[Application of narrow-band optical radiation with a wavelength of 650 nm in complex treatment of children with developmental speech delay]

OBJECTIVE

To substantiate the use of photochromotherapy (narrow-band optical radiation with an average wavelength of 650 nm) in the complex treatment of children with developmental speech delay on the type of general speech underdevelopment (GSU) of I and II degree.

MATERIAL AND METHODS

A number of children equal 70 aged from 4 to 6 years with developmental speech delay were examined. All patients were randomized into 2 clinically comparable groups: the 1st (study) group included 35 patients who received medical treatment in accordance with clinical recommendations in combination with the use of narrow-band optical radiation with an average wavelength of 650nm for 10 days; the 2nd (comparison) group consisted of 35 subjects who received standard drug therapy according to the established clinical recommendations. All patients underwent a comprehensive clinical examination and a special neurological investigation, including electroencephalography and electromyography, as well as an assessment of the development of speech functions and dynamic coordination of gesture, the level of social and communication skills development and neuropsychological processes.

RESULTS

The following data were obtained during the complex treatment with the inclusion of narrow-band optical radiation with an average wavelength of 650 nm (red radiation): statistically significant improvement of speech development (p<0.05); improvement of values of social adaptation skills of medium (71%) (Z=2.769; p=006) and low level (29%) (Z=2.691; p=0.007); significant positive dynamics of speech status (Z=3.911; p=0.000); spontaneous activity relief at rest, indicating normalization of muscle tone.

CONCLUSION

The inclusion of photochromotherapy in standard therapeutic regimens for children with developmental speech delay on the GSU type of I, II degrees contributes to a significantly confirmed pronounced clinical improvement and can be recommended for practical health care.

A New Technology for Recovery of Locomotion in Patients after a Stroke

Neural networks in the spinal cord can generate the walking pattern and control posture in the absence of supraspinal influences. A technology using transcutaneous electrical spinal cord stimulation (tSCS) was created. During walking, tSCS activated spinal locomotor networks, as well as leg flexor/extensor motor pools in the swing/stance phases, respectively. It was assumed that the use of this technology in subjects with locomotion disorders would improve walking. Patients with hemiparesis were studied 3-11 months after stroke, the duration of the course was 2 weeks. Patients of the main and control groups received standard therapy and rehabilitation using the technology; in the control group, sham tSCS was used. After the course, minimal clinically important differences in walking parameters were achieved in the main group, in contrast to the control group. The developed technology is an effective means of restoring walking in patients with hemiparesis.

[Terahertz modulated infrared radiation in the complex treatment of patients in the acute period of ischemic stroke]

Ischemic stroke (IS) is a serious medical and social problem due to the widespread prevalence, profound and long-term disability of patients. The effectiveness of pharmaceutical neuroprotection in IS remains low which necessitates the investigation of new therapeutic methods in post-stroke patients.

OBJECTIVE

The rationale for the use of infrared (IR) radiation with terahertz (THz) modulation in the complex treatment of patients in the acute period of IS.

MATERIAL AND METHODS

The results of transcranial application of IR radiation with THz modulation in 112 patients in the acute period of IS are presented. In the main group (38 patients) the infrared radiation with THz modulation was used on the projection of the IS focus in addition to basic drug therapy; in the control group (37 patients) - basic drug therapy; in the placebo group (37 patients) the physiotherapy was mimicked. The data of neurological status and neuro-functional indicators were assessed using the NIHSS, MMSE, Rankin, and Rivermid scales. Cerebral blood flow was examined using duplex scanning of brachiocephalic vessels.

RESULTS

The inclusion in the complex treatment of IR radiation with THz modulation on the projection of the IS focus in the acute period contributed to a significant regression of neurological deficit, a complete recovery of cognitive functions and an increase in daily activity due to the restoration of adequate blood supply on the side of the affected hemisphere.

CONCLUSION

A pathogenesis justified method of treating acute IS is proposed which can increase the effectiveness of early neurorehabilitation measures. An early improvement in cerebral hemoperfusion led to the creation of optimal conditions for the survival of neural structures and the preservation of their functional activity that demonstrated the neuroprotective feasibility of early inclusion of IR radiation with THz modulation in the complex treatment of patients in the acute period of IS.

[The srategy of programed multistage surgical treatment ("damage control surgery") of neurotrauma]

A retrospective analysis of diagnostics and surgical treatment was made in 440 patients with polytrauma, who were on the treatment in hospitals in Saint-Petersburg, Syktyvkar and Omsk during 2009-2012. The neurotrauma was the dominating damage. The patients were divided into two groups: the main and the control group, using the equal quantitative ratio according to the sex, age, circumstances of trauma and type of damages. The strategy of programmed multistage surgical treatment ("damage control surgery") was used in the main group (220 patients, average age 31.7 +/- 5.2 years). The traditional strategy of treatment was applied in the control group (220 patients, average age 30.7 +/- 5.4 years). The damage control surgery allows the reduction of lethality in neurotrauma by 15.0% and improvement of social adaptation of patients by 12.7%.

[Principles of early rehabilitation of the neurotrauma]

The retrospective analysis of surgical and rehabilitation treatment of 172 patients with neurotrauma was made. The patients were treated in Russian Polenov Neurosurgical Institute and Municipal hospital of St. Elizabeth in the period since 2009 till 2012. Rehabilitation of different types of neurotrauma presented the system of surgical and recovery methods of treatment, which should be used in a short term after damage. Means of internal cerebral decompression, including drainage of ecephalocoel and cerebral basal cistern and the tentoriotomy, should be used in acute period of craniocerebral trauma according to morphometric data of beam inspection. Management of wound by means of laser or LED radiation, SHWF-therapy, magnetic and electrostimulation were the effective methods of neurorehabilitation. It is noted, that 73 (43,4%) patients returned to a former employment rate among 172 victims, though 26 patients had a moderate invalidization. An average figures of Glasgow scale outcomes were 1,9+/-0,2.

[Selection criteria for parameters of electric current in trans-CSF brain stimulation in patients with posttraumatic vegetative state]

Trans-CSF brain stimulation is on of applied methods of stimulation in posttraumatic vegetative state. The paper analyzes application of this technique under the control by different methods of electrophysiological monitoring. Authors suggest principles of selection of stimulation parameters and detectable criteria of its effectiveness.