[On the Draft Regulations on Districts of Sanitary (Mountain Sanitary) Protection of Natural Medicinal Resources: Comments, Suggestions]. / O proekte Polozheniya ob okrugakh sanitarnoi (gorno-sanitarnoi) okhrany prirodnykh lechebnykh resursov: zamechaniya, predlozheniya.

The purpose of the article is to attract the attention of specialists in the resort business in the document being developed - the Decree of the Government of the Russian Federation «On Approval of the Regulations on the Districts of Sanitary (Mining and Sanitary) Protection of Natural Medicinal Resources¼, the draft of which is proposed for discussion. The article presents all the comments on the discussed draft Regulation and proposals for making appropriate changes with their reasoned justification. The proposals put forward to change the wording of specific paragraphs of the Regulation are aimed at protecting and preserving the wealth of our country - natural healing factors that form the basis of sanatorium treatment. The proposals made to edit the paragraphs of the Regulation will undoubtedly guarantee the preservation of Russia's natural healing resources in order to use them for the prevention, treatment and rehabilitation of the population of our country and the successful development of the resort industry.

[Meteocorrective effect of physical and balneal factors in patients with joint diseases]. / Meteokorrigiruyushchee deistvie fiziobal'neofaktorov u patsientov s zabolevaniyami sustavov.

The environment has the potential to adversely affect human health. Among the variety of adverse factors, one of the leading is the weather, including its abnormal patterns, helio- and geomagnetic disturbances, and extreme hydrometeorological phenomena. Currently, the study of mechanisms of weather and climate factors impacting sick and healthy organisms is warranted by the need to determine the main clinical types of meteotropic (pathological) reactions and development of scientific-based programs for their prevention and treatment with the use of non-drug methods. OBJECTIVE: To identify the patterns of meteotropic reactions to biotropic weather conditions and evaluate the meteocorrective efficacy of physical and balneal factors in patients with joint diseases. MATERIALS AND METHODS: We studied the features of weather-related disorders in 165 patients diagnosed with osteoarthrosis/osteoarthritis, including those after total hip and knee arthroplasty. Most patients (55.7%) had cardiovascular comorbidities. All patients received balneal and physiotherapeutic procedures in addition to background drug therapy and exercise therapy. The patients were divided into 3 groups: Group 1 (55 patients) received general sodium chloride baths and exposure to alternating magnetic field (AMF); Group 2 (54 patients) received «dry¼ carbon dioxide baths and AMF; Group 3 (56 patients) received general baths with the antioxidant and antihypoxic agent Mitofen, and AMF. The weather-sensitivity and severity of meteorological reactions were evaluated using questionnaires, and self-observation diaries, correlated with medical and meteorological weather forecasts. We used the WAM method (well-being, activity, mood), the Abbreviated Multifactor Personality Inventory (AMPI), and the Hospital Anxiety and Depression Scale (HADS). Medical and meteorological weather assessment was performed using a modern medical and meteorological complex (AMMC). RESULTS: Increased weather sensitivity of varying severity was confirmed in 140 (84.8%) patients, and 25 (15.2%) patients were classified as conditionally weather-sensitive. The most severe meteotropic reactions were noted in patients with cardiovascular comorbidities (55.7%) and older individuals with a compromised medical history (29.1%). The use of balneal and physiotherapeutic methods in the medical rehabilitation programs had a positive effect on the manifestations of autonomous disorders and psychological dysadaptation; also, they contributed to the increase of adaptation and functional reserves of the organism exposed to biotropic weather conditions. The effects of the factors were manifested by the reduction of severity of meteotropic reactions. The high effectiveness of general baths with antioxidant and antihypoxic action was revealed in 71.8% of patients with cardiovascular comorbidities. The meteocorrective effect of sodium chloride baths was less pronounced (29.7%), although the majority of patients after the treatment course showed an improvement in their psychoemotional status (39.7%) and a decrease in severe weather-related exacerbations during spastic weather (from 17.6 to 6.7%). CONCLUSION: The meteocorrective efficacy of complex non-drug methods in patients with joint diseases, including concomitant cardiovascular diseases, has been proved.

