[The effectiveness of the application of medicinal mineral water from the 'Omonkhona' source in the patients presenting with the diseases of the hepatobiliary system]. / Éffektivnost' primeneniia lechebnoi mineral'noi vody iz istochnika 'Omonkhona' u patsientov s zabolevaniiami gepatobiliarnoi sistemy.

BACKGROUND: Investigations into the medicinal properties of 'Omonkhona' mineral water used for the treatment of hepatobiliary pathology make up the entirely new field of balneological research in Uzbekistan. AIM: The objective of the present study was to identify the hepatoprotective and choleretic components of the 'Omonkhona' mineral water and elucidate their action in the patients presenting with the diseases of the hepatobiliary system. MATERIAL AND METHODS: A total of 77 patients suffering from the diseases of the hepatobiliary system were available for the examination including 38 patients with chronic hepatitis (CH), 17 with chronic cholecystitis (CC), and 22 patients with liver cirrhosis (Cr). All the patient were prescribed drinking the mineral water (from 1.0 to 3.0 liters per day) during consequtive 12-14 days. The clinical, biochemical, and instrumental studies were carried before and after the treatment. RESULTS: The treatment with 'Omonkhona' water resulted either in the complete elimination or the significant alleviation of pain in the right hypochondrium. The patients presenting with CH and CC experienced normalization of ESR even though it remained high in the Cr patients. All the patients exhibited a decrease of specific gravity of the urine, probably due to the diuretic effect of the mineral water. The biochemical studies of blood and bile showed that the initially slightly enhanced bilirubin levels, alanine aminotransferase and alkaline phosphatase activities in the CH and CC patients normalized after a course of the treatment with 'Omonkhona' mineral water (p<0.05). No such changes were documented in the patients with liver cirrhosis. The patients with CH and CC experienced the two-fold reduction in the intensity of inflammation whereas the bilirubin and bile acid levels increased although the relative cholesterol content decreased and the cholate-cholesterol coefficient increased (p<0.05). The Cr patients demonstrated only insignificant changes of these parameters. The ultrasound examination showed that the CC patients treated with 'Omonkhona' mineral water had a decrease in the swelling of the gallbladder walls, the improvement of its motor function and the disappearance of the stagnation phenomenon. In the CH patients, there was a significant decrease in the cranio-caudal size of the right lobe of the liver, the cranio-caudal size of the left lobe, and the anteroposterior size of the left lobe (p<0.05). A decrease in the acoustic conductivity was noted that can probably be attributed to the reduced swelling of the liver parenchyma. The Cr patients had no significant changes of these parameters following the treatment. CONCLUSIONS: The results of this study give evidence that the treatment of the diseases of the hepatobiliary system with 'Omonkhona' mineral water exerts the well apparent positive influence on the patients presenting with CC and CH even though its beneficial effect was less pronounced in the patients with livre cirrhosis.

[Influence of meteopathogenic factors on population visits for emergency medical care].

AIM: To study the features of the impact of the extreme climate and weather factors of an arid area, which cause exacerbations of circulatory system diseases (CSD). MATERIALS AND METHODS: The authors have studied 32,339 visits for emergency medical care (EMC) because of exacerbations of CSD (coronary heart disease, angina pectoris (n = 29,932), myocardial infarction (n = 306), hypertensive crises (n = 2,101) and their events) when the Afghan wind forms in winter and spring and on heat discomfort days in summer. Meteological parameters, synoptic patterns, partial oxygen density (AOD) in the atmosphere, atmospheric electric potential gradient, and human heat sensation (equivalent and effective air temperatures (EEAT)) were estimated using the generally accepted three-hour gradations. RESULTS: In the formation of the Afghan wind (24-48 hours before its surge, i.e. in the prodromal phase), the atmospheric electric potential gradient increased by 4-10 times. Atmospheric pressure fell by 15-20 mbar; air temperature rose by 10-15oC, AOD dropped by 15-25 g/m3--a hypoxic type of weather formed. In the surge phase, the hypoxic type drastically changed to the spastic one - there was an increase in atmospheric pressure and a decrease in air temperature (by 12-19 degrees C), which gave rise to circulatory hypoxia due to vascular spasm. The average daylight air temperature changed from +31.1 to +42.2 degrees C, amounting to +36.6 +/- 1.2 degrees C; EEAT was in the gradation of heat (27-30 degrees C) and very heat (32 degrees C or higher), AOD decreased (248.6 +/- 1.3 g/m3), a hyperthermia-and-hypoxia type of weather was observed. The rates of EMC visits by the population for CSD exacerbations were strongly correlated with the formation of the Afghan wind (Spearman rank correlation 0.82). In the prodromal and Afghan wind surge phases, the number of exacerbations of CSD increased by an average of 2.2-3.6 times. Analysis of annual patient visits by hours during a day showed that their first rise was seen at 9.00 to 12.00 and the second (more substantial) one at 18.00 to 21.00 (p < 0.05). However, in summer, the patient visit rates increased at 15.00 local legal time when there was human thermal sensation at the gradation of heat under hyperthermal hypoxia more frequently in people older than 70 years. CONCLUSION: The rates of EMC visits by patients for CSD exacerbations increased in the formation of the Afghan wind and in summer during significant heat discomfort; hypoxia (external weather and internal circulatory hypoxia) is a major pathophysiological factor in these situations.

