[Functional state of a solitary kidney after nephrectomy for renal cancer].

INTRODUCTION: The outcome of surgical treatment of renal cancer depends not only on cancer-specific survival, but also on the degree of loss of renal function, which often develops after surgery, especially radical nephrectomy. AIM: To study the features of functional changes in a solitary kidney as a compensation mechanism after radical nephrectomy for renal cancer. MATERIALS AND METHODS: The functional state of a solitary kidney in 36 patients with renal cancer who undergone to radical nephrectomy was evaluated. There were 20 and 16 women. The mean age was 59.0+/-10.8 years (from 39 to 76 years). The size of the tumor was in the range of 7.0-12.0 cm. All patients with a solitary kidney underwent a follow-up examination 3 months after surgery, including measurement of peripheral blood pressure with calculation of mean dynamic pressure, renal ultrasound, calculation of glomerular filtration rate (GFR), renal doppler ultrasound, determination of serum fibrinogen and fibrin monomers, and microscopy of the bulbar conjunctiva. Patients who had pathological abnormalities during the examination were prescribed reno-cardioprotective drugs, including perindopril in a titrated dose, apixaban 5 mg a day as thromboprophylaxis and for improvement of the flow properties of blood for a period of 3 months with re-evaluation of the above parameters. RESULTS: In 61.1% of patients after radical nephrectomy, on 2-4 postoperative days, there was a tendency to increase blood pressure compared to baseline values (p<0.05). By the seventh day after the procedure, the volume of the contralateral kidney increased on average by 16% (from 110.4+/-11.2 cm3 to 132.4+/-4.8 cm3, p<0.05). After radical nephrectomy, a decrease in GFR was detected in 33 cases (91.7%; p<0.05). Renal doppler ultrasound showed a moderate increase in linear blood flow, the resistance index in the main renal artery, and a decrease in the pulse index in the segmental and arcuate arteries. The microscopy of the bulbar conjunctiva in 83.3% of patients revealed changes in the microcirculatory bed, including narrowing of arterioles, dilation of venules, a decrease in venular and capillary blood flow. After 3 months of reno-cardioprotective therapy, it was revealed that the target values of blood pressure (<130/85 mm Hg) were achieved with an average dynamic blood pressure of 93.4+/-2.6 mm Hg. In addition, a decrease in creatinine to an average of 106.2+/-6.4, fibrinogen and fibrin monomers to subnormal values of 3.2+/-0.2 g/l and up to 8.1+/-0.5x10-2 g/l, respectively were seen. Renal hypertrophy according to ultrasound examination was preserved with a mean kidney volume 119.7+/-3.6 cm3. Disturbances in peripheral microcirculation according to the microscopy of the bulbar conjunctiva was assessed as moderate. CONCLUSION: The development of CKD in patients with a solitary kidney is accompanied by a structural reorganization of the organ with an increase in blood pressure, an increase in its volume, a decrease in function, microcirculatory disorders and hypertensive nephropathy. Considering the prognostic significance of changes in the solitary kidney, it is important not only to control the functional parameters, but also to include reno- cardioprotective therapy as a standard, since it contributes to the preservation of the renal function and prevents the rapid progression of CKD. Thus, medical and social rehabilitation of patients with a solitary kidney is required. However, it is currently cannot be considered comprehensive.

[Correction of age-related changes in facial tissues and restoration of the body's functional reserves using dynamic electroneurostimulation and spectral phototherapy]. / Korrektsiya vozrastnykh izmenenii tkanei litsa i vosstanovlenie funktsional'nykh rezervov organizma s ispol'zovaniem dinamicheskoi elektroneirostimulyatsii i spektral'noi fototerapii.

