[Cardiac rehabilitation: investigation of efficacy, results, perspectives]. / Kardioreabilitatsiya: issledovaniya effektivnosti, rezul'taty, perspektivy.

Previous research experience on cardiac rehabilitation programs as a part of general health care system has shown that they are an important part of the management of cardiovascular patients. Improving quality of life, reducing the severity of risk factors, increasing physical performance, slowing disease progression, decrease in morbidity and mortality indicate the clinical efficacy of cardiac rehabilitation and make it an integral part of therapeutic interventions. Heart rehabilitation is a 1st class recommendation in the majority of modern cardiovascular guidelines around the world.

[Noninvasive peripheral magnetic stimulation in the treatment of neurogenic urination disorders in children]. / Neinvazivnaya perifericheskaya magnitnaya stimulyatsiya v terapii neirogennykh rasstroistv mocheispuskaniya u detei.

Neurogenic urination disorders in children are often clinically represented by urinary incontinence (UI). The prevalence of UI reaches 8.6%, but tends to decrease in frequency with age. One of the methods of non-drug therapy of UI is extracorporeal magnetic stimulation (ExMI) - a type of non-invasive peripheral magnetic stimulation, which is widely used in adult urological practice. However, the effectiveness of the method in children has not been studied. OBJECTIVE: To study the effectiveness and safety of ExMI in the rehabilitation of children with neurogenic UI. MATERIAL AND METHODS: A prospective open randomized comparative clinical trial included 75 children (from 5 years to 16 years and 6 months) with neurogenic UI, who were divided by simple randomization into a main group (n=39), who received a standard rehabilitation and ExMI program for 21 days, and a comparison group (n=36), in which the standard rehabilitation program did not include the use of ExMI. RESULT AND DISCUSSION: A prospective open randomized comparative study revealed that the clinical effectiveness of the ExMI method in the complex rehabilitation of children with neurogenic UI is 94.8%, which is 25.4% higher than in the comparison group. After treatment, patients in the main group had a noticeable decrease in UI episodes, an increase in the micturition volume, and an improvement in the quality of life. Patients with various background neurological pathology responded to treatment, which indicates the common pathogenetic mechanisms of the development of LUTS in these conditions and the independence of the final effect from the basic diagnosis. CONCLUSION: The use of the perineal ExMI method in children with neurogenic UI increases the effectiveness of rehabilitation and is a promising and safe direction of rehabilitation treatment.

[Non-drug methods of treatment of post-thrombophlebitic syndrome]. / Nemedikamentoznye metody lecheniya posttromboflebiticheskogo sindroma.

Postthrombophlebitic syndrome (PTPS) develops in 20-50% of patients who have had deep vein thrombosis (DVT). Patients with chronic venous insufficiency (CVI) of class C4-C5 according to the CEAP clinical classification, which developed as a result of DVT of the lower extremities, including those who underwent endovascular treatment (iliac vein stenting), are subject to staged medical rehabilitation. In this regard, the development of personalized complex technologies for the sanatorium treatment of patients with PTPS is an important medical and social problem. PURPOSE OF THE STUDY: Study of clinical efficacy and identification of the mechanisms of action of a new complex of spa treatment of patients with PTPS of the lower extremities using supravenous laser radiation, low-frequency magnetotherapy, dry-air carbon dioxide baths and structured therapeutic exercises in the gym. MATERIAL AND METHODS: 60 patients with PTPS of the lower extremities (CVI C4-C5 according to CEAP) were under observation. All patients were randomly divided into 2 groups: first group (main group) included 30 patients who received a treatment, including procedures for supravascular laser blood irradiation, pulsed magnetotherapy and dry-air carbon dioxide baths, as well as structured therapeutic exercises in gym under the supervision of an exercise therapy instructor; second group (control group) included 30 patients who received standard elastic compression (compression class 2-3) while taking lymphovenotonics (a combination of diosmin and hesperidin) and therapeutic exercises in the gym. RESULTS: Against the background of the course of treatment in patients of the main group, to a greater extent than in the control group, a decrease in the clinical symptoms of the disease was noted: a more pronounced regression of edema, a decrease in heaviness in the legs, as evidenced by the data of anthropometric studies and questionnaires on the CIVIQ-2 scale. Positive dynamics in the microcirculation system (MC) was established, which was confirmed by the data of laser Doppler flowmetry. In patients with spastic-congestive type of MC, a decrease in the initially increased myogenic and neurogenic tone of arterioles was registered. There was a decreasing of stagnation in the venular link. In patients with hyperemic-congestive type of MC, the initially reduced tone of arterioles increased, which contributed to the improvement of blood flow in the capillaries. There was also a decrease in congestion in the venular link of the microvasculature. CONCLUSION: A new effective complex method for the rehabilitation of patients with PTPS has been developed, including laser exposure according to the general method, pulsed magnetotherapy and dry-air carbon dioxide baths, which have a multifocal effect on different links in the pathogenesis of PTPS.

