[The effect of low-frequency electrostatic therapy on immunoinflammatory reactions in patients with acute myocardial infarction after endovascular myocardial revascularization at the inpatient stage of medical rehabilitation]. / Primenenie nizkochastotnoi elektrostaticheskoi terapii v korrektsii immunovospalitel'nykh reaktsii u bol'nykh s ostrym infarktom miokarda posle endovaskulyarnoi revaskulyarizatsii miokarda na statsionarnom etape meditsinskoi reabilitatsii.

PURPOSE OF THE STUDY: To study the effect of complex rehabilitation with the inclusion of low-frequency electrostatic therapy on the dynamics of immune status in patients with myocardial infarction (MI) after endovascular myocardial revascularization. MATERIAL AND METHODS: The state of the immune status was studied in 68 patients with MI after percutaneous coronary intervention (PCI) - coronary angioplasty with stenting, admitted to the inpatient stage of medical rehabilitation. RESULTS: The study proved the involvement of the immune system in a complex set of reactions occurring in patients with myocardial infarction after PCI. Significant correlations between biochemical and immunological markers of inflammation and risk factors for cardiovascular diseases have been established. Carrying out complex rehabilitation measures using low-frequency electrostatic therapy at the stationary stage of medical rehabilitation helps to reduce the activity of the inflammatory process and eliminate the immunological imbalance in MI patients after endovascular myocardial revascularization. CONCLUSION: The inclusion of low-frequency electrostatic therapy in the medical rehabilitation complex has a significant immunocorrective effect on the parameters of cellular and humoral immunity, the ratio of pro- and anti-inflammatory cytokines, which justifies the prospects for its use in the rehabilitation of patients with myocardial infarction.

[Comprehensive medical rehabilitation using therapeutic physical factors including hydrokinesiotherapy in a pool with mineral water and its effect on circadian rhythms of arterial pressure and autonomic regulation in patients with arterial hypertension and with chronic psychoemotional stress]. / Kompleksnaya reabilitatsiya lechebnymi fizicheskimi faktorami s vklyucheniem gidrokinezioterapii v basseine s mineral'noi vodoi i ee vliyanie na tsirkadnye ritmy arterial'nogo davleniya i vegetativnuyu regulyatsiyu u bol'nykh arterial'noi gipertoniei i s khronicheskim psikhoemotsional'nym napryazheniem.

OBJECTIVE: To study the effect of the course-based comprehensive rehabilitation using the therapeutic physical factors of the Belokurikha resort, including hydrokinesiotherapy in a pool with mineral water on the circadian rhythms of arterial pressure and its autonomous regulation in patients with arterial hypertension (AH) associated with chronic psychoemotional stress (CPES). MATERIAL AND METHODS: The study involved 83 patients with stage I-II grade 1-2 of AH, whose professional activities were associated with CPES. Each participant had 24-hours Holter blood pressure monitored, and cardiointervalography (CIG) was performed before and after the medical rehabilitation course. The rehabilitation complex of the main group (II) included medication therapy for AH, diet, morning hygienic gymnastics, manual massage, total magnet therapy, and hydrokinesiotherapy in a pool with mineral water. Patients in the comparison group (I) were exposed to similar therapeutic physical factors with identical parameters of the procedures, except hydrokinesiotherapy, which was replaced by full baths with mineral water. RESULTS: Medical rehabilitation using the therapeutic physical factors of the Belokurikha resort with hydrokinesiotherapy in a pool promotes a decrease in the activity of a sympathetic nervous system and increase of vagal effects contribute to the regulation of vital functions of the AH patients, associated with CPES, thus minimizing the frequency of abnormal daily profiles night-peaker and over-dipper to 12.5% and 1.78% of cases, respectively, and increasing the percentage of subjects with its normal type (dipper) to 57.1% (p=0.039). CONCLUSION: The study results show the benefits of hydrokinesiotherapy in a pool with mineral water as a part of the course-based comprehensive rehabilitation in patients with hypertension and chronic psychoemotional stress in terms of normalizing circadian rhythms of arterial pressure and optimizing the activity of higher autonomous centers, which largely determine the cardiovascular system performance in this setting.

[Leukocyte indices of patients with bronchial asthma: informative significance of use].

AIM: Determination of informativeness of leukocyte indices in patients with bronchial asthma, who have comorbid diseases in clinical remission of asthma. MATERIALS AND METHODS: The work based on a single examination of 225 patients with bronchial asthma. Criteria for inclusion in the study are following: the presence of a verified diagnosis of bronchial asthma, the phase of clinical remission. The patients have been divided into 4 groups, taking into account the type of comorbid diseases: the 1 group (53 patients) bronchial asthma was combined with lesions of the upper gastrointestinal tract; the 2 group (73 patients) with allergic rhinitis; the 3 group (76 patients) with hypertension; the 4 group (23 patients) comparison group: the patients without comorbid pathology. According to the clinical blood analysis, 10 leukocyte indices were calculated for each group of patients and their values were analyzed taking into account the frequency and severity of deviations from the reference values. Mathematical processing of the material was carried out using the statistical software package SPSS13.0 for Windows. RESULTS: Using leukocyte indices, it has been revealed that even during the period of clinical remission, almost all examined patients with BA have endogenous intoxication, the severity of which increases in comorbid diseases. Intoxication was inflammatory in nature and, according to the data of leukocyte indices, was due to the presence of persistent inflammation (local and systemic) and during clinical remission. Violation of immunological reactivity has been revealed in most of the examined patients. The presence of correlation relationships of leukocyte indices with a number of biochemical and immunological indicators allows one to exclude the latter from the plan of examination of patients without reducing the quality of their examination: for example, in the conditions of polyclinics, small hospitals, and resorts. Eight leukocyte indices that are the most informative at BA have been selected. CONCLUSION: Additional information about the condition of BA patients who have comorbid diseases during clinical remission can be used to develop programs for their comprehensive treatment and rehabilitation.

