[Somatic pathology in elderly and senile persons suffering from Alzheimer's disease and Alzheimer's type dementia.]

In order to study the prevalence of chronic somatic age-associated pathology in elderly and senile people suffering from Alzheimer's type dementia with the presentation of the hypothesis of somatopsychic pathogenetic comorbidity observation and treatment, 217 patients were observed, conditionally divided into 2 comparable groups: with a definitive diagnosis of Alzheimer's disease (n=73) and with so-called Alzheimer's type dementia (n=144). Distinct differences in the variants of comorbid to the selected types of dementia of somatic pathology were determined, which had a negative impact not only in terms of the occurrence of cognitive disorders, but also in the future, during the formation of the most severe variants of dementia. In cases of Alzheimer's disease, pathological processes in the large intestine turned out to be leading, with Alzheimer's type dementia - diseases of the circulatory system and type 2 diabetes mellitus. Nevertheless, the diagnostic algorithm of patients with dementia should include the most comprehensive somatic examination, and treatment should affect not only the mental, but also the somatic sphere, taking into account the principles of a comprehensive geriatric assessment. With such approaches and under the condition of social well-being in the family, it is possible to achieve not only stabilization, but also some improvement in terms of psychopathological disorders, in particular with Alzheimer's type dementia.

[The state of the oral cavity in early diagnosis and predicting cognitive disorders.]

A review of the literature on the problem of the use of non-invasive technologies in early diagnosis and prediction of age-associated cognitive decline associated with Alzheimer's disease is presented. The main attention is paid to the study of the buccal epithelium, oral fluid, as surrogate models of degenerative lesions of cerebral structures, as well as determining the role of oral microorganisms in the formation and development of cognitive disorders. An original hypothesis of neurodegenerative lesions of cerebral structures is presented, on the basis of which an algorithm for studying the state of the oral cavity is proposed in order to detect and predict cognitive deficits as early as possible.

[The dependence of medical and diagnostic measures carried out in geriatrics on age, gender and the doctor's health status.]

The article discusses the probable dependence of the actions of a specialist working with geriatric patients on the age, gender, and other characteristics of this specialist. This seemingly unconventional approach to research in the field of gerontology and geriatrics reveals distinct differences in a number of aspects of clinical thinking and following clinical recommendations in doctors of different ages, genders, and in different states of their own health. On the basis of a survey of 126 doctors and an analysis of 2 394 of their opinions, the results were obtained, indicating a certain conservatism of doctors over the age of 50, especially men with extensive clinical experience. The article discusses cases of so-called self-ageism of an elderly specialist who uses in his professional actions the results of diagnosis and treatment of the age-associated pathology that he himself suffers from. It is proposed in the process of continuing education or professional training of geriatricians to take into account their age, sex and health status, as well as accompany classes mandatory determination of the biological age of the specialist.

[Ontogenetic principles of accelerated aging and the prospects for its prevention and treatment.]

This article examines the phenomenon of «intrauterine programming¼, which largely determines the further life cycle and the likelihood of developing a number of age-associated pathological processes. The possibility of the formation of pathological (accelerated) aging at various stages of ontogenesis is discussed with the use of large literary material from the standpoint of modern science. The reasons, mechanisms and phenotypic manifestations of accelerated aging and the possibilities of the earliest one, its diagnosis starting from the perinatal period, and prediction of age-associated pathologies are discussed in close interrelation.

[Indicators of the hormonal spectrum in the acute period of stroke in representatives of different gender and age with different degrees of severity of functional disorders.]

The level of serum levels of a number of hormones in the acute period of stroke was determined in 29 men and 29 women aged 45 to 88 years. Comparison of the results obtained was carried out in relation to the age of the patients and the severity of the functional defect formed at the end of the acute period of stroke. The most pronounced dynamics in relation to different severity of functional disorders was found for cortisol, aldosterone and estradiol (p=0,014-0,022) in men under the age of 60 years and for testosterone (p=0,001-0,0001) in men 60-88 years. In women over the age of 60 years parallel to the increasing severity of the functional defect is only significant increase in the concentration of prolactin in the blood (p=0,02), the dynamics of the other components of the hormonal spectrum did not show any statistically significant dependence on age and functional outcome of acute stroke. It is concluded that some hormones are actively involved in the formation of post-stroke functional defects, and the level of their content in the blood serum in the acute period of stroke can be considered as prognostic criteria for acute cerebrovascular pathology. However, the present differences in the dynamics of the hormonal spectrum in representatives of different ages and genders indicate the need to personalize diagnostic and therapeutic measures in gender and age aspects.

[Mechanisms of pathogenetic treatment with interstitial electrostimulation for spinal pain syndrome]. / Mekhanizmy patogeneticheskoi terapii bolevogo sindroma pozvonochnika vnutritkanevoi élektrostimuliatsiei.

