Saratov JOURNAL of Medical and Scientific Research

Lipatova Т.Е.

Saratov State Medical University n. a. V. I. Razumovsky, Head of Department of Therapy with Courses of Cardiology, Functional Diagnostics and Geriatrics, Assistant Professor, DSc

Stroke awareness among Saratov respondents, and risk factors for acute cerebral circulation disorders (according to a population survey)

Year: 2020, volume 16 Issue: №1 Pages: 394-402
Heading: Neurology Article type: Original article
Authors: Yakovlev D.S., Kolokolov O.V., Makarov N.S., Lipatova Т.Е., Loiko V.S., Kolokolova A.M., Lukina E.V., Sitkali I.V., Tolstykh А.О., Yudina V.V.
Organization: Saratov State Medical University
Summary:

Objective: to analyze awareness level among Saratov's population about stroke, and to identify regional characteristics of risk factors for the development of acute cerebrovascular accident (ACVA) based on the results of a survey. Material and Methods. A personal questionnaire was conducted through a personal conversation with the residents of Saratov who applied for medical care in polyclinics as part of the campaign "World Day Against Stroke" October 29, 2019. Results. The survey involved 123 people. Most respondents showed a high level of awareness of such risk factors for ACVA as arterial hypertension, obesity, high blood cholesterol, alcohol abuse, and smoking. The significance of cardiac arrhythmias, a history of transient ischemic attacks, and a hereditary predisposition to the development of stroke were underestimated by the participants of the action. The level of knowledge of the population about thrombolytic therapy and surgical intervention on the vessels of the neck and brain as the leading methods of treating stroke is insufficient. Conclusion. Public informing is necessary to increase the level of awareness about stroke, which allows motivating citizens to remain committed to a healthy lifestyle and eliminate risk factors for developing ACVA.

AttachmentSize
2020_01-3_394-402.pdf901.87 KB

Hemostasiological and Theological parameters of blood in elderly and mature patients with ulcerative colitis

Year: 2020, volume 16 Issue: №1 Pages: 186-189
Heading: Тhematic supplement Article type: Original article
Authors: Tyultyaeva L.A., Mikhailova Е.А., Lipatova Т.Е., Alipova L.N.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Purpose: analysis of hemostasiological and rheological parameters of blood in elderly and mature patients with ulcerative colitis. Material and Methods. In 34 elderly patients and 32 mature patients with ulcerative colitis, we investigated the aggregation ability of platelet, antithrombogenic properties of the vascular wall, blood viscosity; erythrocyte aggregation index, erythrocyte aggregation index, erythrocyte deformability index, erythrocyte deformability index, and the efficiency of oxygen delivery to tissues were determined in comparison with similar indicators in healthy people. Results. In elderly patients with ulcerative colitis, as well as in patients of mature age, changes in the vascular-platelet link of the hemostatic system and blood rheology manifested by inhibition of anti-platelet activity of the vascular endo-thelium, changes in the functional activity of platelets and erythrocytes associated with the severity and activity of the process. Ulcerative colitis was accompanied by the development of the first (compensated) phase of the chronic form of DIC-syndrome. Conclusion. Elderly and mature patients with ulcerative colitis have disorders in the vascular-platelet link of hemostasis and blood rheology, manifested by inhibition of antithrombogenic activity of vascular endothelium, a change in platelet and red blood cell activity.

AttachmentSize
2020-01-1_186-189.pdf286.51 KB

Heliogeomagnetic parameters and pathology of digestive organs in patients of different ages

Year: 2020, volume 16 Issue: №1 Pages: 181-185
Heading: Тhematic supplement Article type: Original article
Authors: Tyultyaeva L.A., Denisova Т.Р., Lipatova Т.Е., Shulpina N.Yu.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

The purpose: to analyze the prevalence of digestive system pathology among the population of different age groups in comparison with the heliogeomagnetic environment. Material and Methods. Based on official statistical reports of medical institutions and medical documentation of medical institutions of Saratov in the period 1990-2006, digestive system prevalence rates in different age groups were studied. A correlation analysis of these indicators with the average annual values of Wolf numbers is performed. Results. A strong negative relationship was found between the prevalence of ulcer perforation among the young population and solar activity; for the elderly and senile population, a strong positive relationship between the prevalence of acute cholecystitis and solar activity was revealed. Conclusion. Some parameters of the "gastroenterological" health of the population may be associated with solar activity, which differs in different age groups of the population.

