Vol 15, No 5 (2016)

Irradiation-induced reactions of rectum, bladder and bowel are the main early and late radiation injuries in the course of radiotherapy in patients with cervical cancer and greatly determine the quality of life in treated patients. According to various authors, the rate of early and late complications of radiotherapy from organs adjacent to uterus varies from 10% to 50%. Recently, low-level laser therapy has been used to prevent and reveal acute and late radiation-induced reactions in intestine and bladder. In PA. Herzen MCRI the technique of laser therapy for prevention of radiation induced reactions in cancer patients was developed. Laser therapy in the course of radiation was performed in 48 patients with cervical cancer. Twenty seven patients of 48 had no complications. In the course of radiotherapy grade I radiation proctitis occurred in patients received dose of 38 Gy, grade II radiation proctitis was in patients with dose of 39.3 Gy. Grade I radiation cystitis occurred in patients received dose of 39.4 Gy, grade II radiation cystitis was in patients with dose of 41.3 Gy. Grade I radiation enterocolitis occurred in patients received dose of 33.7 Gy, grade II radiation enterocolitis was in patients with dose of 43.6 Gy, grade III was diagnosed in one patient who received dose of 48 Gy. Thus, low-level laser therapy in patients with cervical cancer decreases rate and severity of radiation-induced reactions, allows to perform radiotherapy in scheduled time and to improve quality of life in this group of patients.

Postmastectomy syndrome inevitably arises naturally and progressively developed for all, without exception, patients with breast cancer after a radical treatment. One of the most common post-operative complications of the upper extremity after a radical mastectomy lymphedema of the upper limb. Signs of development are оbserved in 35-40% of treated women. Accordingly, only Moscow has 13,000 to 15,000 women with different upper limb limfostazom extent of 93-95% of I-II, and 5-7% - III-IV. All women who have graduated from a radical treatment for breast cancer are in need of complex rehabilitation. Design, study and implementation of integrated programs of medical rehabilitation will reduce the dynamics of development and the number of possible complications, and will improve the quality of life of patients in the postoperative period.

The article presents the results of medical rehabilitation of patients with oncological pathology in the specialized rehabilitation department of sanatorium facility. There has been evaluated the efficiency of the two-week course of medical rehabilitation of patients with oncological diseases of various localization in the specialized rehabilitation department of sanatorium facility. There has been determined the positive dynamics of the main criteria of maximally individualized programs of rehabilitation of oncological patients being under supervision subject to localization of process.

There are no concepts of carcinogenesis in clinical oncology, which go beyond the cellular-molecular -genetic level of the organism, there is no distinguishable categories of cancer patients with psychogenic medical history and there is no concept of "anti-relapse rehabilitation of cancer patients." But this does not mean that it is not present in real life. Our studies have shown that among all cancer patients there are patients with psychogenic medical history and a high level of psycho-emotional disorders, which have a significant effect on the occurrence, development and outcome of cancer disease. We have presented a systemic view of the pathogenesis of malignant tumors in patients with a psychogenic medical history, which goes far beyond the cellular-molecular-genetic level of the body. As a result of the systematic, multi-level changes in the body it generates a steady pathophysiological state - the state of "cancer reparative trap". This state is based on reparative orientation of the immune system with the suppression of anti-tumor immunity, which are formed and maintained as a result of disturbances of higher nervous activity and the imbalance of autonomic nervous system toward sympathico-/hypersympathicotonia. New ideas of the pathogenesis of malignant tumors in patients with a psychogenic medical history allowed to develop pathogenetically reasonable measures of anti-relapse rehabilitation, which consist of two strictly consecutive stages: a stage of psycho-correction and a stage of immunocorrection. The original interdisciplinary approach to rehabilitation of cancer patients with psychogenic medical history has shown to be effective and requires a broader application in clinical practice.

