[Influence of the method of manual-physical correction on autonomic regulation in patients with essential arterial hypertension]. / Vliyanie metodiki manual'no-fizicheskoi korrektsii na vegetativnuyu regulyatsiyu u patsientov s essentsial'noi arterial'noi gipertenziei.

One of the methods of non-drug treatment of essential arterial hypertension, is manual, osteopathic effects on the spine, primarily the cervical spine. Despite the absence of these methods in clinical guidelines for essential arterial hypertension, they continue to develop and improve. One of the promising areas is manual-physical correction with an effect on the cervical spine and subsequent strengthening of the muscle corset with the help of physical exercises (method of A.Yu. Shishonin). One of the supposed mechanisms for reducing blood pressure (BP) in this case is the effect on the autonomic nervous system (ANS). In the course of the study, which was based on the study of heart rate variability (HRV), the presence of pronounced signs of a decrease in sympathetic influences and activation of the parasympathetic nervous system was shown. The parameters of statistical linear analysis (standard deviation of NN intervals; stress index, etc.) and the wave spectrum shifted towards sympathicotonia during therapy using the method of A.Yu. Shishonin. The HRV data were obtained against the background of a decrease in blood pressure and a decrease in heart rate (HR), which suggests the impact of manual physical correction on the ANS as one of the key mechanisms mediating its effect.

[«Selfish brain¼ theory: modern concept and practical use. (Literature review)]. / Teoriya «egoistichnogo mozga¼: sovremennoe predstavlenie i prakticheskoe ispol'zovanie. (Obzor literatury).

In the early 20th century, the term «selfish brain¼ appeared in scientific literature, around which theory was formed, finding its proof in the work of doctors and scientists. The basic principle of the theory is that the superior hierarchy of the brain, whose needs are prioritized, results in the primary satisfaction of one's own needs, often to the detriment of the functioning of other organs and systems. The origins of the theory of «selfish brain¼, according to researchers, lie in the work of neurosurgery pioneer Harvey Cushing, who discovered a reflex named after him and consisting in increasing arterial pressure at high intracranial pressure. Later, the field of action of this phenomenon was expanded by specialists who showed that an increase in arterial pressure can occur not only in critical situations and arise not only at high intracranial pressure, but also as a result of hypoxia of the brain. It was also found that the remodeling of intracranial vessels in hypertensive disease may be not only a consequence, but also a cause. Currently, similar patterns have been established in relation to other processes - exchange, immune and others. It was found that the priority of brain energy needs in different situations can affect insulin resistance and glucose tolerance. These effects can be realized through various mechanisms, but the advantage is through vegetative (autonomous) nervous system, mainly through sympathetic link, and also through simulation of the functioning of parasympathetic link. It is known that there is currently a rapidly increasing number of pathologies associated with degenerative-dystrophic processes of the spine, and other factors that disrupt the blood flow in the vertex-basilar zone of the Willis circle, Correction of these processes with the help of a set of manual techniques and physical methods (A. Yu. Shishonin's method with correction of aerobic-anaerobic energy balance in the reflex zones of the brain stem) Can have a good effect on the treatment of hypertensive disease and other chronic non-communicable diseases.

[Spinal manipulation techniques in the treatment of arterial hypertension. (A literature review)]. / Manual'nye tekhniki v terapii arterial'noi gipertenzii. (Obzor literatury).

There is a long-observed relationship between the pathology of the spine and arterial hypertension. There are a number of explanations for this, including one based on reflex effects and obstruction of blood flow to the cerebral vasodilatory centre localized in the rhomboid fossa projection. Obstruction can be absolute and relative, preventing the increase of blood flow during stress, when the brain turns on additional energy demand (phenomenon of «selfish brain¼). In conditions of insufficient blood supply anaerobic metabolism is included, requiring in the future, the addition of anaerobic glycolysis products. This leads to the persistence of an elevated level of AD and is part of the theory of centralized compensation of aerobic-anaerobic balance (theoretical aerobic-anaerobic energy concept, TAAEBC). The existing methods of manual manipulation and physical action on the spine, mainly the atlantoacral section of the cervical spine, have, according to existing publications, varying degrees of effectiveness. The modern approach to treatment of arterial hypertension and correction of metabolic disorders by A. Shishonin is promising. It is based on the TAAEBC concept and assumes a system approach and long-term effect through a consistent three-step manual and physical interventions aimed at restoring, retaining and long-term support of the vertebral blood flow.

