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We have studied the influence of enhanced external counterpulsation (EECP) applied in the combination with gaseous carbon dioxide baths and infrared laser therapy on the dynamics of clinical and functional abnormalities in the patients presenting with coronary heart disease (CHD) including those after surgical myocardial revascularization. The study was conducted on 40 patients of whom 20 suffered from chronic coronary heart disease and FC II-III angina of effort and the remaining 20 ones presented with coronary artery disease following myocardial revascularization (including 5 patients six months after coronary bypass grafting (CBG) and 15 ones three months after translumbar angioplasty (TLAP) in the combination with stenting of the coronary arteries). The study demonstrated that EECP in the combination with gaseous carbon dioxide baths and infrared laser therapy produced anti-ischemic and antianginal effects, stimulated myocardial contractility, contributed to economization of the cardiac activity, increased exercise tolerance, myocardial and coronary reserves. These changes resulted in the improvement of both the psychological status and the quality of life of the patients.

The introduction of statokinesitherapy with biological feedback into combined rehabilitative treatment of the patients presenting with coronary heart disease associated with arterial hypertension and clinical manifestations of dyscirculatory encephalopathy and/or vertebrobasilar insufficiency reduced the severity of clinical symptoms of cerebral syndromes. Specifically, it resulted in the decreased frequency of dizziness and shaky walk, improved coordination and sense of equilibrium, enhanced postural stability in the vertical position. The positive dynamics of clinical manifestations was confirmed by the results of stabilometry that suggested decreased deviation from the centre of pressure in the frontal and saggital directions and diminished total area of the statokinesiogram.

The results of clinical trials give evidence of the close correlation between the data obtained by clinical, biochemical, and instrumental methods and the data of screening studies designed to estimate the risk factors responsible for the development of cardiovascular diseases in the women of late reproductive age.

The present paper is designed to report the results of a clinical study undertaken to estimate the efficacy of artificial silicious-carbon dioxide baths for the rehabilitation and secondary prophylaxis in the patients presenting with arterial hypertension associated with coronary heart disease. The study included 130 patients whose treatment outcome was compared with that in a group of patients treated with the use of ordinary silicious baths alone. It was shown that artificial silicious-carbon dioxide baths have an advantage over the ordinary silicious baths in that they produce a more pronounced therapeutic effect especially in the patients with the most severe forms of hypertension associated with cardiovascular disorders. This effect is due to the combined action of their constituent components, in the first place water soluble silicates and carbon dioxide. The simultaneous action of the water soluble silicon on the structure and permeability of cellular membranes coupled with the reduction of sensitivity of vascular beta-adrenorecepors to pressor agents and inhibition of aldosterone secretion from the adrenal glands under effect of carbon dioxide accounts for the more pronounced hypotensive, anti-ischemic, and antiarrhythmic effect of artificial silicious-carbon dioxide baths that is associated with the beneficial effect on the quality of life in the majority of the treated patients.

The present review of the literature data highlights modern approaches to and major trends in diagnostics and conservative treatment of lymphedema of the lower extremities based on the generalized world experience. Patients with lymphedema of the lower extremities comprise a "difficult to manage" group because the disease is characterized by steady progression and marked refractoriness to various conservative therapeutic modalities creating problems for both the patient and the attending physician. Modern methods for the diagnosis of lymphedema are discussed with special reference to noninvasive and minimally invasive techniques (such as lymphoscintiography, computed tomography, MRT, laser Doppler flowmetry, etc.). During the last 20 years, combined conservative therapy has been considered as the method of choice for the management of different stages and forms of lymphedema of the lower extremities in foreign clinics. The basis of conservative therapy is constituted by manual lymph drainage (MLD), compression bandages using short-stretch materials, physical exercises, and skin care (using the method of M. Foldi). Also reviewed are the main physiobalneotherapeutic methods traditionally widely applied for the treatment of lymphedema of the lower extremities in this country. Original methods for the same purpose developed by the authors are described including modifications of cryotherapy, pulsed matrix laserotherapy, hydro- and balneotherapy. Mechanisms of their therapeutic action on the main pathogenetic factors responsible for the development of lymphedema (with special reference to lymph transport and formation) are discussed. The principles of combined application of physiotherapeutic methods for the rehabilitative treatment of patients presenting with lymphedema of the lower extremities are briefly substantiated. Special emphasis is laid on their influence on major components of the pathological process.

The article describes the technique of nonpharmacological treatment of hypertension with light. Chromotherapy can be used in outpatient clinics, hospitals, rehabilitation centers and sanatoria.

