[Peculiarities of the strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome].

The study showed that ulcer disease in patients with metabolic syndrome is characterized by painless clinical course, bowel disorders in the form of constipation, enhanced appetite, unmotivated requirement for hypoglycemic therapy predisposition to complications along with activation of the inflammatory process in duodenal mucosa, high H. pylori count. The data obtained were used to develop the age-specific strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome.

[Assessment of diagnostic scales in cardiovascular patients being at home social service from the position of geriatric syndromes].

The obtained data, from a position of geriatric syndromes, testify to need of including of simple estimated scales of a self-rating of health and cognitive disorders in the program of inspection of the elderly patients being on home social service. The special attention in group of elderly patients with arterial hypertension should be paid to widowers who have a low self-rating of health.

[The use of piribedil for the prevention of falls in elderly patients with metabolic syndrome].

Effects of pirebedil used to prevent falls in elderly patients with metabolic syndrome are discussed. A prospective controlled study showed that therapy with pirebedil significantly decreases the frequency of falls, reduces severity of pro-inflammatory and pro-oxidative activities, improves cognitive abilities. Prevention of falls by virtue of improved cognitive abilities is a new clinical effect of pirebedil and gives reason to recommend it for the treatment of geriatric patients with metabolic syndrome.

[Optimization of nursing care in emergency cases in elderly patients residing in nursing homes].

The study analyzes data on the frequency of emergencies in elderly patients residing in nursing homes. We propose to introduce into the nursing care the screening phase of emergency conditions in elderly patients residing in nursing homes based on the selection of the leading symptom. This improves the quality of the nursing process in pre-hospital geriatric care in emergencies.

[The details of clinical examination of elders].

At present, the ever-increasing number of persons of elderly and senile age does not receive from health and social care agencies sufficient volume of health services and social care they require. This article reveals the essence of such a concept as the phenomenon of senile asthenia. It also describes the characteristic of the algorithm of the specialized geriatric examination of elderly patients, which includes not only traditional but also very important for an elderly person special part, in particular, balance and gait assessment, identification of nutritional status to objectify the syndrome of malnutrition, assessment of mental function, activity level of an elderly person, the state of movement, a detailed identification of the social features of life of an elderly person, the quality of his life. The application of this algorithm will significantly improve the quality of geriatric care provided through the objectification of the pathology in the elderly person and assessment of the volume of medical and social care he needs.

[Peculiarities of management of the elderly patients suffering from chronic obstructive pulmonary disease].

The authors present the results of an open prospective study undertaken to elucidate the influence of combined treatment of 72 patients presenting with chronic obstructive pulmonary disease (COPD). It was shown that traditional therapy supplemented by physical rehabilitation procedures, psychotherapy, and patient education during 6 months resulted in significant improvement of physical working capacity and mobility of the patients; moreover, it reduced the severity of apnea in the elderly subjects. The combined treatment of patients with COPD modulated the neuroimuunoendocrine status of their respiratory apparatus, enhanced the production of signal bronchodilatory molecules of vasoactive intestinal peptide, and decreased the level of bronchoconstrictor endothelin-1. It is concluded that the observed positive clinical and neuroimmunoendocrine effects of combined therapy give reason to recommend the use of this approach when providing the medical care for the elderly patients presenting with moderately severe COPD.

[Neuroimmunoendocrine effects of ethanol in the development of pathology of internal organs].

Neuroimmunoendocrinology is a new science studying the interplay between major regulatory systems (nervous, endocrine, and immune) mediated through regulatory (signal) molecules. Its applied aspects concern elucidation of the influence of various exogenous factors on the organism manifested as alteration of signal molecule homeostasis. Effects of ethanol on organ systems are considered from the standpoint of neuroimmunoendocrinology.

[To the problem of organization in regions of rehabilitation of handicapped elders with gastroenterological diseases].

Authors have revealed that rehabilitation index in young and middle ages are higher, than in elders. Also the state of elder invalidis is rather stable and more severe. The reasons of such situation are discussed.

[Neuroimmunoendocrine mechanisms of protective effects of medical rehabilitation in elderly patients].

Physical rehabilitation is the basic method for all programs of medical rehabilitation on different pathologies. Such important diseases as chronic heart failure, diabetes mellitus, chronic pulmonary obstructive disease have the high risk of disability. There is a high motivation to their rehabilitation. These diseases progress in situations associated with immune inflammation. Such signal molecules as tumor necrosis factor (TNF-alpha), interleukins-1,6 (IL-1,6) take part in these processes. The role of medical rehabilitation methods in connection of neuroimmunoendocrinic homeosthasis are described in this article.

[Quality control criteria for hospital care of aged patients with otorhinolaryngologic pathology].

This article presents data about criteria of quality of hospital aid for aged patients with otorhinolaryngologic pathology worked out by the authors basing on analyses of 708 cases. The criteria of effectiveness, adequacy and satisfaction of aged patients are described.

[The role of the short-wave therapy in rehabilitation of elderly patents with chronic obstructive pulmonary disease].

