[Results of analysis of the prescriptions for elderly patients in ambulatory practice.]

A randomized retrospective analysis of medical records of patients aged 65 years and older receiving ambulatory medical care was carried out in order to assess drug prescriptions for the detection of polypharmacy and potentially dangerous and significant drug interactions. The average number of visits per patient over 65 is 11,2±8,4. Comorbidity was detected in 89,4% of patients. Polypharmacy was detected in 76,6% of patients. In 1/3 of cases, patients were prescribed not recommended drugs (Beers criteria 2015). Authors found 364 interactions of various hazard categories. The obtained data shows that it is mandatory to implement various systems of prescription audit for the timely detection of potentially hazardous and incompatible drugs, as well as to correct prescriptions and improve efficacy and safety of drug use in patients older than 65 years.

[Early Markers of Cardiovascular Risk in Women With Hereditary Burdening by Cardiovascular Diseases].

PURPOSE: to identify early markers of development of cardiovascular diseases (CVD) in women. MATERIALS AND METHODS: Female firstdegree relatives from 39 families formed 2 groups: families (n=19) containing mothers with arterial hypertension (AH) (group 1) and healthy daughters (group 1a); families (n=20) containing practically heathy mothers (group 2) and healthy daughters (group 2a). We assessed data of anamnesis, including registration of cardiovascular risk factors, and family history of CVD. Examination included registration of anthropometric parameters, automatic and manual measurement of intima-media thickness (IMT) and resistance indexes of brachiocephalic arteries (BCA). We also determined cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), and measured magnitude of ß-adrenoreception of membranes (ß-ARM) of erythrocytes in micro-quantities of venous blood. RESULTS: Mothers in both groups of families had excessive body mass or obesity. Mothers of group 1 had more pronounced signs of abdominal obesity (AO). They also had abnormalities of IMT and sings of subclinical atherosclerosis of BCA. CAVI in this group was significantly higher than in group 2. In group 1a median BMI (25.5 kg/m2) and waist/hip ratio were significantly higher than in group 2a. Daughters of group 1a contrary to group 2a had abnormalities of vascular wall: increased automatically measured IMT of carotid arteries and elevated CAVI. Arterial pressure and heart rate (HR) in group 1a were within limits of physiological norm but significantly higher than in group 2a. All included women had elevated ß-ARM values but in group 1a this parameter was significantly higher than in group 2a and moderately correlated with HR. CONCLUSIONS: Risk factors of CVD development in women are AH, AO, high activity of the sympathoadrenal system. These factors provoke changes of vascular wall (elevation of its stiffness and early subclinical atherosclerosis). In daughters of mothers with AH important prognostic components of CVD risk in addition to family history of CVD are AO, systolic blood pressure (BP) >120 mm Hg, diastolic BP >78 mm Hg, HR approaching upper limit of physiological norm, and high CAVI (indicator of vascular wall stiffness).

[The development of the geriatric service in the Republic Sakha (Yakutia).]

The medical and demographic data on the health status of older citizens in the Republic Sakha (Yakutia) in 2000-2017 and the analysis of medical care for elderly patients in 2015-2017 demonstrated the urgent need to expand primary health care (including at home) and to organize specialized medical care for older citizens (including geriatric service) in one of the largest regions of Russia. The main directions of implementation in the Republic Sakha (Yakutia) of the Strategy of actions in the interests of the older generation of the Russian Federation until 2025 are given: the formation of the legislative basis, the creation of a three-level geriatric service, the introduction of new technologies for the provision of medical care to elderly residents of the Republic, training of personal. Measures are planned to implement the regional program «Older generation¼ of the National project «Demography¼ in order to improve the current medical and demographic situation and increase the life expectancy of the older generation and the whole population of Yakutia.

Association of chronotype and social jetlag with human non-verbal intelligence.

The aim of this study was to evaluate the effects of chronotype and social jetlag (SJL) on intelligence. Subjects were aged 14-25 years (n = 1008). A significant effect of intelligence on academic performance, as measured by the Raven's Standard Progressive Matrices test, was found (F2,917 = 11.75, P < 0.0001, η2 = 0.03). When SJL was less than 2 hours, the intelligence of people with late chronotype was found to be higher than that of subjects with early and intermediate chronotypes (F2,305 = 3.12, P < 0.05, η2 = 0.02). A negative effect of SJL on the results of intelligence testing was noted only in subjects with late chronotype (F2,536 = 2.61, P < 0.05, η2 = 0.02). Our data suggest that people with late chronotype have a higher level of intelligence, but these advantages disappear when SJL ≥2 hours.

