Vol 23, No 3 (2024)

The Manual presents the possibilities of using the MAVIT device in the combination treatment of patients with benign prostatic hyperplasia.

The content of the Manual is consistent with the higher education program for training the highest qualification resident physicians and the professional retraining program for physicians (OD.A.03.2.3 Alternating Currents, Electric, Electromagnetic and Magnetic Fields. High, Ultra-High and Extra-High Frequency) in the specialty 31.08.50 “Physiotherapy” and (B.1.B.1.4.5.1 “Physiotherapy in Urology,” B.1.B.1.6.3.5. “Prostatitis”) in the specialty 08/31/68 “Urology”.

The team of authors has, based on the available scientific data and their own clinical observations, summarized the information relative to the use of the MAVIT device in the combination treatment of patients with benign prostatic hyperplasia and outlined its indications and contraindications. The equipments used in performing the procedures are characterized.

This Manual was developed and prepared by the workers of the Chair of Urology with Course of Surgical Diseases of the I. P. Pavlov Ryazan State Medical University jointly with the workers of the chairs of urology, surgical andrology, physical therapy, sports medicine and medical rehabilitation, and the workers of the Research Institute of Molecular and Personalized Therapy of the Federal State Budgetary Educational Institution of Further Professional Education Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia in accordance with the system of standards for information, library and publishing.

ICD-10 code: Chapter XXI. Factors influencing health status and contact with health services.

BACKGROUND: Osteoarthrosis is the most frequently diagnosed disease of the musculoskeletal system. The grown number of patients awaiting surgical treatment and the possible negative consequences resulting from long-term pharmacological therapy lead to searching for non-pharmacological methods aimed at relieving pain and reducing doses of analgesics, including physiotherapy using magnetic fields.

AIM: To evaluate the analgesic effects of the pulsed magnetic therapy in patients with idiopathic hip osteoarthrosis.

MATERIALS AND METHODS: The randomized study enrolled 28 men aged 48 to 75 years (mean age: 62.8 years) with diagnosed idiopathic hip osteoarthrosis. The subjects were randomized into 2 groups (14 patients each): the first group included the patients who received pulsed magnetic therapy cycles, the second (comparison) group included the magnetic therapy-naïve ones. During the exposure cycle, both groups underwent multiple assessments of their mood, pain intensity, and dose of analgesics.

RESULTS: No statistically significant differences were found in the assessment of respondents’ mood. The magnetic therapy group showed, on Day 14 and Day 21 of the procedures cycle, and in Week 1 after the therapy cycle, significantly decreased intensity of the perceived pain (p <0.05). In the group of the patients that received courses of magnetic therapy, the use of painkillers was by 14% (р <0.05) reliably lower than at the baseline; this was not reported in the comparison group.

CONCLUSION: Using the pulsed magnetic therapy in the treatment of men with idiopathic hip osteoarthrosis results in a statistically significant improvement of the analgesic effect with a concomitantly decreased need for analgesic, without, however, any significant changes in the patient’s mood.

BACKGROUND: Personalized medical rehabilitation options are required for patients with chronic rhinosinusitis with nasal polyps owning to the relatively high prevalence of this disease, its long and often uncontrolled course, and the significant decrease in quality of life of patients. Comorbid asthma is common in patients with rhinosinusitis with nasal polyps and is associated with more severe clinical manifestations and increased unresponsiveness to therapy, reducing the effectiveness of rehabilitation efforts.

AIM: The aim of the study was to identify predictors of personalized comprehensive rehabilitation options to be used in patients with rhinosinusitis with nasal polyps and comorbid asthma in order to achieve greater clinical effectiveness of therapy and control of nasal polyps.

MATERIALS AND METHODS: The study was conducted in 35 patients with rhinosinusitis with nasal polyps and comorbid asthma. Comprehensive medical rehabilitation included endonasal use of Nasonex 2 doses twice daily; nasal rinsing twice daily; subcutaneous use of dupilumab at 300 µg every 2 weeks; use of low-dose inhaled corticosteroid (beclomethasone dipropionate at 200 µg twice daily); a course of alternating magnetic field therapy, low-intensity laser radiation, and interval hypoxic training. At baseline, nasal polyp severity, respiratory function, quality of life, and levels of cytokines, immunoglobulins, leukocytes, lymphocytes, and eosinophils were assessed. The effectiveness of rehabilitation measures was assessed 6 months after the start of treatment using the International Classification of Functioning, Disability, and Health criteria.

RESULTS: Using multiple regression analysis, an information model was developed to predict effectiveness of comprehensive medical rehabilitation in patients with rhinosinusitis with nasal polyps and comorbid asthma. The resulting attribute of the model was the final score of the seven selected domains of the International Classification of Functioning, Disability, and Health. A cluster of baseline clinical and laboratory variables was identified as predictors, including blood eosinophil level, blood tumor necrosis factor-alpha (TNF-alpha) level, total score for a 22-item Sino-Nasal Outcome Test (SNOT-22) functional domain, and forced expiratory volume in one second. Higher level of rehabilitation was achieved with the following baseline characteristics: blood eosinophil counts no more than 0.85 × 10⁹/L; blood TNF-α level no more than 18.0 pg/mL; total score for the SNOT-22 functional domain no more than 8; forced expiratory volume in one second no less than 2.6 L.

CONCLUSION: At baseline, the identified thresholds of the selected predictors predict the outcome that could be achieved for each patient who receives personalized comprehensive rehabilitation.