[Negative result of exercise testing in patient with severe coronary artery disease].

The ECG stress test allows to determine possible presence of obstructive coronary atherosclerosis. The more severe the atherosclerotic lesion of coronary arteries the more likely a ST segment depression during the stress test. The article provides a description of a negative result of a stress test in a patient with multivessel coronary disease.

[Use of ozonotherapy (OT) in combined treatment of patients with discirculatory encephalopathy (DEP)].

The purpose of the work was assessment of clinical efficiency of OT and study of cerebral blood flow indices in combined treatment of DEP patients, including OT. It was detected that addition of intravenous OT in a complex of planned therapy of DEP patients at the age about 60 years leaded to more significant and more rapid (vs. control groups) regress of DEP symptoms, in the first place headache, ear noise, sleeplessness, memory reduce. Decrease in objective manifestation of neurological syndromes such as dysmnesic, akineticorigid, asthenic ones. Blood lipid spectrum, blood glucose level, blood coagulant system and cerebral blood flow indices were improved. These effects were more expressive in patients with the age less than 60 years. In control subgroups these changes were less expressed. Thus, of OT in combined treatment of patients with DEP improved efficiency of drug therapy and accelerated regress of various symptoms of this pathology, especially in patients with the age less than 60 years.

[Clinico-functional effect of a course of interval normobaric hypoxic therapy in patients with chronic obstructive bronchitis and bronchial asthma]. / Kliniko-funktsional'nyi éffekt kursa interval'noi normobaricheskoi gipoksiterapii u bol'nykh khronicheskim obstruktivnym bronkhitom i bronkhial'noi astmoi.

AIM: To study short- and long-term clinicofunctional effects of primary and secondary courses of interval normobaric hypoxia (INH) in patients with chronic obstructive bronchitis (COB) and bronchial asthma (BA). MATERIALS AND METHODS: The study group of 45 COB and BA patients were exposed to INH. The control group of 20 COB and BA patients received conventional drugs. The INH patients were examined using the acute hypoxia test, return respiration test, peak-flowmetry, assessment of external respiration function (ERF), immune status, heart rate, blood pressure. Stange test ERF and the disease course within the last 2-3 years were analyzed. RESULTS: INH proved more beneficial for COB and BA patients than the standard drugs. Bronchial obstruction reduced by 10-15%, exercise tolerance, general condition, ventilation, hemodynamic and immunological parameters improved, frequency of bronchopulmonary infection exacerbations dropped 2-fold. CONCLUSION: An INH course is effective in the majority of COB and BA patients. It is recommended for treatment and rehabilitation once or twice a year.

[Possibilities of normobaric hypoxic training in rehabilitation of patients with chronic bronchitis]. / Vozmozhnosti normobaricheskoi gipoksicheskoi trenirovki v reabilitatsii bol'nykh khronicheskim bronkhitom.

To provide evidence for the potentialities of normobaric hypoxic training (NHT), oxygen cascades from the lung to tissues and responses to hypoxic and hypercapnic stimuli were analyzed in chronic bronchitis patients with Stages 1, 2, and respiratory failure. Since at Stages 2 and 3, compensatory responses are substantially decreased, there is arterial, and occasionally, venous hypoxemia, NHT is contraindicated in these patients. Compensatory responses are preserved only during early stages 0 and 1 respiratory failure, showing it expedient to employ NHT. NHT regimens (as many as 20 sessions) used in these patients improved the patients' condition and physical activity, normalized ventilation function. However, the concurrent diseases exacerbated in some cases. Medical monitoring is needed when the NHT regimen is used.

[Hypoxic stimulation and inspiratory resistive training in the rehabilitation of patients with chronic bronchitis]. / Gipoksicheskaia stimuliatsiia i inspiratornyi rezistivnyi trening v reabilitatsii bol'nykh khronicheskim bronkhitom.

