[Nutraceutical correction in the complex non-drug treatment of metabolic syndrome]. / Nutritsevticheskaya korrektsiya v kompleksnom nemedikamentoznom lechenii metabolicheskogo sindroma.

The use of complex non-drug technologies at the stage of rehabilitation of metabolic syndrome (MS) includes multifactorial correction of its main manifestations: abdominal obesity, insulin resistance, arterial hypertension and dyslipidemia. A prospective randomized study on the use of low-calorie diet (LCD) and nutraceutical correction of the nutritional status of patients with MS was carried out. OBJECTIVE: To study the effect of a non-drug complex including LCD, physical exercises, as well as correction of the gut microbiome and hepatic protection in relation to reduction of visceral fat volume in abdominal obesity and the dynamics of lipid and carbohydrate metabolism hormones in metabolic syndrome. MATERIAL AND METHODS: 120 patients with MS were randomized into 2 groups: Group 1 received LCD, physical exercises in the gym, and physical activity like daily walking up to 3-5 km/day. Group 2 received LCD, physical exercises in the gym, physical activity like daily walking up to 3-5 km/day, as well as nutraceutical correction of increased appetite, gut probiotic composition, hepatic protection. The treatment duration was 4 weeks. Anthropometric methods in order to control the body weight, waist and hip circumferences and bioimpedansometry were used. RESULTS: As a treatment result, patients in group 1 represented a reduction in body weight, lean and active cell mass, a decrease in musculoskeletal mass and a decrease in total fluid due to extracellular fluid. A decrease in total cholesterol and blood triglyceride fraction was noted. Leptin decreased by 13.96%. Patients of the 2nd group represented a decrease in body weight, fat mass, lean mass, total fluid and extracellular fluid. There was a statistically significant increase in active cell mass, skeletal muscle mass. There was a decrease in total cholesterol, triglycerides and transaminases. Due to weight loss and fat mass reduction a decrease in leptin expression by 29.85% and decrease in blood insulin levels by 11.2% were noted. CONCLUSION: Thus, LCD accompanied by nutraceutical correction of the gut microbiota and hepatic protection can be effectively used in combination with physical training in order to reduce the fat mass without pre-sarcopenia development that was confirmed by positive dynamics of volume indices, bioimpedance measurements and reduction in leptin and insulin expression.

[Methods of medical rehabilitation in the complex program therapy for patients with cervicobrachialgia caused by pathological dental occlusion]. / Metody meditsinskoi reabilitatsii v programme kompleksnoi terapii patsientov s tservikobrakhialgiei, obuslovlennoi patologicheskoi dental'noi okklyuziei.

Chronic pain syndromes in the neck and shoulder girdle are one of the important clinical problems due to their high prevalence. In addition, it's of great interest to study the mutual influence of the musculoskeletal system pathology, balance organs and dentoalveolar system due to the possible negative impact of these structures on each other which surely affects the treatment timing and its results. OBJECTIVE: To develop a diagnostic algorithm and a comprehensive program for the treatment and rehabilitation of patients with cervicobrachialgia combined with pathological dental occlusion. MATERIAL AND METHODS: The study involved 90 persons of both genders aged 18 to 55 years consisted of 3 clinical study groups (25 patients) and one control group (15 healthy persons). The clinical groups included 75 patients with chronic myofascial pain syndrome in the neck and shoulder girdle resistant to drug therapy, with temporomandibular joint (TMJ) dysfunction and/or pathological dental occlusion (PDO). The groups were formed depending on the chosen treatment methods: manual therapy was used in the 1st group; in the 2nd group - dental treatment aimed at correcting PDO; in the 3rd group the manual therapy was used together with the correction of the jaws' occlusal relationship. RESULTS: In the study course the most effective algorithm for the diagnosis and rehabilitation of patients with cervicobrachialgia caused by pathological dental occlusion was determined. Positive clinical results were noted in patients of all three groups; however, in the 3- group where manual therapy and complex dental treatment were carried out the results are not differing significantly from the controls. The study showed that in patients with myofascial pain syndrome at the cervical and shoulder levels caused by TMJ dysfunction and pathological dental occlusion it's advisable to include manual and osteopathic diagnostics in the algorithm. Manual muscle testing, posture tests in combination with 3D X-ray imaging and computerized functional studying the maxillofacial region should be used to identify etiology-pathogenesis links between these conditions. These methods are also applicable for quality control of treatment. CONCLUSION: Thus, as a study result the diagnostic algorithm was developed; it allows to determine the relationship of pharmacoresistant pain syndrome of the cervicobrachial region with dental pathology at high degree of accuracy; and a comprehensive interdisciplinary approach to the therapy and rehabilitation of this combined pathology was proposed.

