[Evaluation of the effectiveness of the third stage of rehabilitation after a knee joint injury in persons of older age groups by means of physiotherapy exercises.]

The main task in the rehabilitation of athletes with traumatic injuries of the knee joint and surrounding soft tissues is effective and painless recovery at all stages of treatment. The aim of this work is to introduce a set of physical exercises for the treatment and prevention of traumatic injuries of the knee joint in middle-aged and elderly patients at the third stage of rehabilitation treatment (ICD-10: S80-S89). To date, there is no single regulated program for the management of middle-aged and elderly patients at the outpatient stage. The article describes the third stage of the organization of medical rehabilitation assistance in the late rehabilitation period, the period of residual symptoms of the course of the disease, without relapses. Physical exercises, presented in this complex, give the patient independence in everyday life in the implementation of self-service, independent movement, in the presence of the prospect of restoration of function (rehabilitation potential) confirmed by the results of the examination. The proposed technique was tested on 148 patients who underwent all 3 stages of rehabilitation treatment, in whom the duration of remission was 12-36 months.

Risk factors associated with portal vein thrombosis in liver cirrhosis: A case-control study.

AIM: To build a predictive model for PVT in cirrhotic patients. MATERIALS AND METHODS: A single centre case-control study was carried out. From the database of 1512 cirrhotic patients 94 with newly diagnosed PVT based on contrast-enhanced computed tomography were referred to the Case group. Malignant PVT was an exclusion criterion. Patients without PVT were stratified and matched according to sex, age and etiology of cirrhosis; case-control ratio was 1 : 3-4. The prevalence of PVT in the database, clinical, laboratory, instrumental parameters of the groups were evaluated. Logistic regression model was used to estimate association between variables and PVT. RESULTS: The overall prevalence of PVT was 6.2% with the highest rates among the patients with HBV infection - 16.7%, nonalcoholic steatohepatitis - 15.6%, alcohol abuse in combination with HCV infection - 11.7%. The best predictive model included variables: Child-Pugh classes B-C (coefficient of regression ß=1.853, р=0.001), ascites (ß=0.460, р=0.003), hepatocellular carcinoma without vascular invasion (ß=2.126, р=0.0001), endoscopic band ligation (ß=0.774, р=0.003), azygoportal disconnection (ß=2.734, р=0.001), portal hypertensive gastropathy (ß=0.793, р=0.017), portal vein diameter (ß=0.203, р=0.004), and local factors - ulcerative colitis flare, Clostridium difficile enterocolitis, spontaneous bacterial peritonitis, colorectal cancer, splenectomy, cholecystectomy (ß=2.075, р=0.017). The model had accuracy 85.8% (95% CI 81.7-89.4%), sensitivity - 55.1% (95% CI 43.4-66.4%), specificity - 95% (95% CI 91.6-97.3%), and AUC - 0.871 (95% CI 0.826-0.916). CONCLUSION: Child-Pugh classes B-C, severe portal hypertension, hepatocellular carcinoma without vascular invasion, and local factors were estimated as risk factors of PVT in cirrhotic patients.

[Changes in oxidative stress and apoptosis parameters of neutrophils in rheumatoid diseases].

AIM: Study parameters of oxidative stress and apoptosis of neutrophils in patients with ankylosing spondylitis, systemic lupus erythematosus, systemic scleroderma and rheumatoid heart disease. MATERIALS AND METHODS: 240 patients with rheumatoid diseases and 25 healthy control group volunteers were examined. Neutrophil isolation from peripheral blood was performed by using double density gradient of ficoll-urografin. Cell functional activity was studied by chemiluminescence method. Pro-apoptosis antigen bak expression by neutrophils was studied by using streptavidin-biotin method. Griss reagent was used for nitrogen oxide production analysis. RESULTS: An increase of oxygen dependent neutrophil metabolism processes was detected in patients with ankylosing spondylitis in comparison with systemic lupus erythematosus and systemic scleroderma patients. Systemic lupus erythematosus is characterized by higher biocidity of neutrophils in comparison with systemic scleroderma and rheumatoid heart disease. Increase of neutrophil granulocyte activity in ankylosing spondylitis is accompanied by an increase of superoxide-anion formation. In spite of high level of metabolic activity neutrophils in patients with ankylosing spondylitis have a low functional reserve, and neutrophils in patients with systemic scleroderma have the highest reserve potential. CONCLUSION: Differences in expression parameters of oxidative stress by neutrophils depend on nosological form, varying by production level and active oxygen form formation reserve.