[High-tone therapy in complex rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery. (Open-label, prospective, randomized controlled trial)]. / Vysokotonovaya terapiya v kompleksnoi reabilitatsii bol'nykh s poststernotomicheskim sindromom posle aortokoronarnogo shuntirovaniya. (Otkrytoe prospektivnoe randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: At present it remains relevant to develop new rehabilitation technologies for patients with circulatory system diseases who have undergone a cardiac surgery to restore the functions of the cardiorespiratory system more quickly, improve physical and mental health, and prevent the development of the atherosclerotic process. AIM: To study the effectiveness and safety of the new rehabilitation technology for the inpatient stage of medical rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery (CABS) using high-tone therapy. MATERIAL AND METHODS: The study included 85 men (the average age was 56.8±2.46 years old) with post-sternotomy syndrome after CABS. They were divided into two groups by simple randomization: the first/main (42 patients) and the second/control (43 patients). The control group of the patients had a standard rehabilitation complex; the main group was additionally prescribed a high-tone therapy according to a local method. The immediate results of the treatment were assessed by the dynamics of the clinical picture, the six-minute walk test, respiratory function, echocardiography, the level of cytokines, C-reactive protein and natriuretic peptide (NT-proBNP); distant - by QOL endpoints (questionnaire MOS SF-36). RESULTS: The groups of the patients were comparable in all baseline parameters. After the course of the procedures in the main group of patients there were positive reliable (p<0.05-0.001) shifts in clinical (pain, shortness of breath, general weakness), functional (forced expiratory vital capacity, forced expiratory volume1, effusion separation) and laboratory parameters (leukocytes, interleukin-2 and 10, NT-proBNP). The intergroup analysis of long-term results registered significant (p<0.05) differences in the QOL of patients in the main group by subscales: the role of somatic problems, vitality and mental health. Compliance to the III stage of medical rehabilitation (outpatient/home) was noted with 95.2% of the patients in the first group and 93.0% in the second. CONCLUSION: The additional appointment of a high-tone therapy to the rehabilitation standard for the patients with post-sternotomy syndrome after CABS significantly improves the immediate and long-term results of the treatment (QOL) contributing to a more pronounced reverse development of inflammatory and edematous syndromes, an increase in physical activity and psychosomatic health. The absence of adverse reactions with all the patients indicates the safety of rehabilitation complexes.

[Natural therapeutic factors in medical rehabilitation of patients with post-COVID syndrome]. / Prirodnye lechebnye faktory v meditsinskoi reabilitatsii patsientov s postkovidnym sindromom.

The feasibility of using therapeutic physical factors in post-COVID syndrome is due to their sanogenetic effects that ensure the restoration of impaired bodily functions, which serves as the basis for their use at various stages of medical rehabilitation of this category of patients. OBJECTIVE: To develop a new medical technology for the 3rd outpatient stage of medical rehabilitation of the patients with post-COVID syndrome using natural therapeutic factors of Nalchik resort. MATERIAL AND METHODS: There has been carried out a controlled study in compliance with the principles of randomization to develop an outpatient medical rehabilitation program including 168 patients with post-COVID syndrome. All the patients were divided into four groups: the control group (n=40) was prescribed pharmacotherapy and physical therapy in the hall in accordance with federal clinical recommendations; comparison group 1 (n=43) had drinking mineral water in addition; comparison group 2 (n=43) received physical therapy on the route of Nalchik resort terrainkur in addition to the treatment in comparison group 1; the main group (n=42) included a group psychotherapy on the Terrainkur route in addition to the treatment in comparison group 2. RESULTS: The results of the comparative analysis showed the feasibility of the developed outpatient medical rehabilitation program for the patients suffering from post-COVID syndrome: the overall effectiveness of rehabilitation measures increased compared to other follow-up groups by 10-15% due to the improvement of external breathing function (p<0.05), cognitive status (p<0.01), increased exercise tolerance (p<0.01), physical recovery (p<0.01) and mental health (p<0.01). CONCLUSION: The summation and integration of sanogenetic effects of physical factors, psychocorrective techniques, and pharmacotherapy provide a significant improvement in the physical and mental status of the patients with post-COVID syndrome.

[Physical factors in the medical rehabilitation of patients with chronic cerebral ischemia in the outpatient stage]. / Fizicheskie faktory v meditsinskoi reabilitatsii patsientov s khronicheskoi ishemiei golovnogo mozga na ambulatornom etape.

