Vol 23, No 2 (2024)

International experience, as well as many Russian research works, prove the necessity to concentrate efforts of healthcare professionals and researchers on development of healthcare technologies for diagnosis, prevention and treatment (including health resort treatment and rehabilitation) of so-called environmental diseases caused by unhealthy environments and adverse environmental factors (physical, chemical, biological, social ones). This paper proposes the integration of research areas in environmental medicine into profiles of various research specialties (Occupational Medicine, Ecology, etc.). It is also proposed to transform the healthcare specialty of Doctor of Occupational Medicine into Doctor of Environmental Medicine.

Finding ways to improve the system of prevention and treatment of environmental diseases, discussing the issues of further integration of environmental medicine, public health, ecology, occupational medicine, restorative medicine and other biomedical, preventive and clinical disciplines may improve the diagnosis and treatment of human diseases caused by adverse effects of environmental factors, as well as contribute to the development of preventive strategies.

The methods of epidemiologic (including prenosologic) diagnostics based on the assessment of functional reserves of the body should play a key role in scientific research with the implementation of its results in the practice of health professionals of various profiles, including environmental occupational pathologists, in order to improve clinical diagnostics and develop personalized treatment and rehabilitation programs for patients exposed to adverse environmental factors.

Background: During radiation therapy for breast cancer, healthy tissues are damaged, leading to both systemic and local reactions, including radiation dermatitis with such symptoms as erythema, dryness, peeling, and pain. Disturbances of the microcirculation lead to hypoxia and fibrosis. The use of low-temperature argon plasma is a promising method for preventing acute radiation-induced skin damage, which is crucial for maintaining quality of life, preventing complications, and minimizing long-term effects.

Aim: To evaluate the effectiveness of low-temperature argon plasma used in the complex medical rehabilitation of patients undergoing external radiation therapy for breast cancer.

Materials and methods: A prospective, randomized interventional study was conducted involving 60 breast cancer patients undergoing radiation therapy. All patients received a course of medical rehabilitation, including general magnetic therapy, exercise therapy, balance response training on a biofeedback simulator, nutritional support, and sessions with a medical psychologist. In the main group (n = 30), rehabilitation included low-temperature argon plasma treatment. Outcomes were assessed using the RTOG scale for acute complications of radiation therapy and laser Doppler flowmetry.

Results: After completing radiation therapy and complex medical rehabilitation, statistically significant differences were observed between the main group and the comparison group (which did not receive low-temperature argon plasma treatment) in the severity of radiation reactions on the RTOG scale (p = 0.016) and in peripheral blood flow parameters.

Conclusion: Low-temperature argon plasma supports nutritional blood flow and active mechanisms for microcirculatory regulation, preserving skin blood supply and preventing severe acute radiation dermatitis.

BACKGROUND: Obstructive megaureter in children, most commonly classified as a congenital defect of the urinary tract, is a leading cause of chronic kidney disease. Obstructive megaureter is mainly diagnosed by prenatal ultrasound of the defect. Treatment options for children with obstructive uropathy include medical and surgical interventions, but in most cases surgical treatment does not restore renal function, renal blood flow, or urodynamics. However, there is no medical rehabilitation system for these patients.

AIM: The aim of the study is to provide a scientific basis for the combined use of dry carbon dioxide baths and calcium/iodine ion electrophoresis as part of the medical rehabilitation for children with obstructive megaureter.

MATERIALS AND METHODS: Clinical observations and special studies were dynamically performed in 80 children with obstructive megaureter aged 3 to 10 years. All children received medical rehabilitation during treatment with uroseptic agents. Among them, 40 patients in the experimental group received dry carbon dioxide baths and calcium/iodine ion electrophoresis, and 40 patients in the control group received rehabilitation without physical treatment.

RESULTS: The addition of dry carbon dioxide baths and calcium/iodine ion electrophoresis in the medical rehabilitation of children with obstructive uropathy improved symptoms of intoxication and impaired urination. Positive effects of physical factors on renal function and renal blood flow are reflected in the increased glomerular filtration rate and urine osmolarity, decreased blood levels of creatinine and urea, improved renal blood flow, and growth of renal parenchyma.

CONCLUSION: Dry carbon dioxide bath activates renal circulation and metabolic processes in the renal parenchyma. Calcium/iodine ion electrophoresis has an antisclerotic and tonic effect on the smooth muscles of the renal pelvis and ureters. The combined use of these treatment options is a pathogenetically based and promising method of rehabilitation of children with obstructive uropathy.