[Effectiveness of using a hardware complex with biofeedback in the rehabilitation of children with dysfunction of the upper limbs]. / Effektivnost' primeneniya apparatnogo kompleksa s biologicheskoi obratnoi svyaz'yu v reabilitatsii detei s narusheniem funktsii verkhnikh konechnostei.

The upper limb is of exceptional importance for human life as an organ of cognitive and practical activity. Fine motor skills of hands are a set of small, highly coordinated, precise and coordinated movements of varying degrees. Diseases and injuries of the musculoskeletal and nervous systems lead to violations of fine motor skills. Effective programs for medical rehabilitation of hand and fingers include using biofeedback devices (BFB). PURPOSE OF THE STUDY: Efficiency evaluation of the hardware-software complex with BFB in restoring the impaired function of the upper limb in children. MATERIAL AND METHODS: The clinical study included 79 patients aged 4 to 18 years with dysfunction of the upper limb not higher than level III according to MACS (The Manual Ability Classification System), who were divided by simple randomization into the main group (49 patients) who received 21 days of a comprehensive rehabilitation program (physiotherapy exercises, paretic muscle massage, mechanotherapy, hydrokinesiotherapy, methods of apparatus physiotherapy) using a hardware-software complex, and a comparison group (30 patients), in which the complex rehabilitation program did not include biofeedback procedures. RESULTS: This performed prospective open randomized comparative study revealed the effectiveness of the standard rehabilitation program in combination with training on the BFB complex (main group) to be higher than using only the standard program. After treatment, patients of the main group showed a noticeable decrease in the degree of muscle spasticity in the affected limb, strengthening of muscle strength, improvement of fine and gross motor skills of the hands, and improvement of manual skills. CONCLUSION: The use of a hardware-software complex with biofeedback in children with dysfunction of upper limbs increases effectiveness of the rehabilitation program.

[The use of underwater horizontal traction and mechanotherapy in the complex treatment of degenerative spondylolisthesis of the lumbosacral spine: a pilot clinical study]. / Primenenie podvodnogo gorizontal'nogo vytyazheniya i mekhanoterapii v kompleksnom lechenii degenerativnogo spondilolisteza poyasnichno-kresttsovogo otdela pozvonochnika: pilotnoe klinicheskoe issledovanie.

Underwater traction of the spine is a physiotherapeutic method that combines the effects of mechanical traction and fresh water of indifferent temperature and seems promising for the treatment of pain in the lower back, which is due to the physiological basis of the mechanism of action on the spinal motion segment by eliminating muscle spasm and restoring the biomechanics of the spine. OBJECTIVE: To study the effectiveness of underwater horizontal traction in combination with mechanotherapy in patients with non-stenosing unstable degenerative spondylolisthesis of the lumbosacral spine of the 1st degree, accompanied by pain. MATERIAL AND METHODS: The clinical study included 14 patients (mean age 50.21 years). Patients underwent underwater horizontal traction of the spine according to the modified Pushkareva-Vozdvizhenskaya method in a variable mode, the procedures were performed every other day, for a course of 6 procedures. After completion of the traction procedure, patients were recommended to put on a fixing lumbosacral corset, in which they rested for 30 minutes in the supine position. At the end of the rest period, the patients performed training of the back muscles with biofeedback on the mechanotherapeutic complex of simulators for 30 minutes daily, except for weekends, for a course of 10 procedures. RESULTS: All patients completed the course of treatment, during the procedures no side effects or deterioration were noted. During the treatment, motor and daily activity significantly improved according to the Oswestry scale (p=0.002), the severity of the pain syndrome and its effect on the patient's activity decreased, according to the Roland-Morris questionnaire (p=0.003). According to an objective assessment of the muscle strength of the lumbosacral spine at the initial level, no deviations from the normative parameters were revealed, however, during the treatment, a significant increase in strength was noted in all muscle groups. CONCLUSION: Underwater horizontal traction of the spine in variable mode according to Pushkareva-Vozdvizhenskaya is an effective and safe method of conservative treatment of unstable non-stenosing degenerative spondylolisthesis of the 1st degree, accompanied by back pain, which helps to reduce the intensity of the pain syndrome and improve the daily motor and social activity of patients. The traction method should be supplemented with therapeutic exercises using mechanotherapeutic simulators to achieve a clinical result.