[The potential of using the underground mineral waters of the Moscow region in the organization of medical rehabilitation and medical tourism]. / Potentsial ispol'zovaniya podzemnykh mineral'nykh vod Moskovskogo regiona v organizatsii meditsinskoi reabilitatsii i lechebnogo turizma.

Moscow in modern borders is the largest metropolitan area in the country with a fairly high and unevenly distributed population density. This predetermines the need to address environmental regulation of urbanization in order to create the most comfortable living conditions for the population. Health care and the maintenance of health of all age groups are the leading role in the list of the most important tasks to ensure the social well-being of citizens. In the bowels of the Moscow region there are natural therapeutic resources: low-mineralized (M 3-5 g/l) sulfate sodium-magnesium-calcium drinking mineral water and chloride sodium bromine brine. The article presents the characteristics of the natural therapeutic resources of the Moscow region, the area of their therapeutic use, justified the possibility of wider use based on the available scientific data on the effect on the body of these waters and their analogues. All this provides an opportunity to achieve the main goal of medical resortology - the use of mineral water as a means of therapy, rehabilitation and prevention of most existing human diseases.

[Chronic gastrite: modern state of the problem].

AIM: Тo evaluate the modern view on the problem of chronic gastritis and the effectiveness of the drug ursodexic acid (UHC) Grinterol in the treatment of patients with chronic antral reflux-gastritis (biliar). MATERIALS AND METHODS: The work provides modern ideas about chronic gastritis, the issues of etiology and pathogenesis are considered. Contemporary classifications and the attitude of the authors of the work to them are presented. Clinical studies were conducted in 50 patients with chronic antral reflux-gastritis biliary (32 women and 18 men) between the ages of 20 and 80 years (average age 50.3 to 8.0 years). The treatment uses the drug Grinterol in a daily dose of 12.5 mg/kg of body weight for 4 weeks. RESULTS: Among patients with chronic antral gastritis isolated patients with reflux-gastritis biliary, the pathogenetic factor of which is the damaging property of aggressive bile acids. The main treatment for such patients are drugs UHC (in this study (this study uses Grinterol at a daily dose of 12.5 mg/kg of body weight); the duration of treatment is 4 years. The overall efficiency (according to endomorphological data) was 76%, according to clinical data 100%. DISCUSSION: Critical consideration of the classifications used and proposed for consideration indicates that the time has come for the adoption of a new classification with the allocation of reflux-gastritis biliary. Treatment of this form of antral gastritis is effective with UDHC drugs. CONCLUSION: the selection of a form of antral reflux-gastritis biliar in a separate classification group is scientifically justified. The results suggest that for the treatment of patients with chronic biliary refluxdrugs of choice are drugs UDHC.

[Modern medical and meteorological assessment of Moscow weather and the effectiveness of non-drug methods of increased meteosensitivity correction in patients with joint diseases]. / Sovremennaya mediko-meteorologicheskaya otsenka pogody Moskvy i effektivnost' nemedikamentoznykh metodov korrektsii povyshennoi meteochuvstvitel'nosti u patsientov s zabolevaniyami sustavov.

Weather is one of the leading negatively acting on the human body factors. Abnormal regimes and extreme hydrometeorological and geophysical phenomena form the most biotropic external conditions that can have a negative effect and provoke weather-related exacerbations in people with chronic non-infectious diseases. Today, the problem of the climatic and weather factors influence acquires a new content and becomes relevant in connection with the global climate change and its regional manifestations. PURPOSE OF THE STUDY: To scientifically substantiate the need for medical and meteorological monitoring to determine the most biotropic weather conditions in the Moscow metropolis and to evaluate the meteorological effectiveness of non-drug rehabilitation methods. MATERIAL AND METHODS: 335 patients diagnosed with osteoarthritis of various locations, and after total hip and knee arthroplasty, were included in the study. Patients were divided into 4 groups: 67 patients of the 1st group received "dry" carbonic baths and exercise therapy; general radon baths and exercise therapy were prescribed to 60 patients of the 2nd group; 61 patients of the 3rd group received general sodium chloride baths and exercise therapy; 84 patients of the 4th group got local cryotherapy and exercise therapy procedures. The study of weather sensitivity was carried out by the questionnaire method. Psychological examination was carried out using the tests HAM (health, activity, mood), Mini-Mult (Abbreviated multifactor questionnaire for personality research) and HADS (Hospital Anxiety and Depression Scale). RESULTS: 272 (81.2%) patients had increased meteosensitivity, which was accompanied by mild manifestations in 24.3%, moderate severity in 48.2%, and severe ones in 27.5%. The effectiveness of the balneotherapy and cryotherapy methods was confirmed by positive dynamics and a clear regression of meteopathic reactions in 76.1% of patients after a general radon therapy and in 61.7% after «dry¼ carbon dioxide baths. Total sodium chloride baths did not have a significant meteorological effect. However, a positive trend in psychological testing indicators was noted, which indicates an improvement in psychological adaptation after a course of treatment. Local cryotherapy procedures helped to reduce only severe meteopathic reactions from 14.3 to 8.3% and improve the psychoemotional state, which may be the choice when it is impossible to use balneotherapy. CONCLUSION: The increase in the frequency of biotropic weather conditions (hypoxic and spastic) is observed in the climate of the Moscow metropolis. This contributes to the increase and aggravation of the meteopathology manifestations. The effectiveness of non-drug methods in the prevention of increased meteorological dependence in patients with joint diseases has been proved.

