The advantages of drinking mineral water in the rehabilitation of patients with viral hepatitis C with accompanying non-alcoholic fatty liver disease after suffering from COVID-19.

INTRODUCTION AND OBJECTIVE: Past COVID-19 significantly worsens Chronic viral hepatitis C patients with concomitant NAFLD. The aim of the study was to assess effectiveness of including mineral water in the rehabilitation complex in patients with chronic hepatitis C with concomitant non-alcoholic fatty liver disease who contracted COVID-19. MATERIAL AND METHODS: 71 patients with chronic hepatitis C with concomitant NAFLD wo contracted COVID-19 were examined. Group I (control) - 39 patients prescribed dietary nutrition and exercise therapy. Group II (main) - 32 patients, in addition to the above, received packaged 'Shayanskaya' mineral water. Methodology comprised anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, and statistical methods. RESULTS: Due to the treatment, there were significant improvements in carbohydrate and lipid metabolism, as well as the cytokine profile. CONCLUSIONS: The effectiveness was established of the use of silicon low-mineralized bicarbonate sodium mineral water in the complex rehabilitation of patients with chronic hepatitis C and suputor NAFLD after contracted COVID-19. There was a significant improvement in the clinical course of the disease and improvement in the functional state of the liver.

Features of clinical, biochemical, and sonographic parameters in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease.

INTRODUCTION AND OBJECTIVE: Introduction. Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely fatty degeneration, which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine of this category of patients for further development of a new pathogenetically directed course of treatment. Objective. To study clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS: Tested 339 patients with chronic hepatitis C with concomitant NAFLD; and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, statistical methods. RESULTS: Conducted clinical, instrumental, and laboratory studies have shown that CHC patients with concomitant NAFLD are characterized by various disorders - a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, the presence of histological and non-inflammatory activity in the liver. CONCLUSIONS: The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.

The effectiveness of high-tone therapy in the complex rehabilitation of servicemen with post-traumatic stress disorder complicated by traumatic brain injury.

INTRODUCTION: As a result of local military conflicts that have become more frequent over the past decades, the number of military personnel subjected to combat stress has sharply increased. More than 50% of them suffer from combat posttraumatic stress disorder. The most common comorbidity in this category of patients is a traumatic brain injury. Due to the undesirability of the long-term use of pharmacological agents, for rehabilitation, preference should be given to physiotherapeutic procedures. OBJECTS AND METHODS: We examined 50 patients with post-traumatic stress disorder in combination with a closed craniocerebral injury. Group 1-25 patients received standard complex treatment at the sanatoriumresort rehabilitation stage (diet therapy, climatotherapy, balneotherapy, exercise therapy, psychotherapy). Group 2-25 patients, in addition to the standard complex treatment, received a course of high-tone therapy. RESULTS: Complex rehabilitation of patients with the use of high-tone therapy contributes to a significant decrease in astheno-neurotic (p < 0.05) and asthenic depressive (p < 0.01) syndromes and has a psycho-relaxing effect on anxiety syndrome (p < 0.01). There was also a decrease in the severity of pyramidal symptoms and regression of the vestibulo-atactic syndrome (p < 0.05). The course application of hightone therapy was accompanied by a significant restoration of the elastotonic properties of the vascular wall and an improvement in cerebral perfusion (p < 0.05). Positive dynamics of electrophysiological indicators were noted: a decrease in the intensity of slow rhythms against the background of an increase in the frequency and intensity of the alpha rhythm in both hemispheres (p < 0.05), which indicates the harmonization of the bioelectrical activity of the brain.

The role of macronutrients in the implementation of the corrective effect of low-mineralized water in experimental metabolic syndrome.