[Method of manual-physical correction in the treatment of hypertensive disease and normalization of psychoneurological status in patients with degenerative-dystrophic processes of the musculoskeletal system]. / Metod manual'no-fizicheskoi korrektsii pri lechenii gipertonicheskoi bolezni i normalizatsii psikhonevrologicheskogo statusa u patsientov s degenerativno-distroficheskimi protsessami oporno-dvigatel'nogo apparata.

There are some non-communicable diseases (NCD) associated with arterial hypertension (AHT) that are cured after recovery from AHT. Recently confirmed the theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) originated some NCDs with the obstructions of arterial blood flow access to the rhomboid fossa. For some sergeants, this has already been demonstrated. Since neurological NCDs are similarly considered by TCAAEBC, it is logical to analyze dynamics of such musculoskeletal neurological problem as isolated musculoskeletal chest pain (IMCP) in connection with the therapy based on TCAAEBC. We retrospectively evaluated the medical records of adult patients with AHT, simultaneously suffering from IMCP. All these patients underwent complex treatment including manual techniques that restore arterial blood flow to the rhomboid fossa, followed by therapy that strengthens the muscular corset primarily of the cervical region. This, in addition to the normalization of AHT, led to a decrease in the musculoskeletal pain syndrome. The dynamic of pain was recorded according to four questionaries - Oswestry Disability Index (ODI) Hospital Anxiety and Depression Scale (HADS), Numerical Rating Scale (NRS), and the Quality-of-life assessment questionnaire (SF-12). The collected data were analyzed with the Wilcoxon signed-rank test, which confirms the recovery of the patients from both AHT and IMCP.

[Efficacy of manual correction of cervical spine osteochondrosis in the treatment of arterial hypertension syndrome and prediabetes]. / Effektivnost' manual'noi korrektsii osteokhondroza sheinogo otdela pozvonochnika v terapii sindroma arterial'noi gipertenzii i prediabeta.

Cardiovascular diseases and diabetes mellitus, debuting as arterial hypertension (AH) syndrome and prediabetes, are common types of chronic non-communicable processes, that are the leading cause of death in the world. The main treatment method for above mentioned disorders, according to the current guidelines, is pharmacotherapy. However, it is possible to effectively apply non-pharmacological correction methods, aimed at the probable etiological factor and inversive mechanism involved in AH maintenance, in the early stages when no permanent changes are maintaining a high level of blood hypertension (BH) and glycemia. Frequently, this mechanism is hypoxia in the vertebral arteries system due to cervical spine osteochondrosis. OBJECTIVE: To evaluate the therapeutic effect of non-pharmacological methods of restoring brainstem blood supply in patients with AH and prediabetes. MATERIAL AND METHODS: The number of patients equal 125 (57 men and 68 women, mean age 63.3±11.5 and 65.4±11.8 y.o., respectively) with prediabetes and 1st degree of AH without target organs damage, among whom 102 patients with prehypertension or 1st degree of hypertension and 24 ones with 2nd degree of hypertension, were examined. The original method of manually restoring brainstem blood supply developed in the Shishonin's Clinic was applied to all patients. The control group included patients with the same disorder, who did not receive manipulations. Blood pressure (BP) measurement, ultrasound and triplex ultrasonography of vertebral arteries, biochemical blood test, and estimation of glycemia and glycated hemoglobin were performed. RESULTS: All patients of the study group had decreased levels of systolic BP (by 23.8±10.7 mm Hg for men and 32.8±11.9 mm Hg for women), an increase of flow velocity in vertebral arteries (by 20.6±7.5 and 21.5±7.2 cm/s, respectively), a decrease of glycated hemoglobin concentration (by 0.32±0.51 and 0.34±0.41%, respectively). In the comparison group, there were no patients with improvement in these indicators. CONCLUSION: The effectiveness of the author's manual method of cervical spine osteochondrosis correction in the reduction of BP and glycemia levels in the early stages of the disease is shown.

