The use of physical rehabilitation methods, in particular respiratory rehabilitation for pneumonia, allows to increase the tolerance to physical activity, improve oxygen consumption and endurance of patients compared to the initial level, reduce the frequency and duration of their hospitalization, as well as significantly improve the effectiveness of drug therapy. In the first stage of assisting patients with pneumonia of various genesis, therapeutic exercises are recommended that improve drainage function of the bronchi and promotes the discharge of bronchial mucous. Prescription of physiotherapeutic methods of treatment, which have a bactericidal, anti-inflammatory, anti-edema and resorption effects, significantly increase the effectiveness of complex therapeutic measures. A comprehensive approach to the treatment of pneumonia can produce better results by using all therapeutic physical exercise and physiotherapy options that have proven effective over many decades.

Цель исследования-оценить распространенность основных факторов сердечно-сосудистого риска среди трудящихся мужчин на примере предприятия N. г. Казани. Материал и методы. Проведена оценка состояния сердечно-сосудистой системы 678 мужчин 22-66 лет. План обследования пациентов включал электрокардиографию, эхокардиографию, ультразвуковую допплерографию брахиоцефальных артерий, общий и биохимический анализы крови (определение гликемии, липидного профиля), консультацию кардиолога. Пациентам был рассчитан риск фатального сердечно-сосудистого осложнения в ближайшие 10 лет (по шкале SCORE, Systematic Coronary Risk Evaluation), а также их сосудистый возраст. Результаты и их обсуждение. Возрастной состав исследуемой группы мужчин-работников предприятия составил 22-66 лет. Распространенность гипертонической болезни и бессимптомного атеросклероза среди трудящихся на предприятии мужчин достаточно высока: 39,5 и 33,9% соответственно. У 334 (49,26%) человек по результатам обследования данных кардиоваскулярной патологии не выявлено. Более чем у половины (52,7%) здоровых мужчин трудоспособного возраста выявлен повышенный риск развития фатального кардиоваскулярного заболевания, у 68,6%-раннее старение сердечно-сосудистой системы. Даже у молодых мужчин (34-36 лет) обследованной группы рассчитанный сосудистый возраст значительно (до 15 лет) опережал хронологический. 12 пациентов направлены на дообследование в связи с впервые выявленным сахарным диабетом, впервые выявленной ИБС, значимыми изменениями гемограммы. Для 44% мужчин-работников предприятия N. медицинский осмотр завершился диагностикой того или иного прогностически значимого заболевания, включая острый инфаркт миокарда. Выводы. Полученные данные, а также широкая распространенность модифицируемых факторов риска сердечно-сосудистых заболеваний и их осложнений определяют необходимость проведения скрининга среди сотрудников предприятий и организаций с целью коррекции образа жизни и подбора оптимального медикаментозного лечения. Следует отдельно обратить внимание на тот факт, что у молодых здоровых исследуемых мужчин (34-36 лет) также отмечается раннее сосудистое старение. В качестве дополнительного инструмента коммуникации «врач-пациент» и повышения комплаентности пациентов, особенно молодых, возможно использование расчетного показателя «сосудистый возраст пациента». Ключевые слова: факторы риска сердечно-сосудистых заболеваний, профилактика. Для ссылки: Распространенность основных факторов сердечно-сосудистого риска в ограниченной категории трудящихся мужчин / З.Ф. Ким, М.Н. Садыков, А.М. Делян [и др.] // Вестник современной клинической медицины.-2018.-Т. 11, вып. 5.-С.48-51.

