Saratov JOURNAL of Medical and Scientific Research

Denisova T.P.

Saratov State Medical University, Department of Therapy and Gerontology, Professor, Doctor of Medical Science

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: -
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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.

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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.

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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.

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Tentative analytic biomarker panel of maladaptive myocardial remodeling (systematic review)

Year: 2019, volume 15 Issue: №3 Pages: 773-779
Heading: Cardiology Article type: Review
Authors: Malinova L.I., Denisova Т.Р., Furman N.V., Dolotovskaya P.V., Puchinyan N.Ph., Povarova T.V.
Organization: Saratov Road Clinical Hospital, Saratov State Medical University
Summary:

The purpose is to design a tentative analytical panel of biomarkers (BM) of maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction. eLibrary.ru and PubMed were used for data extraction. Reproducibility of the obtained data was calculated, as well as the intragroup correlations of BM maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction with the clinical phenotype of heart failure (HF) — т. The tentative BM panel design was carried out using the ranking method (R). Analysis included data from 5085 publications. The highest reproducibility was traced in nautriuretic peptides ((3 0.91 and 0.89) and cardiac troponins ((3 0.84), while the highest correlation ratios of BM and the clinical phenotype of CH were detected in natriuretic peptides and ST2 (т 0.81; 0.77 and 0.71). PIIINP and decorin did not reveal any significant correlation with the HF clinical phenotype. A rank of >0.5 was identified in galectin-3, GDF-15, and osteopontin. A set of biomarkers with a proven participation in the pathogenesis of heart failure, which potentially has the greatest diagnostic and prognostic value was designed, i. e. a tentative analytical panel of biomarkers of maladaptive myocardial remodeling/extracellular myocardial matrix dysfunction: NT-proBNP, BNP, cardiac rf-troponins, ST2, GDF-15, galectin-3 and osteopontin.

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Frailty and arterial hypertension (lecture)

Year: 2019, volume 15 Issue: №3 Pages: 757-763
Heading: Cardiology Article type: Lecture
Authors: Lipatova Т.Е., Tyultyaeva L.A., Denisova Т.Р., Shulpina N.Yu.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

The lecture analyses reference data on the problem of combination of senile asthenia and hypertension in elderly and senile patients. It discusses modern views on the possibilities and problems of diagnosis and treatment of patients with a combination of senile asthenia and hypertension.

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Erythrocyte system in elderly: ageing aspects

Year: 2018, volume 14 Issue: №2 Pages: 341-345
Heading: Gerontology and geriatrics Article type: Original article
Authors: Malinova L.I., Denisova Т.Р., Lipatova Т.Е., Khvostikova D.E., Yegorova A.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study was an assessment of erythrocyte system age-dependent characteristics in elderly population dwelling in the same territory during the time period equal to the average life span in the region. Material and Methods. We perform the compare of hematological parameters of 800 patients with hypertension and coronary heart disease hospitalized during 25-years period. Results. In senile patients, red blood cells and hemoglobin levels signifi- cantly decrease, but platelet characteristics remain intact. Revealed differenced are similar during all 25-year period of observation. Conclusion. Over the past 25 years, the trend of age-related decline in the number of red blood cells and hemoglobin has been preserved. The average hemoglobin content in erythrocyte (MCH) during the aging process tends to decrease, which has become statistically significant in recent years. The principal difference of the obtained data from the results of obtained 25 years ago is the absence of an age-related increase in the volume of erythrocytes and a higher level of the average concentration of hemoglobin in the erythrocyte.

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Healthy ageing and regional health care system of the Great Patriotic War veterans

Year: 2018, volume 14 Issue: №2 Pages: 330-334
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.P.,Lipatova Т.Е., Shuldyakov V.A., Kovalev E.P., Alipova L.N.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov Ministry for Public Health
Summary:

The term of "Healthy Ageing" is about creating the environments and opportunities that enable people to be and to do what they value throughout their lives. Healthy ageing require multipurpose policy framework with biological, social, economic, cultural and ecological aspects. The long-term experience of Saratov Regional Hospital for War Veterans in development and management of competencies required for healthy ageing programs is generalized in the article. Science evidence base of healthy ageing was formulated including results of the original studies with veterans of Great Patriotic War involved.

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Clinical diagnosis in terms of insurance medicine

Year: 2018, volume 14 Issue: №2 Pages: 327-330
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.Р., Lipatova Т.Е., Malinova L.I., Tyultyaeva L.A., Kovalev Е.Р., Alipova L.N., Vakhlyueva O.G.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Medical institutions in the conditions of insurance medicine are faced with not always justified interference of insurance companies in the structure of diagnosis and diagnostic process, whose violate the essence of the concepts of clinical classifications and statistical coding of diagnoses provided by ICD-10. Such a situation ultimately harms the patient and society, makes it difficult both to monitorthe adequacy of the ongoing treatment activities, and to protect the patient's rights to receive qualified medical care and doctor's rights.

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Interaction of atherosclerosis and ageing: is there any discussion questionable?

Year: 2018, volume 14 Issue: №2 Pages: 322-327
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.Р., Lipatova Т.Е., Alipova L.N., Yegorova A.V.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Age-related diseases and their link to involutionary processes in human organism remain as one of the burning problems in internal medicine. The article focuses on the discussable questions of the most common mechanisms of atherogenesis and ageing, their similarity and difference. Both processes mutually burdens each other, bringing the "fading" of the organism closer.

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