Tracking T-cell immune reconstitution after TCRαß/CD19-depleted hematopoietic cells transplantation in children.

αßT-cell-depleted allogeneic hematopoietic cell transplantation holds promise for the safe and accessible therapy of both malignant and non-malignant blood disorders. Here we employed molecular barcoding normalized T-cell receptor (TCR) profiling to quantitatively track T-cell immune reconstitution after TCRαß-/CD19-depleted transplantation in children. We demonstrate that seemingly early reconstitution of αßT-cell counts 2 months after transplantation is based on only several hundred rapidly expanded clones originating from non-depleted graft cells. In further months, frequency of these hyperexpanded clones declines, and after 1 year the observed T-cell counts and TCRß diversity are mostly provided by the newly produced T cells. We also demonstrate that high TCRß diversity at day 60 observed for some of the patients is determined by recipient T cells and intrathymic progenitors that survived conditioning regimen. Our results indicate that further efforts on optimization of TCRαß-/CD19-depleted transplantation protocols should be directed toward providing more efficient T-cell defense in the first months after transplantation.

[Mortality of old-aged (60 years and older) population in Yakutia subject to data of prospective cohort seven-year study].

Level of total mortality and mortality from cardiovascular diseases was defined subsequent to the results of carried out novel prospective study of cohort of old-age population of the Republic. Subject to seven-year cohort study high indexes of mortality from all reasons (42,7%) and from cardiovascular diseases (28,4%) were registered for the population of Yakutia aged 60 years and older. Circulatory diseases comprise 68% of all died; ischemic heart diseases (59%) and cerebrovascular diseases (22%) are the main reasons among the cardiovascular pathology. In the studied cohort there were found no ethnic and gender differences in mortality levels. Total mortality and mortality from cardiovascular pathology, relative risk of fatal issue development increase statistically significant with the age. The growth rate of total and cardiovascular mortality are practically identical in both ethnic groups.

[Arterial blood pressure in persons of elderly, senile age and long-livers of Yakutsk: population screening].

The values of arterial blood pressure according to the Yakutsk population screening at the age of 60 and older have been studied. The average values of systolic arterial pressure (both sexes--148, men--145, women--151 mm Hg) are higher than normal values specified by Society of Cardiology of Russian Federation. Long-living persons show its decrease that is more marked in men. The average values of diastolic arterial pressure (both sexes--87, men--88, women--87 mm Hg) correspond to the category of high normal pressure and are decreasing with age to more extent in men than in women. The average values of pulse pressure in elderly and senile age are higher than normal values (both sexes--61, men--57, women--64 mm Hg) with a tendency to grow by 90 years old. Differences in arterial blood pressure levels are educed in gerontic persons depending on presence of abdominal obesity, hypercholesterolemia, hyperglycemia, smoking and family anamnesis with cases of hypertension.

[Features of arterial blood pressure in elderly persons of different ethnic groups in Yakutsk].

The differences in arterial blood pressure in the sample of population in the age of 60 and older of different ethnic groups in Yakutsk, as well as its connection with the other cardiovascular diseases risk factors have been analyzed. It was shown that the average values of systolic and diastolic blood pressure in subsample of the Yakuts appeared to be lower than in Caucasoid gerontic persons. The average values of systolic arterial blood pressure both in the Yakuts and in the Caucasoids were detected higher than normal values in all age-dependent subgroups. The average values of diastolic blood pressure in both ethnic groups were within the limits of high normal level. From 60 to 90 years and older the decrease in systolic and diastolic arterial blood pressure was detected; it was more marked in Caucasoid gerontic persons. The average values of pulse pressure in the Yakuts and in the Caucasoids appeared to be higher than the existing standard and didn't have any differences in ethnic groups. In both ethnical subsamples, pulse pressure values increase was observed in persons of 60-89 years old and its decrease after 90. Persons with overweight, obesity, central (abdominal) obesity, dyslypoproteidemias irrespective of belonging to ethnical group were characterized as having higher levels of arterial blood pressure. Statistically significant differences in the levels of arterial blood pressure in the Yakuts and in the Caucasoids depending on hyperglycemia, smoking, the presence of burdened anamnesis, educational level, marital status was not detected.

[Phenomenon of super-longevity in Yakutia].