Keywords: -
AttachmentSize
2020-01-1_181-185.pdf491.42 KB

Age and age-dependent predictors for the risk assessment in elderly and senile patients with chronic heart failure

Year: 2020, volume 16 Issue: №1 Pages: 172-176
Heading: Тhematic supplement Article type: Original article
Authors: Malinova L.I., Lipatova Т.Е., Zhuk A.A., Dolotovskaya P.V., Furman N.V., Denisova T.P.
Organization: Saratov State Medical University
Summary:

Objective: to assess the presence and nature of age-dependent changes in the predictors used for risk stratification of patients with chronic heart failure (CHF). Material and Methods. We perform an analysis of predictive models of CHF, including a comparative assessment of predictors and age of patients. At the second stage, age-dependent changes in the most commonly predictors of CHF were characterized. The study included hospitalized patients with CHF (36-94 years, n=2764). Results. We analyzed 275 prognostic models based on results of large studies (n=36062±5814). The mean age of the patients involved was 68.9±7.6 years. The major predictors included the patient's age and/or potentially age-dependent parameters: hemoglobin, creatinine, RDW, LVEF, SBP and NT-proBNP. In the study sample all of these parameters correlated with the age of the patients with the maximum correlation strength of "NT-proBNP — age" (R=0.57; p<0.05) and "hemoglobin level — age" (-0.57; p<0.05). Conclusion. The prevalence of mature and elderly patients in the populations of studies used to develop the majority of risk instruments for heart failure is revealed. The age-dependent nature of the predictors used in the risk of heart failure is established (hemoglobin, creatinine, RDW, LVEF, SBP and NT-proBNP). The simultaneous use of age and age-dependent parameters as predictors when creating risk-assessment tools may be considered as one of the reasons for the unsatisfactory quality of risk stratification in CHF, including elderly and senile patients.

AttachmentSize
2020-01-1_172-176.pdf389.36 KB

Peptic ulcer in women and men: clinical, endoscopic and morphofunctional features in young and elderly patients

Year: 2020, volume 16 Issue: №1 Pages: 164-167
Heading: Тhematic supplement Article type: Original article
Authors: Lipatova Т.Е., Tyultyaeva L.A., Islamova Е.А., Khaybekova T.V., Shulpina N.Yu.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Purpose: analysis of clinical, endoscopic and morphofunctional parameters of the course of peptic ulcer of the stomach and duodenum in women and men of young and old age. Material and Methods. 170 patients with peptic ulcer were examined. We used a clinical, endoscopic examination with a histological examination of biopsy with determination of H. pylori in the stomach by a histobacterioscopic method, estimated sex hormone receptors density by relative area (the ratio of the area of immunopositive cells to the total area of the drug). Results. The features of the course of the disease were found: age-related, gender-related, not related to gender and age, associated with the localization of an ulcerative defect (in the stomach or duodenum). It has been shown that among women more than among men, the number of patients with an atypical course of the disease increases with aging; gender differences in the course of the disease in the elderly are more pronounced with duodenal ulcer localization. Conclusion. Clinical, endoscopic and morphofunctional features of the course of peptic ulcer of the stomach and duodenum associated with the gender and age of patients were revealed.

Keywords: age
AttachmentSize
2020-01-1_164-167.pdf387.05 KB

Chronic atrophic gastritis in patients over 60 years of age: clinical, morphofunctional, and neuroendocrine parameters

Year: 2020, volume 16 Issue: №1 Pages: 160-163
Heading: Тhematic supplement Article type: Original article
Authors: Lipatova Т.Е., Islamova Е.А., Tyultyaeva L.A., Khaybekova T.V., Vakhlyueva O.G.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Objective: to analyze the clinical, morphological and neuroendocrine parameters of the course of chronic H. pylori-associated atrophic gastritis in patients 60 years of age and older in comparison with similar parameters in patients younger than 60 years with chronic H. pylori-associated non-atrophic gastritis. Material and Methods. 60 patients with chronic atrophic H. pylori-associated gastritis and 20 healthy individuals were examined. Clinical symptoms of the disease, H. pylori seeding rate, esophagogastroduodenoscopy, morphological and immunohistochemical analysis were evaluated. Results. Patients older than 60 years are less likely than patients younger than 60 to have epigastric pain and heartburn pain, but more often dyspeptic syndrome, but the degree of gastritis activity and the degree of contamination of H. pylori was lower. There are more NO synthase-immunopositive cells, and less immunotropic motilin cells than in patients under 60 years of age. Conclusion. Patients older than 60 years have specific features of the formation of chronic H. pylori-associated atrophic gastritis.