BACKGROUND: General injury rates tend to increase in most federal districts of Russia. The patients with fractures of the bones of the lower extremities reaches for 8.525% of the total number of patients with fractures. Fractures of the bones of the lower extremities are characterized by long period of reparation, persistent contractures, a violation of the congruence of the articular surfaces, and changes in the biomechanics of walking. Only full course of rehabilitation can eliminate the these complications and restore the previous motor activity. АIMS: The study aimed to analyze the structure of injuries in patients of the traumatology department and to present and the results of the recovery of patients with fractures of the bones of the lower extremities using and algorithm of organization of medical rehabilitation in the case study. MATERIALS AND METHODS: A retrospective analysis of statistical data on 995 patients of the traumatology department № 1 of the Kazan City Clinical Hospital, who underwent 981 operations, was carried out. Randomly selected two groups of patients ― I main (n=45) and II control (n=45). Patients of group II after the treatment at the trauma center underwent outpatient medical rehabilitation, group I received inpatient medical rehabilitation in the rehabilitation department of the Kazan City Clinical Hospital № 7. In a hospital setting, a comprehensive rehabilitation program included physiotherapy exercises, CPM-veloergometry, exercises on rehabilitation simulators, the PNF kinesiotherapy technique, etc. RESULTS: A more pronounced statistically significant positive dynamics at the end of the course of medical rehabilitation was noted in patients of group I (reduction of pain syndrome, increased joint mobility, degree of dependence on others, increased mobility index, the ability to dress independently, maintain body position in space, reduced dysfunction in lifting and carrying objects, walking disorders, and caring for body parts). The dynamics of motor function and psycho-emotional sphere also improved to a greater extent in patients of group I. CONCLUSIONS: The effectiveness of the presented algorithm of organization of medical rehabilitation of patients with fractures of the bones of the lower extremities is confirmed by the results of present study. It is revealed that patients in the I (main) group showed more significant improvement in functions, activity and participation, a decrease of disability, reduce of pain, anxiety and depression, as well as an increase of the level of quality of life compared to patients of group II (control), who did not receive comprehensive medical rehabilitation in the hospital (p 0.1).

The purpose of the study: to study the effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports.Materials and methods: examined 48 male patients aged 25.9 ± 2.1 years with traumatic disease of the lumbar spinal cord. All examined were divided into 2 groups: patients of the main group (19 people) against the background of standard therapy received a course of active medical rehabilitation (AMR), including mechanotherapy and electrical stimulation with biofeedback under the control of electromyography (EMG) of the muscles of the lower extremities and back. Patients in the comparison group (29 people) received standard therapy. After the AMR course, a comprehensive examination was performed, including the data of the questionnaires: the ASIA classification (American Spinal Injury Association), the FIM (Functional Independence Measure) scale of functional independence, the modified functional assessment scale of activity and quality of life VFM (Valutazione Funzionale Mielolesi), State-Trait Anxiety Inventory, the Beck depression scale; electroneurophysiological studies on the Neurosoft Neuro-EMG-Micro device, heart rate variability (HRV) on the Neurosoft Poly-Spectrum computer electrocardiograph, indicators of free movement with concentric and eccentric muscle contractions on EN-TreeM.Results: polysympathetic reflex excitability (PRV) significantly decreased in patients of the main group. There was also an improvement in vegetative reactivity (coefficient 30/15 is 1.45; p <0.001) during the orthostatic test, indicating normalization of parasympathetic regulation and heart rate. The assessment on the ASIA scale revealed an improvement in sensory function by 13.4 % and motor function by 17.4 %. On the VFM scale, an increase in indicators was observed by 14.7 % and on the FIM scale by 11.5 %. When assessing the psycho-emotional sphere on the Spielberger-Khanin scale, a significant decrease in the level of reactive anxiety was noted by 10.9 %, and the level of depression by 30.5 %. A significant increase in muscle strength by 18.1 % (p < 0.001) was also observed during concentric contractions, the average power increased by 83.1 % (p < 0.001), the average amplitude increased by 68.7 % (p < 0.001), the average speed by 27.2 % (p=0.002). When analyzing the indicators after the treatment, significant differences were obtained between the main and the comparison group (p < 0.001).Conclusion: the use of biofeedback technologies under the control of electromyography leads to an increase in the effectiveness of medical rehabilitation and improves the quality of life in Paralympians with traumatic spinal cord disease.

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