Chronic cerebral ischemia is an urgent problem of modern medicine due to high disability of this contingent of patients and requires new approaches to the treatment and medical rehabilitation. OBJECTIVE: To develop a new technology for medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis using therapeutic physical factors (such as ozone therapy and magnetic field in combination with endomassage) against the background of rational pharmacotherapy and psychocorrection. MATERIAL AND METHODS: There have been observed 122 patients with chronic cerebral ischemia stage I. They were divided into three groups by simple randomization. The patients of the group of comparison 1 (GC1) (n=39) had neurotropic pharmacotherapy (Cerepro and Mexidol) and a group psychotherapy; the rehabilitation programme of the patients of the group of comparison 2 (GC2) (n=41) included ozone therapy (intravenous infusions of ozone-oxygen mixture) in addition to the treatment program of GC1; the patients of the main group (MG) (n=42) received a combination of magnetic field exposure and endomassage in addition to the treatment program of GC2. Clinical monitoring, coagulation hemostasis, and cerebral vascular ultrasound were used to assess the treatment efficiency. RESULTS: The rehabilitation treatment performed on an outpatient basis with the inclusion of ozone therapy and the combined effect of magnetic field and endomassage in MG ensured the leveling of clinical symptoms in 91.2% of cases (p<0.01). The efficiency of rehabilitation in GC1 was 74.4%, with the additional use of ozone therapy in GC2 - 82.6%. CONCLUSION: The use of the new technology with the use of intravenous infusions of ozone-oxygen mixture and magnetic field in combination with endomassage against the background of rational pharmacotherapy and psychocorrection in medical rehabilitation of the patients with chronic cerebral ischemia on an outpatient basis provides a reliably significant increase in the effectiveness of rehabilitation measures.

[Evaluation of the influence of different physical and chemical composition mineral waters on the state of carbohydrate metabolism in experimental metabolic syndrome]. / Otsenka vliyaniya mineral'nykh vod razlichnogo fiziko-khimicheskogo sostava na sostoyanie uglevodnogo obmena pri eksperimental'nom metabolicheskom sindrome.

Purpose of the study. To carry out a comparative analysis of the intake effect of mineral waters (MW) of various physicochemical compositions, including those ones enriched in selenium, on the pathogenesis of metabolic syndrome (MS) in the experiment. MATERIALS AND METHODS: The experiment was carried out on 68 male white rats aged 3 months, which were divided into 5 groups. Control groups: CG1 - 10 animals without exposure; CG2 - 14 animals with MS, received only drinking water. Experimental groups: EG1 - 14 rats with MS, received MW1 of chloride-sulfate sodium composition (Ivanovo region); EG2 - 15 animals, received MW2 of chloride-hydrocarbonate-sodium composition (Essentuki No. 4); EG3 - 15 animals, received MW2 enriched with selenium. MS was modeled by double injection of streptozotocin, intraperitoneally, 30 µg/kg, after 60 days of finding the animals on a hypercaloric diet. RESULTS: According to the oral glucose tolerance test (GTT) in animals with MS, two variants of the glycemic response were identified, according to which two subgroups (SG) were identified in each group. In the 1st SG CG2 and EG1-3, a moderate increase in glucose at the 60th minute of GTT was revealed, which was 1.2 times higher than the glucose level at the 60th minute in CG1. In SG 2, an increase in glucose was noted at the 60th minute by 2.5-5.0 times, by the 120th minute of GTG the glucose level was higher than in CG1. In animals CG2, there was no decrease in glucose by the 120th minute, in contrast to EG1-3. The activity of blood α-amylase increased by 2 times was determined in animals CG2 compared to CG1, and in groups EG1 and EG2 the level of its activity approached the level of CG1. CONCLUSION: In animals with MS, a decrease in the sensitivity of ß-cells to the stimulating effect of glucose and the involvement of the exocrine pancreas in the pathological process was determined. Under the influence of therapeutic course drinking MW of different physicochemical composition in animals with MS in the experiment, the sensitivity of tissues to the stimulating hyperglycemic signal was restored to varying degrees and the increased activity of blood α-amylase decreased.

[To the 100th anniversary of the founding of the Pyatigorsk research institute of balneology]. / K 100-letiyu so dnya osnovaniya Pyatigorskogo nauchno-issledovatel'skogo instituta kurortologii.

The article is dedicated to the 100th anniversary of the Pyatigorsk state research Institute of balneology. It presents the main stages of formation and development, scientific achievements of the Institute and highlights the main activities at the present stage.

