[The use of electromyostimulation in motion in the treatment of post-traumatic edema of the ankle joint]. / Primenenie elektromiostimulyatsii v dvizhenii pri lechenii posttravmaticheskikh otekov golenostopnogo sustava.

Injuries of the ligamentous apparatus of the ankle joint are one of the most common injuries of the ODA. A large number of complications and a long period of disability require the development of modern methods of physiotherapy treatment that can reduce the number of relapses and reduce the duration of rehabilitation. OBJECTIVE: Evaluation of the effectiveness of the use of electromyostimulation in motion in the treatment of post-traumatic edema of the ankle joint. MATERIAL AND METHODS: 51 athletes with post-traumatic edema of the ankle joint were examined. The main complaints were the presence of pronounced edema in the area of injury, pain, restriction of movement in the joint. The patients were randomly divided into 2 groups: the 1st group (25 patients) received treatment with electromyostimulation in motion (while performing therapeutic gymnastics); the 2nd (control) group (26 patients) performed therapeutic gymnastics recommended for the treatment of patients with lymphovenous insufficiency. The method of laser Doppler flowmetry was used to study microcirculatory disorders in the area of injury. Peripheral hemodynamics was evaluated by the RVG method. The severity of edema was assessed by measuring the circumference of the lower leg in the lower third of the injured and healthy limb. The thickness of subcutaneous fat was assessed by ultrasound. The subjective feelings of athletes were evaluated using CIVIQ-2 questionnaires and pain syndrome assessment according to VAS. RESULTS AND CONCLUSION: The use of electromyostimulation in motion in patients with post-traumatic edema of the ankle joint helped to reduce pain, relieve soft tissue edema, increase the volume of movements in the affected joint, increase motor activity and improve the quality of life.

[Application of kinesis-taping and low frequency pulse magnetic therapy in medical rehabilitation of athletes with post-traumatic edema of the lower extremities]. / Primenenie kinezioteipirovaniya i nizkochastotnoi impul'snoi magnitoterapii v meditsinskoi reabilitatsii sportsmenov s posttravmaticheskim otekom nizhnikh konechnostei.

In the conditions of increasingly stringent anti-doping rules, the development of new non-drug methods of treatment and rehabilitation of athletes is of particular importance. OBJECTIVE: Development of new methods of medical rehabilitation of athletes after injury. MATERIAL AND METHODS: Thirty-three athletes with knee injuries were examined. The main complaints were the presence of pronounced edema in the area of injury. All patients were randomly divided into 2 groups: in group 1 (16 patients) lymphatic drainage kinesis-taping was performed; in the 2nd group (17 patients) - complex treatment including lymphatic drainage kinesis-taping and low-frequency pulse magnetic therapy. Using laser Doppler flowmetry a study of microcirculatory disorders in the area of injury was carried out. The severity of edema was assessed by measuring the circumference of the knee joint of the diseased and healthy limbs. The assessment of the subjective feelings of athletes using questionnaires CIVIQ2 andVAS. RESULTS AND CONCLUSION: Based on the obtained subjective and objective data, a medical complex was developed using lymphatic drainage kinesis-taping and low-frequency pulse magnetic therapy, which affects different steps in the pathogenesis of edema formation. Data obtained resultedin more pronounced positive effect during complex treatment compared with monotherapy with kinesis-taping.

[The modern trends in the treatment and prevention of lymphedema of the lower extremities]. / Sovremennye tendentsii v lechenii i profilaktike limfedemy nizhnikh konechnostei.

This article was designed to describe the main pathogenetic factors underlying the development of lymphedema of the lower extremities, the social implications of this condition, its prevalence throughout the world, and the impact of this disease on the quality of life of patients. In addition, the review presents the modern data on the management of patients with chronic lymphatic edema of the lower extremities. Special attention is given to the principles and methods of its combined conservative treatment, including the use of medications, compression therapy, physiotherapy, thalassotherapy, and balneotherapy. Moreover, the results of the analysis of the effectiveness of the treatment as a whole and of the individual methods, such as intermittent pneumatic compression (SPC), electrical myostimulation, laser therapy, magnetic-laser therapy (MLT) are reported with special reference to their outcomes when applied as isolated interventions and the components of the combined therapy. The review is devoted to the systematization of information about the currently available methods for the prevention and treatment of lymphadema of the lower extremities and the evaluation of the treatment regimens applied in this country and leading foreign clinical centres. Also considered are both the classical scheme of the combined treatment of lymphedema of the lower extremities and the schemes including novel therapeutic modalities. The most promising methods for the treatment of this condition including those proposed during a few recent years (such as kinesiotaping, LPG-engineering, and gravity therapy) are highlighted, and their influence on the generally accepted schemes of the combined treatment of lymphedema of the lower extremities is evaluated. The basic principles of modern pharmacotherapy and its role in the system of methods for the treatment of lymphedema of the lower extremities including phlebotomies, lymphokinesia, antibacterial drugs are considered.