Features of the current of bronchial asthma in the presence of komorbidy allergic rhinitis.

AIM: Aim - study of the influence of komorbidy allergic rhinitis (AR) on the course of bronchial asthma (BA). MATERIALS AND METHODS: Clinical research, single performed by a survey of 96 patients divided into two groups: the main - 73 patients with BA combined with AR and a group of comparison-23 patients who do not have allergic rhinitis. The data of clinic, bronchial passableness, level of control of asthma, severity of inflammation in bronhopulmonary region on content of nitrogen oxide in exhaled air and in nasal flushes of a number of biochemicals were studied in comparative aspect. Indicators, the manifestation of systemic inflammatory response according to biochemical, immunological indicators and calculated lejkocitarnym indices. RESULTS: It is revealed that activity of inflammatory process in patients with BA without AR is higher both in the bronhopulmonary region and at the system level. At the same time in the period of clinical remission, most of them have sufficiently well functioning protective mechanisms on the part of the antioxidant system, humoral immunity, non-specific protection. CONCLUSION: When combined BA and AR inflammation at both local and system levels is less pronounced, but the activity of protective mechanisms decreases. In parallel to the growth of violations on the part of cell and humoralal links of immunity in the blood increases the content of Circulating immune complexes, which contributes to the torpor current of inflammation, which is the basis of a more significant violation of bronchial permeability and complicates achieve control of asthma. These changes increase as the duration of the disease both BA and AR, as well as frequency exacerbations of the disease.

[The evaluation of the effectiveness of cardiac rehabilitation of the patients after percutaneous coronary interventions]. / Otsenka éffektivnosti kardioreabilitatsii patsientov posle chreskozhnykh koronarnykh vmeshatel'stv.

BACKGROUND: Notwithstanding the current abundance of the methodological approaches to the evaluation of the outcomes of medical rehabilitation, the criteria for the effectiveness of the combined influence of the curative physical factors are still inadequate and remain at variance with the principles of evidence-based medicine. AIM: The objective of the present study was to develop a method for the evaluation of the effectiveness of the rehabilitation activities in the patients presenting with the acute coronary syndrome following endovascular cardiac interventions. MATERIAL AND METHODS: This work is based on the results of a prospective single-center cohort-based clinical study involving the subjects who had undergone myocardial infarction following endovascular cardiac surgical interventions. The duration of the patient's participation in the study was 21 days. RESULTS: We have developed the integrative approach to the creation of the unified multi-criteria system for the evaluation of the effectiveness of the treatment of the patients presenting with cardiovascular diseases after percutaneous coronary interventions (PCI). In addition, the step-by-step description of this technology is presented. The algorithm for the calculation of the integrated health index and the evaluation of the overall effect of the rehabilitation activities was proposed based on the assessment of the clinical, laboratory, and functional indicators of the health status together with the psychological characteristics of individual patients. It is proposed to consider an integrated health index as a parameter for estimating the rehabilitation potential of the patients suffering from cardiovascular diseases after percutaneous surgical interventions. CONCLUSION: The proposed system for the evaluating of the effectiveness of comprehensive medical rehabilitation differs from analogous intellectual products in that it excludes the subjective interpretation of the severity of clinical symptoms associated with the concrete pathological process and makes impossible the arbitrary determination of the weight of the peculiar features of the patient's condition. Moreover, it allows to reduce the parameters of different types chosen as the criteria for the evaluation of the effectiveness of rehabilitation to the standardized values, to obtain an unambiguous numerical expression of the results of the rehabilitative treatment, and to compare the outcomes of the rehabilitation activities based at different treatment and prevention settings.

[The clinical and functional rationale for the application of the baths containing the Siberian Stag velvet antler extracts in the rehabilitative treatment of the patients presenting with arterial hypertension and concomitant chronic psychoemothional overtension].

We have developed the method for the treatment of the patients presenting with arterial hypertension and concomitant chronic psychoemothional overtension. The method consists of the application of the baths containing the Siberian Stag velvet antler extracts in combination with exercise therapy and massage. A total of 35 patients with arterial hypertension and concomitant chronic psychoemothional overtension were enrolled in the study. It was shown that inclusion of the baths containing the Siberian Stag velvet antler extracts in the combined treatment of arterial hypertension and concomitant chronic psychoemothional overtension has positive effect on the parameters of the main homeostatic systems, enhances the working capacity of the patients, promotes their psychological stability, and increases the adaptive potential of the organism.