[The substantiation of the application of the high-intensity pulsed magnetic field for the combined treatment of biliary sludge]. / Obosnovanie primeneniia vysokointensivnogo impul'snogo magnitnogo polia v kompleksnoi terapii biliarnogo sladzha.

Despite the considerable achievements in the field of gastroenterology, there is still high incidence of diseases of the organs of the hepatobiliary system which necessitates the development of new therapeutic techniques for their management. Nowadays, high-intensity pulsed magnetic therapy is considered to be a highly efficacious method characterized by well-pronounced and many-sided action on the processes proceeding in the organism as a new preformed factor producing neurostimulatory, vasodilatory, trophic, and hypoalgesic effects. It appears to be effective with respect to biliary sludge (BS) since it can promote depletion of stagnant contents of the gall bladder and also intensify its contractile function. AIM: The objective of the present study was to evaluate the effectiveness of the application of the high-intensity pulsed magnetic field in the combination with the intake of mineral water (MW) and rational pharmacotherapy as the components of the combined treatment of biliary sludge. METHODS: The study included 117 patients presenting with biliary sludge (BS) who were randomly allocated to three groups. Group 1 was comprised of 38 patients and served as the control group. These patients received medicamentous therapy (hymecromone - 200 mg 3 times daily during two weeks and ursodeoxycholic acid at a dose of 10-15 mg/kg a day during a period from 3 to 6 months). The second group consisted of 40 patients and served as the group of comparison. The patients of this group received medicamentous therapy in the combination with the intake of 'Sernovodskaya' hydrocarbonate-chloride-sulphate sodium mineral water (from a spring in the Chechen republic). The third group was composed of 39 patients and constituted the main study group. These patients completed a course of therapy with the use of the high-intensity pulsed magnetic field applied to the gall bladder region. Each patient underwent 10 sessions of magnetic therapy after the completion of the treatment with hymecromone and 'Sernovodskaya' mineral water. The treatment was carried out with simultaneous monitoring dynamics of the clinical symptoms of biliary sludge, the ultrasound examination of the abdominal organs with the evaluation of the contractile function of the gall bladder, the level of bilirubin in the cystic bile, bile acids, cholesterol, and cholate-cholesteric coefficient. RESULTS: The combined treatment of the patients suffering from BS including the application of the high-intensity pulsed magnetic field alleviated the clinical symptoms of the disease much faster than medicamentous therapy combined with the intake of 'Sernovodskaya' mineral water. Moreover, it promoted the restoration of the motor activity of the gall bladder and accelerated the evacuation of the hyperechoic particles. CONCLUSION: The course of the combined treatment of the patients presenting with biliary sludge including the application of the high-intensity pulsed magnetic field in the combination with the intake of mineral water (MW) and rational pharmacotherapy significantly relieved abdominal pains, alleviated the symptoms of biliary dyspepsia, and improved the motor function of the biliary tract. These therapeutic effects persisted as long as 3 months. The results of the present study give evidence of the necessity of prescription of an optimum dose of ursodeoxycholic acid to the patients suffering from biliary sludge.

[One-time effects of drinking mineral water and tap water enriched with silver nanoparticles on the biochemical markers of liver condition and metabolic parameters in healthy rats].

AIM:  The objective of the present research was to study the influence of tap water enriched with silver nanoparticles (NP) as well as that of «Krasnoarmeysky¼ and «Essentuki №17¼ mineral waters after their single administration through the oral gavage to the rats on the metabolism of carbohydrates and lipids, the biochemical markers of the liver condition, and the endocrine profile in the healthy animals. MATERIAL AND METHODS:  The laboratory animals (130 male Wistar rats) were allocated to thirteen groups comprised of 10 rats each as follows: 1st group (n=10) intact animals, 2nd group (5 minutes after the administration of silver NP (n=10), 3rd group (15 minutes after the of silver NP), 4th group (60 minutes after the administration of silver NP), 5th group (n=10) (5 minutes after the introduction of the «Krasnoarmeysky¼ mineral water), 6th group (n=10) (15 min after the introduction of the «Krasnoarmeysky¼ mineral water), 7th group (n=10), (60 minutes after the introduction of the «Krasnoarmeysky¼ mineral water) 8th group (n=10) (5 minutes after the introduction of the «Essentuki № 17¼ mineral water), 9th group (n=10) (15 min after the introduction of the «Essentuki № 7¼ mineral water) , 10th group (n=10) (60 minutes after the introduction of the «Essentuki №17¼ mineral water), 11th group (n=10) (5 minutes after administration of tap water (control),12th group (n=10) (15 minutes after administration of tap water (control), and 13th (n=10) group 60 minutes after administration of tap water (control). RESULTS:  The study has demonstrated that the tap water enriched with silver nanoparticles similar to the mineral waters caused stress reactions that are inferior to those induced by «Essentuki №17¼ mineral water in terms of the magnitude; however, the effect provoked by the tap water was of longer duration. Moreover, the tap water enriched with silver nanoparticles stimulates prooxidant reactions, and inhibit the activity of antioxidant protection. Silver nanoparticles appear to produce some destructive effect on the hepatocytes. CONCLUSION:  The silver nanoparticles present in the tap water have a significant biological potential of their own. Moreover, their one-time action is apt to alter the biological potential of the water into which they are administered. The single intake of the tap water enriched with silver nanoparticles by the healthy laboratory animals produces the response that resembles that of the drinking mineral water.

