Vol 16, No 5 (2017)

The purpose of the study. To investigate the clinical effectiveness of a rehabilitation program with the inclusion of physical training (FT) average intensity in patients of working age with acute myocardial infarction (AMI) on the background of arterial hypertension (AH) in the framework of the Russian randomized trial. Materials and methods. The study included 206 patients with hypertension who have had an AMI (not earlier than 3 weeks from the event). Patients were randomized into 2 groups: basic ("O") - 102 human and control ("K") - 104. All patients received standard medical therapy. In the group "O" used in FT mode of medium intensity (50-60% of capacity with load test) 3 times a week for 1 year. The efficacy was assessed by clinical data and results of instrumental and laboratory analysis. Results. After a year of FT hypertensive patients surviving an AMI, there was a significant increase in physical performance (FRS): increase the duration of the load (38%, p<0.001) and total volume of performed physical work (to 89.7%, p<0.001) with a reduction in load value "double works" (DP; 8.2%, p<0.01). This was accompanied by a significant increase in ejection fraction (EF) left ventricle (LV) of 7.6% (p<0.001) and stroke volume of the heart by 5.1% (p<0.01). In the group of "K" was not noted positive developments, in contrast, there was a significant increase in size of LP (4.3%, p<0.05) in the absence of dynamics of indicators of the fed. Under the influence of CFT was lower BP levels: systolic 3.1% (p<0.05) and diastolic by 3.5% (p<0.001) against the increase in the group natrenirovavshit patients (3.1%, p<0.05 and 3.4%, p<0.05, respectively). After a year of FT, a decrease of episodes of myocardial ischemia, including silent, strokes and needs of consumption of nitroglycerin (NTG) in contrast to patients of group "K". Have trained patients revealed a significant decrease of the primary endpoint by 50% (p<0.05) and disability days (by 43.2%, p<0.05) vs patients of group "K". Conclusion. A comprehensive rehabilitation program with the inclusion of CFT annual average intensity in patients with AMI on the background of hypertension, provides a stable course of the disease, reduces the likelihood of developing cardiovascular complications (CVC) and improves the patient’s quality of life.

Goal. The study of the influence of dynamic and isometric leg physical exertion (FN) of different intensity (maximum -100%, and submaximal - 80, 70 and 60% of individual maximum tolerance) on the parameters of the spectrum of lipoproteins (LP), and apolipoproteins (APO) serum from healthy individuals and patients with coronary heart disease (CHD). Results. It is established that dynamic FN (DFN) high intensity (80% and higher) and isometric FN (IFN), maximum (100%) to moderate (60%) of the intensity of both healthy and patients with CHD received lipid-transport blood system changes atherogenic: increased levels of total cholesterol (TC), cholesterol low-density lipoproteins (LDL), triglycerides (TG), apabila In apolipoproteinb and the atherogenic index of serum - relationship APO/apoa. In contrast, DFN, moderate intensity (60%) leads to a favourable anti-atherogenic changes in cholesterol transport system: reducing the level of LP containing APO b, and increased concentrations of APO AI and in healthy and in patients KBS. Conclusion. In the complex treatment and preventive measures for correction of atherogenic lipid disorders and in the training and rehabilitation programs of patients with CHD is advisable to include DFN, moderate intensity.

The role of junctional adhesion molecule JAM-A in the pathogenesis of essential hypertension and hypertensive crises has been demonstrated. The study involved a total of 100 women of comparable age and body weight. There are 70 of them had stage II arterial hypertension. It was found that the level of JAM-A increased, the content of estrogen and progesterone decreased, and the initial and steady-state rate of fibrin clot formation as well as its size were significantly increased in hypertensive patients. All this shows an obvious intensification of the process of thrombosis. Regular kinesitherapy largely reduced these shifts. Junctional adhesion molecule JAM-A is an adequate marker for the rehabilitation of patients with essential hypertension.

