Vol 16, No 3 (2017)

The article covers the issues related to the use of mineral waters in clinical practice. It has been found that mineral waters, if chosen and prescribed appropriately for a given patient, help to restore regulation of gastric and pancreatic juices to the normal values seen in healthy individuals, to stimulate biliary formation and secretion, to exert the positive influence on the hormonal and neurohumoral regulation. Mineral waters help to improve different types of metabolic processes and immune regulation as well as to enhance the blood flow in kidneys and liver. The mineral waters are efficient for the treatment of the urinary system disorders, diabetes mellitus, obesity, and other pathologies, including those that are characterized by concomitant metabolic disorders. On the other hand, mineral waters are prescribed for or advised to be used by the patients not only by the doctors affiliated with the health resorts, but also by other healthcare practitioners who occasionally fail to be fully aware of the specific problems related to their clinical application. For this reason, the present article was designed to cover the main principles related to the prescription of mineral waters for the clinical use and elaborate the proper procedures that would serve as the guidelines on their application as well as to provide general information for the physicians of different specialty profiles on the availability of the extensive range of natural and spa mineral waters that originate from various regions of this country. The emphasis is placed on the filling of the expertise gaps related to the classification of mineral waters and their main properties that are believed their efficient clinical use.

Comparative analysis of the effectiveness of different methods of physical therapy including hydrokinesitherapy and therapeutic gymnastics with the use of exercises on an unstable support (stabiloplatform) was made for a group of 72 patients suffering from pain in the spine of vertebrogenic genesis who had repeatedly received standard medical therapy, physiotherapy (magnetotherapy, laser therapy), and massage therapy before the onset of the study. The effectiveness of therapy was assessed based on the VAS scale, using the Schober’s test, Tomaier test, and Ott test as well as the summary index of health status. The pain intensity estimated based on the VAS scale was significantly reduced in all the patients after the completion of the treatment. Especially good results were obtained for the group of men making exercises on the stabiloplatform and in the group of women given hydrokinesitherapy in the water pool. The results of the present study of the psychoemotional state, vertebroneurological status, and spinal pain intensity in the patients presenting with dorsopathies lead to the conclusion that men and women respond differently to the rehabilitative treatment with the use of the static and dynamic methods of physical therapy.

We have created the experimental model of chronic inflammation of lungs by means of prolonged mechanical irritation of the bronchi in 30 outbred rats and studied the morphological changes in the lung tissue of these animals rats in three series of experiments. Each rat was given an intraperitoneal injection of an ozonised saline solution produced by a «Binafsha» ozonator. The objective of the study was to compare a control group of healthy animals and the group of experimental animals with chronic purulent pneumonia. The prolonged irritation of the respiratory tract in experimental animals was found to induce the structural changes in the tissues of the lungs characteristic of chronic purulent inflammation. The course of treatment with the ozonised saline solution in healthy animals with experimentally modelled chronic purulent inflammation of the lungs did not have a negative impact on the general condition and the behaviour of the animals. The treatment of experimental chronic inflammation of lungs caused by prolonged mechanical irritation of the respiratory tract resulted in the improvement of the morphological status of the laboratory animals, but the purulent inflammation process failed to be completely resolved after the treatment which needs to be taken into consideration in the clinical practice.

The effect of combined alternating exposure to a laser emitting in the infrared and red wavelength ranges of the light spectrum on the bone marrow cells of the adult rats under conditions of both shin irradiation was investigated. The duration of the irradiation session was varied from 1 to 3 minutes. The ana-telophase method has demonstrated that the alternation of daily laser irradiation sessions of different intensity and depth of penetration into the biological tissues disturbed the division of bone marrow cells. This effect depended on the intensity of laser irradiation. Apparently, both the therapeutic corridor of laser therapy and the permissible energy irradiation were exceeded in the regime of laser therapy chosen for the present experiment, i.e. the combined alternation of exposure to pulsed infrared laser radiation (890 nm, 1500 Hz, contact labile mode) and continuous red laser radiation (632.8 nm in the remote steady mode) at a rate of 10 procedures per each animal’s hindlimb during two weeks.

Клинические рекомендации (КР) разработаны на основе анализа результатов отечественных и зарубежных исследований по применению методов климатотерапии в клинической практике при различных заболеваниях и состояниях, содержат информацию об основах климатолечения, основных направлениях применения климатических факторов, алгоритме назначения и использования различных методов климатотерапии, обладающих доказанной эффективностью по международным критериям. КР разработаны коллективом авторов (Герасименко М.Ю., Астахов П.В., Бадалов Н.Г.,Уянаева А.И., Тупицина Ю.Ю., Мухина А.А., Львова Н.В., Максимова Г.А., Поважная Е.Л., Смирнова М.Д., Барашков Г.Н., Персиянова-Дуброва А.Л.) и утверждены в соответствии с Федеральным законом от 21.11.11 № 323-ФЗ (ст. 76, п. 2). Структура и содержание КР отвечают требованиям ГОСТ Р 56034-2014 «Клинические рекомендации (протоколы лечения). Общие положения». Предварительная апробация настоящих рекомендаций проведена в ФГБУ «Российский научный центр медицинской реабилитации и курортологии» Минздрава России. КР предназначены для врачей-физиотерапевтов, специалистов в области медицинской климатологии, реабилитации и курортологии, врачей клинических специальностей.