[Prospects for the use of antioxidant pharmacopuncture in metabolic syndrome]. / Perspektivy primeneniya farmakopunktury antioksidantnymi sredstvami pri metabolicheskom sindrome.

OBJECTIVE: The purpose of the study was to further reveal the mechanisms and therapeutic capabilities of the pharmacopuncture method (the introduction of drugs into the area of reflexotherapy points) in metabolic syndrome. In previously published materials on the problem, we pointed out the efficacy of the pharmacopuncture antioxidant Ubiquinone Composite (as a pilot study), similar in effect to the drug Coenzyme Composite (Heel, Germany). The present work develops this topic by further comparing the characteristics of pharmacopuncture with the presented drugs. MATERIAL AND METHODS: The study included 160 patients (103 women and 57 men) with metabolic syndrome. In addition to clinical parameters, lipid and carbohydrate metabolism, atherogenic index, catalase and superoxide dismutase activity, the level of prooxidant processes, and the presence of insulin resistance were evaluated. In the clinical phase, the patients were divided into four groups. In group 1, treatment was limited to standard medication, in other groups, pharmacopuncture was additionally performed. In the 2nd group, physiological solution (placebo) was used as an agent, in the 3rd and 4th groups - the drugs Ubiquinone compositum and Coenzyme compositum, which differ mainly in antioxidant effect. RESULTS AND DISCUSSION: It was found that pharmacopuncture with both drugs leads, in general, to comparable positive results, significantly superior to the effectiveness of other methods. However, certain differences were noted within these groups: in the case of using the drug Ubiquinone compositum, a predominant decrease in blood pressure and dyslipidemia is observed, and when using the drug Coenzyme compositum, a shift in insulin resistance against the background of regression of disbalance in the peroxidation system. On the one part, the presented data show about the therapeutic breadth of the effects of pharmacopuncture, and on the other part, they demonstrate the possibility of a differentiated influence.

[Effectiveness of various methods of cryotherapy in patients with osteoarthritis]. / Effektivnost' raznykh metodik krioterapii u patsientov s osteoartrozom.

Aim of this study - the comparative effectiveness of cryotherapy (CT) with ice 0 °C, CT with ice 0 °C + SMC (cryo-SMC), air cryotherapy (ACT) -30 °C, hyperbaric gas cryotherapy (HC) CO2 -78 °C. MATERIAL AND METHODS: We examined 150 patients with II - IV stage osteoarthritis of the knee and hip joints, movement pain of more than 40 mm on a VAS and Leken index more than 9. 120 of these patients received a course of CT of various temperatures and cryo-SMC for 2 weeks: 1st group (n=30) - CT of ice 0 °C; 2nd group (n=30) - cryo-SMC; 3rd group (n=30) - ACT; 4th group (n=30) - HC. The 5th group (control) included patients (n=30) who received only non-steroidal anti-inflammatory drugs (NSAIDs). We assessed dynamics of rest and movement pain according to VAS, the WOMAC index, the effectiveness according to the OMERACT-OARSI criterion and the need for NSAIDs. Effectiveness of treatment was evaluated by the patient and the doctor. RESULTS: OMERACT-OARSI analysis demonstrated a high percentage of CT response. A statistically significant decrease in rest and movement pain intensity was registered in all patients of the groups: ice 0 °C, cryo-SMC, ACT, HC and control groups. The pain decreased by 82-83% in the groups 1-4, and by 70% in the control group. There were no differences in the effectiveness of treatment between groups 1, 3, and 4 and the cryo-SMC group; effectiveness of treatment was statistically significant (p<0.01) between groups 1-4 and the control group. A statistically significant decrease in the total WOMAC index, as well as in «pain¼ and «stiffness¼ VAS subscales (p<0.01) in the absence of intergroup differences in the 1st, 3rd, 4th groups and the cryo-SMC (p>0.05) group and a statistically significant difference between the 1st-4th groups and the control group (p<0.01). According to the «function¼ subscale of the WOMAC index, a statistically significant difference between all groups was not found (p>0.05). CONCLUSION: Results of this study according to the OMERACT-OARSI effectiveness evaluation criteria indicate the comparability of CT as a treatment method with NSAID therapy in terms of the effect on improving the patient's functional capabilities and greater CT efficiency in relieving pain and stiffness in the joints.

