Landscape therapy: rehabilitation potential in patients with post-infarction cardiosclerosis.

OBJECTIVE: Aim: To evaluate the rehabilitation potential, effectiveness and safety of landscape therapy in the complex rehabilitation treatment of patients with post-infarction cardiosclerosis (PC) complicated by chronic post-infarction cardiac aneurysm (CPCA) at the sanatorium stage. PATIENTS AND METHODS: Materials and Methods: We examined 62 patients with PC complicated by CPCA aged 38 to 65 years. Patients were randomized into two groups: the 1st group was undergoing the "Progressive gait" physical activity protocol in the city, and the 2nd group - in the rehabilitation department in a sanatorium. Survey, six-minute walk test, electrocardiography, echocardiography, coronary angiography were performed. RESULTS: Results: The average distance that 2nd group patients walked in 6 minutes increased from 301.00 ±17.00 to 467.00 ±32.00 m (p<0.05). Only in patients of 2nd group during 3 weeks of complex rehabilitation there was a decrease in body mass index from 23.70 ±1.60 to 18.90 ±1.50 and the diameter of the calf muscle significantly increased from 33.90 ±2.30 cm to 38.10 ±3.10 cm (p < 0.05). Ejection fraction in the 2nd group was 51.00 ±4.50% compared to the 1st group - 44.70 ±3.60% (p < 0.05), which was accompanied by a decrease in the functional class of heart failure in patients of the 2nd group. CONCLUSION: Conclusions: The rehabilitation potential of landscape therapy in the complex rehabilitation treatment of patients with complicated PC at the sanatorium stage is determined by a significant improvement in myocardial contractility and physical endurance of patients, and improving the quality of life.

Asthma in patients with the syndrome of undifferentiated dysplasia of connective tissue: peculiarities of the course or mutually aggravating mechanisms?

OBJECTIVE: Aim: To analyse laboratory and biochemical features of the severe persistent course of asthma in patients with undifferentiated connective tissue dysplasia (UCTD) syndrome, and their phenotypic and visceral stigmas of dysembryogenesis. PATIENTS AND METHODS: Materials and Methods: We enrolled 60 male patients with asthma, aged from 23 to 62 years (mean age (46.83 ±0.85) years): 30 patients with the background of UCTD, and 30 - without UCTD. We analysed clinical, somatometric, surveying (original questionnaire based on the phenotypic map of Glesby), instrumental (spirography, echocardiography, endoscopy, esophagofibrogastroduodenoscopy) and laboratory (including eosinophilic granulocytes and aldosterone levels) data. RESULTS: Results: Correlations were found in men with UCTD between the number of UCTD markers and rate of earlobe diagonal fold (r=+0.75; р<0.05), asthenic constitution (r=+0.72; р<0.05), easy bruising (r=+0.7; p<0.05) and straight abdominal line hernia (r=+0.52; p<0.05). Average aldosterone serum level in patients with UCTD (176,10 ±11,22) was significantly higher than in those without UCTD (142,77 ±9,43), (p<0.05), as well as average eosinophils levels (1.3 ±0.25 vs. 0.57 ±0.12, p<0.05). In the absolute majority of patients with UCTD (93.3%) asthma onset was confirmed after pneumonia, and their age of asthma manifestation was significantly higher (37.2 ±1.21) than in patients without UCTD (21.4 ±1.13). Also, in patients with UCTD there was a high number of severe exacerbations during the last year (2.7 ±0.12 per year) on the background of high doses of combined inhaled glucocorticosteroids use. CONCLUSION: Conclusions: Identified "phenotypic profile", clinical and biochemical features of patients with asthma on the background of UCTD syndrome, which determine the severe course and early formation of asthma complications, will further accelerate the diagnosis of this asthma phenotype and improve approaches to the selection of treatment regimens for these patients.