[Dependence of medical rehabilitation effectiveness of patients with somatic diseases and meteopathology on features of weather-forming factors of the Moscow region]. / Zavisimost' effektivnosti meditsinskoi reabilitatsii patsientov s somaticheskimi zabolevaniyami i meteopatologiei ot osobennostei pogodoobrazuyushchikh faktorov Moskovskogo regiona.

Climate change and formation of regional weather features increase both direct (immediate effects of extremal temperature and other weather and climatic anomalies) and indirect (environmental deterioration, etc.) consequences of global climate change. The development of investigations of medical weather assessment, medical and meteorological forecasting system, the use of treatment and preventive measures give the opportunity to prepare for weather biotropic conditions and reduce weather-conditioned exacerbations. OBJECTIVE: To assess the clinical effectiveness of non-drug comprehensive methods, including balneotherapy and physiotherapy, in patients with somatic diseases, complicated by increased meteosensitivity, depending on the features of weather conditions in the Moscow region. MATERIAL AND METHODS: The study included 120 patients diagnosed with «osteoarthrosis/osteoarthritis¼ with predominant hip and knee joint damage. The majority of patients had comorbidities, namely hypertensive disease (67.2%), ischemic heart disease (32.8%), chronic obstructive pulmonary disease and bronchial asthma (10.8%), grade II-III obesity (10%) and compensated diabetes mellitus (9.2%). The severity and main symptoms of the meteopathic reactions' manifestation were assessed by questionnaires consisting of three blocks, HAM, SF-36 tests and psychological stress scale. Medical and meteorological assessment of weather conditions in Moscow included analysis of the main weather-forming factors for 4 main synoptic observations in 10-minute mode for current and predictive 2 days, as well as daily characteristics of solar activity. Treatment methods included alternating magnetic field (AMF) procedures, general sodium chloride baths, massage and rehabilitation exercises (RE) (1st group); AMF, «dry¼ carbon dioxide baths, applications with brine on the affected joints and RE (2nd group); AMF, «dry¼ radon baths, applications with brine and RE (3rd group). RESULTS: The conducted studies have revealed the trigger role of most biotropic combinations of weather-forming factors that provoke exacerbation in patients with joint diseases. Sodium chloride, «dry¼ carbon dioxide and radon baths combined with AMF, applications with brine on the affected joints and RE are pathogenetically justified and contribute to increase of adaptive potential, functional reserves of the body and provide significantly high (p<0.05) meteocorrective action. CONCLUSION: The obtained results can be used for rehabilitation of patients with joint diseases complicated by increased meteosensitivity.

[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 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 role of physiobalneotherapy in the prevention of weather-dependent exacerbations in the patients presenting with chronic obstructive pulmonary disease].

The present publication presents the available data concerning the mechanisms of the development of enhanced meteosensitivity in the patients presenting with chronic broncho-obstructive pulmonary pathology with special reference to the characteristics of the most important biotropic weather factors acting on the population of the Moscow region. The possibility is substantiated for the introduction of non-medicamental methods (such as gas-air sodium dioxide bathtubs, whole body bathtubs with the use of mitofen preparations, and interval hypoxic trainings) into the prophylactic programs designed to prevent weather-dependent exacerbations of the chronic obstructive pulmonary disease.

[The rationale for the combined application of cryomassage and silvinite speleotherapy for the rehabilitative treatment of the patients with bronchial asthma].

The present study is devoted to the estimation of therapeutic and prophylactic effects of cryomassage and silvinite speleotherapy in the patients with partially controlled asthma. Advantages of the combined application of rehabilitative technologies are illustrated by their well-expressed anti-inflammatory and immunocorrecive actions, reduced obstruction and hyper-reactivity of the bronchi, improved pulmonary cardiohemodynamics, enhanced physical tolerance and better psychological adaptation.

[Complex treatment of tobacco dependence by means of psychotherapeutic correction in combination with mesodiencephalic modulation in patients with chronic diseases of digestive organs].

This paper deals with the problem of tobacco dependence and its medical treatment. Various methods available for this purpose are considered with special reference to their clinical efficiency. A scheme for combined treatment of the given pathology is proposed.

[Turpentine baths in rehabilitation of patients with chronic obstructive pulmonary disease].

We have investigated effects of turpentine baths with white emultion, yellow solution and mixed on the course of inflammation, immunocompetent system, external respiration function, pulmonary cardiohemodynamics, physical performance in patients with chronic obstructive pulmonary disease. We developed differential indications for each bath variant depending on the features of a clinical picture of the disease, comorbid pathology and revealed contraindications to their administration.

[The meteoropathic reactions of patients with cardiovascular diseases and the methods for their prevention with contrasting temperature exposures]. / Meteopaticheskie reaktsii u bol'nykh serdechno-sosudistymi zabolevaniiami i metody ikh profilaktiki kontrastnymi temperaturnymi vozdeistviiami.

High sensitivity of patients with cardiovascular diseases to weather conditions was successfully managed by contrast temperature training which secured not only resistance to temperature fluctuations but also to a complex of weather factors. This, in the long run, secured a decline in the number of coronary heart disease and hypertension exacerbations and higher quality of life.