[Cervical vertigo: a neurologist's point of view]. / Tservikogennoe golovokruzhenie: vzgliad nevrologa.

Cervical vertigo (CV) hasn't yet been recognized by many neurologists, as it has no specific clinical symptoms and reliable diagnostic criteria. However, over the past 150 years, there has been accumulated numerous experimental and clinical evidence to support the legitimacy of CV allocation as a separate nosology. This review presents data regarding the vertigo associated with neck pathology: possible evidence of CV existence and the description of its type as well. The principles of CV diagnosis and treatment are considered, an attempt to create a unified concept is proposed.

[The novel approaches to the rehabilitation of the patients presenting with gastroesophageal reflux disease and co-morbid pathology]. / Novye podkhody k reabilitatsii bol'nykh gastroézofageal'noi refliuksnoi bolezn'iu s komorbidnoi patologiei.

This paper was designed to discuss the problems of co-morbidity and approaches to the rehabilitation of the patients presenting with gastroesophageal reflux disease and a concomitant pathology and to analyze the issues concerning the possible vertebro-visceral correlations inherent in the diseases of the internal organs. AIM: To evaluate the vertebro-neurological status of the thoracic segment of the vertebral column in the patients suffering from gastroesophageal reflux disease and to further improve the methods for their treatment taking into consideration the concomitant pathology, if any. MATERIAL AND METHODS: A total of 290 patients at the age varying from 25 to 60 (mean 44,3±11,3) years with the non-erosive form of gastroesophageal reflux disease were examined in the phase of its exacerbation. They included 132 (45.5%) men and 158 (54.5%) women. The duration of the disease averaged 13.1±3.3 years and that of the exacerbation period 1.2±0.5 months. All the patients underwent the vertebro-neurological examination. The visual analog scale was used to obtain the subjective characteristics of the pain syndrome associated with thoracalgia The quality of life of the patients was estimated based on the Medical Outcomes Study Short Form-36 (scores of MOS SF-36). To evaluate the effectiveness of the proposed approach to the treatment of the gastroesophageal reflux disease, the 260 participants of the study were randomly allocated to two groups, the main and control ones. The latter group was comprised of 130 patients given the standard treatment including the use of histamine H2-receptor antagonists, proton pump inhibitors, stimulators of the motility of the gastrointestinal tract, alginates, and other drugs, as indicated. The former group consisted of the remaining 130 patients undergoing the standard course of pharmacopuncture to correct the functional disorders in the thoracic segment of the vertebral column. The medications of choice for the purpose were the anti-homotoxic agents, such as placental compositum, co-enzyme compositum, and ubichinon compositum (Biologische Heilmittel Heel GmbH, Germany). The statistical analysis was performed with the use of the non-parametric methods based on the Statistica application software package ('StatSoft Inc.', США). RESULTS: The present article reports the results of the study that demonstrate significant strong positive correlation between the clinical manifestations of gastroesophageal reflux disease (the frequency and severity of symptoms) and thoracalgia and provides a rationale for the assessment of the vertebro-neurological status of the thoracic spine in the patients exhibiting the clinical signs of gastroesophageal reflux disease. The study substantiated the inclusion of pharmacopuncture with placenta compositum, co-enzyme compositum, and ubichinon compositum anti-homotoxic medications in the complex rehabilitation programs for the patients presenting with the clinical signs of gastroesophageal reflux disease and the concomitant thoracalgia symptoms. To assess the effectiveness of the proposed method for the treatment of this condition, such diagnostic criteria as the vertebro-neurological symptoms, coefficient of the thoracalgia-associated pain syndrome, the frequency and intensity of the gastroesophageal reflux disease symptoms, and the quality of life parameters were used. CONCLUSION: The results of the present study provide strong evidence that pharmacopuncture helps to improve the quality of life of the patients, alleviate thoracalgia symptoms and clinical signs of gastroesophageal reflux disease, and reduce the intensity of the pain syndrome caused by thoracalgia.

