[The scientific rationale for the use of electroneurostimulation of the cervical sympathetic ganglia in patients with computer vision syndrome]. / Nauchnoe obosnovanie primeneniya elektroneirostimulyatsii sheinykh simpaticheskikh gangliev u patsientov s komp'yuternym zritel'nym sindromom.

A frequent reason for visiting an ophthalmologist for patients of working age is computer vision syndrome (CVS): statistics show that up to 90% of users of personal electronic computers (PCs) suffer from this disease. Therefore, the actual task of modern rehabilitation medicine and ophthalmology is the search for an effective and safe way to prevent and treat the CVS among employees of enterprises. THE PURPOSE OF THIS STUDY: Was a scientific justification, an assessment of the effectiveness and safety of the use of electroneurostimulation (ENS) of the cervical sympathetic ganglia in patients with CVS. MATERIAL AND METHODS: 120 patients with the syndrome observed on an outpatient basis were examined. Patients were divided into 3 groups using simple randomization method. The 1st group (the main group - MG) included 39 patients who, against the background of gymnastics of the oculomotor muscles and muscles of the shoulder girdle, used ENS on the area of the sympathetic ganglia; in the 2nd group (group of comparison - GoC) included 41 patients who strictly performed the same muscle gymnastics (after every 2 hours of work with the PC); Group 3 (control group - CG) consisted of 40 patients who took an ENS course of exposure in placebo mode. In the dynamics, the stock of relative accommodation, near heterophory, tear production, threshold electrical sensitivity of the retina, electrolability of the optic nerve, contrast sensitivity, reading speed, print speed and accuracy and the level of subjective asthenopia were evaluated. RESULTS: Initially, groups of patients with CVS did not differ among themselves in any of the investigated parameters. After a course of procedures in the MG, in contrast to the other two (GoC and CG), statistically significant positive shifts were revealed in relation to the selected endpoints, reflecting the severity of asthenopia, sensorineural, accommodative and oculomotor functions of the visual analyzer, as well as ophthalmoergonomics. Of the side effects of the procedures were recorded: moderate drowsiness (in 4 patients), a feeling of heaviness of the head (in 1 patient) and an increase in blood pressure (BP) by more than 15% of the initial (in 1 patient). They disappeared on their own and did not require withdrawal of treatment. A patient who noted a single increase in blood pressure subsequently received therapy every other day. Redness of the skin of the neck in the area of application of the electrodes was found with the same frequency in MG and CG. CONCLUSION: The inclusion of ENS in the rehabilitation treatment of workers professionally using a personal computer significantly increases the effectiveness of therapeutic measures, which proves the appropriateness of applying the proposed technology in CVS. The therapeutic action of complex therapy is realized through the effect of the ENS on an important reflexogenic zone - the cervical sympathetic ganglia, the activation of which ensures the normalization of the central, peripheral and autonomic functioning of the visual analyzer. Analysis of the frequency of registration of side effects in patients of the three groups allows us to conclude that the technique is safe.

[The role of the combined balneotherapeutic treatment as the 'add-back therapy' against the background of the anti-hormonal effects of the agonists of gonadotropin-releasing hormone in the women suffering from endometriosis genitalis externa]. / Kompleksnoe bal'neolechenie v kachestve terapii prikrytiia na fone antigormonal'nogo vozdeistviia agonistami gonadotropin-rilizing gormona u zhenshchin s naruzhnym éndometriozom.