BACKGROUND: Interstitial electrostimulation (IES) is used to treat spinal pain syndromes. The phenomena occurring in tissue around the electrode that is connected to a vertebra remain unknown. AIM: To reveal the mechanisms of action of IES on inflammatory and dystrophic phenomena and blood flow in osseous and paravertebral tissues in low back pain syndrome. METHODS: Examinations were made in 64 patients with back pain of vertebral genesis in an exacerbation or incomplete remission with intervertebral disc protrusions. Two homogeneous groups of patients treated with different techniques of electrotherapy were identified. A study group was treated with IES, in which the active electrode as a sterile injection needle was brought into the focus of pathology in contact with the diseased vertebra. A control group received a cutaneous procedure with a 50 Hz current with the same physical parameters. Blood flow in the bone and the adjacent tissues and the intensity of pain syndrome were studied. That in the vertebrae was investigated using needle-rheography and polarography. RESULTS: The intensity of pain depends on circulatory disturbances affecting the vertebral tissues, where a focus of inflammation is formed with signs of free radicals, acidosis, and edema. IES could relieve pain in 90.5% of patients. At the same time, blood circulation in the vertebral tissues considerably improved. Cutaneous electrostimulation was not found to have a substantial effect. The result of the therapeutic effect can be explained by electrochemical phenomena in the plasma from the vessels in the focus of inflammation and by electrophysical processes on the cell membranes of the tissue around its anode introduced. CONCLUSION: IES is a pathogenetic treatment. In this case, the active anode electrode must be inserted into the focus of pathology, resulting in a contact with the diseased vertebra.

The level of NT-proBNP in ambulatory patients with chronic heart failure with preserved ejection fraction of the left ventricle.

AIM: The prevalence of chronic heart failure (CHF) remains high. Echocardiography is a reliable method of diagnosing heart failure. Determination of brain natriuretic peptide allows to identify patients with the most probable diagnosis of heart failure, which requires further instrumental examination of patients. To study the level of the brain natriuretic peptide in patients with diastolic chronic heart failure with preserved left ventricular ejection fraction. MATERIALS AND METHODS: The study included 96 outpatients with diastolic chronic heart failure I-III functional class with a preserved left ventricular ejection fraction at the age of 65.06 ± 1.15 years and 50 practically healthy people aged 39.90 ± 1.64 years as a control group who underwent a preventive examination. The level of the N-terminal fragment of the medullary natriuretic peptide (NT-proBNP) in serum was determined using a test system (Vector-Best, Russia). RESULTS: The concentration of NT-proBNP in patients with diastolic heart failure with a preserved left ventricular ejection fraction was 108.18 ± 21.64 in the range from 0.0 to 1212.3 pg/ml compared to the control of 7.6 ± 1.38 pg/ml, p<0.05. A positive correlation was found between the concentration of NT-proBNP and the area of the left atrium (r=0.35), left ventricular E/e '(r=0.6), and left ventricular end-systolic volume (r=0.48). The level of NT-proBNP had no correlation with the functional class of CHF (r=0,23), as well as with the stage of CHF (r=0,23). CONCLUSION: Thus, patients with diastolic CHF with a preserved ejection fraction in 67% of cases had a level of NT-proBNP in the blood less than the diagnostic threshold. The concentration of NT-proBNP in the serum positively correlates with increased pressure in the cavity of the left ventricle, the end-systolic volume in it and the area of the left atrium.

[Comparative analysis of different methods of geroprotective].

In the monitoring process 110 representatives of different age groups held a comparative analysis of the efficacy and safety of several geroprotective techniques, including the use of dry carbon dioxide baths, hyperbaric oxygen therapy, therapeutic massage and receiving Oligopeptide preparations containing complexes lysyl-glutamyl-asparagin and glutamyl-asparagin-arginine (Vezugen and Pinealon). The most pronounced positive impact on indicators of biological age were detected during the combined use of these two Oligopeptide complexes. The most safe from the point of view of influence on a number of biochemical, immunological parameters, clinical condition of the patients were therapeutic massage and Oligopeptide drugs. The use of dry carbon dioxide baths and hyperbaric oxygenation with an undoubtedly positive influence on the indices of biological age has a number of limitations and contraindications regarding its security.

[EFFECT OF SYNTHETIC PEPTIDES ON AGING OF PATIENTS WITH CHRONIC POLYMORBIDITY AND ORGANIC BRAIN SYNDROME OF THE CENTRAL NERVOUS SYSTEM IN REMISSION].

We've estimated the cellular and metabolic part of geroprophylactic effects of short synthetic tripeptides vesugen and pinealon for correction of the biological age. 32 people (18 men, 12 women) aged 41-83 years with polymorbidity and the organic brain syndrome in remission participated in the study. The preparations of "Pinealon" and "Vesugen" have had the significant anabolic effect. They have improved the activity of the Central nervous system and other vital organs, which slows the rate of aging by biological age indicators. Vesugen has demonstrated more visible geroprophylactic effect than Pinealon. At the same time we've found the prooxidant activity through chemiluminescence. Decrease of markers CD34+ positive hematopoietic polypotent cells in blood has shown significant inhibition of hemopoiesis. Apparently, the cells have not been involved in the adaptive reactions. Pinealon and Vesugen haven't affected the degree of chromatin condensation, so they are safe on nuclear genetic level. This property should be studied in future. In geriatric practice, we recommend to apply the peptides Pinealon and Vesugen as geroprotectors anabolic neuroprotective and no antioxidant type for reducing the rate of aging in patients with the organic brain syndrome vascular and/or traumatic genesis.