[The physical methods for the prevention and management of weather-dependent pathological reactions (a literature review)]. / Fizicheskie metody profilaktiki i korrektsii meteopaticheskikh reaktsii (obzor).

The review presents data on the non-pharmacological methods and technologies for the prevention and management of meteopathic reactions (MPR) applied in Russia for the treatment of the patients suffering from obstructive and cardiovascular diseases. It is assumed, based on the concept of heliogeophysical imprinting, that the major factors responsible for the development of MPR are the disturbances of electromagnetic homeostasis. The acupuncture points and channels are regarded as a system designed for the maintenance of electromagnetic balance in the human body. In this context, it is proposed to encourage the application of the methods of electro-diagnostics and reflexology for the prevention and correction of meteopathic reactions.

[The application of invasive and non-invasive reflexotherapeutic methods for the improvement of tolerance to the influence of seasonal meteorological factors and correction of bronchial asthma].

The present study included 94 patients presenting with bronchial asthma (BA) who underwent the controlled treatment during one year. The treatment consisted of basal anti-asthmatic therapy in combination with acupuncture reflexotherapy or a complex of non-invasive reflexotherapeutic methods (CNIRTM) designed to increase the effectiveness of correction of asthma, to improve the clinical status of the patients, to decrease by more than two-fold the frequency of unstable episodes of the disease showing the well-apparent seasonal dependence, and to diminish the consumption of pharmaceuticals (reduction of the mean daily dose of prednisolone by 31% and 37% in comparison with its 79% increase in the patients receiving the standard treatment). Moreover, it was shown that the achievement of clinical and preventive effect of the application of non-pharmacological methods may be associated with the activation of the mechanisms of adaptation to the stress factors (such as correction of the cortisol blood level and parameters of the immune status, etc.) and the increase of the patient's tolerance to their influence.

[The adaptive mechanisms of cardio- and angioprotective action of reflexotherapy].

The adaptive mechanisms of action of reflexotherapy are analysed. It was shown in physiological and biochemical experiments on the whole organism, the isolated hearts and strips of resistive arteries of animals that stimulation of acupuncture points by different physical factors increased the activity of opioid, antioxidative, and other stress-limiting systems, reduced secretion of corticosteron during stress, stimulated biosynthesis of stress proteins, induced cyto- and cardioprotective effects, prevented or limited functional and structural hyperadrenal damages. Clinical investigations demonstrated significant hypothensive, anti-ishemic and anti-arrhythmic effects of reflexotherapy, improved resistance of healthy subjects and patients with cardiovascular diseases to physical and emotional loadings.

[Reflexotherapy in the context of rehabilitative medicine].

The main stages of the history of reflexotheray and its principal methodological aspects are reviewed in the context of the introduction of this approach into rehabilitative medicine. Productive results of such integration find the demonstrative reflection in the defense of 56 theses for the degree of candidate of science and 28 ones for the degree of doctor of science devoted to various aspects of reflexotherapy. The growing tendency toward the more extensive application of non-pharmacological approaches to complementary medicine opens up new prospects for the further development of reflexotherapy in the context of modern health care practices.

[Combination of clinical homeopathy and dynamic neurostimulation for the restoration of male sexual function].

The impairment of sexual function diagnosed in approximately one third of apparently healthy men dictates the necessity of their rehabilitative treatment. The objective of the present study was to evaluate effectiveness of the combination of clinical homeopathy and dynamic electrical neurostimulation (DENS) for the restoration of disturbed sexual function. The study demonstrated that the efficiency of the proposed method in terms of dynamics of subjective and objective improvement surpasses that of isolated application of clinical homeopathy or DENS when compared against the use of placebo.

[Application of contrast thermopuncture for the treatment of dorsopathies].