The psychophysiological, functional, biochemical indices of the homeostasis of the patients with obesity and arterial hypertension under conditions of RDT had been studied using the clinical material (1533 patients). The RDT course, lasting 19-21 days, included either curative fasting, or a reduced diet (1000-1200 kcal/day) with unlimited access to water drinking, dosed physical activity, physiotherapeutic recreational procedures, teaching lectures. The weight loss of the individuals having obesity of II-III degree is mainly due to fat mass, and loss of muscle mass decreases as increasing degree of obesity. Along with the loss of body weight, a reliable and persistent decrease of blood pressure was noted due to a decrease of the heart intensity, a decrease in the parameters of peripheral vascular resistance, the most stated with people having arterial hypertension in combination with obesity. The improvement of the lipid spectrum indicators was noted, combined with a decrease in leptin and insulin resistance, an improvement in the protein-synthesizing function of the liver. As the weight was normalized, the concentration of leptin and insulin decreased and the physiological ratio of leptin-insulin was restored. The study of the parameters of acid-base equilibrium showed the presence of compensated metabolic acidosis, which does not require correction. The most marked changes in the intercellular sector were observed with patients who had a combination of arterial hypertension and obesity. Hypotensive and hypoglycemic drugs were canceled for most patients. These changes occurred against the background of life quality improving. The indicators of the heart and vessels pump function have been preserved after 3 years for people having healthy lifestyle.

В статье представлены результаты исследования вариабельности ритма сердца у больных, перенесших острый коронарный синдром, проходивших трехнедельную программу реабилитации в дневном стационаре. Проведен сравнительный анализ спектральных показателей в группах пациентов с нестабильной стенокардией, больных, перенесших инфаркт миокарда без коронарной интервенции и перенесших инфаркт миокарда с последующим чрезкожным коронарным вмешательством. Во всех группах были выявлены нарушения вегетативной регуляции сердечно-сосудистой системы, указывающие на снижение функциональных возможностей и адаптационных резервов. В процессе проведения программы кардиореабилитации отмечена положительная динамика показателей вариабельности ритма сердца у пациентов, перенесших инфаркт миокарда с последующим чрезкожным коронарным вмешательством, свидетельствующая об эффективности реабилитационных мероприятий.

Research objective: to estimate efficiency of a technique of remedial gymnastics with including power and cardio-loads at a metabolic syndrome at men of 40-50 years. The research was conducted on the basis of the rehabilitational center LLC Versatile Center of Modern Medicine Evromed (Omsk) during the period from February 1, 2016 to March 28, 2016. The research included the men of 40-50 years suffering from a metabolic syndrome. Assessment of a functional condition of cardiovascular system, the loudspeaker of arterial pressure calculation of heart rate, the Harvard step test was carried out. Indicators of a saturation were estimated with use of computer pulsioxymetry. For assessment of the indicators characterizing an obesity were analyzed: the body weight, a body weight index, a waist/ femur index, a zone of visceral fat, the brachium circle, a circle of fatty tissue in a shoulder measured by a bioimpedance method (the device InBody 720, South Korea). The control group was engaged by a technique of remedial gymnastics of V. A. Yepifanov at arterial hypertension [13]. The experimental group was engaged by an advanced technique of remedial gymnastics of V. A. Yepifanov at arterial hypertension with including power and cardio-loads. The analysis of data of a saturation during the occupations remedial gymnastics allowed to make changes to a technique, by including of pauses of rest and breathing exercises. As a result of use of an advanced technique of remedial gymnastics with including power and cardio-loads at men in experimental group anthropometric indicators, a functional condition of cardiovascular system, level of physical working capacity improved (р&^;0.05). In control group positive dynamics of the studied indicators which dynamics is less significant is received.

The article considers the problem of improving programs for the prevention of addictive behavior using methods of distributional semantics. Based on the obtained factors semantic proximity of a number of concepts of the category «prevention» the proposed methodological approach allows to identify uneven representation of components of programs of prevention of addictive behavior in educational institutions. To solve the problems of improving and evaluating the effectiveness of programs for the prevention of dependent behavior based on the use of methods of distributive semantics, at the first stage of the study a list of concepts reflecting the category of «prevention» was compiled on the basis of the theoretical and methodological analysis of medical, psychological and pedagogical literature on the problem of preventing dependent behavior. In the second stage of the study, using the method of distributive semantics, an analysis was made of the semantic proximity of these concepts to the category of «prevention». The analysis of the obtained data allows to draw conclusions that in the programs of preventive maintenance of dependent behavior implemented in educational institutions, the concepts «diagnostics», «hygiene», «efficiency» and, consequently, adjacent components of prevention are not sufficiently represented. They reveal the genesis of dependent behavior, its causes and conditions, the characteristics of diagnostic procedures, taking into account the belonging to the target groups of prevention of various addictive risks, as well as assessing the effectiveness and effectiveness of preventive measures.