[Influence of frozen-dried antlers of Siberian stags on humoral homeostasis in athletes of cyclic sports].

The authors evaluated effects of antlers of Siberian stags on humoral homeostasis parameters in highly qualified athletes during contest period. Medication based on antlers of Siberian stags provides more balanced operation of energy supplying processes, maintains stable lipid metabolism, favors balance in "prooxidants - antioxidants" system.

[Gender analysis of efficiency provided by general bath containing antlers of Siberian stags in skiers].

The authors performed gender analysis of efficiency caused by general bath containing antlers of Siberian stags in athletes engaged into winter sports. Male athletes demonstrated increased physical performance, low RBC membrane response to epinephrine, decreased cortisol level, higher testosterone level and longer time of breath-holding in Stange's test. Female athletes demonstrated no reliable changes in the mentioned parameters.

[A new approach to the treatment of patients presenting with bronchial asthma and concomitant allergic rhinitis].

The present study included 73 patients presenting with bronchial asthma (BA) and concomitant allergic rhinitis (AR). Based on the results of their examination, a program of their two-step treatment was proposed including elimination therapy during 5-7 days followed by the combined treatment with the use of physical factors, such as peloid therapy, supratonal frequency currents, inhalations, massage, and remedial gymnastics. This approach allows to significantly reduce the frequency of clinical manifestations of the primary and concomitant diseases. Specifically, the incidence of daytime choking fits decreased by 66.7%, coughing by 76.7%, nasal stiffness by 60%, and rhinorrhea by 62,6 with the simultaneous acceleration of the overall clinical effect by 3-4 days. The requirement for short-acting broncholytic agents decreased after the treatment by 56.7%. Its anti-inflammatory effect in the upper and lower respiratory tract was confirmed by the results of endoscopic examination of the nasal cavity (the occurrence of mucosal hyperemia and mucosal oedema decreased by 70% and 60% respectively whereas the presence of secretion in the nasal passages was recorded 76.7% less frequently than prior to the treatment). Cytological studies of surface epithelium revealed reduced neutrophilia and eosinophilia, decreased number of goblet cells in nasal mucosa, and lowered content of sialic acids, IL-1, and IL-6 in nasal lavage. Combined therapy improved the patency of both upper and lower respiratory tract. Moreover, the number of patients with the totally controlled clinical course of BA increased by 66.6%. It was shown that remission of BA and AR persisted within 10 and 8.2 months after the treatment respectively.

[Mathematical prognostication of the efficacy of peloidotherapy in the patients with chronic bronchitis and obstructive pulmonary disease].

This study included prognostication of the results of daily application of peloids for the treatment of the patients presenting with chronic bronchitis and obstructive pulmonary disease using a mathematical model. It was shown that the individualized selection of the patients for the daily application of peloid preparations taking into consideration the results of mathematical prognostication makes it possible to significantly improve the total efficacy of the treatment (up to 97.7%), accelerate the achievement of positive outcome of peloidotherapy, reduce by a factor of 4 the frequency of moderately severe balneoreactions, and increase the duration of the remission period by 3.5-4 months.

[Anti-inflammatory effect of mineral water inhalation: validity of identification of biochemical markers in nasal secretion]. / Protivovospalitel'noe deistvie ingaliatsii mineral'nykh vod: tselesoobraznost' opredelenia biokhimicheskikh markerov vospaleniia v nazal'nom sekrete.

The study was made of therapeutic activity of silicon mineral water Tersinka inhalations on clinical symptoms, external respiration function and activity of inflammation in patients with chronic bronchitis and bronchial asthma as shown by biochemical markers of inflammation in the blood serum and nasal secretion. A correlation was found between treatment efficacy and concentration of sialic acids in the nasal secretion in pulmonological patients.

[Determination of sialic acids in the nasal mucosa lavage]. / Opredelenie sialovykh kislot v smyvakh so slizistoi obolochki polosti nosa.

A modified method of determining the sialic acids by using Ehrlich's reagent and according to G. Sydow (1985) was worked out; the method is characterized by a higher sensitivity as compared to the unified methods of Hess and Svennerholm, which enables to process the nasal mucous lavage that has an essentially lower concentration of sialic acids than the blood serum. A clinical approbation of the modified method (in patients with bronchial asthma, and with obstructive and non-obstructive bronchitis) showed that it preserved the specificity typical of the original method and is sufficiently sensitive. Examinations of 12 healthy volunteers showed that the concentration of sialic acids in their lavage amounted to 0.110 +/- 0.012 mumol/L.

[An intensive regimen of pelotherapy in pulmonology]. / Intensivnyi rezhim peloidoterapii v pul'monologii.

The authors show that intensification of peloid therapy, i.e. more frequent procedures, in patients with pulmonary diseases imposes additional load on the regulatory systems: vegetative, cardiovascular, immune. Moderate balneological reactions become more frequent, therapeutic results worsen. How to correct the above negative effects is proposed.