Theoretical background of a rational combination of dynamic electric neurostimulation (DENS) and spectral phototherapy (SPT) for complex elimination of age-related changes of facial tissues (ARCFT) and restoration of the body's functional reserves (BFR) is provided. Comparative results of separate and combined application of DENS and SPT (DENS&SPT) are provided. The results obtained upon examination of 90 patients have shown that DENS&SPT is more effective compared to separate application of the above procedures for both eliminating ARCFT and increasing BFR. After a course of DENS&SPT procedures, 87.5% of women evaluated the obtained aesthetic result as «significant improvement¼ and «improvement¼. When exposed to DENS&SPT, 5 of 8 measured parameters of facial skin condition improved significantly. At the same time, there was a restoration of BFR stress levels to moderate and optimal levels. DENS&SPT provides a mutually potentiating effect both in the aspect of correction of ARCFT and restoration of BFR decreasing with age.

[The relationship between obesity, cardiometabolic disorders and disease activity in psoriatic arthritis patients: data from the Russian register].

AIM: To study the relationship between obesity, cardiometabolic disorders and disease activity in patients with psoriatic arthritis (PsA) in real practice. MATERIALS AND METHODS: The Russian register included 614 PsA patients [female 331 (54%)/283 (46%)]. Average age 45.20.52 years, PsA duration 5.70.27 years, psoriasis 15.710.56 years. Patients underwent examination, body mass index (BMI), PsA activity according to DAPSA, cDAPSA, analysis of concomitant diseases were assessed. The patients were divided into 3 groups depending on BMI (kg/m2): normal 25 (group 1), increased 2530 (group 2), obesity 30 (group 3). RESULTS: The average BMI was 27.70.23 kg/m2, normal BMI in 213 (34.7%), increased in 214 (34.8%) and obesity in 187 (30.5%). Concomitant diseases in 297 (48%). In group 3, arterial hypertension was observed significantly more often than in groups 1 and 2 (p0.0001); more often than in group 2 diabetes mellitus (p0.0001), metabolic syndrome (p0.0001); more often than in group 1 ischemic heart disease (p=0.026). PsA activity at Baseline, after 6/12 months was significantly higher in group 3 (p0.031). In obese patients, the chance of a decrease in disease activity to a moderate/low level and remission during therapy for 6/12 months is 2.484 times lower than in group 1, and 2.346 times lower than in group 2: odds ratio 2.346 (95% сonfidence interval 1.075.143) and 2.484 (95% сonfidence interval 1.1355.439), respectively. CONCLUSION: In the majority (65.3%) of PsA patients, BMI exceeded the norm. Obesity is associated with a high incidence of cardiometabolic disorders, with higher PsA activity and lower treatment efficacy.

[Clinical implications of chronic mesenteric ischemia in elderly and senile patients].

AIM: To evaluate the sensitivity and specificity of the clinical criteria for the diagnosis of chronic mesenteric ischemia in elderly and senile patients with mesenteric atherosclerosis. MATERIALS AND METHODS: The study included 142 patients (82 men and 60 women). The median age of patients is 66.0 [62.0; 72.0] years. RESULTS: According to MDCT atherosclerotic lesions of the abdominal aorta and its unpaired visceral branches were diagnosed in 105 (73.9%) patients. A combination of atherosclerosis of the celiac trunk and the superior mesenteric artery with the presence of hemodynamically insignificant stenosis was revealed. Hemodynamically significant atherosclerotic narrowing of at least one mesenteric artery was present in 15% of cases. Among them, a single vascular lesion was found in 6 patients (4.2%), a combination of hemodynamically significant lesions of two arteries in 15 (11%) patients. Depending on the clinical manifestations, all patients are divided into two groups: the first group 30 (21.1%) patients with the presence of symptoms characteristic of chronic mesenteric ischemia (CMI). The second group consisted of 112 (78.8%) patients without a characteristic triad of symptoms. The clinical symptom complex of СMI, including postprandial abdominal pain, intestinal dysfunction and progressive weight loss, as a diagnostic criterion showed low sensitivity 13.3% and specificity 77.9%. At the same time, the sensitivity of such a clinical combination as a combination of atherosclerosis of the arteries of the lower extremities, weight loss and abdominal pain syndrome with a severity of more than 5.5 points, with respect to the detection of hemodynamically significant stenoses of two or more mesenteric arteries was sensitivity 86.7%, specificity 74.0%.