With the development the systemic therapy and screening programs for the early diagnosis of cancer, the survival rate of cancer patients is increasing nowadays, which proves the special urgency of the problem of improving the quality of life. The amount of rehabilitation of patients with malignant tumors, according to the international recommendations, should include psychotherapy, massage, physical therapy, in combination with physiotherapy. Despite the world achievements in rehabilitation, as well as in patients with malignant tumors, and despite the availability of developed world standards of medical assistance and international clinical recommendations, a large number of patients with tumors are often denied in rehabilitative treatment in Russia.

The article is devoted to modern concepts of the relationship of parodontal disease and temporomandibular joint. The results of a comprehensive examination, diagnosis and treatment in 73 patients suffering from chronic generalized parodontitis of moderate severity due to bruxism, the results of their research and conclusions. The characteristic clinical features of these patients. The developed program of medical rehabilitation. There was a positive dynamics: the index of hygiene fell by 37%, the index of bleeding by 59% and gingival index by 55%. The effectiveness of the treatment in the control group was 23%, in the intervention group 37%. Under the influence of amplipulsetherapy bear increased: the masticatory muscles by 20%, the temporal muscle by 18%, the activity nadpodyzechchnymi muscle decreased by 18%.

The main marker of quality of rehabilitation treatment of patients after total hip replacement (THR) is to restore physiological walking stereotype. Among patients drew the attention of an increasing number of elderly and obese. Judgments about excessive weight influence the body and the elderly in the effective rehabilitation after prosthesis in the global medical community contradictory. Objective: to study the effectiveness of rehabilitation techniques enable hardware walk in patients in the early postoperative period after THRinto comprehensive treatment program with a differentiated approach with regard to the age and weight of patient characteristics. The study included 300 people, including 60 healthy volunteers for the study of "standard" parameters walk according to the age and body weight (three subgroups). 240 patients in the early period after THRwere as follows: control group, receiving basic rehabilitation, without the inclusion of hardware methods of rehabilitation walk (n = 60, including three groups of 20 patients with the average parameters, obese and elderly) and basic (n = 180). All patients of the main group, received basic rehabilitation, and one of three hardware techniques for reconstruction walk (walking in the discharge of body weight system (URMT), biofeedback - associated training walk, robotic training) were also divided into sub-groups based on body weight and age, so that each of the three subgroups for each of the three methods studied included 20 patients. As a result, podometric assessment of gait in patients subgroups studied comparative analysis revealed that the mature age of patients without obesity has achieved high efficiency of the reconstruction of the stereotype of walking on all types of devices, so each of them can serve as a method of choice. In elderly patients were observed significantly higher scores in the application biofeedback - associated training walk: 3 times in comparison with the methods of training in URMT and 4 times in comparison with the course of robotic walk. Evaluation of the use of techniques in obese patients revealed advantage robotic training Lokomat (6 times higher than in URMT and 5 times higher than biofeedback - associated training walk).

The states of emotional stress arising in the course of various types of professional activity, have an adverse effect on the functional state of the specialists and the effectiveness of their work. The aim of the study is to establish the relationship of structural and dynamic characteristics of sensory and motor, functional asymmetry with indicators of the level of emotional stress of firefighters and rescuers. Established significant relationships dynamic and stable performance of functional asymmetries and indicators evaluating the level of expression of states of emotional stress. Features functional asymmetries observed in the form of increasing the value and the sign inversion asymmetry, as well as changes in the ratio of motor and sensory asymmetries. The relationship dynamic and stable performance of functional asymmetries and indicators evaluating the level of the functional state, the intensity of the manifestations of mental and emotional stress. The high level of functional state is provided by a combination of optimally expressed stable and dynamic indices of functional asymmetries. Changes in functional asymmetries in the predominance of dynamic indicators provide relatively stable inerrancy of psychomotor reactions and effectiveness of coordination of movements. Reducing the dynamic performance of functional asymmetries of relatively stable rates leads to a deterioration of the functional state and psychomotor reactions. Dynamic changes of functional asymmetries, motor and sensory, reflect the level of the functional state of the organism in the emerging internal and external conditions.