[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.

[Modern medical and meteorological assessment of Moscow weather and the effectiveness of non-drug methods of increased meteosensitivity correction in patients with joint diseases]. / Sovremennaya mediko-meteorologicheskaya otsenka pogody Moskvy i effektivnost' nemedikamentoznykh metodov korrektsii povyshennoi meteochuvstvitel'nosti u patsientov s zabolevaniyami sustavov.

Weather is one of the leading negatively acting on the human body factors. Abnormal regimes and extreme hydrometeorological and geophysical phenomena form the most biotropic external conditions that can have a negative effect and provoke weather-related exacerbations in people with chronic non-infectious diseases. Today, the problem of the climatic and weather factors influence acquires a new content and becomes relevant in connection with the global climate change and its regional manifestations. PURPOSE OF THE STUDY: To scientifically substantiate the need for medical and meteorological monitoring to determine the most biotropic weather conditions in the Moscow metropolis and to evaluate the meteorological effectiveness of non-drug rehabilitation methods. MATERIAL AND METHODS: 335 patients diagnosed with osteoarthritis of various locations, and after total hip and knee arthroplasty, were included in the study. Patients were divided into 4 groups: 67 patients of the 1st group received "dry" carbonic baths and exercise therapy; general radon baths and exercise therapy were prescribed to 60 patients of the 2nd group; 61 patients of the 3rd group received general sodium chloride baths and exercise therapy; 84 patients of the 4th group got local cryotherapy and exercise therapy procedures. The study of weather sensitivity was carried out by the questionnaire method. Psychological examination was carried out using the tests HAM (health, activity, mood), Mini-Mult (Abbreviated multifactor questionnaire for personality research) and HADS (Hospital Anxiety and Depression Scale). RESULTS: 272 (81.2%) patients had increased meteosensitivity, which was accompanied by mild manifestations in 24.3%, moderate severity in 48.2%, and severe ones in 27.5%. The effectiveness of the balneotherapy and cryotherapy methods was confirmed by positive dynamics and a clear regression of meteopathic reactions in 76.1% of patients after a general radon therapy and in 61.7% after «dry¼ carbon dioxide baths. Total sodium chloride baths did not have a significant meteorological effect. However, a positive trend in psychological testing indicators was noted, which indicates an improvement in psychological adaptation after a course of treatment. Local cryotherapy procedures helped to reduce only severe meteopathic reactions from 14.3 to 8.3% and improve the psychoemotional state, which may be the choice when it is impossible to use balneotherapy. CONCLUSION: The increase in the frequency of biotropic weather conditions (hypoxic and spastic) is observed in the climate of the Moscow metropolis. This contributes to the increase and aggravation of the meteopathology manifestations. The effectiveness of non-drug methods in the prevention of increased meteorological dependence in patients with joint diseases has been proved.

[Recipe and application of new oxygen cocktail with high protein content in nutrition of cardiological patients].

The aims of this study was to develop recipe composition and to evaluate the use of new oxygen cocktail with high protein content in the dietary therapy of cardiological patients. Objects of the study were: the control sample - an oxygen-containing product prepared using dairy whey, fruit and berry juice, highly esterified pectin; experimental samples - oxygen-containing products, which differed from the control sample by additional introduction of whey protein hydrolysate. Experimental samples have been modified by adding to them whey protein hydrolysate in the amount of 1-3% from the total weight of composition. Technological scheme to produce protein-carbohydrate basis with high content of protein 3% has been developed, parameters of the production process were worked out. Analysis of product chemical composition has shown that 100 g contained 3.4-3.6 g of protein, 0.2-0.3 g of fat, 6.0-8.0 g of carbohydrates. Food value of the product made up 34-46 kcal (162-196 kJ). Assessment of effectiveness of new oxygen-containing product in the diet in conditions of cardiological hospital was carried out. 30 patients aged 60-75 years were included in local open prospective study, meeting the following criteria: patients with chronic heart failure I-IIА stage I-II functional classes, were hospitalized in the cardiology department, not having contraindications to enteral oxygen therapy and signed an informed consent form. In combination with standard therapy patients received new oxygenated product with high content of protein in the dose 250 ml (from 100 g of the basis) daily for 10 days during the second breakfast. By the end of the observation period, according to results of the survey, the psycho-emotional state of patients improved. It has been found that the developed oxygen-containing product with high protein content in combination with a standard diet and drug therapy of the disease was well tolerated by patients.