[Potentiation of anti-ischemic and anti-anginal action of nitrates by hydrogen sulfide balneotherapy in patients with angina of effort].

The objective of this comparative study was to evaluate effects of nitrosorbid (NS) and hydrogen sulfide-based balneotherapy (HSB) applied alone or in combination for the treatment of patients presenting with angina of effort. It was shown that long-term HSB therapy enhances the anti-anginal and anti-ischemic action of NS in such patients. The authors argue that prolonged HSB-based maintenance therapy in combination with nitrates prevents habituation to these preparations and potentiates their beneficial therapeutic effect.

[The clinical efficiency and safety of iodide-bromine balneotherapy in patients with coronary heart disease concurrent with chronic obstructive pulmonary disease].

AIM: to evaluate the efficiency of iodide-bromine balneotherapy (IBB) in patients with coronary heart disease (CHD) concurrent with chronic obstructive pulmonary disease (COPD). SUBJECTS AND METHODS: Sixty-six patients with CHD, Functional Class HII stable angina on exertion concurrent with mild and moderate COPD were examined. Group 1 included 36 patients with CHD concurrent with mild and moderate COPD (a study group); Group 2 consisted of 30 patients (a control group). The groups were matched for age, gender, and concomitant abnormality. The patients from both groups undergone a complex clinical and instrumental study (clinical and biochemical study, echocardiography, 24-hour ECG monitoring, EchoCG, external respiration function (ERF) test. In both groups, CHD and COPD were treated by the generally accepted standards, Group I patients were additionally given IBB at a water temperature of 37 degrees C; the concentration of iodine and bromine was 10-15 and 30-40 m/I, respectively; the duration was 10-15 min for 2 consecutive days, followed by a rest day or every second day; the course comprised 10-12 sessions. RESULTS: After the course of IBB, there were significant reductions in the number of anginal attacks and the dose of nitrates weekly, the number of episodes of supraventricular and ventricular premature contractions, producing no impact on the cardiac conduction system. The duration of silent myocardial ischemia and the degree of ST-segment depression significantly reduced. No significant changes were obtained in the control group. ERF examination confirmed the safety of IBB used in patients with CHD and COPD. CONCLUSION: IBB has a beneficial antiischemic activity in patients with CHD concurrent with COPD, without producing a negative impact on ERF.

[Application of ammotherapy for the remedial treatment of patients with chronic obstructive pulmonary disease in the rehabilitative phase].

The objective of this study was to evaluate clinical and physiological efficiency of ammotherapy (PT) applied to the treatment of 112 patients in the phase of partial remission. It was shown that combination of standard baseline therapy and ammotherapy ensured positive dynamics of clinical symptoms and substantially improved parameters of external respiration and hemodynamics. It is concluded that ammotherapy can be recommended for a more extensive application to the management of chronic obstructive pulmonary disease.

[Efficacy and safety of hydrogen sulfide balneotherapy in ischemic heart disease the arid zone]. / Effektivnost' i bezopasnoct' serovodorodnoi balneoterapii pri ishemicheskoi bolezni serdtsa v usloviiakh aridnoi zony.

AIM: To evaluate efficacy of hydrogen sulfide (HS) balneotherapy in patients with coronary heart disease (CHD) in conditions of heat discomfort. MATERIAL AND METHODS: The study included 72 CHD patients aged 35 to 60 years with stable angina pectoris of the second functional class taking balneotherapy in summer under arid climatic conditions. Before and after balneotherapy the patients were examined with estimation of clinical symptoms, stress bicycle exercise (SBE) parameters, number of nitroglycerine tablets. RESULTS: The balneotherapy resulted in a significant prolongation of SBE (p < 0.0018), in longer time to depression of the ST segment by 1 mm (p < 0.01), to an anginal attack in the course of SBE (p < 0.0036), shorter duration of pain after SBE (p < 0.001), less number of anginal attacks (p < 0.0002) and reduced need in short-acting nitrates (p < 0.0002). CONCLUSION: In a hot climate of the arid zone use of moderate HS baths raises tolerance of CHD patients to exercise, attenuates clinical manifestations of CHD and, consequently, reduces daily need in nitrates.

