[Therapeutic physical factors in chronic inflammatory diseases of the pelvic organs. (A wounded home-controlled study)]. / Lechebnye fizicheskie faktory pri khronicheskikh vospalitel'nykh zabolevaniyakh organov malogo taza. (Randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: In case of chronic inflammatory diseases of the pelvic organs (CID) in women, it is advisable to use therapeutic physical factors that have a sanogenetic effect in rehabilitation treatment programs. AIM: To study the effectiveness of complex restorative treatment of patients with chronic salpingoophoritis with the consistent use of therapeutic physical factors. MATERIAL AND METHODS: The study included 96 patients with chronic salpingoophoritis at the age of 18 to 49 years. Two groups were formed by a simple sampling method: in the main group (MG/n=44), against the background of standardized treatment in inpatient conditions, patients received intravaginal ultrasound therapy, in non-hospital settings - interference therapy; in the control group (CG/n=41) - women received only standardized therapy. The criteria for the effectiveness of treatment were: determination of markers of pain and inflammation; ultrasound examination of the ovarian arteries with their Doppler measurements; assessment of quality of life criteria. RESULTS: Comprehensive restorative treatment of patients with chronic salpingoophoritis with sequential use of curative physical factors (CPF), according to direct and long-term observations, provides a significant reduction in pain intensity (p<0.01), inflammation (p<0.01), peripheral blood flow (p<0.01), physical and mental health (p<0.01). CONCLUSION: The implementation of a new developed method of restorative treatment of patients with chronic salpingoophoritis with sequential use of CPF provided a significant increase of 10-12% in the effectiveness of therapeutic measures in comparison with standardized therapy (p<0.05-<0.01).

[The effect of internal course intake of selenium-modified mineral water on bone mineral density after long-term diet-induced metabolic disorders in the experiment. (Randomized controlled trial)]. / Vliyanie vnutrennego kursovogo priema modifitsirovannykh selenom mineral'nykh vod na mineral'nuyu plotnost' kostnoi tkani posle dlitel'nogo diet-indutsirovannogo narusheniya metabolizma v eksperimente. (Randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: The phenomenon of therapeutic and prophylactic effect of natural mineral waters (MW) used to restore tissue tolerance to glucose and normalize basal insulin secretion in metabolic syndrome is well known. At the same time, the use of selenium-enriched MW is promising due to its multitarget action including participation in the regulation of the protein-synthesizing function of cells. AIM: To study the effect of internal course intake of selenium-modified mineral waters of different composition on bone mineral density after long-term diet-induced metabolic disorders in the experiment. MATERIAL AND METHODS: The study was carried out on outbred male white rats that were distributed into 3 control groups (CG) and 4 main groups (MG). In CG1 14 animals received laboratory food and drinking water; in CG2 14 animals were modeled for diet-induced metabolic disorders, and they were withdrawn from the experiment the day after the cancellation of the hypercaloric diet (180 days); after the cancellation of the hypercaloric diet 180 days later 14 animals with diet-induced metabolic disorders in CG3 had a standard diet (laboratory food and drinking water) for 30 days. In the experimental groups (EG), the animals similarly to CG3 were modeled diet-induced metabolic disorders, after the cancellation of the diet they had a standard diet and watering with MW. In MG1 18 animals were given MW1 (Essentuki-4); in MG2 19 animals had a course of MW1Se (Essentuki-4 enriched with selenium); in MG3 14 animals had a course of MW2 (Slavyanovskaya); in MG4 18 animals had a course of MB2Se (Slavyanovskaya enriched with selenium). The weight (body weight) of the animals was monitored monthly. Biochemical studies, densitometry and computed microtomography were used to determine the effectiveness of MW. RESULTS: The characteristics of spongy bone tissue of femoral metaphysis of the rats of the control groups revealed disorders of varying degrees, but, despite this, the bone tissue structure of the examined vertebral bodies in animals without a hyper caloric diet (CG1) was preserved. The analysis of the study results demonstrated a significant effectiveness of selenium-enriched MW in regulating metabolic processes (p<0.05-p<0.01), bone mineral density (p<0.05), reduced bone resorption (p<0.05), that is, the characteristics of spongy bone tissue of femoral metaphysis and vertebral bodies of animals showed a clear tendency to restore bone structure. CONCLUSION: The results of this study make it possible to predict an increase in the effectiveness of medical rehabilitation of patients with somatic diseases when selenium-enriched MW is included in the programmes.

