Vol 15, No 4 (2016)

This questionnaire study involving 3105 patients has demonstrated the importance of physiotherapy as a highly efficient method of rehabilitation medicine. The positive therapeutic outcome has been reported by 92.1% of the participants with 90.4% of them being totally satisfied with the quality of treatment and care provided to them. It is concluded that the temporal dosimetric parameters of the treatment courses applied in physiotherapy are clinically well-substantiated and satisfy the majority of the patients. The results of the sociological questionnaire studies with the special emphasis placed on the quality of the provided medical assistance are considered to be the most important component of its comprehensive assessment.

The objective of the present study was the development and application of various physiotherapeutic procedures and therapeutic strategies on an individual basis with a view to improving the outcome of the treatment of chronic constipation associated with colonic malformations. The experience in the management of 389 patients with this condition is summarized and reported. Taking into consideration the clinical form of constipation, we used the procedures of electrical stimulation differing in the mode of placement of the electrodes, characteristics of the stimulating current, and total duration. The commercial Endoton 01-B apparatus was employed for the purpose. The therapeutic impact was focused on the restoration of the propulsive properties of the colon. It was shown that the primary role in the combined treatment of chronic constipation belongs to electrical stimulation of the colon and rectal sphincters used in different modifications. The most popular of them is rectal stimulations performed in the form of a few courses. The criterion for the adequacy of the procedure was the achievement of the maximum isolated contraction under effect of the minimal current strength. The application of the above procedures yielded good and satisfactory results. The choice of the physiotherapeutic procedure depended on the clinical form of constipation. We consider the rectal and anal electrical stimulation to be the method of choice for the treatment of chronic constipation associated with colonic malformations. The most pronounced permanent effect of the combined conservative treatment was documented in the patients at the age between 18 and 35 years.

Psoriasis is a systemic chronic inflammatory disease that affects in the first place the skin and occurs in 1-5% of the general population. The treatment of the patients presenting with this condition implies the application of the topical agent and biological preparations as well as phototherapy and systemic therapy. The patients suffering severe forms of psoriasis in whom systemic immunosuppressive therapy does not yield the desired effect are in need of the treatment with biological preparations. The use of the inhibitors of tumour necrosis factor-alpha produces the insufficient effect even in the case of the positive response, i.e. the psoriasis area and severity index (PASI) of approximately 50 scores (PASI 50). This article presents the results of the application of photodynamic therapy (PDT) for the treatment of 8 patients treated with the inhibitors of tumour necrosis factor-alpha in whom the PASI value of 50 was achieved within the first week after the onset of the treatment. In all these patients, a course of photodynamic therapy consisting of 2-3 procedures made it possible to increase the PASI values to 75 and even 100 scores. It is concluded that the patients showing positive but insufficient effect of biological therapy (PASI 50) need to be prescribed a course of photodynamic treatment in order to enhance the effectiveness of the biological therapeutic factors.

The objective of the present study was to compare the results of the treatment and changes in the measurements of the laboratory characteristics in the patients suffering from severe poisoning with the scolding liquids under effect of the combined treatment including the application of extremely high frequency electromagnetic radiation (EHF therapy). The study included ten patients given a course of EHF therapy and 10 ones treated without it. The patients of the two groups developed the oppositely directed alterations in the rheological properties of blood and hemostasis including the elevation of the hemorheological viscoelastic constituent, erythrocyte and platelet aggregation, the increase in blood viscosity at a high shear velocity and, conversely, its decrease at the low and moderate shear velocities and hematocrit. Moderate leukocytosis was observed during this period along with the 3-4 rise in the concentration of lymphocytes involved in the apoptotic process and the substantial increase (1,4 - 8,1 times) in the values of parameters of endotoxicosis (the leukocytic index of intoxication and the erythrocyte sedimentation rate). The use of EHF therapy for the management of this category of the patients at the stage of their medical rehabilitation produced a modulating hemorheological effect manifested as the reduction of the elevated hemorheological characteristics, with the especially pronounced increase in the parameters below the respective normal values. In the group comprising the control patients, the undesirable changes occurred more frequently than in the previous one; specifically, deviations of the parameters of interest from their normal values were more pronounced. EHF therapy resulted in the reduction of the concentration of dead leukocytes in blood and a two-fold decrease in the amount of lymphocytes at the later stages of apoptosis whereas the concentration of the lymphocytes just entering apoptosis was elevated; this situation reflected the process of sanogenesis. In contrast, this parameter decreased in the patients of the group of comparison. The reduction in the level of endogenous intoxication under effect of EHF therapy manifested itself as a more significant decrease of leukocytic index of intoxication and erythrocyte sedimentation rate in the patients of the main group in comparison with those of the group of comparison. It is concluded that the inclusion of EHF therapy in the combined treatment of severe poisoning with the scolding liquids reduces the time of epithelization of gastrointestinal mucosa by 4.7 days on the average. Accordingly, the duration of the hospital stay can be decreased by 3.8 days.

The objective of the present study was to evaluate the effectiveness of the application of the herbal tea having an original composition for the combined treatment of the patients presenting with chronic acalculous cholecystitis. A total of 84 patients with this condition at the age varying from 18 to 60 years were available for the examination. The patients of the control group (n = 42) were treated with the use of the basal pharmacotherapeutic modalities while those in the main group (n - 42) received. in addition. the herbal tea of original composition following the specially elaborated regimen for its consumption. It was shown that the inclusion of this herbal tea in the sstandard pharmacotherapy resulted in the significant reduction of the activity of the key enzymes of the hepatobiliary system. such as alanine aminotransferase. aspartate aminotransferase. alkaline phosphatase. and gamma-glutamyl transferase. Simultaneously. the motor function of the gallbladder was considerably improved while the severity of the clinical symptoms of the disease decreased. These beneficial changes were less apparent in the control patients treated with standard pharmacotherapy alone.

The treatment of irritable bowel syndrome is currently regulated based on the clinical guidelines for the management of the patients presenting with gastroenterological pathologies. Generally speaking, the pharmacotherapy is aimed at the main clinical symptoms of this condition (in the first place, constipation and diarrhea). Also important is the development of the therapeutic modalities designed for the correction of vegetative dysfunctions developing in the association with long-staying psychoemotional tension. At present, there are several factors exerting the corrective action on the vegetative system including magnetic therapy, electrically-induced sleep, and EHF-therapy. The present review of the literature does not exhaust all possibilities for the correction of the functional disorders associated with irritable bowel syndrome but emphasizes the necessity of the further investigation of this problem and the search for the new approaches to its solution.