[Weakly mineralized nitrogen thermal waters of Russia]. / Azotnye slabomineralizovannye termal'nye mineral'nye vody Rossii.

Russia has almost all hydrochemical types of underground mineral waters; however, unlike the well-known and popular resorts in the world, they are used very limitedly. In addition to their high medicinal value, mineral waters, when properly marketed, is a natural product that is comparable, and, in many cases, superior in price to that of similar volumes of high-octane gasoline. In addition to the characteristics of the chemical and gas composition, some underground mineral waters in their native state have an elevated temperature and are thermal and hyperthermal. Low-mineralized nitrogen thermae are one of the large groups of mineral waters; they are common in the areas of young tectonic faults in the earth's crust, which frame the mountainous areas. The deposits of thermae within the blocky and folded-blocky structures are fractured water-pressure systems; the thermal waters in the sedimentary and volcanic-sedimentary rocks saturate the reservoir or fissure-interstitial aquifers and are typical artesian basins. The successful development of health resort business in Russia should be, first of all, based on the extensive use of natural therapeutic factors. As clearly confirmed by the experience with spa treatment in both Russia and world practice, accumulated data from researches, thermal mineral waters determine the possibility of creating large spa centers that provide high economic efficiency.

[The non-medicamentous methods for the prevention and treatment of the patients presenting with neurocirculatory asthenia and concomitant enhanced meteosensitivity].

OBJECTIVE: The relevance of the problem stated in the title of this article comes from the significant increase in the prevalence of the functional cardiovascular disorders having been documented during the past years especially such as circulatory asthenia that most frequently affects the young people of the working age suffering from the systemic neurogenic imbalance in the organism and can be seriously aggravated by the influence of biotropic weather conditions and be responsible for enhanced meteosensitivity that has negative effect on the quality of life and impairs the effectiveness of the therapeutic interventions. AIM:  The objective of the present study was to provide the scientifically sound substantiation of the feasibility of the application of the non-medicamentous methods (including the interval hypoxic training and «dry¼ carbonic baths) for the prevention and treatment of neurocirculatory asthenia complicated by enhanced meteosensitivity and evaluate the therapeutic effectiveness of these approach. MATERIAL AND METHODS:  A total of 50 patients with the verified diagnosis of neurocirculatory asthenia were recruited to participate in the study. All the patients were divided into two groups. 62% of them exhibited the well apparent meteosensitivity and were included in the study group 1. Group 2 was comprised of the remaining patients (38% of their total number) presenting with neurocirculatory asthenia who did not suffer appreciable changes in the general physical and mental state under the influence of varying weather conditions. The patients of both groups received the identical combined treatment consisting of interval hypoxic training and taking «dry¼ carbonic baths. Monitoring of the main meteorological parameters was carried out on a daily basis. It was combined with the assessment of the weather conditions from the medical perspective, the evaluation of the physical performance capability of the patients based on the results of the veloergometric testing, and the estimation of their functional state of the autonomous nervous system with the use of the data obtained in cardiointervalographic studies. In addition, the state of the microcirculatory system was evaluated by means of laser Doppler flowmetry and making use of a capillary blood flow analyzer. The psychological status of the patients was characterized using a computer-generated version of the abridged multifactorial questionnaire for the elucidation of the manifest personality-scale anxiety (Spielbeger's State-Trait Anxiety Inventory). All these studies were carried out both before and after the course of non-medicamentous therapy. RESULTS:  After the course of the combined non-medicamentous treatment had been completed the health status of the patients comprising the two groups was found to be improved as appeared from the decrease of the number and severity of subjective autonomous manifestations, the positive changes in the functional state of the cardiovascular system and the autonomic nervous system as well as in the general psychological status. The most clinically significant result of the treatment included the reduction in the incidence of the severe meteopathic reactions in the patients of group 2 (from 14% before to 3% after therapy). The frequency of moderately expressed meteopathic reactions likewise decreased (from 31% before to 14% after the treatment). CONCLUSIONS:  The study has demonstrated that under the environmental and climatic conditions of the of Moscow region formation of biotropic weather factors of the hypoxic type (39%) constitutes a serious risk factor contributing to the development of imbalance in the vegetative nervous system and its exacerbations in response to variations of weather parameters. The application of the non-medicamentous therapeutic modalities (including interval hypoxic training and «dry¼ carbonic baths) for the management of the meteosensitive patients presenting with neurocirculatory asthenia is pathogenetically justified, and they can be recommended for both the treatment and prevention of weather- dependent pathological processes and their exacerbations.