The positive clinical effects of using the short-wave therapy in rehabilitation of patients with chronic obstructive pulmonary disease are presented in this article. 49 patients were included in this investigation. The criteria of successful rehabilitation were more expressive in the cases when the short-wave therapy was included in rehabilitative program.

[Rehabilitation of patients with duodenal ulcer developing in the advanced age].

A rationale is proposed for the principles and strategy of non-medicamentous therapy of duodenal ulcer (DU) developing in the advanced age and assessment of its socio-medical efficiency. Staged treatment was given to 234 patients in whom DU was diagnosed between 61 and 65 (mean 63.2) years of age. Basic therapy and long-term dynamic follow-up were carried out in outpatient settings (basic stage). The aim of the inpatient treatment was to maintain the previously achieved level of physical working capacity and quality of life (maintenance stage). Sanatorium therapy was needed to consolidate remission and strengthen resistance to the illness (consolidation stage). The study demonstrated higher socio-medical efficiency of the three-stage non-medicamentous treatment compared with single-stage therapeutic programs. Its use for physical rehabilitation of patients with DU is substantiated based on modern concepts of neuroimmunoendocrinology.

[Nonpharmacological therapy of duodenal ulcer in elderly patients].

AIM: To validate principles and policy of non-pharmacological treatment of duodenal ulcer (DLU) with onset at old age, to study medico-social efficacy of DU non-pharmacological treatment. MATERIAL AND METHODS: The study was made of 234 cases of DU in patients aged 61-65 years (mean age 63.2 years). DU was diagnosed in them at an old age. RESULTS: Non-pharmacological treatment of old DU patients was performed at three stages: outpatient basic treatment, inpatient rehabilitation with nonpharmacological methods, sanatorium remission and nonspecific resistance consolidation. CONCLUSION: Nonpharmacological measures by 3-stage scheme have higher medico-social efficacy compared to one-stage management.

[Clinical and neuroimmunoendocrine effects of doxasosine in treatment of benign hyperplasia of the prostate in elderly people].

Benign hyperplasia of prostate is a very important not only medical but also social problem. The clinical and neuroimmunoendocrine status of elderly patients with benign hyperplasia of prostate treated by 1-blocker doxasosine is described in this article. Intercellular interactions were examined for tumor necrosis factor a (TNF-alpha), proinflammative interleukine-6 (IL-6), soluble intercellular molecule of adhesion (sICAM). The positive role of doxasosine is demonstrated.

[Clinical and neuroimmunoendocrine effects of doxasosine in treatment of arterial hypertension accompanied by prostate benign hyperplasia in elderly people].

Arterial hypertension accompanied by prostate benign hyperplasia is very important not medical but social problem in elderly people. The clinical and neuroimmunoendocrine status of elderly patients with arterial hypertension accompanied by prostate benign hyperplasia treated by alpha1-blocker doxasosine is described in the article. Intercellular interactions were examined for tumor necrosis factor alpha, proinflammative interleukine-6, soluble intersellular molecule of adhesion. The positive role of doxasosine is demonstrated.

[Medical and social problems in gerontology and geriatrics: the acknowledgment of patients and medical personnel].

The positions of patients and medical personnel are described in this article. The problems of prevention in elders and medical education of patients are investigated.

[Physical training in chronic therapeautical diseases in aged patients].

In this article the stage principles of physical training in chronic therapeautical diseases in aged patients are presented: basic stage in polyclinics, support measures in hospitals and consolidation of remission in sanatoria.

[Changes of the endothelium in cardiovascular pathology in the elderly. Part I. Signal molecules and endothelial functions].

The review discusses the issue of the interaction between the endothelium and numerous biologically active substances, secreted by endotheliocytes and their environment--the so called signal molecules - in the most prevalent pathology in the elderly. In the elderly, signal molecules are synthesized by endothelial cells less intensively by comparison to young and middle-age people because a range of morphological features of endotheliocytes at elderly age: a hyperchromic nucleus; a smaller number of ribosomes, which leads to the inhibition of protein synthesis; a bigger number of lysosomes; structural changes in myofibrils; alterations in the mitochondrial structure such as crista death as well as the swelling and destruction of some organellas, which disturb the process of energosynthesis. At the same time, the main regulatory functions of the endothelium--vasomotor, antithrombocyte, anticoagulatory, thrombolytic, antiinflammatory, antioxidative, and antiproliferative ones--are the same in the healthy elderly and at earlier stages of ontogenesis. Disturbances in one or another endothelial function, especially at elderly age when the peculiarities of endothelial functioning under normal conditions are formed together with age-related morphological changes, result in fast development and progress of cardiovascular diseases.

[Stages in medical rehabilitation]. / Etapnaia meditsinskaia reabilitatsiia.

Organizational foundations of a stage-by-stage medical rehabilitation of therapeutic-profile patients were motivated on the basis of the modern understanding of logistic management principles. Data, confirming the advantages of a three-stage rehabilitation scheme versus its one stage variation, are described. A conclusion is made on the need to introduce as much as possible of the logistics into the healthcare management to ensure the continuity and succession between different stages of medical care organization.