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Duchenne muscular dystrophy is a genetic orphan neuromuscular disease caused by a mutation in the DMD gene encoding the protein dystrophin. As a result of developing and progressive muscle damage and atrophy, children lose the ability to walk, develop respiratory and cardiac disorders. The core elements of good care standards are early diagnosis, prevention and treatment of osteoporosis, daily physical therapy, regular rehabilitation, glucocorticosteroids, and control of heart and lung function. The clinical effect of new targeted pathogenetic therapies for Duchenne muscular dystrophy, restoring synthesis of full or truncated dystrophin, depend on their appropriate combination with existing standards of care.

BACKGROUND: One of the effective and pathogenetically substantiated methods of therapeutic action on cicatricial changes in the skin are laser technologies in combination with collagenases. However, as previous studies have shown, the presence of metabolic syndrome in patients significantly reduces the clinical efficacy of the combined use of laser therapy and phonophoresis of Fermencol. The most reasonable solution in this situation can be scientific research and experience in the practical use of drinking mineral waters, which have a high corrective efficiency in relation to metabolic processes, the course of which is significantly impaired in type II diabetes mellitus and metabolic syndrome. AIMS: Assessment of clinical indicators of cicatricial changes in the skin of patients with metabolic syndrome in the combined application of the method of phonophoresis Fermenkol, fractional photothermolysis and drinking mineral waters. MATERIAL AND METHODS: The study included 60 patients (49 men and 11 women) with cicatricial changes in the skin aged 19 to 50 years, with a confirmed diagnosis of metabolic syndrome. All patients by the method of simple fixed randomization were divided into two groups: the control group (30 people) and the main group (30 people). Both groups received treatment, which included a course of phonophoresis of 0.01% Fermencol gel in combination with the technique of fractional laser therapy. Patients of the main group, in contrast to the control group, in addition to the specified physiotherapeutic treatment received bottled sodium bicarbonate-chloride water Essentuki No. 17 (mineralization 11.8 g/l) at room temperature, 200250 ml three times a day for 1520 minutes before meals for 3 weeks. RESULTS: The addition of physiotherapeutic combined anti-scar therapy with a course of drinking mineral water Essentuki No. 17 in patients with cicatricial changes in the skin in combination with metabolic syndrome was accompanied by a significantly more pronounced clinical effect, assessed by the Vancouver scale and the Dermatological Index of Quality of Life. CONCLUSION: Additional course use of drinking mineral water Essentuki No. 17 is accompanied by a more pronounced dynamics of clinical manifestations of cicatricial deformities of the skin and an indicator of the quality of life of patients, due to the sanogenetic mechanisms of the drinking balneofactor.

A study of the state of hemostasis and inflammatory markers in patients with post-COVID syndrome was conducted. An increase in the activity of procoagulant factors against the background of high values of inflammatory markers was found. The presence of a history of non-infectious chronic diseases significantly aggravates disorders in the hemostasis system, and the centers of correlation pleiades are the severity of leukocytosis and the degree of decrease in activated partial thromboplastin time. The use of standard therapy and interval hypoxic training for the treatment of post-COVID disorders did not have a significant effect on hemostatic parameters, but the anti-inflammatory effect was clearly manifested. Mesodiencephalic modulation (MDM therapy) had a significant normalizing effect on the coagulogram and inflammatory markers, and its combination with hypoxic exposure slightly enhanced the therapeutic effects. It is suggested that complex physiotherapy is viable in the treatment of post-COVID syndrome by influencing not only hemostasis and inflammatory reactions, but also non-regulatory mechanisms of the brain and respiratory organs.

The variation of indicators that characterize skin scarring increases in patients with metabolic syndrome, which may affect the effectiveness of therapeutic measures. It has been found that pathological processes in the skin scar in the initial state correlate to the greatest extent with the index of insulin resistance, the atherogenic coefficient and the coefficient of antioxidant protection. It is proved that the effectiveness of complex physiotherapy with the addition of the internal intake of medium-mineralized water «Essentuki №17» directly correlates with an increase in tissue sensitivity to insulin and the activation of antioxidant enzymes, as well as with a decrease in dyslipidemia. Linear regression equations are presented to determine significant predictors of treatment effectiveness, which can lead to the creation of individualized therapeutic programs using preformed and natural physical factors.

BACKGROUND: The effectiveness of physiotherapy treatment of scarring of the skin is reduced in patients with impaired carbohydrate and lipid metabolism and the use of drinking mineral water is proposed for their correction of metabolic reactions, but the long-term results of using this technology have not been studied. AIMS: To study the long-term results of treatment of patients with scarring of the skin after the use of photothermolysis, fermencol ultraphonophoresis and internal intake of mineral water, taking into account the presence or absence of metabolic syndrome. MATERIALS AND METHODS: We observed 120 patients with scarring of the skin, 60 of them with metabolic syndrome. The patients were randomly selected into 2 groups: with and without metabolic syndrome, each of which was further subdivided into 2 subgroups according to the treatment method: the first was standard therapy, fractional photothermolysis, fermencol ultraphonophoresis, the second was a similar complex supplemented with internal intake of Essentuki No. 17 mineral water. Glucose, insulin, body mass index, malondialdehyde were determined in the blood of all patients RESULTS: It was found that in patients with metabolic syndrome, the duration of maintaining the achieved therapeutic effects decreases after 6 months of observation, whereas against the background of taking mineral water, this period is extended by 34 months. An additional course of mineral water to physiotherapy treatment effectively corrects metabolic reactions and helps to reduce insulin resistance. CONCLUSION: The use of drinking mineral waters, which have a pronounced activating effect on the insulin regulation of metabolic reactions by reducing resistance to this hormone, allows you to maintain favorable changes in metabolism and energy for at least six months, which contributes to the consolidation of the therapeutic effects of complex physiotherapy and to a certain extent has a preventive potential.

BACKGROUND: The information-predictive approach can be used for determining biomarkers as predictors that allow predicting the effectiveness of the treatment of chronic generalized periodontitis using the combined use of ozone and transcranial magnetotherapy. AIMS: Determination of the set of initial morphometric parameters that have predictive significance, as well as the development of a method for the integral assessment of the clinical effectiveness of the combined use of ozone and transcranial magnetotherapy in patients with chronic generalized periodontitis. MATERIALS AND METHODS: A multiple regression model was built, which establishes the relationship between the dependent variable (effective sign treatment effectiveness) and the value of independent variables (factors characterizing the initial state of patients). RESULTS: It has been established that the technology of combined use of ozone and transcranial magnetotherapy is most effective in the initial clinical manifestations of chronic generalized periodontitis and minimal values of other pathogenetically significant parameters (microcirculation, oxygen metabolism, lipid peroxidation disorders) in the initial state. CONCLUSION: The clinical and laboratory cluster identified as a result of mathematical analysis the index of bleeding of the gingival sulcus, the volume of nutritive blood flow, the fluorescent indicator of oxygen consumption, the quality of life according to the Daily Life domain generalized periodontitis, determining the indications and contraindications for the use of this treatment regimen for inflammatory periodontal diseases.

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