[Molecular mechanisms of adaptive and therapeutic effects of physical activity in patients with cardiovascular diseases]. / Molekulyarnye mekhanizmy adaptatsionnykh i lechebnykh effektov fizicheskikh nagruzok u patsientov s serdechno-sosudistymi zabolevaniyami.

Physical activity is one of the main components of the rehabilitation of patients with cardiovascular disease (CVD). As shown by practice and the results of evidence-based studies, the beneficial effects of physical activity on disease outcomes in a number of cardiac nosologies are comparable to drug treatment. This gives the doctor another tool to influence the unfavorable epidemiological situation in developed countries with the spread of diseases of the cardiovascular system and CVD mortality. Reliable positive results of cardiorehabilitation (CR) were obtained using various methods. The goal of CR is to restore the optimal physiological, psychological and professional status, reduce the risk of CVD and mortality. In most current CVD guidelines worldwide, cardiac rehabilitation is a Class I recommendation. The molecular mechanisms described in the review, initiated by physical activity, underlie the multifactorial effect of the latter on the function of the cardiovascular system and the course of cardiac diseases. Physical exercise is an important component of the therapeutic management of patients with CVD, which is supported by the results of a meta-analysis of 63 studies associated with various forms of aerobic exercise of varying intensity (from 50 to 95% VO2) for 1 to 47 months, which showed that CR based on physical exercise improves cardiorespiratory endurance. Knowledge of the molecular basis of the influence of physical activity makes it possible to use biochemical markers to assess the effectiveness of rehabilitation programs.

[Nutraceutical correction in the complex non-drug treatment of metabolic syndrome]. / Nutritsevticheskaya korrektsiya v kompleksnom nemedikamentoznom lechenii metabolicheskogo sindroma.

The use of complex non-drug technologies at the stage of rehabilitation of metabolic syndrome (MS) includes multifactorial correction of its main manifestations: abdominal obesity, insulin resistance, arterial hypertension and dyslipidemia. A prospective randomized study on the use of low-calorie diet (LCD) and nutraceutical correction of the nutritional status of patients with MS was carried out. OBJECTIVE: To study the effect of a non-drug complex including LCD, physical exercises, as well as correction of the gut microbiome and hepatic protection in relation to reduction of visceral fat volume in abdominal obesity and the dynamics of lipid and carbohydrate metabolism hormones in metabolic syndrome. MATERIAL AND METHODS: 120 patients with MS were randomized into 2 groups: Group 1 received LCD, physical exercises in the gym, and physical activity like daily walking up to 3-5 km/day. Group 2 received LCD, physical exercises in the gym, physical activity like daily walking up to 3-5 km/day, as well as nutraceutical correction of increased appetite, gut probiotic composition, hepatic protection. The treatment duration was 4 weeks. Anthropometric methods in order to control the body weight, waist and hip circumferences and bioimpedansometry were used. RESULTS: As a treatment result, patients in group 1 represented a reduction in body weight, lean and active cell mass, a decrease in musculoskeletal mass and a decrease in total fluid due to extracellular fluid. A decrease in total cholesterol and blood triglyceride fraction was noted. Leptin decreased by 13.96%. Patients of the 2nd group represented a decrease in body weight, fat mass, lean mass, total fluid and extracellular fluid. There was a statistically significant increase in active cell mass, skeletal muscle mass. There was a decrease in total cholesterol, triglycerides and transaminases. Due to weight loss and fat mass reduction a decrease in leptin expression by 29.85% and decrease in blood insulin levels by 11.2% were noted. CONCLUSION: Thus, LCD accompanied by nutraceutical correction of the gut microbiota and hepatic protection can be effectively used in combination with physical training in order to reduce the fat mass without pre-sarcopenia development that was confirmed by positive dynamics of volume indices, bioimpedance measurements and reduction in leptin and insulin expression.

