Russian Journal of Physiotherapy, Balneology and Rehabilitation

BACKGROUND: In the pathogenesis of true eczema, an important place is occupied by stress, under the influence of which stimulation of the hypothalamus and brain stem occurs, as well as activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Stress-induced secretion of neurotransmitters impairs the barrier function of the epidermis, slows wound healing, increases itching and inflammation, and suppresses immunity by changing the immune response of T-helper cells.

AIM: Assessment of the severity of the corrective effect of a course of application of supravenous laser irradiation of blood and broadband medium-wave phototherapy on the blood levels of adrenocorticotropin, cortisol and beta-endorphin in patients with true eczema with a moderate form of the course.

MATERIALS AND METHODS: The study was carried out with the participation of 120 patients with a moderate form of true eczema. Using simple fixed randomization, all patients were divided into 4 groups. The first group (control, n=30) received only basic drug therapy, including the use of detoxification, hyposensitizing, antihistamines and topical glucocorticosteroids. Patients of the second group (comparison group 1, n=30) additionally underwent a course of supravenous laser irradiation of blood. In the third group (comparison group 2, n=30), broadband medium-wave phototherapy was performed against the background of basic therapy. Patients of the fourth group (main group, n=30) in addition to basic therapy received a course of combined exposure to supravenous laser blood irradiation and phototherapy. The concentrations of adrenocorticotropin, cortisol and beta-endorphin were determined in the blood of patients twice (before the start of treatment and 1 month after the start of therapy) using ELISA. The clinical condition of patients in the groups was assessed by changes in the EASI index. Additionally, we studied the dynamics of the level of reactive and personal anxiety using the Spielberger–Khanin questionnaire.

RESULTS: Positive dynamics of adrenocorticotropin, cortisol and beta-endorphin were noted only in the comparison groups and the main group, which proves the high efficiency of correction of the neurohumoral status of patients through a course of complex use of supravenous laser blood irradiation and broadband mid-wave phototherapy. Quantitative changes in the assessed parameters during complex therapy with therapeutic physical factors indicate a supra-additive version of their interaction, realized through different modalities, points of application and mechanisms for realizing the biological potential of physiotherapeutic effects.

CONCLUSION: The results obtained convincingly prove the effectiveness of an additional course of use of supravenous laser irradiation of blood in combination with broadband medium-wave phototherapy when correcting the neuroendocrine status in patients with true eczema. The close correlation between neurohumoral indicators and clinical and psychological patterns of the disease proves the pathogenetic significance of the studied neuroendocrine indicators, which allows us to consider their dynamics as informative criteria for the effectiveness of the treatment.

BACKGROUND: Significant prevalence of inflammatory complications after dental implantation determines the necessity to search for a more effective solution of this problem with the formation of a comprehensive program of prevention and treatment of peri-implant diseases and its integration into the modern concept of dental rehabilitation.

AIM: Study of oxidative stress patterns, level of pro- and anti-inflammatory cytokines in patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination.

MATERIALS AND METHODS: The study was carried out with participation of 116 patients with peri-implantitis of I and II classes according to S.A. Jovanovic. By means of simple fixed randomization (based on random numbers generation by computer program) all patients were divided into 4 groups. The first group (control group, n=28) received standard dental therapy, including professional oral hygiene and local application of antiseptic agents. In the second group (comparison group 1, n=29) in addition to the standard therapy the course ozone therapy was carried out, for which the peri-implant zone was irrigated with ozonized physiological solution with ozone concentration 2.5–5.5 mcg/ml for 15 min. In the third group (comparison group 2, n=30) the standard treatment was supplemented with the course application of mesodiencephalic modulation. Patients of the fourth group (main group, n=29) along with the standard treatment received complex treatment including course application of ozone therapy and mesodiencephalic modulation. The results were evaluated after the end of therapy by the dynamics of oxidative stress markers and the content of pro- and anti-inflammatory cytokines. The assessment of clinical efficacy in randomized groups was based on the determination of oral hygiene indexes, papilla bleeding and papillo-marginal-alveolar index, as well as the implant stability coefficient.

