Vol 15, No 3 (2016)

The clinical, neurological, and functional studies in the children suffering from type 1 diabetes mellitus have demonstrated that practically every fourth patient presented with the complaints and symptoms of this pathology associated with the development of diabetic polyneuropathy, the reduced bioelectrical activity, and the changes of peripheral blood circulation strongly depending on the duration and the quality of compensation of the disease. Under the influence of the treatment under the conditions of a spa and health resort facility with the inclusion of hydrodynamic tablet therapy, the positive dynamics of the parameters of interest was documented in the form of the improvement of the state of carbohydrate metabolism, clinical and neurological characteristics, and the effectiveness of the functional methods for the examination of the children presenting with type 1 diabetes.

Under the term of osteoarthritis (OA) is currently meant the clinical condition with the predominant syndrome that manifests itself as the combination of joint pain and compromised functional activity leading to the deterioration of the quality of life for the affected patients. The principal objective of rehabilitation of the patients presenting with OA which practically all of them strongly need after each next aggravation of the pathological process consists in the reduction of the pain syndrome, elimination of synovitis, restoration of the functional ability of the joints lost during the exacerbation, and, eventually, the improvement of the quality of life in the patients experiencing the constantly progressing degenerative process in the musculoskeletal apparatus. The effectiveness of the rehabilitative treatment was evaluated based on the following criteria: the degree of pain alleviation, the increase in the levels of joint functional activity, and the improvement of the general condition of the patients. These criteria were chosen according to the recommendations of the OMERACT (Outcome measures in Rheumatology) international working group. Also, the quality of life related to the health status and side effects of the rehabilitative measures were estimated. One of the most important aspects of the treatment of the patients with osteoarthritis bearing in mind frequent cases of co-morbidity is the scientifically-sound substantiation of the application of the non-medicinal technologies of physical therapy, remedial gymnastics, and massage for the management of the secondary aseptic inflammatory process and the subsequent rehabilitation for the restoration of the compromised locomotory stereotype and, as the result, the improvement of the quality of life in these patients. One of the effective methods for physical therapy used in the treatment and rehabilitation of patients with OA is hyperbaric gas cryotherapy (HBGCT). This method is based on the rapid withdrawal of heat from the organism that responds by the compensatory and/or reflective activation of the heat production processes in the tissues as a consequence of stimulation of metabolic processes, vascular, neuroendocrine and immune systems of regulation of homeostasis producing the desirable therapeutic effect in the form of elimination of secondary aseptic inflammation and progression of the OA-associated degenerative process. In this context, the objective of the present research consisted of the scientific substantiation of hyperbaric gas cryotherapy as a component of the combined treatment of the patients presenting with gonosteoathritis and coxosteoathrosis. The article was designed to report the results of the combined treatment of 110 patients (22 men and 88 women) at the age from 40 to 75 years suffering gonosteoathritis and coxosteoathrosis of the II-III stages (based on the classification of Kellgren). They were randomly divided into two groups (each comprised of 55 patients). The patients of the main group, unlike those in the control one (group of comparison) were given, in addition to the traditional treatments such as instrumental physical therapy, balneotherapy, remedial gymnastics, and massage, hyperbaric gas cryotherapy with the assessment of the results based on the Lequesne, WOMAC, Likert international indexes. Such an approach allowed to identify the predictors for the use of hyperbaric gas cryotherapy and to raise by 33%, in comparison with controls, the effectiveness of the combined treatment of the patients with osteoarthrosis of the large joints. The dispersion analysis has demonstrated the high clinical efficiency of the proposed therapeutic modality in 90% of the cases of gonosteoathritis and in 64% of the patients presenting with coxosteoathritis. These data were not statistically different from those characterizing the effectiveness of HBGCT in the patients with coxosteoathritis included in the group of comparison.

Medical rehabilitation is now a priority of the Russian Healthcare [Skvortsova V.I., 2012]. Rehabilitation centers are usually located in big cities and are not available for most patients. Therefore, one of the modern trends in the development of rehabilitation is a distantly controlled rehabilitation. We have developed a program of distant rehabilitation in Russia, based on our own achievements and experience of foreign colleagues. The article provides an overview of methods according to world literature studies. The survey shows that the problem of distant rehabilitation is relevant in our time, and requires additional clinical research and technological development.

Currently, therapeutic interventions for erectile dysfunction in chronic prostatitis encounter a number of obstacles due to the lack of system-structural approach to sex pathological syndromes so new possibilities of correction of sexual disorders should be explored adequately influencing all the hierarchical levels to ensure the copulatory cycle. The aim of the study is a pathogenetic substantiation of the system magnetic therapy in treatment of patients with chronic prostatitis with erectile dysfunction. Materials and methods. Monitoring of 40 patients with chronic prostatitis with erectile dysfunction aged 22 to 45 years was carried out. All patients taking physical therapy, prostate massage, psychotherapy correction of sexual maladjustment had a course of system magnetic therapy on Magnitoturbotron «EOL» in the «Standard» mode, the rotational speed of the magnetic field of 100 Hz in 1 Hz steps, the direction of rotation of the magnetic field was direct, clockwise, the maximum value of the magnetic field - 1.5-2.0 mT for 15 minutes a day in an amount of 15 procedures. Results. Application of the system of magnetic therapy for chronic prostatitis with erectile dysfunction has a direct effect on the prostate, helping to reduce edema, leukocyte infiltration and glands venules thrombosis and has antiplatelet activity, improving peripheral blood circulation and lymph flow, on the other hand, it increases the duration of erections, improves psychophysical and emotional state. The result is a normalization of the frequency of regular coitus, with the final phase of ejaculation, an improvement of mental and physical and emotional health, which is fundamental in terms of pathogenetic therapy of CP with erectile dysfunction. In addition surveys’ matrix correlation analysis carried out on a scale IIEF showed a clear relationship of the life quality improvement and the disappearance or significant decrease in the severity of pain, increased duration of erection and improvement of the functional status of the prostate.

The problem of providing a continuous staged rehabilitation treatment of patients with severe associated injuries musculoskeletal system is an urgent and important task. This article describes two clinical cases of successful comprehensive medical rehabilitation of disabled persons with severe combined trauma and multiple injuries skeleton in need of long-term continuous rehabilitation program which was successfully launched at the stage of hospital care and continued remotely, through on - line technologies in a familiar patient home medium. As a result of rehabilitation treatment was observed: increased mobility of patients and level of independence in daily life, increased range of motion in the affected joints, increase muscle strength of the affected limbs, improving psycho - emotional status of patients resocialization and adaptation to the familiar home environment.