[The application of hypobaric hypoxic therapy for the treatment of menopausal metabolic syndrome].

The objective of the present study was to evaluate the efficiency of the method designed to adapt women with menopausal metabolic syndrome to periodic hypobaric hypoxia. The patients (68 women at a mean age of 52.8 +/- 1.1 years with menopausal metabolic syndrome) were adapted to hypobaric hypoxia in an Ural-1 low-pressure chamber (twenty two daily 3-hour sessions at a simulated "altitude" of 3,500 m above sea level equivalent to 460 mm Hg). The treatment resulted in a significant decrease of modified menopausal index and body weight (by 53.5% and 6.1% respectively). Moreover, systolic and diastolic blood pressure was reduced by 13.4% and 7.3% while the levels of plasma cholesterol, glucose, and insulin dropped by 19.5%, 21.3%, and 20.2% respectively. The results of the study demonstrate high efficacy of the method of adaptation to periodic hypobaric hypoxia and the possibility of its application for the correction of clinical and metabolic disturbances in postmenopausal women.

[Efficacy of hypobaric hypoxia in the treatment of arterial hypertension in postmenopausal women].

AIM: To assess efficacy of adaptation to periodic hypobaric hypoxia (PHH) in the treatment of postmenopausal women with arterial hypertension (AH). MATERIAL AND METHODS: The method of adaptation to PHH in the pressure chamber Ural-1 (22 three-hour daily sessions, pressure 460 mmHg) was used in 46 postmenopausal AH women (mean age 53.8 +/- 3.9 years). The method was assessed for effects on blood pressure (BP), symptoms of menopausal syndrome, body mass, levels of some hormones, lipid and carbohydrate metabolism. RESULTS: Adaptation to PHH reduced systolic pressure by 13.9%, diastolic one--by 8.2%, the levels of follicule stimulating and luteinising hormones by 26.8 and 21.5%, respectively, cholesterol--by 14.7, glucose--by 21.3, insulin--20.2%; estradiol and dehydroepiandrosteron sulphate concentrations rose by 19.3 and 15.2%, respectively. CONCLUSION: Adaptation to PHH produced an antihypertensive effect and a positive trend in clinicometabolic indices in AH women in postmenopause.

[Association between the levels of metals and the intensity of oxidative stress in the body].

The hair levels of metals were measured in the workers of gas-and-chemical industry. The intensity of oxidative stress was estimated from the activity of antioxidative enzymes in the lysates of erythrocytes and serum gamma-glutamyltransferase. An association was found between the content of the metals under study and the intensity of free radical oxidation processes in persons engaged in different production cycles.

[The functional state of the cardiovascular and central nervous system in patients with occupational deafness].

The workers of the Orenburg gas-processing plant have been found to be at high risk for concomitant diseases of the cardiovascular, central nervous, and other systems in the presence of occupational sensorineural deafness. Among the comorbidities in deaf patients, cardiovascular disease heads the list (63%), of them autonomic vascular dystonia is most common (22%); diseases of the central nervous system and lung rank second (13%) and third (11%), respectively.

[Related to age and length of service, changes in psycho-physiologic occupationally important traits of technologic processes operators].

Psycho-physiologic occupational fitness of technologic processes operators changes during long-standing work in the occupation. The changes are age-related. Over 50 years of age, attention and mental performance do not satisfy the level required, so occupational fitness should be re-assessed after 50 years of age.

[Physical training at ambulatory-polyclinical stage in complex rehabilitation and secondary prevention of patients with ischemic heart disease after acute incidents. Effect on physical working capacity, hemodynamics, blood lipids, clinical course and prognosis (Russian cooperative study)].

AIM: To investigate efficacy of early and long term physical training (PT) of moderate intensity in conditions of practical health care in Russia in patients with ischemic heart disease (IHD) of able to work age - survivors of acute coronary events. MATERIAL AND METHODS: Three hundred ninety two patients were enrolled in this study. They were randomized into intervention group " O" (n=197) and control group " C" (n=195). Inclusion period was 3- 8 weeks from onset of myocardial infarction (MI), unstable angina (UA), or intervention on coronary arteries. Patients were followed up for 1 year and efficacy of intervention was assessed by results of laboratory (levels of lipids), instrumental (ECG, exercise test on veloergometer, echocardiography), and clinical examination. In the group " O" regimen of PT with work loads of moderate intensity (50-60% of power achieved during exercise test) was used. Duration of FT was 45 - 60 min, frequency - 3 times a week. All patients received standard therapy for IHD and a lipid lowering drug when indicated. RESULTS: Proofs of efficacy of PT in the given contingent of patients were obtained. This was manifested by significant increase of physical working capacity: prolongation of exercise time (+31.7%, p<0.001), increases of volume of work performed (+74.3%, p<0.001) and efficiency of cardiac work according to results of exercise tests. All parameters were significantly different from those in the group " C" . Structural functional parameters of the heart also improved in the group " O" : left ventricular (LV) stroke volume increased 4.5% (p<0.005), ejection fraction increased 7.2% (p<0.001), diastolic LV volume decreased 2.5% (p<0.05), systolic LV volume decreased 8.1% (p<0.001). In the group " C" stroke volume and LV ejection fraction rose to a lesser degree - by 5.5% (p<0.01) and 2.9% (p<0.05), respectively. Differences between groups in dynamics of these parameters turned out to be significant (p<0.05). Moreover in group " C" LV diastolic volume increased 2.3% (p<0.05) and systolic volume did not change, while left atrium increased 3.4% (p<0.002). At intergroup comparison differences in dynamics of these parameters were significant (p<0.005). Analysis of lipid profile after 1 year showed no changes in patients of group " C" , while in group " O" it revealed significant (3.6%) lowering of total (T) cholesterol (CH) (p<0.05 compared with baseline and change in group " C" ) and elevation of high density lipoprotein (HDL) CH (+12.3%, p<0.001; compared with group " C" p<0.005). Atherogeneity index TCH/HDLCH decreased 8.5% in the group " O" (p<0.01), and increased 12% (p<0.02) in the group " C" , difference between groups was statistically significant (p<0.001). In the group " O" body mass index decreased 2.8% (p<0.001), and frequency of attacks of angina decreased 50.8% (p<0.001; compared with group " C" p<0.001). Statistically significant differences were registered between the following parameters of composite end point and surrogate points: total number of cardiovascular events - 26 (14.8%) vs 47 (27%), p<0.01; number of cardiovascular catastrophes - 5 (3%) vs 15 (8.7%), p<0.05; number of days out of work because of exacerbation of IHD per 1 person/year - 2.4 vs 4.2, p<0.05 in groups " O" and " C" , respectively. Thus in the group " O" positive effect of PT on the course and outcomes of the disease was registered compared with the group " C" . CONCLUSION: The data obtained are indicative of sufficient efficacy of the used program of PT and feasibility of its application in practice of ambulatory rehabilitation of patients with IHD - survivors of acute coronary events. It also can be looked upon as a method of secondary prevention as results of the study showed its positive impact on risk factors and outcomes of the disease.