[Theory of centralized aerobic-anaerobic energy balance compensation and non-pharmaceutical treatment methods of arterial hypertension]. / Teoriya tsentralizovannoi kompensatsii aerobno-anaerobnogo energeticheskogo balansa i nelekarstvennye metody lecheniya arterial'noi gipertenzii.

Several chronic non-communicable diseases are associated with arterial hypertension and are closely related to increased blood pressure. The theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) was formulated in connection with the above-mentioned processes. This theory, including the hypothesis of the «egoistic brain¼, is a broader concept. The key point of TCAAEBC is hypoxic anaerobic metabolism, which affects reflex vascular zones, including the neurons of the respiratory and cardiovascular centers of the rhomboid fossa of the medulla oblongata. Hypoxia correction using manual techniques, physical exercises, and other non-pharmaceutical methods under certain conditions can stabilize the level of blood pressure and has a curative effect in the case of arterial hypertension syndrome.

[Effectiveness of physical rehabilitation methods based on the impact of eccentric load in upper limb injuries]. / Effektivnost' fizicheskikh metodov reabilitatsii, osnovannykh na vozdeistvii ekstsentricheskikh nagruzok, pri travmakh verkhnikh konechnostei.

The rehabilitation of patients after upper limb injuries is becoming increasingly relevant in current medical practice considering that this pathology is often occurred in professional athletes, elderly people, people with active lifestyle. OBJECTIVE: To study the effectiveness of isolated therapeutic exercises (TE) with eccentric muscle loads when using rubber cable compared to traditional TE to restore functional capabilities of patients after upper limb injuries. MATERIAL AND METHODS: The study included 38 patients with upper limb injuries diagnosed by orthopedic surgeon. Patients were randomly enrolled into group of isolated TE with eccentric muscle loads (group A, 20 patients, mean age 40.2±10.8 years) and group of traditional exercises (group B, 18 patients, mean age 38.6±12.3 years). The study consisted of anamnesis taking, clinical examination, functional tests applying (isometric dynamometry, joint mobility tests, functional scales and questionnaires). The rehabilitation effectiveness was assessed by comparing the indicators before and after treatment course. RESULTS: There has been a significant improvement in muscle strength, movement amplitude and decrease of pain syndrome in patients rehabilitated by eccentric muscle loads. A comparison with a control group using traditional TE methods confirmed the superiority of eccentric exercises in reducing recovery time and improving functional performance. CONCLUSION: The study confirmed the high effectiveness of eccentric muscular loads in the rehabilitation of patients after upper limb injuries. The method has shown significant improvement in clinical and functional indices, which allows to recommend it for inclusion in standard rehabilitation protocols. Further researches may extend application of this approach and reveal the TE effectiveness in other types of traumas and orthopedic injuries.

[Physical methods of correction of arterial hypertension: modern concepts. (A literature review)]. / Fizicheskie metody korrektsii arterial'noi gipertenzii: sovremennye predstavleniya. (Obzor literatury).

Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.

[Determination of cobalt in plasma blood samples by the ICP-MS method after oral intake of dietary supplements containing low doses of cobalt].