[Clinical and Economic Aspects of Meldonium as Part of Physical Rehabilitation Programs in Patients With Coronary Heart Disease After Percutaneous Coronary Interventions].

PURPOSE: to analyze clinical and economical effectiveness of meldonium as component of integrated program of cardio-rehabilitation in patients with ischemic heart disease (IHD) in the early period after percutaneous coronary intervention (PCI) with incomplete revascularization. MATERIAL AND METHODS: A program of controlled physical training (CPT) was carried out in patients with stable IHD and positive post PCI exercise test (n=48, age less or equal 65 years) starting 8-10 days after PCI. CRT program consisted of 2 phases - inhospital (exercise on treadmill with max heart rate [HR] 80% of that achieved in initial test, 10 times during 2 weeks) and home (exercise on treadmill with max HR 60% of HR achieved in initial test, 3 times a week for 2 months). Before initiation of CRT patients were distributed into 2 groups: CRT without (n=23; 56.7+/-7.1 years) and with (n=25; 54.6+/-6.8 years) administration of meldonium (1000 mg/day intravenously). Control group (n=24; 50+/-8.4 years) consisted of patients who were under outpatient observation, received similar drug therapy, but were not subjected to CRT. After completion of CRT (in 2.5 months) all patients underwent clinical-instrumental examination with determination of exercise tolerance. RESULTS: Exercise duration and metabolic equivalent (MET) increased by 43.9, 36.6, 4.1% and 42.1, 34.8, 3.4% in CRT+ meldonium, CRT only, and control groups, respectively. CONCLUSION: In patients with documented ischemia after PCI inclusion of meldonium in the scheme of rehabilitation was associated with improved physical performance and optimal cost-effectiviness.

[Masked Arterial Hypertension in Employed Adult Women: Aspects of Screening and Prognostication].

Masked (M) hypertension (H) remains an unsolved problem of cardiology. Gender aspects of MH require further pathogenetic deciphering and clinical interpretation. We used breathe-hold test and 24-hour blood pressure (BP) monitoring for detection of MH in 275 female middle- aged employees. MH Prevalence of MH was 7.7%. Special clinical and pathogenetic characteristics of MH in studied sample were as follows: high sensitivity of mean hemodynamic BP; body mass index increase, tendency to elevation of fasting glycaemia and lowering of glomerular filtration rate, more frequent presence of dyslipidemia in comparison with normotensive patients, absence of association with levels of anxiety and depression. Ten year risk of fatal cardiovascular events in women with MH was comparable with that among female patients with overt hypertension (0.76 vs 0.68 %). Received data became a basis for elaboration of screening programs of early detection and prevention of H.

[Assessment of functional food of general version of diet in cardiac hospital].