[Lipidspectrum dynamics in patients with myocardial infarction undergoing hypoxic therapy in a pressure chamber].

The aim of the study was to evaluate effect of adaptation to periodic hypoxia in pressure chamber (PHPC) on the serum lipid profile in 45 patients with myocardial infarction (MI) in the period of scarring compared with physical exercises (15 patients). Adaptive therapy was shown to cause significant decrease of total cholesterol, LDLP, triglicerides, and atherogenic index. A course of PHPC resulted in a significant 6.6% fall of serum apoA1 (major component of HDLP). Examination of the serum lipid profile in control patients with MI demonstrated a 4% decrease of the ApoA1/ApoB ratio compared with its value in the PHPC group despite positive dynamics of the parameters of cholesterol metabolism being measured. Taken together, these data suggest the lack of positive changes at the level of major pathways of cholesterol metabolism.

[Changes in the indices of lipid metabolism in patients with ischemic heart disease occupied in natural gas fields]. / Izmenenie pokazatelei lipidnogo obmena u bol'nykh ishemicheskoi bolezn'iu serdtsa, zaniatykh na proizvodstve po dobyche i pererabotke gaza.

The influence of adaptation to periodic pressure-chamber hypoxia produced on the condition of the lipid spectrum of blood serum before and after adaptation as well as in 3, 6 and 10 months after hypoxic training was studied in 46 patients with ischemic heart disease working at a enterprise specializing in winning and processing the hydrogen-sulfide-containing gas-condensate. The adaptation therapy was found to result in a reliable reduction of the total cholesterol level, of the level of cholesterol of lipoproteins of the low and extra low densities and of triglycerides; it also contributed to the increase of cholesterol of lipoproteins of the high density in blood serum, which, in the end, ensures a reduced atherogenic coefficient. The positive-for-organism changes in the lipid spectrum of blood serum hold on in patients with coronary heart disease for as long as 6 months after the adaptation therapy. The nature and degree of blood lipids' changes depend on an initial level of the atherogenic index; they were maximally pronounced in persons with the index exceeding 3, and virtually absent in IHD patients with the atherogenicity coefficient being below the mentioned figure.

[Experience in treating patients with cardiovascular diseases by means of adaptation to periodic barochamber hypoxia]. / Opyt lecheniia bol'nykh serdechno-sosudistymi zabolevaniiami metodom adaptatsii k periodicheskoi barokamernoi gipoksii.

Adaptation to periodic hypoxia (decompression 490 mm Hg) in a multiplace medical pressure chamber of patients with hypertension, cardial neurocirculatory asthenia, coronary heart disease produced a persistent hypotensive effect with improvement of central and peripheral hemodynamics, oxygen homeostasis, electrolyte balance of blood. In patients with neurocirculatory asthenia associated with ventricular and supraventricular extrasystole positive hemodynamic changes accompanied a persistent antiarrhythmic effect. In addition to the latter, CHD patients experienced improvement in myocardial contractility. Clinical effect of baroadaptation to hypoxia manifesting in symptom relief permitted the physicians to diminish the intensity of chemotherapy and to abolish it in patients with neurocirculatory asthenia.

[Loss of creatine in the body in cardiac insufficiency and prevention of this pathology with alpha-tocopherol]. / Poteria organizmom kreatina pri serdechnoi nedostatochnosti i preduprezhdenie étoi patologii s pomoshch'iu alpha-tokoferola.

Peculiarities of creatinemia and creatinurea have been studied in patients with different stages of the heart failure. Administration of alpha-tocopherol, an antioxidant, promotes normalization of these changes. Antioxidants are discussed in the aspect of their possibility prevent the creatine loss by the heart and skeletal muscles in case of the heart failure.