[The effectiveness of complex medical and psychological rehabilitation of women in the menopausal period]. / Effektivnost' metodov kompleksnoi mediko-psikhologicheskoi reabilitatsii zhenshchin v menopauzal'nom periode.

Methods enhancing of women health restoration in the menopausal period is constrained by insufficient knowledge and, therefore, poor consideration of psychological factors in rehabilitation programs. The role of psychophysiological and psychotherapeutic methods for building a personalized program of health improvement for women in the climacteric period and increasing the effectiveness of rehabilitation treatment remains underestimated. OBJECTIVE: Study of the complex medical methods' effectiveness and psychological rehabilitation of patients during menopause with the use of psychophysiological programs and certain psychotherapy techniques. MATERIAL AND METHODS: The study included 90 women in menopause. The average age of the patients was 55.0±7.4 years. All patients were divided into 3 groups. In the 1st (30 menopause patients, average age 53.0±4.4 years) and 2nd (30 menopause patients with cancer or osteoporosis, average age 57.0±5.15 years) complex medical and psychological rehabilitation, including, in addition to drug therapy, physiotherapy procedures, manual therapy, psychophysiological and psychotherapeutic procedures were used. In the 3rd control group (30 patients, mean age 56.0±9.6 years), drug therapy, physiotherapy procedures and manual therapy were used. RESULTS: The analysis of the obtained data revealed the emotional disorders in patients of the 1st and 2nd groups before rehabilitation. There were low and decreased values of the subjective comfort index, SCI (31.4±5.12-40.7±5.21 points); high degree of fatigue reflecting a pronounced and strong degree of chronic fatigue, CF (27.00±3.53-41.40±6.12 points), high values of the personal anxiety indicator, PA (47.6±3.52-55, 1±5.91 points).After a complex medical and psychological care in patients of the 1st and 2nd groups the indicators characterizing the emotional and personal sphere improved significantly (p<0.05). CONCLUSION: The trial aimed to study the effectiveness of the complex medical and psychological rehabilitation of women during menopause showed a change in the indicators of the emotional and personal sphere after psychophysiological and psychotherapeutic influence, an improvement in the emotional state of patients and the life quality.

[Prospects for the development of the sanatorium-and-spa industry of the Russian Federation]. / Perspektivy razvitiya sanatorno-kurortnoi otrasli Rossiiskoi Federatsii.

THE PURPOSE OF THIS WORK: Is to analyze the current state of the sanatorium-and-spa complex of the Russian Federation and to develop promising ways of its development. MATERIAL AND METHODS: The state analysis was carried out on the basis of the results of field events, including the assessment of the quality of medical care; video conference call results; data from the State Register of the Resort Fund of the Russian Federation; reports on medical rehabilitation for people with disabilities and children with disabilities in medical and sanatorium-and-spa organizations. When assessing, an integral indicator of the current state of the medical industry was used, based on which the total integral indicator of the sanatorium-and-spa complex was calculated. RESULTS: Based on the analysis, a rating of the constituent entities of the Russian Federation was compiled depending on the state of the sanatorium-and-spa treatment, the problems of the industry and ways to solve them were highlighted. The development paths of the sanatorium-and-spa complex of the Russian Federation are substantiated, which are reflected in the Development Strategy of the sanatorium-and-spa complex of the Russian Federation, approved by order of the Government of the Russian Federation dated November 26, 2018 №2581-r. CONCLUSION: The implementation of the proposed measures will restore the world-recognized achievements of domestic balneology and increase the effectiveness and accessibility of sanatorium-and-spa treatment, as well as achieve the targets specified in the Development Strategy of the spa complex of the Russian Federation.

Ray tracing matrix approach for refractive index mismatch aberrations in confocal microscopy.

The 2×2 ray tracing matrix (RTM) method is employed for the description of optical aberrations caused by the refractive index mismatch (RIM) in fluorescent confocal polarization microscopy. We predict and experimentally confirm that due to the RIM a liquid crystal layer with highly non-uniform director distribution appears to be imaged as a layer with non-uniform thickness, which shows up in the roughness of the rear surface. For the off-axial focusing of the probing beam in a droplet dispersed in an immiscible liquid, we have developed an extended method still keeping the 2×2 dimensionality of the RTM.

