[Markers of inflammation with decreased functionality in the cognitive and psychological domains of individual vitality in middle-aged and elderly patients with metabolic syndrome.]

Metabolic syndrome is a group of disorders that are closely related to both the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and generally leading to the phenomenon of premature aging of the body. Excessive accumulation of adipose tissue contributes to the development of chronic immune inflammation and oxidative stress, which are both precursors to various disorders, such as insulin resistance, arterial hypertension and dyslipidemia, but also trigger inflammatory processes in patients. An increasing number of studies support the importance of chronic immune inflammation in the pathogenesis of metabolic syndrome, as pro-inflammatory markers such as TNF-α, IL-1ß, IL-6, monocyte chemotactic protein-1 and growth of vascular endothelium. Among a wide range of cytokines, monocyte chemotactic protein-1 is considered one of the most important chemokines, which activates monocytes and other immune cells actively involved in inflammation. Another important point of chronic immune inflammation is its impact on the mental health of patients with metabolic syndrome. Increased levels of anxiety and depression are associated with levels of pro-inflammatory cytokines produced by adipose tissue, which ultimately has an adverse effect on the cognitive status of patients.

[Features of CD68+ and CD163+ expression in the urinary bladder as a marker of cancer in age aspects.]

The study presents a study of the expression of CD68+ and CD163+ in the bladder as a marker of cancer in age-related aspects. As part of the work performed, 35 patients with bladder cancer with histological verification of the disease aged 36 to 70 years were studied. The role of CD68+ and CD163+ cells in bladder reactions can be interpreted as an indicator of diagnostic parameters of the activity of tissue macrophages and endothelial cells in cancer. Their progression during oncogenesis is especially pronounced in the group of middle-aged patients. In old age, there is a decrease in these parameters, which indicates in favor of a decrease in the activity of the development of oncological processes with age. The combination of morphological and immunological atypism leads to a violation of the functional specialization of the organ.

The role of cytokine gene polymorphism in the formation of arterial hypertension associated with metabolic syndrome.

We investigated the association of polymorphisms of genes tumor necrosis factors and their receptors (-308G/A TNFa, +250A/G Lta, +36 A/G TNFR1, +1663 A/G TNFR2) with the predisposition to the development of essential hypertension (EH) and the features of its clinical course in patients with metabolic syndrome. It has been demonstrated that the molecular genetic marker +36G TNFR1 (OR=1,25) is involved in the formation EH in individuals with metabolic syndrome. The risk of stage III EH in patients with metabolic syndrome is enhanced by genetic variants -308GA TNFa (OR=2,72), -308A TNFa (OR=2,72), +250G Lta (OR=1,80), and combinations thereof -308A TNFa with +1663G TNFR2 (OR=3,85), +250G Lta with +36G TNFR1 (OR=3,85), +250G Lta with +1663G TNFR2 (OR=3,85) while protective properties are inherent in -308GG TNFa (OR=0,32), +250AA Lta (OR=0,45), -308G TNFa (OR=0,37), +250A Lta (OR=0,56) and a combination of genetic markers -308GG TNFa with +250A Lta (OR=0,31), -308G TNFa with +250AA Lta (OR=0,39), -308G TNFa with +250A Lta (OR=0,31).

Studies of the structure and functions of blood cells in senile patients with pneumonia on the biological model of hypoxia by scanning probe microscopy.

Biological model of hypoxia can be used for the diagnosis of functional changes in human erythrocytes under the effect of the hypoxic factor. The use of this model together with modern methods of scanning probe microscopy for evaluation of the severity of pulmonological disease in senile patients will help to predict treatment efficiency and outcome.

[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.

[Orthostatic reactions in prognosis of the risks of arterial hypertension as a component of metabolic syndrome].