The efficacy of functional food was evaluated in general embodiment diet of cardiological hospital in patients receiving oxygen-containing products (oxygen smoothies) based on protein-carbohydrate raw materials (dairy whey) with dietary fiber. 60 patients were included in local open, prospective, parallel-group study; among them 36 men and 24 women aged 60-75 years, meeting the following criteria: patients with chronic heart failure I-IV functional class, are hospitalized in the cardiology department, have no contraindications to enteral oxygen therapy and sign an informed consent form. The main group comprised 30 patients, which along with standard therapy received enteral oxygen therapy. 30 patients from the control group received standard therapy and aerated non-oxygen mixture (placebo). Standard therapy included cardioprotective drugs, diuretics and concomitant therapy (enzyme preparations) depended upon the clinical status of the patient. Patients received 500 ml of a cocktail within 10-15 minutes daily for 10 days for 1-1,5 hours before the main meal. The studies revealed the most pronounced clinical effect of enteral oxygen therapy in relation to clinical symptoms and side effects caused by drug administrations. After 3-4 procedures patients with chronic heart failure treated with enteral oxygen therapy had a decrease in fatigue, increase physical performance, improve appetite, emotional lability. By the end the positive dynamics of oxygen therapy on the above grounds was detected in 90% of patients. Monitoring pulse oximetry showed a significant increase of oxygen saturation as a result of the course of enteral oxygen therapy: oxygen saturation increased from 98.13 ± 0.13 to 99.17 ± 0.13% (p < 0.001) while in the control group from 98.12 ± 0.20 to 98.19 ± 0.19% (p < 0.01). Physical activity increased from 318 ± 15 to 389 ± 13 m (p < 0.001), in the control group--from 331 ± 17 to 362 ± 15 m (p < 0.05) in the main group on the test results with the 6-minutes walk test. In the main group dyspnea Borg changed from 11 to 7 scores as compared to the control group--from 11 to 9 scores. Analysis of the results showed the advisability of incorporating developed oxygen-containing products in diet therapy of cardiac patients to reduce the severity of side effects from taking of drugs administration to normalize the process of digestion, to improve the overall health of patients.

[PRECONDITIONING AT THE STAGES OF INVASIVE AND REHABILITATIVE TREATMENT OF PATIENTS WITH CORONARY HEART DISEASE].

The comprehensive analysis of efficiency of different variants of preconditioning is currently of special importance since the realization of the potential of endogenous protective effects extends possibilities for anti-ischemic protection of myocardium at different stages of CHD. Today, the main principles of preconditioning are purposefully applied to the development of therapeutic strategies for the treatment of CHD. The most widely used in the clinical practice are local and distant preconditioning modalities as well as preconditioning by physical exercises whose well-known protective effects are used in cardiosurgery and routine clinical practice. Elaboration of rehabilitative and preventive programs taking account of vaso- and cardioprotective effects of preconditioning may significantly increase the effectiveness of the rehabilitative treatment of CHD patients with poor organic coronary and myocardial reserve.

[Combined Antihypertensive Therapy in Patients at High Risk].

Presents opportunities to increase the effectiveness of combination antihypertensive therapy (AHT) in patients with arterial hypertension (AH) and high cardiovascular risk. Displaying increase in the proportion of patients with target blood pressure up to 82.4%; high commitment combined AHT (96%) and medical recommendations for lifestyle changes (54%) using the power of information computer technology (ICT) in order to carry out continuous monitoring of blood pressure and other risk factors (RF), commitment to the patients drug and non-drug assignments. Thus, ICT can be seen as a tool that can give a real idea of the scale and nature of the deviation from the medical recommendations that can serve as a basis for personalized AHT.

Role of nitric oxide in adaptation to hypoxia and adaptive defense.

Adaptation to hypoxia is beneficial in cardiovascular pathology related to NO shortage or overproduction. However, the question about the influence of adaptation to hypoxia on NO metabolism has remained open. The present work was aimed at the relationship between processes of NO production and storage during adaptation to hypoxia and the possible protective significance of these processes. Rats were adapted to intermittent hypobaric hypoxia in an altitude chamber. NO production was determined by plasma nitrite/nitrate level. Vascular NO stores were evaluated by relaxation of the isolated aorta to diethyldithiocarbamate. Experimental myocardial infarction was used as a model of NO overproduction; stroke-prone spontaneously hypertensive rats (SHR-SP) were used as a model of NO shortage. During adaptation to hypoxia, the plasma nitrite/nitrate level progressively increased and was correlated with the increase in NO stores. Adaptation to hypoxia prevented the excessive endothelium-dependent relaxation and hypotension characteristic for myocardial infarction. At the same time, the adaptation attenuated the increase in blood pressure and prevented the impairment of endothelium-dependent relaxation in SHR-SP. The data suggest that NO stores induced by adaptation to hypoxia can either bind excessive NO to protect the organism against NO overproduction or provide a NO reserve to be used in NO deficiency.