[High-tone therapy in complex rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery. (Open-label, prospective, randomized controlled trial)]. / Vysokotonovaya terapiya v kompleksnoi reabilitatsii bol'nykh s poststernotomicheskim sindromom posle aortokoronarnogo shuntirovaniya. (Otkrytoe prospektivnoe randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: At present it remains relevant to develop new rehabilitation technologies for patients with circulatory system diseases who have undergone a cardiac surgery to restore the functions of the cardiorespiratory system more quickly, improve physical and mental health, and prevent the development of the atherosclerotic process. AIM: To study the effectiveness and safety of the new rehabilitation technology for the inpatient stage of medical rehabilitation of patients with post-sternotomy syndrome after coronary artery bypass surgery (CABS) using high-tone therapy. MATERIAL AND METHODS: The study included 85 men (the average age was 56.8±2.46 years old) with post-sternotomy syndrome after CABS. They were divided into two groups by simple randomization: the first/main (42 patients) and the second/control (43 patients). The control group of the patients had a standard rehabilitation complex; the main group was additionally prescribed a high-tone therapy according to a local method. The immediate results of the treatment were assessed by the dynamics of the clinical picture, the six-minute walk test, respiratory function, echocardiography, the level of cytokines, C-reactive protein and natriuretic peptide (NT-proBNP); distant - by QOL endpoints (questionnaire MOS SF-36). RESULTS: The groups of the patients were comparable in all baseline parameters. After the course of the procedures in the main group of patients there were positive reliable (p<0.05-0.001) shifts in clinical (pain, shortness of breath, general weakness), functional (forced expiratory vital capacity, forced expiratory volume1, effusion separation) and laboratory parameters (leukocytes, interleukin-2 and 10, NT-proBNP). The intergroup analysis of long-term results registered significant (p<0.05) differences in the QOL of patients in the main group by subscales: the role of somatic problems, vitality and mental health. Compliance to the III stage of medical rehabilitation (outpatient/home) was noted with 95.2% of the patients in the first group and 93.0% in the second. CONCLUSION: The additional appointment of a high-tone therapy to the rehabilitation standard for the patients with post-sternotomy syndrome after CABS significantly improves the immediate and long-term results of the treatment (QOL) contributing to a more pronounced reverse development of inflammatory and edematous syndromes, an increase in physical activity and psychosomatic health. The absence of adverse reactions with all the patients indicates the safety of rehabilitation complexes.

[Natural therapeutic factors in medical rehabilitation of patients with post-COVID syndrome]. / Prirodnye lechebnye faktory v meditsinskoi reabilitatsii patsientov s postkovidnym sindromom.

The feasibility of using therapeutic physical factors in post-COVID syndrome is due to their sanogenetic effects that ensure the restoration of impaired bodily functions, which serves as the basis for their use at various stages of medical rehabilitation of this category of patients. OBJECTIVE: To develop a new medical technology for the 3rd outpatient stage of medical rehabilitation of the patients with post-COVID syndrome using natural therapeutic factors of Nalchik resort. MATERIAL AND METHODS: There has been carried out a controlled study in compliance with the principles of randomization to develop an outpatient medical rehabilitation program including 168 patients with post-COVID syndrome. All the patients were divided into four groups: the control group (n=40) was prescribed pharmacotherapy and physical therapy in the hall in accordance with federal clinical recommendations; comparison group 1 (n=43) had drinking mineral water in addition; comparison group 2 (n=43) received physical therapy on the route of Nalchik resort terrainkur in addition to the treatment in comparison group 1; the main group (n=42) included a group psychotherapy on the Terrainkur route in addition to the treatment in comparison group 2. RESULTS: The results of the comparative analysis showed the feasibility of the developed outpatient medical rehabilitation program for the patients suffering from post-COVID syndrome: the overall effectiveness of rehabilitation measures increased compared to other follow-up groups by 10-15% due to the improvement of external breathing function (p<0.05), cognitive status (p<0.01), increased exercise tolerance (p<0.01), physical recovery (p<0.01) and mental health (p<0.01). CONCLUSION: The summation and integration of sanogenetic effects of physical factors, psychocorrective techniques, and pharmacotherapy provide a significant improvement in the physical and mental status of the patients with post-COVID syndrome.