BACKGROUND: Metabolic Syndrome (MS) is a widespread pathological condition, a group of interconnected metabolic disorders that contribute to the development of a number of severe noncommunicable diseases. Natural mineral waters of various compositions are widely used in the correction of MS. Their biological activity and specificity of action is associated with the presence of specific components (micronutrients, biologically active substances). At the same time, many researchers do not pay enough attention to the role of the biological activity of macro nutrients in low mineralized mineral waters. OBJECTIVE: To assess the corrective effect of macro-components of mineral waters based on a comparative analysis of changes in the structure of internal organs of white rats with the MS model, receiving mineral waters of the same balneological type, but with different quantitative composition of macro components. MATERIALS AND METHODS: The material for histological and histochemical tests were the internal organs of male white rats with body weight 280-320 g. Animals were ranked into 4 groups: I - rats served as a control, ӀӀ - rats with a model of MS; ӀӀӀ and ӀV - rats received the mineral waters against the background of MS modeling. The mineral waters used in the work were characterized by an increased (in close amounts) content of organic substances (C org.), similar in chemical but different in quantitative macro-component composition. At the same time, mineral waters practically did not differ in terms of total mineralization. Modeling of MS was carried out for 60 days by replacing 10% fructose solution in drinking water bowls, introducing white bread crackers into the diet, and excluding green mass from the diet. In groups where animals were corrected for MS, mineral waters were administered with an intragastric tube with olive at a dose of 1% of body weight daily, starting from the 60th day of the experiment, for 12 days. Upon completion of the experiment on day 72, histological sections (which were stained with hematoxylin-eosin) were prepared from the extracted pieces of the heart, stomach, liver and kidneys tissues. The succinate-dehydrogenase (SDH) and lactate-dehydrogenase (LDH) activity were determined on the prepared cryostat sections. Using a light microscope, changes in the structure of the above organs and changes in the activity of oxidative-restorative enzymes were evaluated. RESULTS: The activity of oxidative-restorative enzymes was approaching normal; some manifestations of changes in water metabolism in the animal organism persisted. At the end of the use of both mineral waters, a significant decrease was found in the content of visceral fat around the intestines, renal capsule, under the pericardium, which correlated with a decrease in the animal's body weight and restoration of the fasting blood glucose level to the cereal level. The authors believe that the established features of the corrective effect of both mineral waters on changes in the structure of internal organs are explained not so much by the difference in the content and ratio of the bioactive component (C org.), but by differences in the content of macronutrients. In mineral waters obtained by rats of group III, the content of Cl- and SO4+2 ions is 2.30 and 3.67 times, and Ca2+ and Мg2+ ions are 2.75 and 4.57 more than in mineral waters, which received rats of group IV. However, the content of HCO3-, Na+, K+ is 1.14 and 1.30 times higher in the mineral waters obtained by rats of group IV. CONCLUSIONS: The authors believe that the macronutrients involved in the implementation of MWs biological activity affect the metabolic background of the organism, which creates the bioactive element - C org. conditions for the performance of more intensive corrective action.

Application of mineral waters in the complex treatment of patients with gastroesophageal reflux disease.

BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common gastric pathologies. Recently, there has been a growing interest in the healing effects of mineral waters (MW). METHODS: Ninety patients with GERD were under observation. The study used the following methods: anamnestic, clinical, studies of biochemical blood parameters, ultrasonographic studies of the digestive system, fibroesophagogastroduodenoscopy with intragastric pH-metric. After preliminary research, all patients were randomly divided into three groups of 30 people. The control group (group 1) who were prescribed a basic treatment complex-dietary and proton pump inhibitor group drugs. Patients of group 2 in addition to the standard course of treatment received boric highly mineralized bicarbonate sodium water. Patients of group 3 in addition to the basic therapy were prescribed an internal course treatment of highly mineralized sulfate-bicarbonate sodium-magnesium water. RESULTS: The use of the basic complex of treatment for a month in control group did not lead to a significant leveling of signs of dyspeptic and asthenic syndromes. The use of boron highly mineralized sodium bicarbonate water led to a significant leveling of signs of abdominal pain and dyspeptic syndromes, improvement of acid-forming function of the stomach, but no reliable dynamics were observed in eliminating signs of cytolytic, mesenchymal inflammatory and cholestatic syndromes. Application of highly mineralized sulfate-hydrocarbonate sodium magnesium water improves the elimination of dyspepsia and pain syndromes, normalization of the functional state of the liver. CONCLUSIONS: The obtained data confirm the prospects of using highly mineralized mineral waters in the complex treatment of GERD patients.