humoral homeostasis parameters in highly qualified athletes during contest period. Medication based on antlers of Siberian stags provides more balanced operation of energy supplying processes, maintains stable lipid metabolism, favors balance in "prooxidants - antioxidants" system.

[Gender analysis of efficiency provided by general bath containing antlers of Siberian stags in skiers].

The authors performed gender analysis of efficiency caused by general bath containing antlers of Siberian stags in athletes engaged into winter sports. Male athletes demonstrated increased physical performance, low RBC membrane response to epinephrine, decreased cortisol level, higher testosterone level and longer time of breath-holding in Stange's test. Female athletes demonstrated no reliable changes in the mentioned parameters.

[The influence of the products prepared from young not ossified antlers marals of siberian red deer on the characteristics of the blood oxygen-supplying system in the athletes during the contest season].

The objective of the present study was to estimate the influence of the products prepared from young not ossified antlers marals of Siberian red deer on the characteristics of the blood oxygen-supplying system in the athletes undergoing heavy physical loads during the contest season. It was shown that the use of such preparations promotes correction of humoral characteristics reflecting the development of iron-deficient conditions.

[Role of platelet NO synthase in insulin-mediated antiaggregability in patients with 2 diabetes mellitus].

It was established that insulin caused a reduction in the parameters of collagen-induced platelet aggregability in healthy donors; this effect of insulin on platelets was not found in patients with type 2 diabetes mellitus. In the healthy donors, joint incubation of platelets with insulin and L-arginine (a NO synthase substrate) resulted in an even more pronounced decrease in collagen-induced platelet aggregability while the group of patient showed a reduction in the degree and rate of the aggregability only along the light scattering curve. In the healthy individuals, addition of the NO synthase blocker LNMMA to the incubation medium containing platelets and insulin, as well as that of insulin and L-arginine eliminated insulin antiaggregability. The effect of insulin on platelet aggregation seems to be displayed with the involvement of platelet NO synthase and NO-dependent mechanisms. The change in the antiaggregability of insulin in patients with type 2 diabetes mellitus may be due to both lowered platelet NO synthase activity and insulin receptor dysfunction.

[Phenazine methosulfate system-induced membrane hyperpolarization in the human erythrocytes].

Erythrocyte membrane potential was recorded via measurement of pH of the incubation medium in presence ofprothonophore. The increase of intracellular calcium concentration in presence of calcium ionophore A23187 and addition of the artificial redox-system ascorbate-phenazine methosulfate led to membrane hyperpolarization due to opening of Ca(2+)-activated potassium channels that are regulated by multiple signaling pathways. The opening of the Ca(2+)-activated potassium channels in presence of artificial redox-system ascorbate-phenazine methosulfate is mediated at least by two mechanisms including an increase in affinity of channels to calcium ions and involvement of the protein SH-groups and the components of the respiratory circuit which have beer found in erythrocyte membrane.

Effect of insulin on Ca(2+)-dependent hyperpolarization in erythrocytes from healthy donors and patients with type 2 diabetes mellitus accompanied by arterial hypertension.

Insulin decreased A23187-induced hyperpolarization of the erythrocyte membrane in healthy donors. These data indicate that insulin plays a role in the regulation of Ca(2+)-activated potassium channels in human erythrocytes. However, insulin had little effect on hyperpolarization response of cells induced by artificial ascorbate--phenazine methosulfate donor-acceptor system. Addition of insulin to cell suspension from patients with type 2 diabetes mellitus did not modulate hyperpolarization of the erythrocyte membrane induced by A23187 or ascorbate-phenazine methosulfate, which reflects impairment of regulatory mechanisms for Ca(2+)-activated potassium channels in erythrocytes.

Volume-dependent regulation of Ca2+-activated potassium channels in erythrocytes from healthy donors and patients with type II diabetes mellitus aggravated by arterial hypertension.

Increase in intracellular Ca2+ concentration caused by calcium ionophore A23187 or ascorbate+phenazine methosulphate electron donor system added to erythrocyte suspension induced similar shifts in erythrocyte membrane potential. These processes are most likely mediated by Ca2+-activated potassium channels. Changes in the osmolarity of the incubation medium produced opposite effects on membrane hyperpolarization induced by A23187 or ascorbate+phenazine methosulphate in erythrocyte isolated from healthy donors, which attests to the existence of different mechanisms of regulation of Ca2+-activated potassium channels. There was no difference in the volume-dependent changes of potassium permeability in cells from patients with type II diabetes mellitus combined with arterial hypertension induced by application A23187 or electron-donor system.

Effect of lipid matrix and cytoskeleton proteins on Ca2+-activated K+ channels in erythrocytes of alcoholic and II type diabetes mellitus patients.

We studied the effect of changes in erythrocyte volume and irreversible thermal denaturation of cytoskeleton proteins and lipid matrix on activity of Ca(2+)-activated K+ channels in erythrocytes of alcoholic and patients with II type diabetes mellitus. Changes in Ca(2+)-dependent potassium permeability of erythrocyte membrane in alcoholic patients and patients with II type diabetes mellitus are related to modification of cytoskeleton, rather than to changes in lipid matrix.