Higher therapeutic efficacy of iodine-bromine baths in conversion of iodine from an ionic form (standard iodine-bromine baths) into a molecular one is registered. This is explained by a 23.8 times increase in precipitation and a 4-times increase in iodine penetration into the body when it is molecular. A more effective function of the cardiovascular system, a stronger corrective effect on lipid metabolism, microcirculation in the absence of changes in a secretory function of the thyroid were registered.

A physiotherapeutic complex (laser therapy, dry carbon dioxide and iodine-bromine baths) addition to a course treatment with beta-blockers and thiazide diuretics produced positive changes in the levels of triglicerides, total cholesterol, beta- and alpha-cholesterol, lipid peroxidation in patients with proatherogenic shifts in the lipid spectrum and lipid peroxidation system secondary to long-term therapy with beta-blockers and thiazide diuretics, and therefore can be used for partial correction and prevention of the above shifts.

Three therapeutic complexes were compared clinically in patients with mild arterial hypertension. Complex 1 consisted of dry air--radon baths, bicycle exercise and exposure of the renal projection area to decimetric electromagnetic field. Its efficacy was 90%, mechanism of the hypotensive action is reduction of enhanced activity of the sympathico-adrenal and renin-angiotensin-aldosterone systems, improvement of water-mineral metabolism and lipid peroxidation. Complex 2 consisted of dry effervescent baths, anaprilin electrophoresis with sinusoidal modulated currents and exposure of the renal projection area to low-frequency alternating magnetic field. Its efficacy was 80%. It affects renin-angiotensin-aldosterone system, water-mineral metabolism and lipid peroxidation. Complex 3 consisted of electric sleep, laser therapy and general sodium chloride baths. Its efficacy was 63%. The effect was due to inhibition of high sympathico-adrenal system.

Physiotherapy with neuromuscular manual techniques was applied in programs of rehabilitation of IHD patients with reflex pain syndromes or associated osteochondrosis or early after surgery. Elimination of reflex pain syndromes in the above patients raises the treatment efficacy, improves functional state of the cardiorespiratory system.

Infrared laser therapy was examined for the ability to eliminate tolerance to nitrates and to potentiate their action. Laser radiation (0.85 micron) reduced tolerance to nitrates and potentiated nitrates action. This was evident from a rise in threshold load power, less frequent and weaker myocardial ischemia.

Aim: To elucidate effects of manual therapy on clinical status, central hemodynamics and parameters of Holter monitoring in ischemic heart disease (IHD) patients with angina of effort., Material and Methods: The examination of 70 IHD patients (functional class II-III) included Kubicek tetrapolar chest rheography in modification of Yu. G. Pushkar, bicycle exercise, 24-h Holter ECG monitoring. The condition of the vertebromotor segments was evaluated at manual tests., Results: The addition of manual therapy to combined treatment of IHD patients improves sympathetic innervation in the cervicothoracic segments, depresses myofascial hypertonicity, diminishes sympathicotonic effects on the heart, enhances myocardial, coronary and aerobic reserves., Conclusion: The results of the study allow recommending adjuvant manual therapy in combined treatment of IHD.

Two rehabilitation complexes are described for coronary heart disease patients early after aortocoronary shunting. The first complex includes "dry" effervescent baths, magnetolaser therapy applied to the heart area, cryomassage of the abdomen. The second complex consisted of the above modalities plus dry air baths. Indications and contraindications to these complexes are specified.

Among cardiovascular diseases registered in the Chernobyl wreckers neurocirculatory dystonia and hypertension occur most frequently. Combined treatment including electric sleep, iodinebromine baths, therapeutic exercise, massage relieves clinical symptoms, promotes positive rearrangement of hemodynamics, a decrease in myocardial hyperkinesis and vegetative dysfunction, an increase in cardiovascular reserves, correction of hypersympathicotonia and immune disorders.

Hypertensive patients with coronary insufficiency have received infrared (lambda = 0.85 microns) laser radiation to the skin. The treatment is shown to have antianginal, antihypertensive effects, to improve cardiac performance, myocardial contractility, to increase myocardial, coronary and aerobic reserves. This clinicofunctional efficacy is accompanied by positive shifts in lipid metabolism, lipid peroxidation activity, antioxidant defense, hemocoagulation and microcirculation.

Application of epicutaneous infrared laser radiation early in the course of postoperative aftercare of patients with coronary heart disease who have undergone myocardial revascularization contributes to improved functioning of the cardiorespiratory system. The laser therapy is indicated in the absence of serious intra- and postoperative myocardial infarctions, postoperative arrhythmia and mediastinitis.