[The spa and health resort-based treatment of metabolic syndrome with the application of the therapeutic courses of different duration: the evaluation according long-term results]. / Sanatorno-kurortnoe lechenie metabolicheskogo sindroma pri razlichnoi prodolzhitel'nosti lechebnogo tsikla po rezul'tatam otdalennykh nabliudenii.

AIM: The objective of the present study was to estimate the effectiveness of the new therapeutic modalities for the spa and health resort-based treatment of metabolic syndrome based on the results of the long-term follow-up observations. MATERIAL AND METHODS: A total of 100 patients presenting with metabolic syndrome were recruited for the participation in the study. All of them underwent a shortened course of mineral water intake in the combination with the use of the herbal medicinal products. RESULTS: The results of the study give evidence of the more favorable changes in the clinical and instrumental characteristics of the patients with metabolic syndrome treated with the use of the proposed approach in comparison the patients treated by the conventional methods. Moreover, the beneficial effects of the proposed approach persisted during a longer period. The basal treatment given to our patients was supplemented by dietary therapy, therapeutic physical exercise, narzan baths, intake of mineral water having a temperature of 35-37 °Ð¡ in conjunction with sulphate mineral water (narzan) cooled to 13-15 °Ð¡, and a phytococktail. CONCLUSION: The results of the long-term observations confirmed the enhanced effectiveness of the spa and health resort-based treatment of metabolic syndrome including the therapeutic courses with the intake of cooled narzan mineral water in the combination with phytococktails. This therapeutic modality increased the duration of the favorable changes of various parameters that characterize metabolic syndrome. Specifically, they persisted during 5-6 months after the application of the standard methods, were still apparent within 6-7 months after the two-week course of the treatment with cold narzan and phytococktails, and during 8-9 months when the duration of the treatment course was extended up to 3 weeks.

[The investigation of immunological effects of the new balneotherapeutic preparation glinofir used for the treatment of adjuvant arthritis]. / Izuchenie immunologicheskikh effektov novogo bal'neologicheskogo sredstva glinofir pri ad''yuvantnom artrite.

AIM: The objective of the present study was to investigate the influence of a course of application of the modified natural factors on the immunological mechanisms of regulation under experimental conditions with special reference to the application of the natural yellow clay, the clay from the Novo-Pyatigorsk quarry (the lake Tambokan) and of the new balneotherapeutic preparation glinofir based on this modified clay and designed for the treatment of adjuvant arthritis (AA). MATERIAL AND METHODS: The study of anti-inflammatory activity of the externally applied balneomedicines was carried out with the use of an animal model of adjuvant arthritis. The course of applications started 3 days prior to the initiation of AA and was terminated on the 24th day of the experimental disease. The action of three balneotherapeutic preparations (Tambukan mud, yellow clay, and modified clay in the form of Glinofir) was compared after they were heated to 42 °C and applied to the animals' limbs for 15-20 minutes every second and third days. The experiments were performed on Wistar rats (n=59) divided into five groups. Group 1 was comprised of 9 healthy animals that served as controls. The animals of group 2 (n=10) presented with untreated experimentally-induced adjuvant arthritis, those of Group 3 (n=10) had model AA treated by a course of application of the Tambukan mud. The animals of group 4 (n=10) had model AA and were treated by the application of the yellow clay and those of Group 5 (n=10) with model of AA received a course of application of the modified clay. RESULTS: On day 37 after the induction of adjuvant arthritis, the animals developed leukocytosis (white blood cell count in the blood was 1.5 times higher than in the control group) and alterations in the composition of the lymphocyte population, viz. B-lymphocytes increased 2-2.5 times (p<0,02) while T-lymphocytes decreased (p<0,05). A course of glinofir application contributed to the restoration of the T-cytotoxic cell population (p<0,2) and influenced the regulation of pathological immune complexes (PIC) as confirmed the negative correlation between the PIC level and the absolute number of T-cytotoxic cells (r=-0,8, p<0,01). The chronic stage of AA was associated with a two-fold increase in the absorptive capacity of neutrophils. The treatment with the Tambukan mud and glinofir restored the phagocytic function of neutrophils and simultaneously reduced the blood leukocyte reaction. CONCLUSION: The anti-inflammatory action of the Tambukan mud and glinofir manifests itself in the unidirectional changes of dynamics of the characteristics of cellular and humoral immunity.