It was shown that parameters of metabolic syndrome as predictors of lethal vascular outcomes of arterial hypertension (AH) in Belarus are significantly different fiom those proposed in WHO recommendations (1999). The glucose level of informative value in WHO recommendations is 6.1 mmol/l versus 5.6 mmol/l in Belarus, total cholesterol 5.0 and 5.9 mmol/l respectively. A more detailed verification of the value of both parameters is needed for the patients in Belarus and Russia depending on age and sex using non-linear models. We used a comprehensive approach to prognosis of the risk of vascular lethal outcomes of AH as a component of metabolic syndrome with the evaluation of results of clinical and laboratory examination as well as orthostatic reactions in patients of different age groups. Construction of the prognostic algorithm "Classification tree" taking account of orthostatic reactions enhances the correctness of lethal outcome prognosis up to 81.8%. The study revealed the prognostic value of systolic and diastolic arterial pressure in the supine position (15 min of active aortostatic sample) for prognostication of vascular lethal outcomes. Further studies are needed on the role of orthostatic reactions in AH patients of old age together with clinical and laboratory parameters in the prognostication of outcomes of various cardiovascular diseases.

[The role of genetic polymorphisms of interleukins in chronic lymphocytic leukemia in patients of different ages].

Chronic lymphocytic leukemia (CLL) is a multifactorial disease, in which development the important role played the cytokine genes, in particular interleukins. This type of leukemia is more common in the elderly. The purpose of the study was to evaluate the association of genetic polymorphisms of interleukin with the development of chronic lymphocytic leukemia among residents of the Central Chernozem region of Russia. Genotyping of the -889C/T IL-1A, -590C/T IL-4 and VNTR IL-1 Ra was conducted in 206 patients with CLL and 307 individuals of the control group. The study found that the genetic risk factor for the development of CLL is allele -590T IL-4 (OR=-1,45). The development of thrombocytopenia in patients with CLL is associated with genetic variants -889T IL-1A (OR=1,95), -889TT IL-1A (OR=6,2) and IL-1Ra*1 (OR=-2,32).

[Clinical associations of genetic variants of interleukins with the formation of chronic lympholeukemia in elderly patients].

We investigated association of polymorphisms of interleukin IA (IL-1A), interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin-8 (1L-8) genes in elderly patients with predisposition to the development of chronic lym,nphocytic leukemia (CLL). Risk factor of chronic lymphocytic leukemia is a genetic variant -590T IL-4 (OR = 1,45) and protective factor -590S IL-4 (OR = 0,68). Genetic markers -590T IL-4 (OR = 2,46), -590TT IL-4 (OR = 6,65) and mix-590TT genotype of IL-4 allele 703S-IL-5 (OR = 6.70) were associated with stage 0-1 chronic lymphocytic leukemia whereas genetic markers -889T IL-1A (OR = 1,51), -703T IL-5 (OR = 1,52) and a combination of genotype -703ST IL-5 allele-251A IL-8 (OR = 2.85) were related to the development of stage II of the disease. Risk factor for the formation of II-IV stages of chronic lymphocytic leukemia is a genetic variant -703T IL-5 (OR = 1,95).

[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.

[Morbidity and mortality rate from malignant neoplasms among Belgorod region population as a gerontological problem].

It is established during 1990-2008 new onset of morbidity level of adult people with malignant new growths by 21,2% (among men 16,9%; among women 25,2%). In Belgorod region for the studied period the average age of the population with morbidity has risen by 2,9 years from 37,1 to 40 (men from 33,7 to 37,3 years; women from 40 to 42,2 years).

[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.

[The clinical pathology of polymorbidity in geriatrics practice].

The original data about phenomenon of polymorbidity in geriatrics practice are presented in the article. Most often ways of the development of polymorbidity and their clinical outcomes are discussed.

[Morphological and immunohistochemical characteristic of oral mucosa in patients with inflammatory bowel disease].

The aim of presented study was to investigate the morphological and immunohistochemical characteristics of the oral mucosa in patients with Crohn's disease and ulcerative colitis. The study involved 40 patients aged from 18 to 64 years, among them 30 patients with Crohn's disease and 10 patients with ulcerative colitis. Clinical, endoscopic, morphometric and immunohistochemical study have shown that Crohn's disease is characterized by generalized inflammation in the gastrointestinal tract with signs of immune inflammation in the mouth, whereas in ulcerative colitis the pathologic process is limited to the colon. In this context, the defeat of the oral mucosa can be regarded as a distinct phenotypic characteristic of the localization of Crohn's disease, with some differential-diagnostic and prognostic criteria.

[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.