[High-tone therapy in complex rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery. (Open-label, prospective, randomized controlled trial)]. / Vysokotonovaya terapiya v kompleksnoi reabilitatsii bol'nykh s poststernotomicheskim sindromom posle aortokoronarnogo shuntirovaniya. (Otkrytoe prospektivnoe randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: At present it remains relevant to develop new rehabilitation technologies for patients with circulatory system diseases who have undergone a cardiac surgery to restore the functions of the cardiorespiratory system more quickly, improve physical and mental health, and prevent the development of the atherosclerotic process. AIM: To study the effectiveness and safety of the new rehabilitation technology for the inpatient stage of medical rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery (CABS) using high-tone therapy. MATERIAL AND METHODS: The study included 85 men (the average age was 56.8±2.46 years old) with post-sternotomy syndrome after CABS. They were divided into two groups by simple randomization: the first/main (42 patients) and the second/control (43 patients). The control group of the patients had a standard rehabilitation complex; the main group was additionally prescribed a high-tone therapy according to a local method. The immediate results of the treatment were assessed by the dynamics of the clinical picture, the six-minute walk test, respiratory function, echocardiography, the level of cytokines, C-reactive protein and natriuretic peptide (NT-proBNP); distant - by QOL endpoints (questionnaire MOS SF-36). RESULTS: The groups of the patients were comparable in all baseline parameters. After the course of the procedures in the main group of patients there were positive reliable (p<0.05-0.001) shifts in clinical (pain, shortness of breath, general weakness), functional (forced expiratory vital capacity, forced expiratory volume1, effusion separation) and laboratory parameters (leukocytes, interleukin-2 and 10, NT-proBNP). The intergroup analysis of long-term results registered significant (p<0.05) differences in the QOL of patients in the main group by subscales: the role of somatic problems, vitality and mental health. Compliance to the III stage of medical rehabilitation (outpatient/home) was noted with 95.2% of the patients in the first group and 93.0% in the second. CONCLUSION: The additional appointment of a high-tone therapy to the rehabilitation standard for the patients with post-sternotomy syndrome after CABS significantly improves the immediate and long-term results of the treatment (QOL) contributing to a more pronounced reverse development of inflammatory and edematous syndromes, an increase in physical activity and psychosomatic health. The absence of adverse reactions with all the patients indicates the safety of rehabilitation complexes.

[Physical factors in the medical rehabilitation of patients with chronic cerebral ischemia in the outpatient stage]. / Fizicheskie faktory v meditsinskoi reabilitatsii patsientov s khronicheskoi ishemiei golovnogo mozga na ambulatornom etape.

Chronic cerebral ischemia is an urgent problem of modern medicine due to high disability of this contingent of patients and requires new approaches to the treatment and medical rehabilitation. OBJECTIVE: To develop a new technology for medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis using therapeutic physical factors (such as ozone therapy and magnetic field in combination with endomassage) against the background of rational pharmacotherapy and psychocorrection. MATERIAL AND METHODS: There have been observed 122 patients with chronic cerebral ischemia stage I. They were divided into three groups by simple randomization. The patients of the group of comparison 1 (GC1) (n=39) had neurotropic pharmacotherapy (Cerepro and Mexidol) and a group psychotherapy; the rehabilitation programme of the patients of the group of comparison 2 (GC2) (n=41) included ozone therapy (intravenous infusions of ozone-oxygen mixture) in addition to the treatment program of GC1; the patients of the main group (MG) (n=42) received a combination of magnetic field exposure and endomassage in addition to the treatment program of GC2. Clinical monitoring, coagulation hemostasis, and cerebral vascular ultrasound were used to assess the treatment efficiency. RESULTS: The rehabilitation treatment performed on an outpatient basis with the inclusion of ozone therapy and the combined effect of magnetic field and endomassage in MG ensured the leveling of clinical symptoms in 91.2% of cases (p<0.01). The efficiency of rehabilitation in GC1 was 74.4%, with the additional use of ozone therapy in GC2 - 82.6%. CONCLUSION: The use of the new technology with the use of intravenous infusions of ozone-oxygen mixture and magnetic field in combination with endomassage against the background of rational pharmacotherapy and psychocorrection in medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis provides a reliably significant increase in the effectiveness of rehabilitation measures.

[The spa and health resort-based treatment of metabolic syndrome with the application of the therapeutic courses of different duration: the evaluation according long-term results]. / Sanatorno-kurortnoe lechenie metabolicheskogo sindroma pri razlichnoi prodolzhitel'nosti lechebnogo tsikla po rezul'tatam otdalennykh nabliudenii.

AIM: The objective of the present study was to estimate the effectiveness of the new therapeutic modalities for the spa and health resort-based treatment of metabolic syndrome based on the results of the long-term follow-up observations. MATERIAL AND METHODS: A total of 100 patients presenting with metabolic syndrome were recruited for the participation in the study. All of them underwent a shortened course of mineral water intake in the combination with the use of the herbal medicinal products. RESULTS: The results of the study give evidence of the more favorable changes in the clinical and instrumental characteristics of the patients with metabolic syndrome treated with the use of the proposed approach in comparison the patients treated by the conventional methods. Moreover, the beneficial effects of the proposed approach persisted during a longer period. The basal treatment given to our patients was supplemented by dietary therapy, therapeutic physical exercise, narzan baths, intake of mineral water having a temperature of 35-37 °Ð¡ in conjunction with sulphate mineral water (narzan) cooled to 13-15 °Ð¡, and a phytococktail. CONCLUSION: The results of the long-term observations confirmed the enhanced effectiveness of the spa and health resort-based treatment of metabolic syndrome including the therapeutic courses with the intake of cooled narzan mineral water in the combination with phytococktails. This therapeutic modality increased the duration of the favorable changes of various parameters that characterize metabolic syndrome. Specifically, they persisted during 5-6 months after the application of the standard methods, were still apparent within 6-7 months after the two-week course of the treatment with cold narzan and phytococktails, and during 8-9 months when the duration of the treatment course was extended up to 3 weeks.