[Tryptophan and nicotinic acid as antioxidants in different age rats brain at the immobilization stress].

It is testified that the intensity of lipid peroxidation (LP) in the brain of old and mature rats did not differ significantly. Stress-effects in the form of immobilization led to activation of the LP and inhibition of antioxidant activity (AOA) in the brain mainly in aged rats. The simultaneous introduction of tryptophan and nicotinic acid reduced negative changes of LP and AOA in the brain of old rats caused by immobilization stress exposure. In the brain of mature rats, the combination of tryptophan and nicotinic acid in normal and immobilization decreased the level of LP and increased the intensity of AOA. The increased activity of antioxidant system in the brain of rats by complex of tryptophan and nicotinic acid demonstrated its protective antioxidant properties.

[Comparative analysis of gerontologic prophylaxis efficiency and membranotropic action of various gas therapy].

The research was executed on 320 male patients aged 35-92 years with various polyorgan pathology in a compensation stage. The treatment by gases was used: hyperbaric oxygenation, dry carbonic acid baths, ozon therapy, hypo oxygen therapy and their combinations. On indicators of biological age various age-dependent geroprophylactics effect of gas therapy was established. On indicators of resistance of erythrocytes various safety of used modes was found.

[Dynamics of health and aging rate of patients of different age and sex in the treatment of moderate multiple pathologies].

The article presents results of investigation of the dynamics of health status of patients of different age and sex, with several non-serious diseases, in the course of their treatment in the hospital, as well as the determination of their biological age before and after the course of treatment. The clear differences in the number of diseases, their nature, duration of the treatment and its effectiveness depending on age and sex were revealed. However, at the age of older than 60 years these differences gradually disappearing. Multiple, although non-serious, pathology has a negative impact on the indicators of the biological age of men in the calendar age of 20-39 years and women in the calendar age of 20-39 and older than 60 years, but the rejuvenating effect of the treatment is extremely low. In a number of cases, in the process of treatment of multiple pathologies the indicators of initially reduced biological age get even higher and adapt to the indicators of the calendar age. The authors explain this from the position of the disturbed by the treatment adaptation of the organism to easy disease, as well as the opportunity of reviewing the biological age significantly reduced in relation to the calendar age as a pathological phenomenon similar to significantly increased biological age.

[Influence of polyorgan pathology on the biological age of male and female patients of different calendar age].

The research was executed on 1433 patients, male (1055) and a female (378), of calendar age from 17 to 93 years with a various polyorgan somatic and psychoneurological pathology in remission. The polyorgan pathology worsens age-dependent indicators and increases the bioage of male and female patients. Thus sexual differences exist and practically disappear with the years. In men the polyorgan pathology makes negative influence on the age-dependent indicators in a greater degree and increases the bioage. This may be a cause of lower life expectancy for men compared with women.

[The final state of lipid peroxidation and antioxidation activity in blood system of elderly patients with cardiovascular pathology].

The state of lipid peroxidation and antioxidation activity in blood system of 118 elderly patients with some forms of cardiovascular pathology was analyzed 2-4 days before death due to various causes--cardiovascular, cerebrovascular, malignant tumours. Distinct differences in the state of lipid peroxidation and antioxidation activity in blood system was revealed as regards to some forms of cardiovascular pathology and combinations of cardiovascular pathology with other diseases, in particular malignant tumours. Most aggressive changes of indexes in the lipid peroxidation were registered in patients with ischemic strokes. Exhaustion of the lipid peroxidation and slow downfall of the antioxidation activity was registered in patients with non-cerebral cardiovascular pathology. High activity of the lipid peroxidation and exhaustion of the antioxidation activity was registered in patients with combinations cardiovascular pathology and malignant tumors. These changes of indexes can be used as criterions of the differential diagnosis and the prognosis.

[Accelerated senescence of armed conflicts participants suffering from the consequences of war cranial-cerebral trauma and alcoholism].

The matter under studies was the way accelerated senescence of armed conflicts participants with brain injuries depends on alcohol addiction developed after the injuries and on dysfunction of neurohumoral regulation of heart activity. It has been established that the posttraumatic alcohol addiction considerably activates the processes of accelerated senescence and lipid peroxidation connected with it, depresses the system of antioxidant protection and enhances the progress of dysfunctions in neurohumoral regulation of heart activity.

[Dynamics of lipid peroxidation and antioxidant defense processes in elderly patients during preparation to ophtalmosurgical interventions].

The changes of indices of the lipid peroxidation and antioxidant activity in elderly patients were studied. All the patients had cardiovascular pathology and had been getting ready for ophthalmology interventions about cataract. It is ascertained that the dynamics of lipid peroxidation and antioxidant activity indices connected with pre-surgery therapy can be the authentic prognosis criterion in regard to safety of an operation and possible cardiovascular complications.