The effects of menopausal hormone therapy on proinflammatory cytokines and immunoglobulins in perimenopausal patients with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD).

AIM: To determine the effects of menopausal hormone therapy dosage on levels of proinflammatory cytokines and immunoglobulins in bodily fluids of patients with type 2 diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) during perimenopause. MATERIALS AND METHODS: The study included 119 perimenopausal females with moderate type 2 DM and stable COPD with signs of menopausal syndrome. Cytokine levels in bronchoalveolar lavage fluid and blood serum were measured with flow cytofluorometry (Вeckman Coulter FC500, USA) using a multiplex kit for human cytokines (BMS810FF) in adherence to the manufacturer's instructions. The lower limit of quantification was 2.5-52.7 pg/mL. The following cytokines were studied: IL-1ß, IL-6, IL-8, TNF-α and IF-γ. The data was analyzed with Flow CytomixProver 3.0 manufacturer-licensed software package. IgМ, IgG and IgА in the blood serum (Vektor-Best, Russia) were detected using an immunoenzymatic assay (Stat Fax 3200Analyzer, Awareness Technology, USA). Menopausal hormone therapy (MHT) with 17 beta-estradiol/dydrogesterone (standard - 2 mg, low - 1 mg, ultralow - 0.5 mg): 0.5/2.5 (estradiol 0.5 mg/dydrogesterone 2.5 mg) - ultralow-dose MHT, 1/10 (estradiol 1 mg/dydrogesterone 10 mg) - low-dose MHT; 2/10 (estradiol 2 mg/dydrogesterone 10 mg) - standard-dose MHT. Саrbohydrate metabolism was assessed in three groups. RESULTS: While 2/10 MHT yielded the most prominent decrease in IL-1ß, IL-6, IL-8, TNF-α and IF-γ levels in bronchoalveolar lavage fluid and blood serum, the effect was statistically insignificant compared to 0.5/2.5 and 1/10 MHT. Initially decreased IgM, IgG and IgA levels were elevated in all the three dosage groups with no significant differences between them. As to carbohydrate metabolism target values of glycemia were achieved in all three groups taking MHT. CONCLUSION: Standard-, low- and ultralow-dose MHT has positive effects on levels of proinflammatory cytokines and immunoglobulins characteristic of the association between type 2 DM, COPD and menopausal syndrome. The differences between the three dosage groups were statistically insignificant. Different dosage of MHT with dydrogesterone provide for improving impaired carbohydrate metabolism.

[Abdominal pain in migraine patients]. / Abdominal'naia bol' u bol'nykh c migren'iu.

AIM: To study the frequency of comorbid abdominal pain in migraine patients and the influence of that symptom on the formation of disease phenotype. MATERIAL AND METHODS: Clinical features of migraine were studied in 66 patients with episodic migraine and 40 patients with chronic migraine. Presence of pain, intensity, duration of seizure-associated abdominal pain and interictal abdominal pain were assessed. RESULTS AND CONCLUSION: The frequency of abdominal pain in the painful phase of migraine was >11% and did not depend on the type of migraine. Pain in the abdomen were reported by 88% of patients, with the increase in the frequency in patients with chronic migraine. The intensity and frequency of abdominal pain did not depend on organic pathology of the digestive system. Correlations between the intensity and duration of abdominal pain during the migraine attack phase (k=0.59), between the intensity of associated pain and maladjustment severity (k=0.59), and also between the abdominal pain intensity during the painful phase and in the interictal period were identified. Allodynia developed more frequently in patients with abdominal pain between migraine attacks (РF=0.005). Also relationships between the level of intensity of interictal abdominal pain and the rates of alexithymia (k=0.24), anxiety (k=0.29) and depression (k=0.25) were revealed. The association of abdominal pain with disease severity and allodynia suggests similar development of these symptoms.

