Vol 16, No 5 (2010)

Medical rehabilitation is an active therapeutic process the goal of which is to achieve complete recovery of disease- or injury-induced dysfunctions. Medical rehabilitation allows the working ability of patients to be regained, but also favors their rapid social adaptation to altered living conditions. Rehabilitative measures contribute to the changed pattern of medical behavior, normalized psychoemotional status, and molded healthy lifestyle elements.

The investigation was undertaken to study an association of the polymorphic markers Gly389Arg and Ser49Gly of the ADRB1 gene, Gly16Arg and Glu27Gln of the ADRB2 gene, Trp64Arg of the ADRB3 gene and C825 of the GNB3 gene with the level of blood pressure (BP) and the structural and functional features of the left ventricular (LV) myocardium in patients with hypertensive disease (HD). One hundred and seventy-seven hypertensive patients, including 83 (46.9%) males and 94 (53.1%) females) were examined. Their mean age was 60.6±0.76 years. A study group comprised 19 (10.9%) patients with grade 1 arterial hypertension (AH); 57 (32.8%) with grade II AH, and 101 (56.3%) with grade III Ah. LV structural features were examined by echocardiography. No association was found between the genotypes and BP levels for the polymorphic markers Ser49Gly of the ADRB1 gene, Gly16Arg and Glu27Gln of the ADRB2 gene, Trp64Arg of the ADRB3 gene, and C825 of the GNB3 gene. As for the polymorphic marker Gly389Arg of the ADRB1 gene, genotype Arg/Arg carriers had elevated systolic and diastolic pressures. There were 40 patients without signs of LV hypertrophy (LVH) and 137 patients with increased LV myocardial mass index in the study group. The patients with LVH were older (p = 0.001) and had a longer history of HD (p = 0.018), higher systolic BP (p = 0.008) and a higher body mass index (p = 0.001). Among the patients with LVH, there were more females (57.7 and 37.5%; p = 0.025) and more patients with type 2 diabetes (17.5 and 5.0%; p = 0.040). The frequency of genotype Arg/Arg of the polymorphic marker Gly398Arg of the ADRB1 gene was ascertained to be significantly higher in the patients with LVH [p = 0.008; OR 2.32 (1.34-4.11)]. Multivariate analysis showed that age, systolic BP levels, overweight, and carriage of genotype Arg/Arg of the polymorphic marker Gly389Arg of the ADRB1 gene were independently associated with increased LV myocardial mass.

The trace elements Zn++ and Cu++ versus C-reactive protein (CRP) and transferrin (TF) were studied in 45 surgical patients (26 males and 19 females) aged 46.6±17.3 years with soft tissue purulent wounds (STPW) in the postoperative period. The baseline CRP levels were found to be 3.8-43 times higher in all the patients. The CRP concentration was greater than 100 mg/l in 75.6% of the patients. There was substantially decreased TF level during the full-scaled picture of STPW, which is indicative of the development of moderate and protein-energy deficiency. Tests for plasma Zn++ revealed that hypozincemia was present in 91.1% of the patients; its values were less than 8.2 μmol/l in 66.6%. A negative correlation was established between CRB levels and Zn++ concentrations (r = -0.4). Cu++ concentrations were less than 11.1 μmol/l in 20% of the patients and greater than 22.0 μmol/l in 17.8%. Of great importance was Cu++/Zn++ ratio (normal values 0.9-1.13). The latter was ascertained to be normal only in 6.7%. There was a direct correlation between the CRP values and the Cu++/Zn++ ratio (r = 0.3) and a negative correlation between the TF levels and Cu++/Zn++ ratio.

The psychogenesis of psoriasis was studied by the Spielberg and Lüscher clinical and psychodiagnostic tests. Cause-and-effect relationships were found in the occurrence and course of psoriasis, which were used to identify 3 clinical types of its development: 1) somatogenic depression-complicated psoriasis; 2) psychogenic depression-associated psoriasis; 3) psoriasis as concomitant pathology of endogenous depression. It has been established that the course of the dermatosis is more frequently complicated by somatogenic depression in female patients and psychogenic psoriasis is commonly a determinant in its development in male patients. The findings formed the basis for correcting affective disorders in patients with psoriasis, which permitted clinical remission to be achieved in a shorter periods of time.