Salts of inorganic cobalt (Со) prevent the degradation of the alpha subunit of the hypoxia-inducible factor (HIF), imitating the state of hypoxia in the body and increasing the production of the endogenous hormone erythropoietin (EPO), and are used as doping substances that increase blood oxygen capacity and endurance, which give competitive advantages in sports. Currently, a large number of dietary supplements, including Co-containing ones, are offered on free sale. Their uncontrolled intake can affect not only the professional career of athletes, but also their health, due to the fact that this trace element and its salts are the strongest inorganic poisons and carcinogens. Despite this, their availability on the pharmaceutical market, a noticeable effect of erythropoiesis stimulation and a convenient oral form of administration lead to the need for their detection in modern doping control. The purpose of this research was to develop an approach to differentiate cobalt from vitamin B12, present in the body in its natural state, from the intake of cobalt salts by quantifying and comparing blood levels of vitamin B12 and total cobalt. Methods. The study involved 9 healthy volunteers (women and men) aged 25 to 45 years, leading an active lifestyle. Three of them took 2500 µg/day of cobalamin for 20 days (comparison group), three - dietary supplement containing cobalt asparaginate (100 µg/day in terms of pure cobalt), and the rest - dietary supplements with cobalt sulfate heptahydrate (100 µg/day in terms of pure cobalt) (administration groups) at the same time after meals. Blood samples were taken at baseline and on days 5, 9, 14 and 20. The concentrations of total cobalt in blood plasma samples of volunteers were measured by inductively coupled plasma mass-spectrometry (ICP-MS), the levels of cobalamin were determined on a Cobas 6000 immunochemical analyzer using the Elecsys Vitamin B12 II Assay ELISA kits. Results. It was found that oral intake of of cobalamin at a therapeutic dose significantly exceeding the recommended daily intake (3 µg), there was a regular slight increase in the blood concentration of total cobalt (1.1 times). At the same time intake of dietary supplements containing cobalt in the form of sulfate or asparaginate (about 100 µg per day in terms of pure cobalt) was accompanied by 4-6.7 fold increase in the concentration of total cobalt while unchanged vitamin B12 plasma concentration was observed. The detection of such changes can reliably indicate the use of prohibited salts and, of course, will be in demand for anti-doping control. Conclusion. Long-term monitoring of vitamin B12 and total cobalt levels, similar to hematological module of the Athlete Biological Passport program, will unambiguously detect possible abuse of cobalt salts and can be an additional evidence of the presence of these doping substances to other analytical methods, such as a combination of liquid chromatography and ICP-MS (LC-ICP-MS).

[The application of bioresonance therapy for the correction of the overtrained athlete syndrome]. / Primenenie biorezonansnoi terapii v korrektsii sindroma peretrenirovannosti sportsmena.

BACKGROUND: Physical overload results in the development of pathological changes in the organs and systems and thereby causes their dysfunction. This leads to disadaptation, vegetative imbalance, and disturbances in the cardiovascular, nervous, endocrine and other systems. Taken together, these changes give rise to a syndrome of overtraining. In this context, the pathogenetically sound method of therapy appears to be the most suitable for the management of this condition based on the physiotherapeutic non-invasive interventions for the correction of physiological characteristics and the psycho-emotional status of the patients. One such method is bioresonance therapy (BRT). AIM: The objective of the present study was to evaluate the influence of bioresonance therapy (BRT) on the health status of the athletes presenting with the overtraining syndrome. MATERIAL AND METHODS: The study included 60 athletes presenting with the overtraining syndrome. They were divided into two groups each comprised of 30 subjects of comparable age, sex, sport, and sports qualification. Group I was composed of 30 athletes who were treated by means of bioresonance therapy. Group II (control) contained the athletes who received placebo procedures (i.e. the procedures with the use of a non-functioning device). All the athletes were examined before and after the treatment with the application of the clinical and instrumental methods. RESULTS: The study has demonstrated that the use of bioresonance therapy significantly increases the parasympathetic influence on the rhythm of the heart, reduces the stress on the central contour of its regulation, contributes to the 'economization' of the cardiac activity; has an antihypertensive effect (more pronounced with respect to systolic blood pressure (SBP)), has a normalizing effect on the variability of blood pressure (BP) in the patients with initial BP instability, and significantly decreases the time index in connection with monitoring blood pressure; moreover, BRT has a normalizing effect on the circadian rhythm of BP and corrects the rate of the morning rise in diastolic blood pressure (DBP). CONCLUSION: Bioresonance therapy can be considered as a method for the correction of the syndrome of overtraining in the athletes with the enhanced activity of the sympathetic nervous system.