[The natural therapeutic resources of Russia: the topical problems]. / Prirodnye lechebnye resursy Rossii: aktual'nye problemy.

Mineral water, therapeutic peloids, favorable landscape and climatic conditions make up the main basis for the creation and development of the health resort business. Mineral water and therapeutic peloids are mineral resources, their prospecting, discovery, exploration and stock assessment of the responsibility of the Geological Survey of the country while the exploration and practical exploitation of the natural medicinal resources is the prerogative of the users of subsurface resources. At present, there are over 1200 deposits of mineral waters as well as more than 260 sources of therapeutic peloids at the territory of the Russian Federation; the include almost all hydrochemical species and types known and exploited in the world's practice The overall picture of the distribution of the potential and developed deposits of mineral waters and therapeutic peloids of the territory of this country is highly non-uniform and depends on the extent of the economic development of different regions, their geographical and climatic conditions as well as the state and availability of the spa and health resort infrastructure. The natural therapeutic resources, territories suitable for the organization and realization of health promoting activities, setting up new spa and health resort facilities are highly vulnerable to any external impact. We possess the scientifically grounded and practice-proven methods for the search, prospecting, practical development, and medical utilization of various natural therapeutic resources as well as technologies for their conservation, restoration, and protection from damages and overexploitation. The rational use and development of the territories promising for the extension of health resort business imply the necessity of the systemic approach in a consistent stage by stage manner based of the reliable prognoses.

[The influence of the climatic and weather conditions on the mechanisms underlying the formation of enhanced meteosensitivity (a literature review)]. / Vliianie klimata i pogody na mekhanizmy formirovaniia povyshennoi meteochuvstvitel'nosti (obzor).

The present review concerns the problem of the influence of the climatic conditions on the human body, the creation of the medical weather forecast service, the development of non-pharmacological methods for the correction of meteopathic disorders, and the reduction of the risk of the complications provoked by the unfavourable weather conditions. The literature data are used to analyse the influence of climatic and weather factors on the formation of enhanced meteosensitivity and the development of exacerbations of chronic non-communicable diseases under the influence of weather conditions. It is concluded that marked changes of the weather may lead to an increased frequency of exacerbations of the chronic non-communicable diseases. The influence of weather and climate on human health is becoming an increasingly important factor under the current conditions bearing in mind the modern tendency toward variations of the global climatic conditions and their specific regional manifestations. The authors emphasize the necessity of the identification and evaluation of the predictors of the development of high meteosensitivity for the prognostication of the risks of the meteopathic reactions and the complications associated with the changes in weather conditions as well as the importance of the improvement of the existing and the development of new methods for the non-pharmacological prevention and correction of enhanced meteosensitivity with the application of the natural and preformed physical factors.