RESULTS: The use of different therapy schemes caused changes in the patterns of peroxidation metabolism and cytokine status, the intensity of which had different character. In the least degree the corrective activity was revealed in the control group of patients. Supplementation of standard treatment with therapeutic physical factors was accompanied by more pronounced dynamics of the estimated parameters, the direction of which indicated normalization of the lipoperoxidation system and cytokine mechanism of inflammation. Maximum changes of the estimated parameters were revealed in the main group, where the standard therapy was supplemented with a course complex application of mesodiencephalic modulation and ozone therapy. This was manifested in the strengthening of antioxidant activity of enzymes and reduction of the level of lipoperoxidation products to the level of the healthy group, as well as regression of the level of proinflammatory factors against the background of an increase in the level of mediator with anti-inflammatory effect.

CONCLUSION: The obtained results convincingly prove the pronounced synergetic interaction observed at course complex application of mesodiencephalic modulation and ozone, characterized by the development of maximum corrective effect aimed at the restoration of pro- and antioxidant equilibrium and reduction of cytokine mechanism activity of inflammation in peri-implant zone. The analysis of the revealed correlations of the biochemical parameters with the index indicators of the dental status of the patients with peri-implantitis allows to consider some indicators of the pro- and antioxidant system and cytokine status as biomarkers determining the prognosis of the treatment efficiency.

BACKGROUND: Therapeutic measures for chronic pelvic pain are of a pronounced interdisciplinary nature and consist of a complex of various means of influence: pharmacotherapy, physiotherapy and psychotherapy, physical therapy, surgical treatment. The solution to problems is usually achieved by prescribing venotonic drugs of systemic action, which increase venous tone, normalize capillary permeability and resistance, improve the rheological properties of blood, and for the same purpose use antihomotoxic drugs of plant origin. In addition, physiotherapy methods have become widespread in the treatment of patients with pelvic pain syndrome. Currently, pulsed magnetic therapy technologies have been developed in detail, but we hypothesized that the combined use of extracorporeal magnetic stimulation of the pelvic organs and the use of local regeneration cream can ensure mutual enhancement of the effectiveness of therapeutic effects.

AIM: To study the clinical effectiveness and characteristics of vascular reactions in response to combined treatment of pelvic pain syndrome with herbal preparations and extracorporeal magnetic stimulation of the pelvic floor.

MATERIALS AND METНODS: A randomized placebo-controlled study was conducted in 91 patients with chronic pelvic pain (more than 6 months in history). The patients were divided into 3 groups and did not differ significantly in the main studied parameters (age, parity, menstrual function, severity and duration of pain). The 1st group (n=30) patients independently carried out daily monotherapy with a cream stick of plant origin ― rectally, the 2nd group group (n=31) included women who, from the 5th to the 15th day of the menstrual cycle, had a menstrual cycle for 10 days procedures for extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor; after completing the course of physiotherapy, a herbal preparation of rectal origin was prescribed daily; group 3 (n=30) included female patients who underwent physiotherapy procedures.

RESULTS: It was found that patients suffering from chronic pelvic pain need to undergo complex treatment, including physiotherapy techniques and rectal preparations of herbal origin. In groups receiving combination therapy for chronic pelvic pain, a long-term clinical effect was obtained; these data correlate with ultrasound parameters.

CONCLUSION: It has been established that women suffering from chronic pelvic pain should undergo a comprehensive treatment including physiotherapy techniques, in particular extracorporeal magnetic stimulation of the pelvic organs, and rectal preparations of herbal origin.

BACKGROUND: In recent decades, there has been a progressive increase in the number of patients with chronic kidney disease worldwide, which is associated with both an actual increase in the incidence of the disease, associated with cardiovascular pathology and type 2 diabetes mellitus, among other things, and an increase in the life expectancy of patients.