[The spa and health resort-based treatment of metabolic syndrome with the application of the therapeutic courses of different duration: the evaluation according long-term results]. / Sanatorno-kurortnoe lechenie metabolicheskogo sindroma pri razlichnoi prodolzhitel'nosti lechebnogo tsikla po rezul'tatam otdalennykh nabliudenii.

AIM: The objective of the present study was to estimate the effectiveness of the new therapeutic modalities for the spa and health resort-based treatment of metabolic syndrome based on the results of the long-term follow-up observations. MATERIAL AND METHODS: A total of 100 patients presenting with metabolic syndrome were recruited for the participation in the study. All of them underwent a shortened course of mineral water intake in the combination with the use of the herbal medicinal products. RESULTS: The results of the study give evidence of the more favorable changes in the clinical and instrumental characteristics of the patients with metabolic syndrome treated with the use of the proposed approach in comparison the patients treated by the conventional methods. Moreover, the beneficial effects of the proposed approach persisted during a longer period. The basal treatment given to our patients was supplemented by dietary therapy, therapeutic physical exercise, narzan baths, intake of mineral water having a temperature of 35-37 °Ð¡ in conjunction with sulphate mineral water (narzan) cooled to 13-15 °Ð¡, and a phytococktail. CONCLUSION: The results of the long-term observations confirmed the enhanced effectiveness of the spa and health resort-based treatment of metabolic syndrome including the therapeutic courses with the intake of cooled narzan mineral water in the combination with phytococktails. This therapeutic modality increased the duration of the favorable changes of various parameters that characterize metabolic syndrome. Specifically, they persisted during 5-6 months after the application of the standard methods, were still apparent within 6-7 months after the two-week course of the treatment with cold narzan and phytococktails, and during 8-9 months when the duration of the treatment course was extended up to 3 weeks.

[One-time effects of drinking mineral water and tap water enriched with silver nanoparticles on the biochemical markers of liver condition and metabolic parameters in healthy rats].

AIM:  The objective of the present research was to study the influence of tap water enriched with silver nanoparticles (NP) as well as that of «Krasnoarmeysky¼ and «Essentuki №17¼ mineral waters after their single administration through the oral gavage to the rats on the metabolism of carbohydrates and lipids, the biochemical markers of the liver condition, and the endocrine profile in the healthy animals. MATERIAL AND METHODS:  The laboratory animals (130 male Wistar rats) were allocated to thirteen groups comprised of 10 rats each as follows: 1st group (n=10) intact animals, 2nd group (5 minutes after the administration of silver NP (n=10), 3rd group (15 minutes after the of silver NP), 4th group (60 minutes after the administration of silver NP), 5th group (n=10) (5 minutes after the introduction of the «Krasnoarmeysky¼ mineral water), 6th group (n=10) (15 min after the introduction of the «Krasnoarmeysky¼ mineral water), 7th group (n=10), (60 minutes after the introduction of the «Krasnoarmeysky¼ mineral water) 8th group (n=10) (5 minutes after the introduction of the «Essentuki № 17¼ mineral water), 9th group (n=10) (15 min after the introduction of the «Essentuki № 7¼ mineral water) , 10th group (n=10) (60 minutes after the introduction of the «Essentuki №17¼ mineral water), 11th group (n=10) (5 minutes after administration of tap water (control),12th group (n=10) (15 minutes after administration of tap water (control), and 13th (n=10) group 60 minutes after administration of tap water (control). RESULTS:  The study has demonstrated that the tap water enriched with silver nanoparticles similar to the mineral waters caused stress reactions that are inferior to those induced by «Essentuki №17¼ mineral water in terms of the magnitude; however, the effect provoked by the tap water was of longer duration. Moreover, the tap water enriched with silver nanoparticles stimulates prooxidant reactions, and inhibit the activity of antioxidant protection. Silver nanoparticles appear to produce some destructive effect on the hepatocytes. CONCLUSION:  The silver nanoparticles present in the tap water have a significant biological potential of their own. Moreover, their one-time action is apt to alter the biological potential of the water into which they are administered. The single intake of the tap water enriched with silver nanoparticles by the healthy laboratory animals produces the response that resembles that of the drinking mineral water.