The objective of this work was to study the possibility of replacing acupuncture variants of reflexotherapy of dorsopathies by non-invasive procedures, such as thermopuncture at biologically active points. Mechanisms of action of contrast thermopuncture were elucidated. Its clinical efficiency for the rehabilitative treatment of cervical and thoracic dorsopathies was demonstrated. It is concluded that many specific features of the method account for its advantages over classical acupuncture.

[The effect of pharmacopuncture on the blood biochemical indices of patients with tunnel syndromes of the hands]. / Vliianie farmakopunktury na biokhimicheskie pokazateli krovi bol'nykh s tunnel'nymi sindromami ruk.

Concentrations of serotonin, beta-endorphine, myoglobin, basic myelin protein were measured in blood of patients with tunnel hand syndromes treated by actovegin or physiological solution pharmacopuncture and acupuncture to the same acupuncture points (AP). The above biochemical indices showed similar changes in pharmacopuncture with actovegin and the solution. These changes were different in acupuncture. This indicates specificity of AP stimulation by introduction of fluid, but not specificity of drug effects.

[The dynamic clinico-physiological indices of sexual function during the management of vertebrogenic pain syndromes]. / Dinamika kliniko-fiziologicheskikh pokazatelei sostoianiia polovoi sfery pri kupirovanii vertebrogennykh bolevykh sindromov.

Sexual changes were registered electrophysiologically in 52 patients with low back pain of vertebrogenic origin. M-response of the bulbocavernous muscle emerged at low threshold. There were shifts in the latency and amplitude of the somatosensory evoked potentials of the brain. These confirm participation of disintegrated functioning of the segmentary and central nervous structures in the genesis of sexual diseases. Treatment-induced positive trends in the above parameters may be used prognostically in relation to the patients' sexual activity.

[Pathogenesis and treatment of sexual disorders in men with vertebrogenic lumbar pain]. / K patogenezu i lecheniiu seksual'nykh rasstroistv u muzhchin s vertebrogennymi poiasnichnymi boliami.

Evaluation of the sexual sphere in 120 men with vertebrogenic lumbar pains revealed sexual disorders in 35% of cases, which may be reduced to two basic symptom-complexes. Decrease of potency in a group of 20 patients presenting with both reflex and radicular patterns of lumbar osteochondrosis was regarded as a reflection of general asthenic processes. In 22 patients primarily suffering from reflex neurovascular syndromes, dysfunction was established to be of vasculogenic nature. Differentiated methods of conventional therapy of the disorders were noted to be effective enough. Doppler investigation of the regional arteries turned out informative in the estimation of the correction of sexual disorders of vascular genesis.

[Pathogenetic mechanisms of sex disorders in the clinical picture of vertebrogenic pain syndromes]. / Patogeneticheskie mekhanizmy seksual'nykh rasstroistv v klinike vertebrogennykh bolevykh sindromov.

Vertebro-sexual correlations were studied in 120 men with low back pain. The weakness of sexual constitution in patients with radicular syndromes indicates a correlation between vertebrogenic and sexual insufficiency. Sexual disorders in this group (27% of cases) are, probably, the result of strongly pronounced asthenia. High occurrence of sexual disorders (41%) in the group of patients with reflex syndromes depends on the main vascular mechanisms.

[Formation of endogenous pyrogen by mononuclear phagocytes]. / Obrazovanie éndogennogo pirogena mononuklearnymi fagotsitami.

Production of endogenous pyrogen by human and rabbit blood monocytes in response to stimulation with agents of different origin was studied by inhibitory analysis under comparable conditions. Actinomycin D and cytochalasin B were applied. New evidence was obtained about an important role in the mechanism of activation of mononuclear phagocytes of initial interaction between a stimulating agent and the leukocyte membrane and of the biphasic process of endogenous pyrogen production.

[Conditions favoring production and mechanism of action of macrophage pyrogen]. / Ob usloviiakh polucheniia i mekhanizme deistviia makrofagal'nogo pirogena.

Activation of mononuclear phagocytes by staphylococci in vitro results in the production of endogenous pyrogen. Macrophage pyrogen does not posses species pyrogenic specificity. Intracisternal injection increases pyrogen susceptibility more than 100-fold as compared to intravenous injection. Still more abrupt increase in pyrogen susceptibility was observed in the animals in the presence of elevated body cAMP concentration induced by theophylline preinjection.