[Spontaneous compensation of severe mitral insufficiency secondary to rupture of chordae tendineae in an athlete].

The article describes an observation of spontaneous compensation of severe mitral insufficiency due to chordal avulsion in a 52-year-old sportsman adapted to hard physical load. After a physical load, the sportsman developed symptoms of acute mitral insufficiency. EchoCG revealed myxomatous degeneration of mitral cusps, chordal avulsion, severe mitral insufficiency, and volume overload of the left heart. The patient refused surgical treatment; conservative therapy was conducted. A three-year follow-up revealed an unexpectedly fast decrease in the size of heart cavities and the speed of regurgitation. The authors reckon that the these fast changes took place due to the sportsmen's heart adaptation to volume overload.

Algebraic instability in shallow water flows with horizontally nonuniform density.

The regimes and mechanisms of the Rayleigh-Taylor instability have been studied in the scope of the nonhydrostatic shallow water model with horizontally nonuniform density. As analysis shows, the nonhydrostaticity has a crucial influence on the instability. It is for this reason that at the final stage a collapse tendency predicted on the base of the hydrostatic scenario slows down and turns into the regime of algebraic instability. The numerical testing has shown that in spite of its simplicity, the model is quite able to describe realistically a number of effects. For example, the model captures the shallowing effect, which manifests itself as profile concavities on either side of the jet coming out of the boundary layer.

Venusian "hot spots": physical phenomenon and its quantification.

An overall picture of the Venusian hot spots phenomenon is considered in the framework of the simplest conceptual models that admit the solutions in the form of steadily rotating "hot" vortices. Model assumptions take into account only those features of the middle atmosphere in the polar region of Venus that are supported by observational data and are essential for understanding the physical mechanism initiating similar vortices. The problem is analyzed in the framework of both the pointlike and petal-like models of cyclostrophic vortices. Interpretation of these models as an upper and lower bound of a complete theory allows one to find the region of existence of the regimes responsible for the Venusian hot spots and also to establish and assess numerically conditions under which such vortices can be formed. The emphasis is on a comparison of the theoretically established results with the observational data.

[Features of interferon and cytokine production in genital herpes]. / Osobennosti produktsii interferonov i tsitokinov pri genital'nom gerpese.

The impaired production of INFs and of other cytokines at different stages of their synthesis in patients with genital herpes before and after treatment were shown to reflect the specificity of the immune response in the mentioned pathology. An activation of the cellular and humoral immunity according to the Th1 and Th2 types was observed in patients with genital herpes. The stimulated activity of Th1, B-lymphocytes and of natural killers (NK) as well as suppression of Th2 occurred in the initial treatment stage by acyclovir (10 days), which brought about a positive clinical effect in a majority of cases. A correlation between the IFN status and cytokine profile, on the one hand, and an effect of therapy in genital herpes, on the other hand, was demonstrated. Finally, the monitoring of the IFN and cytokine status in each patient is needed for choosing a treatment scheme and for prognosticating a therapy efficiency.

[The state of microcirculation during use of long acting metoprolol]. / beta-Adrenoblokatory i perifericheskii krovotok.