Based on clinical notes of 40 outpatients with lower extremity vascular atherosclerosis, a positive dynamics of rheographic parameters of peripheral circulation was found from rheovasculography of the shins, muscle blood flow, thermography, to provide the optimal frequency responses of pulse laser radiation for the treatment of the disease. The studies established the optimal frequency of pulse running for infrared laser radiation of 80 Hz.

One hundred hypertensive subjects with labile and stable disease were exposed to low-intensity low-frequency electrostatic field generated by the unit "Infita-A". In labile hypertension, the field produces a hypotensive effect, improves myocardial contractility, increases myocardial and coronary reserves due to reduced peripheral resistance and stimulation of myocardial propulsion. Therapeutic response to the treatment is attributed to normalization of deep brain structure functioning.

Seventy two patients with coronary heart disease who had undergone aortocoronary bypass grafting were followed up. In the early postoperative periods (on day 16) the patients had ergometer exercise testing along with chest massage. In patients with complete myocardial revascularization and without complications, the exercise was 50% of the individual threshold capacity, followed by its correction every 7 days after control bicycle ergometry. In patients with incomplete myocardial revascularization or with intra- and postoperative complications, exercises with steady capacity (50% of the threshold capacity) were performed, by enhancing its exposition in a gradual manner. A course of physical training (15-18 studies 5 times a week) resulted in improvement of the patients' clinical condition, and caused a training effect and positive alterations in central hemodynamic parameters in patients with both hyper- and hypokinetic hemodynamic baselines.

A modified procedure is described for estimation of 25-hydroxyvitamin D (25OHD) in blood serum, which involves a principle of the saturating analysis. Blood serum from rats, maintained on a ration free of vitamin D, was used as a binding system. Evaluation of the procedure was carried out by conventional criteria (accuracy, reproducibility, sensitivity). Content of 25OHD was estimated in blood of rats, maintained on rations containing various amount of vitamin D, as well as in blood of women in childbirth and in newborns from different climatogeographical zones.

The cardio-respiratory system in 50 healthy subjects and 58 patients with renal hypertension was examined using bicycle spiroergometry at rest and after exercise, before and after the reconstructive surgery on renal arteries and following rehabilitational postoperative treatment by physical training. Before surgery the patients showed excessive pressor response to exercises, ECG signs of overload and hypertrophy of the left ventricle and atrium increasing during exercise, decreased oxygenation of the tissues, decreased compensatory and adaptive capacity. After the operation AD at rest decreased, aerobic reserve improved, while chronotropic cardiac reserve aggravated, and pronounced dystonia was noted. After certain physical training decreased pressor responses, significant increase of tolerance to exercise as well as elevation of the aerobic reserve up to that in the trained persons were observed.

Rehabilitative treatment with the beta-blocker anaprilin was performed in 58 patients with coronary heart disease within early periods (on days 7 to 21) after aortocoronary bypass surgery. Group 1 patients were given oral anaprilin. Group 2 patients took the drug by sinusoidal modulated current electrophoresis. With the latter drug administration, its negative chronotropic effect and abolished adverse decrease in myocardial contractivity were detected in the patients from that group. Bearing in mind the results of pharmacokinetic studies, it was suggested that the therapeutic effect of small blood anaprilin concentrations was due to the electrophoresis-induced passage of only its therapeutically beneficial left isomer and L-propranolol glucuronide, a metabolite.

A total of 117 patients with renovascular hypertension operated upon by employing reconstructive surgery upon renal arteries for producing hypotensive effect and restoration of renal functions were examined. Examination was made before surgery, in the near (up to 6 months) and remote post-operative periods (after a lapse of up to 10 years time). Soon after the operation persistent normalization of the arterial pressure was recorded in 78 (67 per cent) of 117 patients, improvement supervened in 12 per cent of the cases, and a positive hypotensive effect could be achieved in 92 or 79 per cent of the patients. The immediate normalization and improvement in the evolution of arterial hypertension continue, as a rule, also late after surgery. Following reconstructive operations on the renal arteries with normalized arterial pressure or its improvement the great majority of the patients demonstrated re-establishment or a significant improvement of both the summary (filtration, concentration and even nitrogen-excretory) and individual renal functions (as shown by the results of radioisotope renography with I131 hippuranium and excretory urography. In patients with malignant course of arterial hypertension successful reconstructive surgery was followed by a tendency toward retrograde development of the arterial hypertension malignancy.