[From the Russian Balneological Society to innovative technologies of spa and health resort-based treatment. The 95th anniversary of the Pyatigorsk State Research Institute of Balneology].

This article is dedicated to the 95th anniversary of the Federal state budgetary institution "Pyatigorsk State Research Institute of Balneology", Russian Federal Medico-Biological Agency. The main stages of the development of the institution are described with special reference to its scientific achievements and the principal lines of current activities.

[The effectiveness of the spa and health resort-based treatment with the application of Essentuki-type drinking mineral waters for the management of non-alcoholic fatty liver disease in the patients presenting with type 2 diabetes mellitus].

The objective of the present study was to estimate the effectiveness of the spa and health resort-based treatment of non-alcoholic fatty liver disease in 40 patients at the mean age of 48,8 ± 5.7 years suffering from type 2 diabetes mellitus. All of them received combined therapy including the application of potable Essentuki-Novaya mineral water (20 patients) or Essentuki No 4 water (20 patients). This therapeutic modality resulted in positive dynamics of clinical symptoms of the disease, the functional liver tests, and parameters of intra-hepatic hemodynamics, lipid peroxidation homeostasis, and the hormonal status. It is concluded that the spa and health resort-based treatment with the application of local drinking Essentuki-type mineral waters for the management of non-alcoholic fatty liver disease in the patients presenting with type 2 diabetes mellitus leads to the improvement of the main functions of the liver, stabilizes carbohydrate and lipid metabolism, and prevents progression of the pathological process.

[The spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation].

OBJECTIVE OF THE STUDY: To develop a new medical technology for the spa-and-health resort-based treatment of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation. MATERIAL AND METHODS: A total of 100 patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation were available for the examination that included detailed investigations of the clinical picture, characteristics of the immune status, and psychological testing before and after a course of the spa-and-health resort-based treatment. The effectiveness of two therapeutic modalities was evaluated. One of them (control) prescribed to 50 patients consisted of standard antiulcer pharmacotherapy in combination with Essentuki Novaya drinking mineral water and carbon dioxide mineral baths, the other given to 50 patients included radon baths instead of carbon dioxide mineral baths. RESULTS AND DISCUSSION: The combined application of drinking mineral waters, radon baths, and standard antiulcer pharmacotherapy produced the most conspicuous clinical effect in the framework of spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation as confirmed by positive dynamics of their psychoemotional status in 97.7% of the cases, regression of pain syndrome (91.5%), and improvement of humoral and cellular immunity (94%). An important result of the spa-and-health resort-based rehabilitation is the intensification of the reparative processes in gastroduodenal mucosa responsible for the healing of ulcers and erosions in 94.7% of the patients. CONCLUSION: The spa-and-health resort-based rehabilitation is a pathogenetically sound and efficacious approach to the management of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation.

[Balneotherapeutics of non-alcoholic fatty liver disease with the use of the Essentuki-type drinking mineral waters].

The objective of the present work was to estimate the effectiveness of combined spa-and-resort treatment with the use of the Essentuki-type drinking mineral waters for the patients presenting with non-alcoholic fatty liver disease. A total of 40 patients presening with non-alcoholic fatty liver disease (NOFLD) were available for the examination. The study has demonstrated positive dynamics of clinical symptoms and results of liver functional tests, characteristics of intrahepatic dynamics, lipid metabolism, antioxidant hemostais, and the hormonal status of the patients with non-alcoholic fatty liver disease. The intake of the Essentuki-type drinking mineral waters promoted normalization of adiponectin and leptin levels in conjunction with the reduction in the degree of insulin resistance, i.e., the key pathogenetic factors responsible for hepatic steatosis and non-alcoholic steatohepatitis. It is concluded that the Essentuki-type drinking mineral waters may be recommended for the inclusion in the combined treatment and prevention of the progression of non-alcoholic fatty liver disease.