[Clinical efficiency and tolerance of hydrogen sulfide balneotherapy in hypertensive patients living in arid zone]. / Klinicheskaia éffektivnost' i perenosimost' serovodorodnoi bal'neoterapii u bol'nykh gipertonicheskoi bolezn'iu, zhivushchikh v usloviiakh aridnoi zony.

AIM: To examine clinical efficiency and safety of moderate hydrogen sulfide (HS) baths in the treatment of hypertensive patients living in arid zones. MATERIAL AND METHODS: Sixty patients with stable essential hypertension (EH) of stage I-II according to WHO classification living in arid climate took sparing HS baths. Efficiency of the baths was assessed by changes in blood pressure (BP), 24-h monitoring of BP. RESULTS: It is shown that systolic and diastolic BP after HS balneotherapy fell significantly both in daytime and at night. The 24-h profile of BP improved, heart rate decreased by 4.3%, physiological fluctuations of BP and BP variability were not damaged. CONCLUSION: Moderate HS baths are recommended for wider use in a hot climate of the arid zone as an effective and safe method of balneotherapy which can be adjuvant to basic medication of EH.

[Meteopathogenic mechanisms of exacerbating ischemic heart disease in an arid zone]. / Meteopatogennye mekhanizmy obostreniia ishemicheskoi bolezni serdtsa v aridnoi zone.

In arid zone of Uzbekistan summer heat discomfort aggravates the course of ischemic heart disease, provokes meteopathic reactions which we call "meteorological strain syndrome". In this season anginal attacks, episodes of arrhythmia and coronary failure become more frequent especially in patients over 70 years of age and migrants.

[Microcirculatory changes in patients with the initial manifestations of cerebral circulatory failure under the conditions of an arid zone]. / Izmenenie mikrotsirkuliatsii u bol'nykh s nachal'nymi proiavleniiami nedostatochnosti krovoobrashcheniia mozga v usloviiakh aridnoi zony.

Microcirculation was studied in 53 ICCD patients: 28 lived in comfortable weather conditions while 25 patients lived in heat discomfort in arid climatic zone. It is shown that heat discomfort led to compensatory microvascular reactions providing proper supply of oxygen to organs and tissues: tortuosity and dilation of the microvessels, opening of the capillaries, shunting in relative hypoxia and hyperthermia.

[The reserve potentials of patients with ischemic heart disease who live under the conditions of an arid zone]. / Rezervnye vozmozhnosti bol'nykh ishemicheskoi bolezn'iu serdtsa, prozhivaiushchikh v usloviiakh aridnoi zony.

AIM: The study of physical performance of ischemic heart disease (IHD) patients in comfortable and uncomfortable (summer) weather conditions. MATERIALS AND METHODS: Systemic reserves were assessed by physical performance tests in comfortable weather (equivalent-effective temperature--EET 18-24 degrees C) and in heat discomfort (EET 25-30 degrees C), i.e. in summer when atmospheric oxygen is low (hyperthermic hypoxia). RESULTS: In uncomfortable weather, compared to comfortable one, general performance was significantly reduced evidencing uneffective function of the cardiovascular system. Comparison of the main ergometric parameters under the same load provides more accurate definition of the same trends in dynamics. CONCLUSION: General reserve in IHD patients is reduced under conditions of heart discomfort.

[Effect of climate of arid zone on adaptive and non-adaptive changes in microcirculation]. / Adaptivnye i dizadaptivney izmeneniia sistemy mikrotsirkuliatsii v klimaticheskikh usloviiakh aridnoi zony.

State of microcirculatory bed of the bulbar conjunctiva and nail wall skin has been studied in 134 men (18-28 years old) of native (62 men) and non-native (72 men) population. It was found out that under heat discomfort the compensation is observed in native population due to the induration of the capillary network, opening of plasmatic capillaries which did not function before, tonus of venules and arterioles being preserved while the amount of "gigantic" capillaries increased. In this case the blood flow was entire, uniform and moderately accelerated. The number of functioning capillaries does not increase in non-native population, but arterioles does not increase in non-native population, but arterioles and venules were dilated, blood flow in them became more rapid, sludge-phenomenon of the I stage being observed in some people. Consequently, the observed changes in microcirculation under heat discomfort are insignificant in the native population due to available structure-morphological potentialities, while in non-native population these changes are accompanied by certain strain at the expense of available functional reserves.