[Epidemiological and clinical features of viral hepatitis in convicts of penitentiaries]. / Epidemiologicheskie i klinicheskie osobennosti virusnykh gepatitov u bol'nykh, nakhodiashchikhsia v ispravitel'nykh uchrezhdeniiakh.

AIM: Investigation of epidemiological and clinical features of viral hepatitides (VH) in convicts treated in clinics of penitentiaries. MATERIALS AND METHODS: VH were studied in 352 patients of the infection department of the special hospital in one of the penitentiaries of Russian Federation. 97 VH patients were followed up. Incidence of VH was also considered in 144 patients of the somatic department. Mean age of the patients was 24 years, mean duration of the last stay in the penitentiary 19 months. Forms of VH were diagnosed clinically, using EIA, ultrasound, laboratory tests. RESULTS: Serological markers HC-, HB-, HA- of viral infections were detected in 34.3, 32.3 and 11.4% of patients, respectively. VH of mixed etiology was found in 17.6% of cases. 52.1% of patients had previously injected narcotic drugs, 60.4% of them had concomitant infectious or parasitic diseases. 22.9% of the patients had serum proteins below 65 g/l. CONCLUSION: Convicts in the penitentiaries were infected primarily with hepatitis C, many of them had mixed infections and chronic hepatitis. More than half of them had associated infections infectious and/or parasitic diseases. At least one-fifth of the patients suffered from protein insufficiency. The causative agents can be transmitted through different routes, two or more at a time, iatrogenically among them. VH in convicts display special clinical features which allow to consider them as an independent syndrome.

[The characteristics of the epidemic process in hepatitis B, C and D in hemodialysis units and the experience of the vaccinal prevention of HB viral infection in a delimited population]. / Osobennosti épidemicheskogo protsessa gepatitov B, C i D v otdeleniiakh gemodializa i opyt vaktsinoprofilaktiki HB-virusnoi infektsii v ogranichennoi populiatsii.

Patients and medical staff of hemodialysis centers were screened for HBV, HCV and HDV markers. The incidence of mixed infection in patients reached 34.8%, while in medical personnel it was only 3.4%. There was an increasing rate of HBV markers in persons who have been immunized with ENGERIX-B vaccine according to standard schedules one month, one year and three years after the vaccination. Administration of Cuban vaccine using modified schedules is perspective for wide immunoprophylaxis in medical staff. Immunization policy for hemodialysis patients needs further perfection.

[The characteristics of the prevention of HB viral infection in hemodialysis units]. / Osobennosti profilaktiki HB-virusnoi infektsii v otdeleniiakh gemodializa.

Patients and medical personnel of some hemodialysis centres of the north-west region of the Russian Federation were examined for HB-virus infection markers using enzyme immunoassays. Subjects free of HB markers were immunized with ENGEPIX-B vaccine. Immunogenicity of the vaccine was assessed one month and one year after the immunization. Epidemiological HB factors in hemodialysis centers were studied on the simulation computer model. HB-virus-containing blood transfusion factor is not the only determinant of HB-virus infection prevalence. The virus can be transmitted via hemodialysis facilities. Immunization effects proved inferior in the hemodialysis unit patients. It is stated that vaccinoprophylactic policy in the patients of the dialysis centers and relevant equipment need serious improvement to prevent hepatitis B outbreaks.

[Risk of infection with hepatitis B and C viruses of medical workers, patients in the hemodialysis ward, and vaccine prophylaxis of hepatitis B infection in these populations]. / Risk infitsirovaniia virusami gepatita B i C meditsinskikh rabotnikov, bol'nykh otdelenii gemodializa i vaktsionoprofilaktika u nikh gepatit B-virusnoi infektsii.