[The use of mineral waters for the rehabilitative treatment of the patients with non-alcoholic lesions of the liver in the hospital environment].

A method has been developed for the correction of metabolic, hepato-biliary, and ischemic disorders in the patients with chronic nonalcoholic lesions of the liver by means of combined treatment using pharmaceutical agents (ursosan and Omega-3), Tib-2 drinking mineral water, and sinusoidal modulated currents (SMC) electrophoresis of this water in the right hypochondrial region. This therapy ensured pathogenetically sound modulation of the functional state of the liver and the biliary tract; moreover, it reduced the severity of regional ischemia, improved rheologic properties of the blood, normalized lipid metabolism and peroxidation, influenced production ofpro-inflammatory cytokines.

[Diagnosis and treatment of patients with primary "empty" sella turcica syndrome at the stage of sanatorium-and-spa rehabilitation].

The authors report the first attempt to develop the treatment strategy for patients with primary "empty" sella turcica syndrome based at a health resort facility. It is shown that combined therapy including radon baths and acupuncture at specific auricular points makes it possible to improve functioning of the pituitary-ovarian system, decrease body weight, normalize blood prolactin level, eliminate visceral obesity, enhance tissue sensitivity to insulin, reduce hyperinsulimenia and fertility problems (anovulation, hyperandrogenism, and hypoluteinism) associated with insulin resistance.

[Effect of algal preparations on immunological and biochemical characteristics of rats with adjuvant arthritis].

Investigations with the use of a rat model of adjuvant arthritis have demonstrated long-term immune, biochemical, and anti-inflammatory effects of preparations based on green and brown marine algae from the Anapa region (the Black Sea). Comparative studies showed that the algal preparations are in many cases as efficient in terms of various biological actions as local therapeutic muds.

[Modern methods of balneotherapy of digestive pathology at the Caucasian Mineral Waters spa-and-resort complex].

Scientists of Pyatigorsky State Research Institute of Balneotherapeutics are actively engaged in developing new medical technologies for rehabilitative treatment of patients with a variety of pathological conditions based on the current knowledge about mechanisms of action of natural therapeutic factors. Most of these original methods are included in the State Inventory of novel medical technologies by the Federal Supervisory Health and Social Development Service. The proposed medical technologies based on the application of natural and man-made physical factors improved general effect of balneotherapy by 15-20% and accelerated recovery from the disease. Specifically, the length of post-treatment remission increased to 7-12 months and duration of temporary disability decreased 2.5-3 times. Sick list payouts and economic expenditures of the state and the patients for medicinal preparations were reduced 3-4-fold while the quality of life and clinical prognosis significantly improved.

[Correction of syndrome-associated metabolic disturbances in patients with erosive and ulcerative lesions in the gastroduodenal system].

Correction of syndrome-associated metabolic disturbances in patients with erosive and ulcerative lesions in the gastroduodenal system was achieved by inclusion of moderately mineralized drinking water (Essentuki No 4 and the like), low-sulfide mineral baths, and essential phospholipids in the system of combined sanatorium-and-spa treatment. This approach allowed metabolic status of the patients to be improved and peroxide homeostasis stabilized. Moreover, it had generalized beneficial effect on the pathological process.

[Use of drinking mineral waters in children with bronchial asthma and associated biliary tract diseases].

It is shown that supplementation of therapy of bronchial asthma in children by mineral water (Essentuki No 4) has marked beneficial effect on the functional activity of digestive organs and the respiratory system. It is recommended that drinking mineral waters be included in the course of the resort-and-spa treatment of such patients.

[Novel technologies for the correction of aftereffects of deficient nutrition in the dietician practice].

Deficient nutrition is a common pathological factor encountered in medical practice. We evaluated results of combined intake of Essentuki-Novaya mineral water and Nutridrink artificial food mixture (Nutritia, Holland). Spa and resort therapy based on the use of natural factors and well-balanced nutrition resulted in the marked alleviation of clinical symptoms in patients with gastrointestinal disorders. Simultaneously, the consequences of deficient nutrition in the preceding period were corrected and manifestations of the main pathological syndromes decreased. It is concluded that a short-term course of oral alimentation using food substrate mixtures had beneficial effect on the health state of patients by improving their nutritional status and quality of life.