AttachmentSize
2020-01-1_160-163.pdf476.94 KB

Chronic coronary syndromes: clinical features, diagnosis

Year: 2020, volume 16 Issue: №1 Pages: 150-155
Heading: Тhematic supplement Article type: Lecture
Authors: Denisova Т.Р., Lipatova Т.Е., Malinova L.I.
Organization: Saratov State Medical University
Summary:

The lecture is devoted to existing ideas about the diagnosis and treatment of coronary heart disease. The concept of chronic coronary syndromes (CCS) is introduced in accordance with The ESC Guidelines forthe diagnosis and management of chronic coronary syndromes, 2019. CCS pathogenetic mechanisms, clinical flow scenarios and diagnostic methods are considered. Particular emphasis is placed on the late age category of patients.

AttachmentSize
2020-01-1_150-155.pdf634.49 KB

Active monitoring system for elderly and senile patients in a hospital for war veterans

Year: 2020, volume 16 Issue: №1 Pages: 145-150
Heading: Тhematic supplement Article type: Author's opinion
Authors: Denisova Т.Р., Zhuk S.V., Nasarov M.I., Lipatova Т.Е., Alipova L.N., Semenov S.V., Avdienko I.V., Barinova I.V.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

One of the most important problems of modern healthcare is the development of a scientifically based system of active monitoring of patients of older age groups and the provision of medical care to them using the new medical examination procedure. The results of a two-stage monitoring for 5.5 thousand patients of different ages with the inclusion of screening geriatric assessment and the study of a number of hormonal-metabolic markers of aging are presented. Among the elderly, the number of diseases reaches ten or more, the vast majority of such patients belong to the III and IV health groups. Among the elderly, the number of diseases reaches ten or more, the vast majority of such patients belong to the 3rd and 4th health groups. A high level of patient satisfaction was revealed during an optimized clinical examination scenario. Conducting a staged medical observation with synchronous geriatric assessment allows you to form the most homogeneous group of patients. It is necessary to take into account the following factors: age, initial signs of fragility, the level of markers of hormonal-metabolic wilt, the presence and degree of polymorbidity, which is important for monitoring and treating patients, as well as for modifying geriatric function.

AttachmentSize
2020-01-1_145-150.pdf342.42 KB

Assessment of cardiovascular risk factors in patients with chronic peri-odontitis

Year: 2020, volume 16 Issue: №1 Pages: 45-49
Heading: Stomatology Article type: Original article
Authors: Eremin A.V., Lipatova Т.Е., Lepilin A.V., Eremin V.I.
Organization: Saratov State Medical University
Summary:

Aim: to estimate the cardiovascular risk in patients with chronic periodontitis (CP) different severity. Material and Methods. 2400 persons (65.6% male, aged from 40 to 64 years) were examined. Body mass index, lipid spectrum, blood glucose and C-reactive protein levels were determined, and tonometry was performed. The 10-year risk of a cardiovascular event was calculated using SCORE (Systematic Coronary Risk Evaluation) and Reynolds Risk Score. The concentration of interleukin-6 (IL-6) in the oral fluid was studied. Results. Patients with moderate to severe CP are characterized a high incidence of the main cardiovascular risk factors (arterial hypertension, smoking, dyslipidemia, obesity) compared to those with person with intact periodontal tissue and patients with mild CP For patients with CP with a moderate risk of fatal cardiovascular events on the SCORE, it is advisable to calculate the cardiovascular risk on the Reynolds Risk Score too. The oral fluid's level of IL-6 in the patients with CP may be considered as an additional marker of high risk of fatal cardiovascular events. Conclusion. The relation between the results of severe CP as missing teeth, loss of periodontal bone and the risk of fatal cardiovascular events is important for clinical use and may be used as an additional cardiovascular risk marker for patients with chronic periodontitis.

Keywords: -
AttachmentSize
2020_01_045-049.pdf323.78 KB

Protracted course of myocardial infarction in a senior patient against the background of acute calculous cholecystitis (clinical case)

Year: 2019, volume 15 Issue: №3 Pages: 817-821
Heading: Cardiology Article type: Case report
Authors: Romanova N.A., Lipatova Т.Е., Parshina S.S., Haibekova T.V..
Organization: Saratov State Medical University
Summary:

The article describes the clinical case of protracted course of myocardial infarction in a senior patient against the background of acute calculous cholecystitis, discusses medical examinations and treatment; attention is drawn to the need for a particularly careful assessment of temporal dynamics of the ST segment and T wave of electrocardiograms in polymorbid patients to confirm the protracted course of myocardial infarction.

AttachmentSize
2019_03-1_817-821.pdf823.51 KB