AIM: To assess hemodynamics of renal vessels during a course of magnetic laser therapy with the patients suffering from diabetic nephropathy caused by arterial hypertension against the background of the standard of care for this category of patients.

MATERIALS AND METHODS: There has been carried out a randomized controlled trial on 100 patients with diabetic nephropathy caused by arterial hypertension. Their average age was 61,7 [52,8; 69,7] years old, the duration of arterial hypertension ― 24,1 [14,5; 36,1], type 2 diabetes mellitus ― 16,6 [14,9; 19,1] and diabetic nephropathy ― 6,1 [4,2; 8,9] years. In addition to general clinical studies, the patients in the control group (49 people) before and after prescribing the standard medication, and in the main group (51 people) with additional use of magnetic laser therapy, had their renal blood flow examined by Doppler ultrasound.

RESULTS: The obtained data indicate the positive effect of magnetic laser therapy with the patients suffering from diabetic nephropathy caused by arterial hypertension on the hemodynamics of renal vessels with improved blood flow in arteries of both medium and small caliber, which, in turn, apparently should contribute to the normalization of the function of the capillary system of the renal parenchyma.

CONCLUSION: The results of the given study allow us to recommend the use of magnetic laser therapy in the complex rehabilitation treatment of the patients with diabetic nephropathy caused by arterial hypertension taking into account the criteria for their strict selection.

The relevance of the treatment of dry eye syndrome is associated with the widespread prevalence of this disease. Along with the development of information technology and an increase in time spent in front of screens, the number of people suffering from this disease is steadily growing.

The basis of treatment for dry eye syndrome is the use of “artificial tears” preparations, which are instilled into the conjunctival cavity to replenish moisture deficiency. But the effect of tear replacement therapy in case of dysfunction of the meibomian glands does not last long. In this regard, the use of physiotherapeutic methods for treating dry eye syndrome to prolong the effect of drug therapy for this pathology is of particular importance.

Each of the methods of physiotherapeutic treatment of dry eye syndrome has its own unique mechanisms of action and indications for use. Physiotherapeutic methods are an effective tool in the treatment of dry eye syndrome, providing the opportunity to improve the quality of life of patients suffering from this common ophthalmic disease.

Demyelinating inflammation of the pudendal nerve associated with COVID-19 has been clinically identified in many cases and has been proven in animal experiments. Many authors associate the development of erectile dysfunction after suffering COVID-19 with endothelial disorders in the urethra and other endocrine and psychological disorders.

In clinical practice, after the start of the COVID-19 pandemic, we have identified many cases of erectile dysfunction with confirmed neurophysiological and clinical disorders of the pudendal nerve. Despite active medical treatment, not all patients improve. In this regard, we decided to demonstrate this clinical case. The patient underwent a course of pelvic floor muscle training and transcutaneous electrical neurostimulation after the lack of effect of pharmacotherapy.

The diagnosis of erectile dysfunction against the background of damage to the pudendal nerve as a result of a history of COVID-19 was established on the basis of the patient’s complaints, anamnesis, clinical picture, biochemical, neuroimaging and neurophysiological methods of research. Before treatment, the pain syndrome was 7/10 points, the strength of the pelvic floor muscles was 2/5 points, the erectile function according to the erectile function index was 8/30 points and the quality of life as a result of erectile dysfunction was 46/60 points. The use of transcutaneous electrical nerve stimulation of the pudendal nerve in combination with training of the pelvic floor muscles proved to be very effective in the treatment of patients with severe pudendal neuralgia accompanied by severe erectile dysfunction, weakness of the pelvic floor muscles and impaired urination. Against the background of debilitation, the pain syndrome regressed by 78%, erectile dysfunction decreased by 2 times, the quality of life improved by 82.6% and the strength of the pelvic floor muscles increased by 75% and urination disorders completely regressed.