[The application of the preformed physical factors for the combined treatment of the patients presenting with chronic vesiculitis]. / Preformirovannye fizicheskie faktory v kompleksnoi terapii patsientov s khronicheskim vezikulitom.

UNLABELLED: The problem of the development of the new efficient methods for the treatment of the patients presenting with chronic bacterial vesiculitis (CBV) is currently considered among the important priorities. AIM: The objective of the present study was to provide a scientifically sound substantiation for the application of sinusoidal modulated currents (SMC), magnetic fields, and laser radiation in the combined treatment of the patients with CBV. PATIENTS AND METHODS: A total of 121 patients presenting with chronic bacterial vesiculitis were examined and treated during the latent phase of the inflammatory process. They were randomly divided into three groups. Group 1 (main) was comprised of 40 patients treated, in addition to basal pharmacotherapy, by supravascular contact laser irradiation of the cubital vein area followed after 2-3 hours by the application of sinusoidal modulated currents to the pubosacral region. Group 2 included 41patents given, besides basal pharmacotherapy, laser therapy in the same regimen as in group 1 supplemented after 2-3 hours by abdominal magnetic therapy. Group 3 (control) received traditional pharmacotherapy in the combination with antibacterial and anti-inflammatory medicines. RESULTS: It was demonstrated that the patients of group 2 exhibited the most pronounced positive dynamics of the clinical signs and symptoms estimated from the total National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and of the characteristics of the quality of life evaluated based on the QLS scale. The patients of the two former groups experienced a more conspicuous decrease in the activity of the inflammatory process in seminal vesicles, restoration of their structural and anatomical features (as shown by the transrectal ultrasound study), improvement of testosterone metabolism, and normalization of the spermogram characteristics in comparison with controls. The analysis of the spermograms revealed the tendency toward the increase in the number of actively motile spermatozoa only in the patients of group 2. The combined treatment of the patients of the two former groups resulted in the decrease of the level of sex hormone-binding globulin and the increase of the free androgen index. CONCLUSION: The results of the study indicate that the application of the preformed physical factors for the treatment of the patients presenting with chronic bacterial vesiculitis enhances the effectiveness of pharmacotherapy and decreases both the frequency and the duration of relapses of the disease.

[Emotional stress as a clinical model to study the pathogenesis of the initial phase of the general adaptation syndrome].

INTRODUCTION: General adaptation syndrome (GAS), the basis of the development of which is stress phenomenon, is an essential component of the pathogenesis of many diseases and syndromes. However, the patho genesis of GAS hitherto is considered exclusively from the endocrinological viewpoint. This relates primarily to the initial phase of the GAS, a clinical model for the study of which may be psycho-emotional stress (PES), which we studied using three groups of volunteers. METHODS: The first one consists of 25 students who were waiting for unaccustomed physical activity (17 men) and play debut on the stage (8 women). The second group consists of 48 children (2-14 years) who expected for "planned" surgery. The third group of volunteers is made up of 80 students (41 women and 39 men) during the first exam. The concentration of cortisol, endotoxin (ET), the activity of antiendotoxin immunity (AEI) and the haemostatic system parameters were determined in the blood serum of volunteers in various combinations. RESULTS: We found laboratory evidence for PES at 92% of students of the first group, 58% of children of the second one and in 21% of students of the third group of volunteers (mostly women). The concentration of ET increased at 13 (52%) volunteers of the first group with a significant increase of average indicators in the whole group (from 0.84 ± 0.06 to 1.19 ± 0.04 EU/ml). At children of the second group, the average concentration of ET increased even more significantly (from 0.42 ± 0.02 to 1.63 ± 0.11 EU/ml), which was accompanied by the activation of the hemostasis system. A degree of the activation was directly dependent on the level of ET in the general circulation and on an activity of AEI. Examination stress in the third group of volunteers is accompanied by activation of plasma hemostasis (increased initial thrombosis rate and reduced the time it starts, lag-period) in 26% of female students and 15% of male students. CONCLUSION: We suggest that it is possible to use the PES as a clinical model for studying the initial phase of the GAS, examine the role of excess of intestinal ET in the general blood circulation (endotoxin aggression) in the induction of systemic inflammation, which is very likely participated in the initiation of the GAS.

[The combined action of drinking mineral water and low-intensity electromagnetic radiation under the immobilization stress conditions (an experimental study)].

