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GRAVITATIONAL THERAPY IN THE TREATMENT OF PATIENTS WITH DIABETIC FOOT SYNDROME
I.V. MAKAROV, R.A. GALKIN Samara State Medical University,Samara, RUSSIA Gravitational therapy - a new non-invasive and effective method of stimulating of peripheral blood flow in lower extremities presently has more practical application in the treatment of diabetic patients with vascular lesions of lower extremities. The aim of the study. The improvement of the results of treatment of patients with diabetic foot syndrome by applying the complex of therapeutic measures of gravitational therapy. Materials and methods. The study included 93 patients with diabetes mellitus type ΙΙ complicated by diabetic foot. Patients were divided into 3 groups according to classification proposed at the I International Symposium on Diabetic Foot (Netherlands, 1991). First group consisted of patients who received only gravitational therapy - 29 (31.2%) patients. In the second subgroup patients along with gravitational therapy received conventional conservative and physiotherapy - 64 (68.8%) people. Results: The maximal effect of gravitational therapy was observed in patients with ischemic diabetic foot syndrome. According to ultrasound dopplerography, volume velocity of blood flow has increased to 35,0%, IRP- to 30.6%, LPI - to 0.1. The increase in the average temperature of feet in computer thermography has made 2,1 °C, thermal profile area has increased to 11,5%, It has lowered to normal levels. Good results were noted in 56% of patients in this subgroup. Clinically, it was confirmed by increase in walking distance in 2-4 times, durability of clinical effect persisted for 8-12 months. Conclusion. One of the basic mechanisms of gravitational therapy is the improvement of regional hemodynamics in lower extremities. It manifests in the increase of main and collateral blood flow. The highest efficiency was observed in patients with ischemic (67.9%) and mixed (46.2%) forms of diabetic foot, the lowest efficiency - in neuropathic form (20.5%).
SPECIALIZED CARE TO CHILDREN WITH CONGENITAL CLEFT LIP AND PALATE IN MODERN CONDITIONS OF DEVELOPMENT OF PUBLIC HEALTH IN RUSSIA
A.A.MAMEDOV, M.A.ABIYEV, O.V.NELYUBINA, O.A.MANEROVA, A.V.CHABAN First Moscow State Medical University named after I.M. Sechenov,Moscow; Far Eastern State Medical University, Dental Clinic, “UNI-STOM”, Khabarovsk RUSSIA
The aim of the study was to substantiate the need to create specialized service of medical examinationand complex rehabilitation of children with congenital cleft lip and palate (CCLP) based data about occurrence and prevalence of children with congenital cleft lip and palate in the regions of Russia. Materials and methods. The frequency of occurrence of CCLP and its growth in the period from 2004 to 2011 was determined. The evaluation of the risk factors of CCLP was given. The prevalence of comorbidity in children with CCLPin Russia was studied. The results of the study. The prevalence of this pathology in children of the Orenburg region, Tula region, Lipetsk region, Khabarovsk Krai remained stable within the period from 2004 to 2011 and constituted average of 1:750 of newborns. Until 2004,in the regions of Russia studied by us there were centers of specialized service engaged in the prevention, clinical examination and complex rehabilitation of patients with CCLP. But in the period from 2000, the work of the centers had sporadic nature. Patients were rendered specialized care by separate surgeons, separate orthodontists, speech therapists and other specialists. Care was provided at appealability. A single complexsuccessive treatment disappeared. Thisaffectedtheresultsoftreatment. In connection with this, we created Centers in Tula, Northern Sakhalinsk, Lipetsk regions and Khabarovsk Krai (Khabarovsk). At present, substantiation of the necessity to create a SINGLE specialized Center of child care with congenital disorders of the maxillofacial area. Draft Order on the Ministry of Health of the Khabarovsk Krai includes the creation of the Centre of rehabilitation care for children with congenital disorders of the maxillofacial area, aimed at the prevention, clinical examination, complex medical and social rehabilitation, epidemiological monitoring, organizational and methodical work.
CHANGES IN THE UPPER SECTION OF GASTROINTESTINAL TRACT AT THE PATIENTS SUFFERING FROM PANCREATIC DIABETES
O.V. MAXIMOVA, V.G. SUBBOTINA, V.G. SUSHKOVA, I.V. KOSTENKO
Saratov Medical University named after V.I.Razumovskiy, Saratov, RUSSIA
Development of generalized later diabetic syndrome contributing to injury of different organs and systems, as well as of gastrointestinal tract (GIT) is one of the frequent reasons of disability and lethality of the patients in pancreatic diabetes. The aim of work was examination of clinic features and frequency of different morphologic injuries of the upper sections of GIT at the patients suffering from pancreatic diabetes in comparison with general theoretical patients, as well as depending on the type of GIT, the character of complications, duration of the disease, sex and age of the patient. Materials and methods. FGDS and determination of H – Pylori was held at 60 patients suffering from PD at the age from 30 to 60 (male – 40%, female – 60%) and 60 general theoretical patients of the same age and sex ratio. The exclusive criteria were the patients with early diagnosed pathology of stomach and duodenum. Results and discussions: Different injuries of GIT was discovered at 89% patients (34 people) suffering from PD of the second type. A reliable increase in frequency of different morphologic injuries of the upper sections of GIT at the patients suffering from PD has been diagnosed in comparison with general theoretical patients. It was discovered that the symptoms of gastric colic were absent at more than a half of the patients suffering from PD (63%), but clinical presentations of gastropathy were moderately present and had unsteady character. A considerably direct correlative dependence has been fixed between different manifestations of gastritis, gastroduodenitis, esophagitis, duodenal ulcer, H-Pylory infection and availability of distal diabetic polyneuropathy ( r› 0,9; p ‹ 0,05), angiopathy of lower limbs (r = 0,2; p ‹ 0,05), moderate correlation dependence between abovementioned forms of pathologies of GIT and duration of PD (r = 0,4; p ‹ 0,05). Summary: According to the data available at us, the frequency of pathology of the upper sections of GIT is higher at the patients suffering from PD than at the general theoretical patients, at the first place it depends on duration of PD and is mainly appeared in development of gastritis, gastrouodenit, gastroduodenitis, esophagitis, H-Pylory infection. Clinical presentation of the diseases of the upper sections of GIT has an oligosymptomatic character at the patients suffering from PD and their formulation may be considered as the manifestation of development of microangiopathy and visceral neuropathy.
Date: 2014-12-28; view: 727 |