Vol 22, No 6 (2023)

The term "glaucoma" unites a large group of eye diseases with a characteristic pathogenesis and clinical picture, but different aetiology. Modern classifications group the different forms of glaucoma according to origin, age of the patient, mechanism of intraocular pressure increase and its level, degree of optic disc damage and course of the disease. The disease is a significant medical and social problem, as it affects large population groups worldwide and is the leading cause of irreversible blindness. Every year the number of glaucoma patients of working age increases, and the presence of concomitant diseases in patients complements and complicates the clinical picture and course of the main pathological process. To date, high therapeutic effectiveness of electromagnetic fields in glaucoma treatment has been determined and proved, specific methods of procedures have been developed, and the list of indications for their prescription is expanding.

The purpose of the review is to present the possibilities of using transcranial magnetic therapy in the treatment of glaucoma.

The authors, based on available scientific data and their own clinical observations, summarizes information regarding the use of transcranial magnetic therapy for glaucoma. Indications and contraindications for transcranial magnetic therapy are outlined. The principles of prescribing various methods of transcranial magnetic therapy are covered in detail. The characteristics of the equipment used for transcranial magnetic therapy procedures are given.

In general, physical therapeutic factors play an important role in the overall complex of therapeutic and preventive measures in the treatment of eye diseases. As methods of external influence they have a direct impact on etiological and pathogenetic mechanisms, as well as on the symptoms of the disease.

BACKGROUND: Non-drug therapy has proven to be the most effective and convenient method in the treatment of patients with post-Covid erectile dysfunction. One of these treatments is low-level laser therapy. The advantage of this method is the high therapeutic effect of a low-intensity laser on the function of the pudendal nerve and on the endothelium of the vessels of the cavernous body.

AIM: To study the effectiveness of low-level laser therapy in the treatment of patients with post-Covid erectile dysfunction.

MATERIALS AND METHODS: Under our supervision from 2021 to 2023. At the medical center Medical Dental Institute there were 40 patients diagnosed with post-Covid erectile dysfunction. The control group (n=20) of patients underwent a 2-month course of standard drug therapy, and the main group, in addition to drug therapy, underwent a course of low-intensity laser therapy. Erectile function was assessed using the International Index of Erectile Function (IIEF) and quality of life was assessed using the Life Satisfaction Index (LSIA).

RESULTS: After treatment erectile function improved in the control group by 11.7% (p <0.05) and in the main group by 33.1% (p >0.05). The quality of life satisfaction in the control group increased by 28.7% (p <0.05) in the control group and by 87% (p <0.05) in the main group.

CONCLUSION: The use of a contact red laser with a wavelength of 635 nm was 1.8 times more effective than standard drug therapy in restoring erectile function. In addition, the improvement in life satisfaction during low-intensity laser therapy exceeded these indicators in the control group by 2 times.

BACKGROUND: Analysis of predictors of the effectiveness of various treatment regimens for diseases, as well as the correction of involutionary processes in the human body, is increasingly becoming a standard in scientific medical research. The technology for identifying them traditionally includes the use of correlation and regression analysis, as well as the principles of correlation adaptometry, which makes it possible to approach the solution of this problem from the position of system analysis.

AIM: Analysis of predictors of the effectiveness of correction of involutive skin changes in middle-aged and older women with metabolic syndrome using various therapeutic regimens, including hyaluronic acid laser phoresis and the use of transcranial magnetic therapy in combination with oxygen barotherapy.

MATERIALS AND METHODS: The study was carried out with the participation of 60 patients from middle and older age with involutional changes in the skin against the background of metabolic syndrome. All patients were divided into 2 groups using simple fixed randomization. The first group (comparison, 30 patients) received laser phoresis of hyaluronic acid in the form of a 1.5% sodium hyaluronate gel using a laser and laser-vacuum therapy device LAZMIK. Patients of the second group (main group, 30 patients) were prescribed combined physiotherapy. For transcranial magnetic therapy, the Amo-Atos device with the Headband attachment was used, and oxygen barotherapy was carried out in single pressure chambers of the Oka-MT or Irtysh-Shch1 type under a pressure of 2 atm for 1 hour.