The present study carried out on white male rats in experiments with the use of biochemical, radioimmunological, and electron- microscopic methods. It was shown that the combined treatment with potable mineral water (MV) and low-intensity electromagnetic radiation (LIEMR) of ultrahigh frequency (power density less than 1 pW/cm2, the frequency about 1000 MHz) facilitated the activation of metabolic and intracellular regenerative processes in the liver and testes. One of the advantages of the combined application of MV and LIEMR over the single-factor treatment manifested itself as the weakening of stress reactions, the increase in the frequency of the plastic processes, and the more harmonious development of different forms of intracellular regeneration. The results of the study provide a deeper insight ino the mechanisms underlying the combined actions of drinking mineral water and low-intensity electromagnetic radiation; also, they justify the application of these factors for the protection of the reproductive system and the entire body from stress-induced disorders.

[The application of the combined resonance-wave therapy for the treatment of the patients presenting with chronic bacterial prostatitis].

UNLABELLED: Recent studies have confirmed the anti-inflammatory and trophic effects of low-intensity electromagnetic radiation with a frequency of 1 GHz in the microwave range in a number of inflammatory diseases. The results of experimental investigations demonstrating the influence of this physical factor on water molecules provide a basis for resonance-microwave therapy. Aim. The objective of the present work was evaluate the effectiveness of this physiotherapeutic method used for the treatment of 50 patients with chronic bacterial prostatitis (CBP). Patients and methods. All the patients were randomly divided into two groups. The main group included 26 patients, and the control group was comprised of 24 patients. The patients of the latter group were given only basic drug therapy, while those in the main group were additionally treated by means of resonance-microwave therapy with the use of the Akvaton-02 apparatus (Russia). Dynamics of the clinical symptoms and the quality of life were evaluated based on the results of microscopic and bacteriological examination of the prostate secretion, measurements of the blood levels of tumor necrosis factor TNF-alpha and interleukin-1beta. RESULTS: The study has demonstrated that resonance-microwave therapy resulted in positive dynamics of pain and dysuric syndromes that was especially well apparent in the patients of the main group. This observation was confirmed by a significant change in the severity of the clinical symptoms of the disease estimated based on the NIH-CPSI scale and in the quality of life (QOL) of the patients. The microscopic and bacteriological examination of the prostate secretion revealed the pronounced anti-inflammatory and antibacterial effects in 19 (73.61%) patients of the main group compared with 16 (66.7%) patients in the control group. In addition, the low-intensity resonance-microwave therapy was shown to produce beneficial effect on the levels of pro-inflammatory cytokines in the blood of patients presenting with chronic bacterial prostatitis. The decline the TNF-alpha and IL-1beta blood levels was documented in the patients of both groups, but only in the main group the level of TNF-alpha was significantly different from its baseline value. In the majority of the patients, the above changes persisted for two months. CONCLUSION: The present study has demonstrated the increased clinical effectiveness of resonance-microwave therapy in the patients suffering from chronic bacterial prostatitis in comparison with baseline drug therapy and thereby confirmed the feasi bility of low-intensity electromagnetic radiation with a frequency of 1 GHz for the treatment of this pathology.

[Changes of endotoxin concentration in blood serum in patients with uncomplicated acute myocardial Q-infarction].

The effectiveness of acute myocardial infarction (AMI) treatment does not correspond to high material costs for the study of its pathogenesis and development of new drugs. This circumstance gives the grounds to assume existence of nowadays unknown mechanisms of emergence and development of this disease. High probability of participation of endotoxin (ET) in the pathogenesis of AMI was theoretically proved by us for more than a quarter of the century ago, but it's clinical evidence to date is not found yet. As a result of the study a significant increase of endotoxin (ET) concentration in the blood serum of patients with AMI increasing from 1 to 14 day of the disease has been found. In women the concentration of ET was higher than in men. It allows to qualify the EA as a factor probably influencing the known difference in AMI tolerance in men and women. The source of ET were Bacteroides (most often--67.8% of patients), Klebsiella, Pseudomonas, Proteus, Escherichia coli. One or two bacteria more often took part in the development of EA. In 9.1% of patients the etiology of EA could not be verified, what indicates the presence of other sources of EA, not evaluated in this study. In 25% of patients with AMI serologic evidence of systemic candidiasis, caused by candida Albicans, has been found, what is able to enhance the biological effects of ET.