Vol 21, No 6 (2022)

BACKGROUND: Contouring of the nasolacrimal sulcus area is becoming an increasingly popular procedure due to the rapid onset of a pronounced aesthetic result, however, in recent years there has been an increase in the pool of complications both in the early and late post-injection recovery period. At the same time, there are no differentiated approaches to the choice of physiotherapy techniques and their combinations depending on the genetic profile of the patient and the clinical and functional picture of the complication.

AIM: to develop and evaluate the use of personalized physiotherapy in patients with complications after the introduction of fillers based on stabilized hyaluronic acid, taking into account their genetic predisposition.

MATERIAL AND METHODS: The analyzed data of the study of 47 patients, average age 35.7±10.2, with a diagnosis of "L57.4 Senile atrophy (lethargy) of the skin", who received late complications (local edema, filler contouring, sensitivity change at the filler injection site) after the introduction of a filler based on stabilized hyaluronic acid in the nasolabial furrow area. All patients underwent genetic testing on the Cosmetology panel before the start of treatment. There were 3 groups that received longidase diadinamophoresis, injection carboxytherapy of the nasolacrimal sulcus area or a combination of the above techniques.

RESULTS: When using a combined course of longidase diadinamophoresis and injection carboxytherapy, there was a significant decrease in clinical manifestations in the form of conturation, local edema and neuropathy, the psychoemotional state of patients stabilized. In addition, the therapeutic complex significantly accelerated the biodegradation of the filler and has a restructuring effect on the skin of the nasolacrimal furrow, reducing the thickness of the dermis. increasing the density coefficient of the dermis and accelerating the biodegradation of the superficially injected compared to other study groups.

CONCLUSION: The personalized combined use of the method, including a course of longidase diadinamophoresis and injectable carboxytherapy for the correction of complications of contouring of the nasolacrimal sulcus area with fillers based on stabilized hyaluronic acid in the form of local edema, neuropathy and filler contouring, is a highly effective treatment method, which is confirmed by the relief of clinical symptoms, acceleration of biodegradation of the drug and improvement of the quality of life of patients.

BACKGROUND: An imbalance between matrix metalloproteinases (MMPs) expression and tissue inhibitors of MMP is considered as a possible mechanism for impaired collagen synthesis and degradation, which leads to the development of hypertrophic scars. The use of a vascular laser, in particular a pulsed dye laser, leads to coagulation of the vascular locus that feeds the hypertrophic skin scar, resulting in a decrease in extracellular matrix synthesis. The use of collagenase phonophoresis increases the effectiveness of laser therapy due to the destruction of the extracellular matrix.

AIM: To study the role of matrix metalloproteinases and their tissue inhibitors in the pathogenesis of immature hypertrophic skin scars and to evaluate the dynamics of enzymes during the combined use of a pulsed dye laser and Fermenkol phonophoresis.

MATERIAL AND METHODS: The study was performed with the participation of 125 patients aged 22 to 55 years with immature (up to 6 months) hypertrophic skin scars. All patients were divided into 4 groups according to the simple fixed randomization procedure. The first group (control, n=32) received course local compression therapy using silicone plates for 2 months. The second group (main group I, n=31) underwent two courses of Fermencol phonophoresis (5 daily procedures lasting 10 minutes each with a break of 3–4 weeks). The third group (main group II, n=31) underwent two pulsed dye laser procedures with an interval of 4 weeks. The fourth group (main III, n=31) received complex treatment, which included a combination of two pulsed dye laser procedures and two cycles of Fermenkol phonophoresis. The study of the clinical condition of patients was carried out according to the modified Vancouver scar scale (VSS). The content of MMP and tissue inhibitor of metalloproteinase-1 in blood serum was determined by enzyme immunoassay. Patients were examined twice: before the start and 2 weeks after the end of the course of treatment. To form a sample of reference values of MMPs and tissue inhibitors of metalloproteinases (TIMPs), a group of 20 somatically healthy individuals was used.