Markers of hepatitis B (HBsAg, anti-HBs) and C (anti-HCV) were detected in 1990-1992 by enzyme immunoassay in 1581 medical workers, 230 last-year students of medical schools, 269 patients hospitalized at hemoperfusion wards, and 701 blood donors. Hepatitis B markers were detected in medical workers two times more frequently than in donors (HBsAg in 4.7 and 2.2% of these, respectively, anti-HBs in 26.2 and 14.0%), and anti-HCV were found almost three times more frequently (in 3.1 and 1.1%, respectively). The incidence of these markers in students of medical schools was the same as in donors. Hepatitis B markers (HBsAg, anti-HBs) were detected in 39.0% of patients of hemoperfusion departments, HBsAg being present in 11.9%, and antiHCV in 25%. A direct relationship was revealed between the incidence of hepatitis B and C markers and duration of treatment at dialysis centers or length of service at therapeutic institutions. Three vaccinations with Engerix B 944 vaccine were administered to 944 medical workers and 162 medical students and four vaccinations in double doses to 40 patients of hemoperfusion centers who had no hepatitis B markers; a month after immunization anti-HBs in protective titers were detected in 91.4, 93.9, and 76.1% of them, respectively, and a year after vaccination these values were 77.2, 82.5, and 53.3%. No cases of hepatitis B, detection of HBsAg, or postvaccination complications in the vaccines were recorded.

[The importance of the blood transfusion factor in the epidemic process in hepatitis C in the patients of chronic hemodialysis units studied using a computer simulation model]. / Issledovanie znachimosti faktora gemotransfuzii v épidemicheskom protsesse pri gepatitie C u patsientov otdelenii khronicheskogo gemodializa s pomoshch'iu imitatsionnoi komp'iuternoi modeli.

Examinations for the presence of antibody to hepatitis C virus (HCV) were carried out in 144 patients of chronic hemodialysis wards and 83 blood donors. The anti-HCV were found in 26.4% of the patients and only in 1.2% of the blood donors. A definite increase in the incidence of HCV infection in the patients of hemodialysis wards was established in relation to the duration of the treatment, namely from 17.4% in the patients treated for up to 1 year to 37.5% in those treated for 6 years or more. Significant differences were observed in the rate of anti-HCV findings in the patients with kidney transplantation and in those who had not experience this operation. The results obtained by an imitation computer model indicated that the hemotransfusion factor is not the only one determining the high rate of HCV infection in patients of chronic hemodialysis wards, however its influence on the intensity of the epidemic process in hepatitis C in these wards was sufficiently high.

[The incidence of detecting antibodies to the hepatitis C virus in children in specialized children's institutions]. / Chastota vyiavleniia antitel k virusu gepatita C u detei spetsializirovannykh detskikh uchrezhdenii.

Marked differences in the distribution of markers of hepatitis C and B among children in closed children's institutions was established. The frequency of detection of anti-C100-3 in children varied from O in St. Petersburg to 29.4% in Nalchik. A high rate of infection in children is primarily associated with a low level of medico-sanitary service. The results indicate the advisability of specific prophylaxis of viral hepatitis C in specialized children's institutions.

[The migratory activity of HIV-infected people in the northwestern region and the routes of the possible spread of the infection]. / Migratsionnaia aktivnost' VICh-infitsirovannykh lits v severo-zapadnom regione i puti vozmozhnogo rasprostraneniia infektsii.

The epidemic situation in HIV infection in the northwestern region of this country has been analyzed. The ways of the spread of HIV infection among the infected persons, residents of the St. Petersburg region, Kaliningrad, Novgorod and Murmansk, have been studied. The infection is transmitted mainly through sexual contacts, both homosexual and heterosexual. High migration activity of HIV-infected persons, homo- and heterosexuals, has been established, and a great number of unknown (casual) sexual contacts among them was noted. The results of these observations may be useful in the prognostication of the epidemic situation in HIV infection not only in the northwestern region, but also beyond its boundaries, and later in the optimization of screening.

[The incidence of detecting antibodies to the hepatitis C virus in different population groups in the USSR]. / Chastota vyiavleniia antitel k virusu gepatita C u razlichnykh grupp naseleniia SSSR.

Markedly unequal distribution of hepatitis C virus (HCV) among blood donors in different regions of the USSR was established. The necessity of introduction into the blood service of regular donor blood screening for anti-C100-3 is substantiated. The portion of chronic hepatitis associated with HCV in the structure of chronic virus hepatitis was established. The results of the study indicate the expedience of specific virus hepatitis C prophylaxis in contingents of high risk of HCV infection.