The aim of the study was to assess the effect of prolonged action metoprolol on the microcirculation in patients with essential hypertension (EH). We studied 51 patients with EH aged 53,4+/-4,5 years. After 7-10 days of "wash-out" period and after 8 weeks of prolonged action metoprolol (betaloc ZOK) the state of microcirculation was investigated with the use of laser Doppler flux-metry (LDF). We found significant decrease in basically enlarged basal blood flow and the level of sympathetic activity, increase in the amplitude of cardiodependent waves, normalization of basal blood flow decrement in postural test, increase in capillary blood flow reserve in patients with stage I-II EH. We failed to observe any significant changes in the microcirculatory parameters in patients with stage III EH. Treatment with prolonged action metoprolol led to increase in the number of patients with normocirculatory type of microcirculation primarily due to the decrease in the prevalence of hyperemic type. We conclude that prolonged action metoprolol does not alter microcirculation in patients with EF. Moreover, at the early stages of EH it improves the functional state of peripheral hemodynamics due to suppression of sympathetic activity.

[Microcirculation in hypertension]. / Sostoianie mikrotsirkuliatsii pri gipertonicheskoi bolezni.

Changes of microcirculatory vascular bed play important role in pathogenesis of essential hypertension. All components of the system of microcirculation including vessels and circulating blood are involved into pathological process. Resistance to blood flow is mostly formed in this system. Resistance depends on length, diameter of microvessels and viscosity of blood. In the process of the disease development the following signs of remodeling at the level of microcirculation emerge: decrease of density of vasculature, modification of the media/lumen ratio, increase of blood viscosity, slowing of angiogenesis, impairment of endothelial function. These phenomena can be both cause and consequence of hypertensive disease. Their heterogeneity depends on a variety of factors (duration, stage of the disease, etc.). It seems feasible to differentiate therapy in accordance with character and severity of changes in the system of microcirculation.

[The state of microcirculation in hypertensive disease (essential hypertension)]. / Sostoianie mikrotsirkuliatsii pri gipertonicheskoi bolezni.

Skin microcirculation was studied by laser doppler flowmetry in 149 patients with essential hypertension (92 men, 67 women; mean age 50.1+/-4.9 years) and in 25 normotensive controls. In patients with hypertension prevailed pathological hemodynamic types of microcirculation. Hyperemic, spastic and congestive types were found in 20.1, 23.5 and 40.3% of patients, respectively, while only 16.1% of patients had normal hemodynamic type. Moreover presence and severity of microcirculatory disorders depended on stage of hypertension and level of blood pressure. Thus, patients with essential hypertension had pronounced impairment of microcirculation caused by structural and functional changes of microcirculatory vascular bed.

[Complex assessment of efficacy and tolerance of metoprolol CR/ZOK in treating hypertension]. / Kompleksnaia otsenka éffektivnosti i perenosimosti beta-blokatora metoprolola CR/ZOK pri lechenii gipertonicheskoi bolezni.

AIM: To study efficacy and tolerance of betaloc ZOK (Astra-Zeneca, UK) in patients with stage I-II (WHO classification) essential hypertension. MATERIAL AND METHODS: 27 patients were enrolled in the study (13 men and 14 women, mean age 40.6 +/- 1.57 years). Complete physical examination, ambulatory blood pressure monitoring, assessment of central hemodynamics, microcirculation were made before the treatment and on the treatment week 8. RESULTS: Monotherapy with betalok ZOK (50-100 mg/day) resulted in a significant lowering of mean daily, day and night systolic and diastolic arterial pressure. Variability index was reduced, circadian rhythm of blood pressure did not change. 28% had to take diuretics (arifon or hypotiazide). CONCLUSION: Betaloc ZOK (50-100 mg) is highly effective in patients with mild to moderate essential hypertension.

Simple model of the Rayleigh-Taylor instability, collapse, and structural elements.

The mechanisms and structural elements of the Rayleigh-Taylor instability whose evolution results in the occurrence of the collapse have been studied in the scope of the rotating shallow water model with horizontal density gradient. Analysis of the instability mechanism shows that two collapse scenarios are possible. One scenario implies anisotropic collapse during which the contact area of a collapsing fragment with the bottom contracts into a spinning segment. The other implies isotropic contracting of the area into a point. The rigorous integral criteria and power laws of collapses are found.