RESULTS: Initially reduced levels of MMP-1 and MMP-9 were found in the blood serum of patients with immature hypertrophic skin scars, with high values of TIMP-1, which allows us to consider reduced expression as an important link in the pathogenesis of the fibroproliferative process in the skin, which causes excessive deposition of extracellular matrix components. The use of pulsed dye laser in combination with Fermencol phonophoresis was accompanied by an increase in the content of MMP in the blood serum of patients with immature hypertrophic skin scars, which positively correlated with the severity of the clinical result of treatment, assessed by VSS.

CONCLUSION: A conclusion was made about the clinical and pathogenetic significance of MMPs and TIMPs in the development of fibroplastic processes, which allows us to consider these biochemical parameters as informative criteria for the effectiveness of the therapy.

BACKGROUND: A personalized approach to the use of therapeutic physical factors should take into account individual predictor biomarkers, which are predictive information regarding the effectiveness of the treatment, taking into account the initial state of the patient's reserve capabilities. The metabolic syndrome was defined as a model of a pathological condition characterized by reduced functional reserves. Previous studies have shown that transcranial magnetotherapy (TMT) and pulsed low-frequency exposure to an electrostatic field (INESP) have potential effectiveness in relation to the pathogenetic manifestations of the metabolic syndrome.

AIM: The purpose of the study is to determine the predictors of effectiveness in the implementation of personalized combined use of TMT and INESP in patients with metabolic syndrome.

MATERIALS AND METHODS: The study involved 100 patients with a diagnosis of metabolic syndrome established in accordance with clinical guidelines. All patients were divided into four groups of 25 by simple fixed randomization. The first group (control) received a placebo effect (imitation of physiotherapeutic effects with the device turned off) for 10 days of observation. Patients of the second group (comparison group 1) were exposed to a low frequency electrostatic field (INESP). The third group (comparison group 2) received transcranial magnetic therapy with a traveling magnetic field (TMT). Patients of the fourth group (main) were subjected to a combined effect of INESP and TMT. All patients before and after a course of physiotherapy underwent a comprehensive examination using functional, biochemical and hormonal methods. Statistical processing of the obtained results was carried out using the Statistica 12.6 software package using the algorithms of correlation and regression analyses.

RESULTS: The analysis performed using the multiple regression algorithm made it possible to identify a cluster of independent variables in the form of an autonomic balance index, microcirculation index, body mass index and catalase activity, determined in the initial value of patients. The high efficiency of the combined use of TMT and INESP is achieved with a probability of at least 95% in patients with metabolic syndrome, the initial state of which is characterized by a level of the autonomic balance index below 1.7 conventional units. units, tissue perfusion parameter more than 14 perf. units, BMI value below 29 c.u. units and catalase activity above 90 units. аct. The results of the verification of the constructed information model convincingly prove its adequacy and objectively confirm compliance with the stated forecast requirements.

CONCLUSION: It is concluded that the identified constellation of phenotypic patterns, which characterizes the state of the pathological process, reflects the main pathogenetic mechanisms that determine the severity of clinical and functional manifestations of metabolic syndrome. Evaluation of the initial values of the autonomic balance index, microcirculation index, body mass index and catalase activity in patients with metabolic syndrome makes it possible to predict the expected effectiveness of the course combined use of TMT and INESP.

Currently, non-drug restorative therapy is becoming more and more popular and in demand. Doctors try to minimize the pharmacological load on the body and replace drugs with physiological analogues that are not inferior to them in effectiveness.

Despite the extensive experience of using kinesiotapes after operations in other sections and areas of surgery, kinesiotaping in dentistry still remains poorly studied and, as a result, little used. There are no clear recommendations on the method of application and the duration of wearing kinesiotapes, as well as on the possibility of combining such applications with other methods of physiotherapy.

This article provides an overview of the possibility of using kinesiotaping by lymphatic drainage type after various surgical interventions in the oral cavity. This article includes publications from 2013 to 2020, which describe various methods and results of the use of kinesiotapes in dentistry and maxillofacial surgery.

Based on the data of the studied literature and experience of using kinesiotaping by lymphatic drainage type after various surgical interventions in the oral cavity, it can be stated that this technique facilitates the postoperative period, reduces the severity of the pain component and has a good decongestant effect.