[Cognitive impairment and compliance in chronic heart failure]. / Kognitivnye narusheniia i priverzhennost' lecheniiu u patsientov s khronicheskoi serdechnoi nedostatochnost'iu.

AIM: To determine the factors of cognitive impairment and non-compliance in patients with chronic heart failure (CHF). MATERIAL AND METHODS: One hundred and fifty-seven patients with CHF and 32 patients without chronic heart failure (controls) were examined. Neuropsychological assessment using a 30-minutes protocol recommended by NINDS-Canadian Stroke Standards (NINDS CSS), magnetic resonance imaging, cognitive ERP and a test of compliance were used. RESULTS AND CONCLUSION: Approximately 62% of patients did not perform medical prescriptions. Non-compliance was associated with an increase in the severity of subcortical and perivenricular leukoaraiosis, a slowdown in decision-making processes (an increase in the P300 latency), worse performance on speech activity tests, optical/spatial and frontal dysfunctions and memory. Patients with non-compliance had frontal cognitive impairment (58%), memory impairment (40%) and mixed forms (21%). Cognitive impairment in patients with chronic heart failure was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function.

[The meteopathic reactions as reflected in the indicators of electropuncture diagnostics. A pilot study]. / Otrazhenie meteopaticheskikh reaktsii v pokazateliakh élektropunkturnoi diagnostiki. Pilotnoe issledovanie.

The present article was designed to report the results of the electropuncture diagnostics (EPD) with the use of the 'Prognoz' electropunctural device obtained during the examination of 12 patients who experienced meteopathic reactions (MPR) during magnetic storms. The most frequently detected changes were deviations affecting the acupuncture channels (AC) of the heart, pericardium and triple energizer. The latter underwent the most pronounced deviation from the 'balanced condition'. In 2 cases out of the three (66,6%), its hypofunction was documented The pericardium channel was characterized by extreme asymmetry of its left and right branches. To a lesser extent, a similar asymmetry was apparent in the acupuncture channels of the heart. The present pilot study revealed the noticeable changed in the functional state of two AC (pericardium and triple energizer) in people suffering from meteopathic reactions. It is concluded that the further studies involving a larger population of the weather-dependent subjects is likely to identify other sensitive acupuncture channels; the analysis of their functional condition may be instrumental in determining the typical MPR profiles based on the results of the evaluation of the effectiveness of electropunctural diagnostics. The newly detected patterns may be useful for the development of the personalized approach to the prediction, prevention, and relief of the meteopathic reactions.

[Clinical significance of nausea in migraine]. / Klinicheskoe znachenie toshnoty pri migreni.

AIM: To study the prevalence and intensity of nausea in pain, prodromal and postdromal phases of migraine paroxysm, and in between the paroxysms in migraine patients, depending on the type of migraine paroxysm and frequency of pain days, and to evaluate an effect of nausea on the course of migraine. MATERIAL AND METHODS: One hundred and four patients with migraine, aged from 18 to 60 years, were examined. The intensity of nausea was evaluated by a 5-point verbal analogue scale, and its intensity in between the paroxysms by the Gastrointestinal Symptom Rating Scale. All of the patients underwent a complex examination of the gastrointestinal tract. RESULTS AND CONCLUSION: Paroxysms with accompanying nausea were found in 90% patients. Acute nausea was associated with older age, earlier onset and longer experience of migraine. In a group of patients with acute nausea, the frequency and intensity of migraine paroxysms, probability of reoccuring pain in the first day and the severity of social disability were higher. Development of nausea in between the paroxysms and its intensity was significantly higher in patients with high intensity of nausea in migraine paroxysms. Nausea in the prodrome was significantly associated with migraine without aura and chronicity of the disorder. Patients with nausea in the prodrome also had a longer painful phase and more severe social disability. No relationship between organic diseases of the digestive tract and nausea was found. Nausea can have its own pathological mechanisms not related to concomitant diseases of the digestive tract that should be taken into account in therapeutic interventions aimed at improving quality of life of the patients.