A study was made of the efficacy of normobaric hypoxic stimulation (NHOS) and inspiratory resistive training (IRT) in multimodality treatment and rehabilitation of patients suffering from chronic obstructive bronchitis. The results were estimated by means of exercise tests and by stimulation electromyography of the diaphragm (SEMGD). The use of NHOS and IRT in multimodality treatment of the given group patients was found to give rise to a more complete physical rehabilitation of the patients, whereas the application of SEMGD is an effective approach to the control of sessions and courses of NHOS and IRT. Besides, the use of the latter method also permits choosing the intensity of the action of the treatment methods in question on the body, particularly on the diaphragm muscle.

[The functional characteristics of an additional dead space and a respirator for preparing hypoxic-hypercapnic mixtures intended for respiration training]. / Funktsional'nye kharakteristiki dopolnitel'nogo "mertvogo" prostranstva i respiratora dlia prigotovleniia gipoksichesko-giperkapnicheskoi smesi, primeniaemykh dlia trenirovki dykhaniia.

A study was made of the characteristics of respiration recorded during the use of a respirator for preparing hypoxic hypercapnic mixtures as compared to the use of an additional "dead" space. In both cases, there was a significant increase of total ventilation, largely at the expense of respiration deepening. However, during respiration via a respiratory mask, the increase of the minute respiratory volume was accompanied by a rise of alveolar ventilation whereas during respiration via the ADS, alveolar ventilation dropped. Hyperventilation did not entail CO2 washing out from the blood and hypocapnia development during respiration via the mask and ADS. The differences revealed may appear helpful for respiration training at the hospital. In this case, an appropriate outfit should be sorted out for each patient on an individual basis.

[Use of normobaric hypoxia in the combined modality therapy of patients with chronic bronchitis]. / Primenenie normobaricheskoi gipoksii v kompleksnom lechenii bol'nykh khronicheskim bronkhitom.

The authors review the main physiological alterations occurring in the body under the influence of hypoxia. Provide the data on successful use of the method in the treatment of a number of diseases with a purpose of increasing nonspecific resistance of the body. Based on the review of literature provide evidence for the use of normobaric hypoxic stimulation (NHOS) in multimodality treatment and prophylaxis of patients suffering from chronic bronchitis (CB). A study was made of the reactions of the cardiorespiratory system towards normobaric hypoxia and of the clinical effect of the continuous treatment with NHOS. The increase of nonspecific resistance of the body was noted, which manifested itself by the deceleration of CB exacerbations, optimization of the work of the cardiorespiratory system and rise of exercise tolerance after a course of NHOS. Recommendations are given for the use of the given method in multimodality treatment and rehabilitation of CB patients.

[The role of sleep apnea in the pathogenesis of cardio-pulmonary insufficiency in patients with chronic obstructive bronchitis]. / O roli nochnogo apnoé v patogeneze legochno-serdechnoi nedosta- tochnosti u bol'nykh khronicheskim obstruktivnym bronkhitom.

Continuous registration of breath, ECG, O2 tension was carried out in sleeping chronic obstructive bronchitis (COB) patients (n-46). Sleep apnea was detected in 19 of them. It was found that signs of pulmonary insufficiency in association of COB and sleep apnea occur significantly earlier. No correlation was observed between the severity of bronchial obstruction and pathological sleep apnea. The discussion covers mechanisms of pulmonary and cardiac insufficiency onset in COB patients with sleep apnea, therapeutic responses to long-term oxygen treatment and introduction of artificial respiratory control.

[The use of a respiratory regulator in the combined therapy of obstructive lung diseases]. / Ispol'zovanie reguliatora dykhaniia v kompleksnoi terapii obstruktivnykh zabolevanii legkikh.

The authors review a method for the treatment of patients suffering from nonspecific pulmonary diseases associated with the obstructive syndrome by means of a respiratory regulator which permits the building of positive pressure of 2-4 cm H2O throughout expiration. External respiration, gas exchange and hemodynamics were explored in 30 patients with chronic obstructive bronchitis and in 30 patients with bronchial asthma treated by the respiratory regulator. There were clinical and functional data indicating the lowering of bronchial obstruction: an increase of the lung capacities, improvement of the velocity indicators, and improvement of the ventilation-perfusion correlations in the lungs.