RESULTS: It was found that in the initial state, the quality of life of patients with involutional changes in the skin against the background of metabolic skin syndrome was largely determined by the presence of pathological correlation galaxies that integrate changes in the condition of the skin, metabolic disorders, indicators of oxidative stress and microhemodynamics, and the activity of proinflammatory cytokines. At the same time, the leading role in the deterioration of the quality of life belonged to the age of the patients, the insulin resistance index, transepidermal water loss and microcirculation indicator. However, predictors of effectiveness varied across different treatment regimens. With laser phoresis of hyaluronic acid, its effectiveness increases in younger women with minimal involutional manifestations of skin aging, tested for the condition of the skin, while combined physiotherapy is also most effective in women with a low average age limit, with minimal manifestations of metabolic syndrome and inflammatory processes, as well as against the background of high activity values of one of the enzymes of antioxidant protection ― superoxide dismutase.

CONCLUSION: The results obtained convincingly prove the effectiveness of combination therapy in correcting involutive skin changes in middle-aged and older women due to metabolic syndrome, which is comparable in a number of parameters to the effectiveness of hyaluronic acid laser phoresis. At the same time, predictors of effectiveness depend on the characteristics of the mechanisms of therapeutic action of the treatment regimens used, which allows for a more correct approach to the choice of personalized treatment methods.

BACKGROUND: The course of benign prostatic hyperplasia is associated with immunological disorders at the systemic and local level. Despite the wide arsenal of pharmacological agents for the treatment of benign prostatic hyperplasia, some patients undergo surgical treatment. Postoperative management programmes should be aimed at reducing the risks of complications, including infectious-inflammatory complications. In this regard, the inclusion of immunomodulatory pharmacotherapy and therapeutic physical factors in the course of reconstructive treatment is reasonable and justified.

AIM: To study the role of the complex effect of pharmacotherapy and extracorporeal magnetic stimulation in the correction of immune disorders with the patients after surgical treatment of benign prostatic hyperplasia.

MATERIALS AND METHODS: There have been observed 88 patients after surgical treatment of benign prostatic hyperplasia, who underwent a medical rehabilitation at stages II and III. At stage II 43 patients in the comparison group underwent standardized drug therapy, individual exercise therapy; in the main group 45 patients additionally were prescribed immunomodulatory therapy with Tameritis. At stage III the patients of the comparison group continued pharmacotherapy, exercise therapy, and transrectal magnetic therapy; in the main group 45 patients were additionally prescribed extracorporeal magnetic stimulation. A method of enzyme-linked immunosorbent assay was used to study the content of interleukins (IL); IPSS-QOL (International Prostate Symptom Score – Quality-of-Life) and SF-36 (The Short Form-36) were used to assess the quality of life. Confidence level (р) <0.05.

RESULTS: After the second inpatient stage of rehabilitation the patients of the main group after surgical treatment of benign prostatic hyperplasia had a decrease the level of pro-inflammatory IL by 47.5% on average (p <0.01) with an increase in the level of anti-inflammatory IL-10 by 36.2% (p <0.01). After the III outpatient rehabilitation stage, a positive dynamics significantly increased and amounted to 63.2% (p <0.01) and 51.9% (p <0.01), reaching the normative values in the population. It should be noted that the achieved results have been preserved in a long time. In the comparison group the positive dynamics was significantly lower (p <0.05; p <0.01) in all the cases after the II and III stages of rehabilitation. The patients of the main group were observed a decrease in the severity of urinary disorders (p <0.01), restoration of quality of life (p <0.05) according to IPSS-QOL and SF-36 questionnaires at significant inter-group values (p <0.05) with the same confidence.

CONCLUSION: The integrated use of pharmacotherapy and extracorporeal magnetic stimulation with the patients after surgical treatment of benign prostatic hyperplasia provides significant correction of immune disorders, restoration of physical and mental health.