[The experimental evaluation of the protective effect of the extract of the cyclodextrin-containing phytotherapeutic composition on the development of osteoporosis].

OBJECTIVE: The relevance of the problem considered in the present communication arises to-day from the widespread prevalence of osteoporosis (OP), the rather low effectiveness of the methods currently available for the treatment of this condition, and iatrogenic effects of its medication therapy. The great diversity of phytotherapeutic modalities of traditional medicine are is only poorly supported by the results of the scientific studies results; moreover, most of them are coming from the foreign literature publications. AIM:  The objective of the present study was to evaluate the influence of the phytotherapeutic preparation (Phytocost) having cyclodextrin in its composition on the restoration of the cartilaginous and bony tissues based on the experimental research with the use of the OP experimental model. MATERIAL AND METHODS:  The experimental studies were performed on 5 month-old Balb/c mice used as the prednisolone-induced osteoporosis model. The animals were divided into four study groups according to the daily doses administered to them: 0.005; 0.05; 0.5 and 5.0 mg/mouse during 30 days and 3 control groups: intact, 14 and 30 days after prednisolone administration, naïve mice. RESULTS:  The study has demonstrated the dose-dependent protective effect of cyclodextrin-containing Phytocost. The most pronounced effect in the form of reduction of osteoblast number and the increase in the number of osteocytes was obtained at a Phytocost dose of 0.5 mg/mouse. No undesirable adverse reactions were documented during the study. CONCLUSION:  The domestically produced Phytocost composition differs from its foreign analogues in that it contains a significantly greater number of constituent components because the ultimate goal of the study was to create a medication acting on all currently known mechanisms of OP pathogenesis, whereas our Chinese colleagues proceed from the ancient knowledge gained by traditional medicine that it is sometimes difficult to understand and explain in the light of the modern concepts. All the plants used as raw materials for Phytocost production grow at the territory of the Russian Federation which provides the possibilities for the efficient import substitution of the components necessary for the manufacture of the preparation in question.

[Significance of sleep deprivation in the development of local epilepsy from neuroplasticity opinion]. / Znachenie deprivatsii sna v razvitii lokal'no obuslovlennoi epilepsii s pozitsii kontseptsii neiroplastichnosti.

AIM: Learning cycle «sleep-wake¼ is of great theoretical and practical importance because it allows to understand the general patterns of adaptive mechanisms of human interaction with the environment (neuroplasticity), violations of which are the basis of many diseases of the CNS, including epilepsy. MATERIAL AND METHODS: Complex clinical and electroencephalographic (video-EEG monitoring with mandatory recording of sleep) study was carried out before and after prolonged sleep deprivation (for at least 1 day) of 178 patients with locally due to epilepsy (LEi). 45 healthy volunteers were examined in the control group as well as the patients with epilepsy. The work was carried out to compare the results of clinical and neurological and electrophysiological studies during sleep deprivation (SD) in patients with LEi and in healthy individuals with neurohistological and electron microscopic patterns of changes in the brain of rats in an experiment with 48-hour SD. RESULTS AND CONCLUSION: Discovered in the CNS of rats after SD morphological changes such as pleyokoniya of mitochondria, damage in the blood-brain barrier, signs of exhaustion astrocytes, glial cells and the change of the nuclei of gliocytes and some neurons of the type of apoptosis and karyorrhexis and destruction of synapses reveal a violation of the fundamental mechanisms of neuroplasticity. The results allow us to consider the SD patients as a damaging factor for the central nervous system, provoking the development of epileptic seizures and epilepsy, and the SD in laboratory animals can be used as a model for further study of the mechanisms of neuroplasticity. In addition the findings greatly complement current understanding of the mechanisms of neuroplasticity and pathogenesis of epilepsy, and justify the need for the study of therapeutic efficacy of modulators of neuroplasticity (transcranial magnetic stimulation, ipidacrin etc.) in the complexe treatment of patients with the this specified profile.