BACKGROUND: The use of agonists of gonadotropin-releasing hormone (GnRH) for the rehabilitation treatment of the patients presenting with endometriosis genitalis externa is known to significantly enhance the risk of development of hypoestrogenism. The so-called 'add-back-therapy' is carried out as a preventive measure to eliminate hypoestrogenism caused by the intake of GnRH agonists without detriment to the effectiveness of anti-hormonal therapy. AIM: The objective of the present study was to estimate the effectiveness of the new method ('add-back hormone replacement therapy') in comparison with anti-hormonal therapy with the use of GRH agonists at the stage of the early postoperative medical rehabilitation based on the drinking of mineral waters (MW) and radon therapy (RT) in the patients who had undergone the laparoscopic interventions for the treatment of endometrioid heterotopies of the ovaries (1-3 months post-operatively). MATERIAL AND METHODS: To evaluate the effectiveness of the spa and health resort-based rehabilitation measures, the long-term effects of GnRH agonists have been studied in 2 groups of the patients formed by the of simple randomization method. The main group (MG) was comprised of 45 women received medical rehabilitation under conditions of a spa and health resort setting with the application of medium-salt water from the Pyatigorsk spring and radon therapy in the combination with triptorelin. The group of comparison (CG) was composed of 44 women given the treatment with the use of triptorelin under the out-patient conditions. The assessment of the results of the study included: the estimation of the intensity of pelvic pain syndrome, indicators of the hormonal status and the quality of life (QL), ultrasonic examination of the pelvic organs, and the occurrence of adverse effects of triptorelin. The duration of the study was 3 years (2014-2016). RESULTS: The analysis of the long-term results of the rehabilitative treatment has demonstrated that the rehabilitation activities under the spa and health resort conditions within 1-3 months after the surgical intervention including the application of MW and RT in the combination with an agonist of gonadotropin-releasing hormone (triptorelin) greatly contributed to the stability of the results of the treatment: specifically, only 2.5% of the patients suffered the recurrence of cystic ovarian endometriosis whereas 24.5% (p<0.001) reported the restoration of the reproductive function. The patients comprising the control group experienced the recurrence of the pathologic process in 7.5% of the cases and the restoration of the reproductive function in 15.8% of the cases (p<0.001). Simultaneously, the quality of life in the patients in the main group improved 3.4 times on the average in comparison with the initial level (p<0.001). The 2.2-fold improvement of the quality of life was documented in the control patients (p<0.001). At the same time, the frequency of adverse reactions to the treatment with triptorelin in the control patients was higher than in the main group including pain in the epigastric area, headache, irritability, hyperhidrosis, and instability of arterial blood pressure (ABP) that significantly deteriorated the life quality in these women. CONCLUSION: The comparative analysis of the results of the follow-up observations has demonstrated that the application of drinking mineral water and radon therapy for the treatment of the women suffering from endometriosis genitalis externa can be recommended as 'add-back therapy' against the background of anti-hormonal effects of agonists of gonadotropin-releasing hormone.

[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.

[The investigation of immunological effects of the new balneotherapeutic preparation glinofir used for the treatment of adjuvant arthritis]. / Izuchenie immunologicheskikh effektov novogo bal'neologicheskogo sredstva glinofir pri ad''yuvantnom artrite.

AIM: The objective of the present study was to investigate the influence of a course of application of the modified natural factors on the immunological mechanisms of regulation under experimental conditions with special reference to the application of the natural yellow clay, the clay from the Novo-Pyatigorsk quarry (the lake Tambokan) and of the new balneotherapeutic preparation glinofir based on this modified clay and designed for the treatment of adjuvant arthritis (AA). MATERIAL AND METHODS: The study of anti-inflammatory activity of the externally applied balneomedicines was carried out with the use of an animal model of adjuvant arthritis. The course of applications started 3 days prior to the initiation of AA and was terminated on the 24th day of the experimental disease. The action of three balneotherapeutic preparations (Tambukan mud, yellow clay, and modified clay in the form of Glinofir) was compared after they were heated to 42 °C and applied to the animals' limbs for 15-20 minutes every second and third days. The experiments were performed on Wistar rats (n=59) divided into five groups. Group 1 was comprised of 9 healthy animals that served as controls. The animals of group 2 (n=10) presented with untreated experimentally-induced adjuvant arthritis, those of Group 3 (n=10) had model AA treated by a course of application of the Tambukan mud. The animals of group 4 (n=10) had model AA and were treated by the application of the yellow clay and those of Group 5 (n=10) with model of AA received a course of application of the modified clay. RESULTS: On day 37 after the induction of adjuvant arthritis, the animals developed leukocytosis (white blood cell count in the blood was 1.5 times higher than in the control group) and alterations in the composition of the lymphocyte population, viz. B-lymphocytes increased 2-2.5 times (p<0,02) while T-lymphocytes decreased (p<0,05). A course of glinofir application contributed to the restoration of the T-cytotoxic cell population (p<0,2) and influenced the regulation of pathological immune complexes (PIC) as confirmed the negative correlation between the PIC level and the absolute number of T-cytotoxic cells (r=-0,8, p<0,01). The chronic stage of AA was associated with a two-fold increase in the absorptive capacity of neutrophils. The treatment with the Tambukan mud and glinofir restored the phagocytic function of neutrophils and simultaneously reduced the blood leukocyte reaction. CONCLUSION: The anti-inflammatory action of the Tambukan mud and glinofir manifests itself in the unidirectional changes of dynamics of the characteristics of cellular and humoral immunity.