[The evaluation of polyclinic rehabilitation after prosthetic arthroplasty].

The study considers quality of assessing functioning, limitation of vital activity and patient participation in outpatient stage of rehabilitation according traumatology and orthopedics profile. The sampling included 712 out-patient records of patients with complete endoprosthesis replacement of hip (299 or 42%) and knee (413 or 58%) joints. The study analyzed application of the Haris, Leken and Rankin scales, hospital anxiety and depression scale (HADS), quality of life questionnaire (EQ-5D), recommended as mandatory examination tools in case of rehabilitation after endoprosthesis replacement. The statistical data processing was performed using software IBM SPSS Statistics version 23. It is established that Harris and Leken scales, hospital anxiety and depression scale (HADS) were not applied to any patient. The functional structural deformation of joint and/or limb with detailed elaboration of degrees and centimeters is described in 10% of medical records, but it completely matches data from hospital case records. At completion of rehabilitation cycle, 55.9% of all primary complaints are repeated in final diaries. What is regarded 39.3% of primary complaints, there is no information about their elimination. In 25.9% of patients in their final diaries the complaints are present that were not indicated after primary and subsequent examinations. The evaluation according both modified Rankin scale (13.1% of patients) and the quality of life questionnaire (EQ-5D) (6.9% of patients) was implemented only in case of referral to medical social expertise examination. The out-patient rehabilitation cycle was uncompleted in 26% of patients.

[Impact of external counterpulsation on microcirculation in patients with coronary heart disease complicated by chronic heart failure after surgical and endovascular myocardial revascularization]. / Vliianie naruzhnoi kontrpul'satsii na sostoianie mikrotsirkuliatsii u patsientov s ishemicheskoi bolezn'iu serdtsa, oslozhnennoi razvitiem khronicheskoi serdechnoi nedostatochnosti, posle khirurgicheskoi i éndovaskuliarnoi revaskuliarizatsii miokarda.

AIM: To study the impact of external counterpulsation (ECP) on endothelial function and microcirculation in patients after myocardial revascularization (stenting and coronary artery bypass grafting) for functional class (FC) II-III chronic heart failure (CHF). SUBJECTS AND METHODS: Sixty patients aged 50 to 75 years after myocardial revascularization for FC II-III CHF were examined. All the patients received one-hour ECP sessions 5 times per week. The treatment cycle consisted of 35 sessions. To evaluate the microcirculatory bed, capillary blood flow was studied by laser Doppler flowmetry. RESULTS: The cycle of ECP in patients with FC II-III CHF after myocardial revascularization had a corrective effect on the microhemodynamic system. Microcirculatory changes were due to the normalized myogenic and neurogenic tone of arterioles and to increased oscillations in the endothelial range. The pronounced beneficial effect of ECP on the cardiovascular system in the examined patients was confirmed by a significant increase in exercise tolerance and by a statistically significant improvement in the results of 6-minute walk test. There was a decrease in FC heart failure. CONCLUSION: ECP is an effective, non-invasive treatment in patients with heart failure.