[The algorithm for the determination of the sufficient number of dynamic electroneurostimulation procedures based on the magnitude of individual testing voltage at the reference point]. / Algoritm opredeleniya dostatochnogo kolichestva protsedur dinamicheskoi elektroneirostimulyatsii po napryazheniyu testirovaniya v repernoi tochke.

This article was designed to present evidence of the advantages of the personified approach to the treatment of the patients presenting with arterial hypertension (AH), lumbar spinal dorsopathy (LSD), chronic obstructive pulmonary disease (COPD), and duodenal ulcer (DU) at the stage of exacerbation obtained by the measurements of testing voltage at the reference point (Utest). AIM: The objective of the present study was to develop the algorithm for the determination of the sufficient number (optimal duration) of therapeutic procedures of the protracted treatment with the use of the Utest at the reference point. THE PATIENTS AND METHODS: The study included 647 patients (439 women and 208 men at the age varying from 25 to 72 years) with grade I-II AH, DU at the stage of exacerbation, grades II and III lumbar spinal dorsopathy, grade II-III COPD. The informed written content to participate in the study was obtained from all the patients. They were divided into three groups. Those comprising group 1 were treated by standard therapy, patients of group 2 received the same treatment supplemented by dynamic electroneurostimulation (DENS) while the patients of the third group were given personified DENS in accordance with the determined sufficient number of DENS procedures. RESULTS: The blood pressure in the patients with AH comprising group 3 was found to decrease more significantly in comparison with those in groups 1 an 2 (by 9% and 3% respectively). The intensity of pain syndrome in the patients with lumbar spinal dorsopathy evaluated based on the visual analog scale decreased two-fold in group 3 in comparison with the 1.2 and 1.8 times decrease in groups 1 and 2 respectively. The level of pH in the stomach of patients with DU increased by 33.3% in group 3 in comparison with 12,5%, in group 1 and 21,8% in group 2. Vital capacity of the lungs in the patients of group 3 presenting with COPD and treated with the use of the personified approach was found to increase almost up to 612 ml in comparison with 477 ml in the patients given DENS in combination with standard therapy and only 219 ml in the control group. CONCLUSION: The results of the present study give evidence of the advantage of the personified treatment based on the determination of the sufficient number of the therapeutic procedures needed for the protracted treatment with the use of the Utest at the reference point. This approach can be used as a tool for the evaluation of the functional state of the patients and a method for the management of a chosen therapeutic strategy.

[The physical methods for the prevention and management of weather-dependent pathological reactions (a literature review)]. / Fizicheskie metody profilaktiki i korrektsii meteopaticheskikh reaktsii (obzor).

The review presents data on the non-pharmacological methods and technologies for the prevention and management of meteopathic reactions (MPR) applied in Russia for the treatment of the patients suffering from obstructive and cardiovascular diseases. It is assumed, based on the concept of heliogeophysical imprinting, that the major factors responsible for the development of MPR are the disturbances of electromagnetic homeostasis. The acupuncture points and channels are regarded as a system designed for the maintenance of electromagnetic balance in the human body. In this context, it is proposed to encourage the application of the methods of electro-diagnostics and reflexology for the prevention and correction of meteopathic reactions.

[The effectiveness of the application of dynamic electrical neurostimulation for the treatment of dorsalgias of the lumbar-sacral localization].

Dynamic electrical neurostimulation (DENS) is a variant of transcutaneous electrical neurostimulation based on the use of biological feedback monitoring the surface impedance of the skin. The present study was designed to estimate the effectiveness of the application of dynamic electrical neurostimulation for the treatment of dorsalgias of the lumbar-sacral localization in comparison with the standard combined treatment including pharmacotherapy, massage, and therapeutic physical culture exercises. The data obtained indicate that the inclusion of DENS in the standard treatment protocol promotes the regression of pain and neurological symptoms; moreover, it accelerates the achievement of clinical remission.