According to preliminary data of UNESCO the oldest inhabitant of a planet now lives in the Republic Sakha (Yakutia). The article presents some results of the examination of a 117-years long-liver Semennikova (Djakonova) Varvara Konstantinovna. The age of the supercentenarian is certified by the record in the metric book of Yakutsk Spiritual Consistory for the Bulunskiy Spasskiy Church. The standard methods and unified criteria of estimation applied in epidemiological researches and at examination of elderly contingent were used. The health state, lifestyle and quality of life of the supercentenarian have been studied. During physical and instrumental examination of the centenarian the following data have been obtained: asthenic type of the constitution, the lowered index of body weight; the pathology of organism's functional systems (cardiovascular, respiratory, osteomuscular), appeared in senior age. The basic biochemical parameters of the blood are registered within the limits of the norm. The centenarian almost has not suffered from serious diseases. She does not remember long-livers among her relatives. The phenomenon of supercentenarian in Yakutia is the unique example of the extremely high level of adaptation to the extreme climate with prevailing clinically slightly expressed form.

[Prevalence of atrophic gastritis in different populations in Siberia on medical evidence of the serological survey].

Prevalence of atrophic gastritis in various population of Siberia with serological tests was studied. Representative samples of Novosibirsk adult population and also urban and rural population of Yakutia were examined. 348 persons at the age more than 45 years (180 males and 168 females) were studied. Concentration of pepsinogen I, gastrin 17 and antibodies to Helicobacter pilori in blood serum was estimated with immune-enzyme analysis ("Biohit GastroPanel", "Biohit", Finland). In addition, domestic test-systems were used for detection cytotoxic (expressing CagA-protein) strains H. pylori. Level of markers (pepsinogen, gastrin, antibodies to Helicobacter pilori and antibodies to CagA H. pilori) in observing populations had no difference between males and females, and also did not depend on age. Occurrence of atrophy in body of stomach in Novosibirsk population, urban and rural population of Yakutia was 10.1, 16.7 and 25.6% respectively, and in antral part--10.7, 25.6 and 8.9% respectively. Total atrophy was registered in 1% in all groups. Helicobacter infection was detected in 78-88% of population. Domestic immune-enzyme test-systems were comparable with data of histological examination and demonstrated greater sensitivity at H. pylori detection vs. foreign. High prevalence of atrophic gastritis in various groups of Siberia population was noticed, which must be was bounded with great level of H. pylori infection in population.

[Demographic indices of the aging and longevity in Yakutia].

The basic demographic indices of the aging and longevity of population in Yakutia have been analyzed. The Sakha Republic (Yakutia) is one of the biggest regions of Russia, which occupies 18% of the territory. Aging of population is shown as one of the main tendencies in the modern demographic development in the Republic and reflection of the world process. In spite of the extreme living conditions, Yakutia was considered to be one of the longevity centres in the country. Regarding this, the basic demographic longevity's indices for recent years were investigated in details. The decrease tendencies of longevity level have been determined in the following: among men and women, urban and rural inhabitants and in the Republic, in the whole.

[On longevity among the population of Siberia and the Far East]. / O dolgozhitel'stve naseleniya Sibiri i Dal'nego vostoka.

Demographic values of longevity have been calculated on the basis of population census data and mortality tables. Analysis of the present-day level of longevity in Siberia and Far East and its time course in 1979-1993 is presented. Regular reduction of longevity parameters from West to East and lower values of these parameters in comparison with the rest of Russia have been revealed. Negative shifts in the levels of longevity over the period of 1979 to 1993 have been observed for all regions of Siberia and Far East.

[Demographic factors of longevity in Siberia and Far East]. / Demografiia dolgozhitel'stva v Sibiri i na Dal'nem vostoke.

Longevity indexes LI2 and LI3 (subjects aged 90 and more and 100 and more, respectively, among subjects of 60 and older) were compared in all administrative units on the basis of results of 1989 Census of the population and data of the Central Statistical Office. These values reduce from West to East: LI2 in Western Siberia is equal to 8.48/1000, LI3 to 0.45/1000, in Eastern Siberia these values are 7.48 and 0.35/1000, in the Far East 5.20 and 0.31/1000, in Russia on the whole 9.16 and 0.47/1000, respectively. The territories with relatively high LI2 values were the Aghinsk Buryat Autonomous Territory (11.42/1000), Yakutia (10.79/1000), Altai (9.41/1000).