Efficiency assessment of shock wave therapy in patients with pelvic pain employing harmonic analysis of penile bioimpedance.

In searching for novel objective methods to diagnosticate pelvic pain and assess efficiency of analgesic therapy, 37 male patients were examined prior to and after the course of extracorporeal shock wave therapy (5-10 sessions) with the waves directed to projections of prostate and/or crura and shaft of the penis. The repetition rate of mechanical pulses was 3-5 Hz. The range of energy pulse density was 0.09-0.45 mJ/mm(2). The overall number of pulses in a session was 1500-3000 in any treated zone with total energy smaller than 60 J. The applicator was relocated every other series of 300-500 pulses. Effect of the shock wave therapy was assessed according to subjective symptomatic scales: International Prostate Symptom Score, International Index of Erectile Function, Quality of Life, and nociceptive Visual Analog Scale. The objective assessment of shock wave therapy was performed with harmonic analysis of penile bioimpedance variability, which quantitatively evaluated the low-frequency rhythmic and asynchronous activities at rest as well as the total pulsatile activity of the penis. The magnitude of spectrum components of bioimpedance variations was assessed with a novel parameter, the effective impedance. The spectral parameters were measured in 16 patients prior to and after the treatment course. The corresponding control values were measured in the group of healthy patients. Prior to the shock wave therapy course, all spectrum parameters of penile bioimpedance significantly differed from the control (p<0.05). After this course, low-frequency rhythmic and the total pulsatile activity decreased to normal, while asynchronous activity remained significantly different from the normal. The novel objective physiological criteria of pelvic pain diagnostics and efficiency of its treatment reflecting the regional features of circulation and neural activity corresponded to the clinical symptom scaling prior to and after the shock wave course, and on the whole, these criteria corroborated improvement of the patient state after this therapy.

Rhythmic oscillations of human penile bioimpedance in healthy individuals and in patients with vascular erectile dysfunction.

Small variations of electric impedance (bioimpedance) of human penis were examined in healthy volunteers and in patients with vascular erectile dysfunction (ED). The harmonic analysis revealed rhythmic oscillations of penile bioimpedance at frequencies corresponding to the heart and respiration rates and Mayer wave (0.1 Hz) and to multiple frequencies (harmonics) of the respiratory and cardiac oscillations. In normal penile bioimpedance spectrum, the Mayer and respiratory peaks were several times higher than the first cardiac (pulsatile) harmonic indicating neurogenic origin of rhythmic bioimpedance variations in the whole penis. The most of healthy individuals (78%) demonstrated the cardiac harmonics at the frequency range of 4-7 Hz that violated the monotone decrement of the pulsatile harmonic series suggesting the resonant character of oscillations of the penile arteries at this "near" frequency range. In contrast to stable 1-4 cardiac harmonics, the amplitudes of the near-range resonant harmonics could vary during few minutes suggesting a causal relation of the corresponding bioimpedance oscillations with the varying vascular tone in penile arteries. The most patients (89%) with vascular ED demonstrated not only the first 1-4 monotonically decrementing harmonics and the near-resonant ones, but also the stable cardiac harmonics at the "far" frequency range of 8-14 Hz that also disturbed the monotonic character of the cardiac harmonic series indicating the sclerotic alterations in regional arteries. In ED patients, insignificant decrease of the initial cardiac harmonics C1-C3 in comparison with the norm was accompanied by pronounced and significant decrease of the respiratory R1 and Mayer M1 peaks. The study showed that the far-frequency bioimpedance resonances at the range of 8-14 Hz and dramatic drop of Mayer and respiratory peaks are the diagnostic signs of vascular ED independent on the accompanying hormonal or neurogenic disorders.