ECG Dispersion Mapping in Preclinical Diagnosis of Cardiovascular Diseases.

The aim of the study was to develop a method for diagnosing pre-nosological changes in the electrophysiological state of the myocardium in patients with somatoform dysfunction of the autonomic nervous system (SDANS) and risk factors for cardiovascular diseases using the ECG dispersion mapping method. MATERIALS AND METHODS: The study involved 109 male patients, 58 of them with SDANS, and 51 were healthy subjects. The patients with SDANS had the following risk factors for cardiovascular diseases, in decreasing order: stress (71% of cases), low physical activity (59%), smoking (57%), overweight and obesity (43%), anxiety (41%), low consumption of vegetables and fruit (36%), lack of extra aerobic physical activity (36%), excessive alcohol consumption (34%), depression (26%), total cholesterol ≥5 mmol/L (23%), and heart rate ≥80 (9% of the cases). All the subjects underwent clinical examination, laboratory investigation, ECG, ECG dispersion mapping, heart rate variability monitoring. RESULTS: Using the method of ECG dispersion mapping allowed a way for diagnosing pre-nosological changes in the electrophysiological state of the myocardium in male patients with SDANS, the basis of the pathogenesis of which is formed by the tension of the regulatory systems. Correlation between the total score according to the developed method, the RRNN value after 4 min of staying in orthostasis, and the "Myocardium" integral index has been proved. The diagnostic sensitivity of the proposed method with a threshold score of 8 was 80%, specificity - 70.8%. CONCLUSION: The developed method for assessing pre-nosological changes in the electrophysiological state of the myocardium which includes cardiovascular risk factors with a reclassifying potential, proves the development of pre-nosological changes in patients with SDANS in response to daily physical strain. The changes are associated with the tension of the electrophysiological state of the myocardium, an increased activity of the sympathetic division of the ANS being one of its pathogenetic mechanisms.

[Options for medical and psychological rehabilitation of combat veterans in the aftermath of combat stress and trauma]. / Varianty mediko-psikhologicheskoi reabilitatsii veteranov boevykh deistvii pri posledstviyakh boevogo stressa i travm.

The problem of combatants' rehabilitation in the modern world is relevant for medicine in all countries. The forms of care are inpatient, sanatorium, outpatient and polyclinic. The choice of a specific program for a combatant is based on the compilation of a personalized target map with the measurement of the functional index measurements that allow assigning patients to relevant correction groups. Three variants of programs for the combatants' rehabilitation are proposed. Each one considers such components as a regimen and drug therapy. Psychotherapy plays an important role. The volume and tasks of psychotherapeutic influences are determined taking into account the mechanisms of the disease development and the psychological state of the patient. In the process of psychotherapy, various techniques and methods are used (psychodynamic, humanistic, cognitive-behavioral). Along with traditional psychotherapeutic techniques, psychophysiological trainings using the principle of biofeedback are used. An urgent component of the rehabilitation of veterans is carrying out correctional work with their family members. An important place is given to the rehabilitation of victims' family members - work with acute grief, life crisis, and catastrophic experiences. Preserving and restoring the health of war veterans is not only a medical but also a social problem.

[Effect of anthropo-technogenic load on medico-social aspects of primary morbidity and disability of population.]

Population aging is a global social phenomenon that affects the most important health indicators of the population. The older generation is particularly vulnerable in the current conditions of urbanization and the associated environmental situation. The comprehension of indicators of disability and morbidity of the population, the study of the factors that determine the negative processes of health damage, taking into account regional features of these processes are necessary for the planning of preventive measures. In the age structure of the primary disability of the adult population in the Voronezh region elderly disabled people make up 53,3%, middle and young people with disabilities are less - 30,1 and 16,6%, respectively. These indicators are higher than the average Russian. The results of non-carcinogenic risk and primary morbidity analysis in population of Levoberezhniy district of Voronezh under permanent anthropotechnogenic load have presented. It has been established that non-carcinogenic risk coefficients were bigger that acceptable level (HQ>1) by for nitrogen dioxide, acrylonitrile, acrolein, 1,3-butadiene, copper oxide, chromium+6. Unacceptable level of non-carcinogenic risk is typical for respiratory organs pathology, pathologies of cardiovascular system and endocrine system. Analysis of the primary morbidity of these nosological forms shows their high distribution in adult population morbidity. Under rehabilitation measures in patients with respiratory organs diseases, circulatory system and endocrine system diseases it is necessary to consider anthropotechnogenic load and relationship between agents and disease development.

[Clinical effectiveness of superoxide inhalations and their effects on crystalline structure and antiradical defense of blood serum and expired air condensate in patients with bronchial asthma]. / Klinicheskaia éffektivnost' ingaliatsii superoksida i ikh vliianie na kristallicheskuiu strukturu i sistemu antiradikal'noi zashchity syvorotki krovi i kondensata vydykhaemogo vozdukha u bol'nykh bronkhial'noi astmoi.

AIM: To raise efficiency of combined treatment of bronchial asthma (BA) by application of intranasal inhalations of gaseous superoxide (GSO) basing on clinicolaboratory, functional and biochemical indices. MATERIAL AND METHODS: The study entered 20 healthy subjects and 57 BA patients. All of the patients received conventional treatment, but 30 of them additionally inhaled GSO. The effect of inhalations was assessed by parameters of LPO products, enzymatic and nonenzymatic antiradical defense (ARD) in the blood and expired air condensate (EAC), morphometry of EAC crystalline structures. RESULTS: GSO intranasal inhalations improve treatment of BA as it produces positive effect on endogenic oxidative stress, LPO, enzymatic and nonenzymatic ARD, blood and EAC tesigraphy. CONCLUSION: Antiinflammatory effect of GSO in BA is suggested.