[Sensitivity and specificity of the cerebral blood flow reactions to acupuncture in the newborn infants presenting with hypoxic ischemic encephalopathy].

OBJECTIVE: To evaluate the effects of acupuncture integrated into the standard therapy, the condition of cerebral blood flow, and other syndromes associated with cerebral ischemia in the newborn infants. MATERIAL AND METHODS. A total of 131 pairs of puerperae and newborns with hypoxic ischemic encephalopathy were divided into four treatment groups. 34 children of the first group were given standard therapy (control), in the second group comprised of 33 mothers and children the standard treatment was supplemented by acupuncture, the third group included only 32 mothers given the acupuncture treatment alone, and the fourth group contained only 32 newborn infants treated by acupuncture. Each course of acupuncture treatment consisted of five sessions. Sensitivity and specificity of cerebral blood flow reactions were determined based on the results of the ROC-analysis and the area under the curve before and after the treatment. RESULTS: The treatment with the use of acupuncture greatly improved the cerebrospinal hemodynamics (p < 0.05). Other symptoms, viz. sleep disorders, vegetative reactivity and excitability were significantly reduced. The ROC analysis confirmed the effectiveness of acupuncture as a tool for the treatment of the impaired cerebral blood flow in the newborn babies. The high level of sensitivity (84.4-94.8%) associated with good specificity makes it possible to distinguish between the true positive and true negative cases. CONCLUSION: Acupuncture integrated into the treatment of "mother-baby" pairs presenting with hypoxic ischemic encephalopathy can be used to improve the initially low level of cerebral blood flow in neonates presenting with this condition.

[New phytotherapeutic composition for restoring bone and cartilage. Experimental study].

Presents a new import-substituting the composition of the powder mixture 60 medicinal plants and dead bees. In prednisolonbuy models of osteoporosis have shown dose-dependent regenerative effects bone and cartilage of the hip joints of mice. Unwanted side effects when taking composition was observed. It is assumed the possibility of effective application of the composition as a complementary treatment for osteoporosis.

[Cognitive functions in patients with chronic heart failure].

OBJECTIVE: To evaluate cognitive functions in patients with different stages of chronic heart failure (CHF) and different degrees of stenosis of precerebral arteries. MATERIAL AND METHODS: Authors examined 148 patients with CHF and 21 patients without CHF (controls). Neuropsychological assessment (NINDS-Canadian Stroke Standards - 30 minutes protocol), ultrasound scanning of the main cranial arteries and transcranial dopplerography and echocardiogram were made. RESULTS AND CONCLUSION: Patients with CHF more frequently had combined (multifocal) cognitive impairment. Patients with systolic heart failure performed significantly worse on neuropsychological tests, in particular, functional domains within the frontal lobes and "executive" dysfunction, than those with diastolic heart failure. Cognitive impairment in patients with CHF was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function but not with carotid artery stenosis.

[Reflexotherapy in the context of rehabilitative medicine].

The main stages of the history of reflexotheray and its principal methodological aspects are reviewed in the context of the introduction of this approach into rehabilitative medicine. Productive results of such integration find the demonstrative reflection in the defense of 56 theses for the degree of candidate of science and 28 ones for the degree of doctor of science devoted to various aspects of reflexotherapy. The growing tendency toward the more extensive application of non-pharmacological approaches to complementary medicine opens up new prospects for the further development of reflexotherapy in the context of modern health care practices.

Stuck in traffic: Patterns of powder adhesion.

The adhesion of fine particles to surfaces is important for applications ranging from drug delivery to fouling of solar cells. In this letter, we show that powder adhesion can occur in unexpected patterns, concentrating particular grain types in some locations and clearing them from others, and we propose a straightforward traffic model that appears to reproduce many of the behaviors seen. The model predicts different patterns depending on inter-particle cohesion, and we find in both experiment and model that adhesion occurs in three distinct stages.