№1, 2015, volume 11
Treatment of chronic generalized periodontitis at women in the period of postmenopause
Heading: Stomatology Article type: Original article
Authors: Ostrovskaya L.U., Khanina A.l.
Organization: Saratov State Medical University
Purpose: an assessment of efficiency of complex treatment of periodontitis at women in a period of postmenopause with the use of zoledronic acid. Material and methods. Examination and treatment of 90 patients with a chronic generalized periodontitis against post-menopausal osteoporosis has been conducted. Material is processed statistically. Results. Application of preparations of zoledronic acid in complex treatment of system osteoporosis and periodontitis allows to reduce the frequency of recurrence of periodontal disease and to improve indicators of bone remodeling. Conclusion. In conclusion it is worth while determining that zoledronic acid in complex therapy of periodontitis is an effective method of drug correction of a mineral exchange before periodontological surgery.
Theoretical background of healthcare management in the conditions of social and economic instability
Heading: Health Service Organization Article type: Author's opinion
Authors: Shuldyakov V.A., Chernenkov Yu.V., Denisova Т.Р.
Organization: Children's Hospital of the Saratovsk Region, Saratov, Saratov State Medical University
Purpose: to develop fundamental basis of science based healthcare management in social and economic instability. Public health state (1998-2008, selected region) was characterized by cardiovascular health parameters (Code IX, ICD-10). Systematic review was performed according to PRISMA guidelines. Dynamic characteristics of major cardiovascular diseases in social and economic instability considered as a cause of a population system destabilization were reconstructed. Conclusion. Fundamentals of science based healthcare management in social and economic instability include long- and short-term prognosis of public health characteristics as the result of multifactor external influences on cardiovascular diseases prevalence.
The quality of life optimization vectors of patients with ischemic heart disease
Heading: Health Service Organization Article type: Original article
Authors: Krom I.L., Erugina M.V., Sazanova G.Yu.
Organization: Saratov State Medical University, Saratov Institute of Social Education, Head of Centre of Medical and Social Research
The purpose of research is an integrative analysis and justification of the priorities of the quality of life optimization with patients with coronary heart disease. Material and Methods. Some sociological and statistical methods were used in this study. Results. The article presents the results of the study of quality of life of patients with ischemic heart disease, using a questionnaire WHOQOL-100. The study established the statistical dependence of the quality of life of patients with coronary heart disease on the quality of medical care, which is considered by the authors as an obligate modifiable predictor of quality of life of these patients. Conclusion. Medical care is considered according to the research as the obligate modified predictor of quality of life of the patients suffering from coronary heart disease. Statistical dependence of indicators of quality of life of sick IBS on medical care is established during research. Correction of standards of medical care acts as one of conditions of optimization of quality of life of sick coronary heart disease.
Источники поддержания здоровья в интерпретациях представителей пожилого возраста
Heading: Gerontology and geriatrics Article type: Original article
Authors: Chernyshkova Е.М., Andriyanova Е.А., Repin V.F., Chernyshkov D.V.
Organization: Saratov State Medical University
The goal is to analyze the main sources of health maintenance among elderly people who continue working after retirement. Material and methods. Analysis of the main sources of health maintenance among elderly people is based on the results of sociological research by means of semi-structured interview, conducted in 2014 in Saratov city. The sample included 8 respondents aged 55-65 years who continue working after their retirement. Results. The main sources of health maintenance among working pensioners include such preventive measures as moderate physical exercise, rational nutrition, folk medicine, hardening, and regular medical examinations. It was revealed that in the case of self-prevention of chronic diseases worsening elderly persons rely on previous doctors' prescriptions, drugs instructions, and medical literature. Conclusion. The data obtained in this research allow to make the conclusion that along with demand for preventive measures of health maintenance among working pensioners, there is an expansion of self-medication practice. This fact could be explained by a decrease of confidence in primary health care services, low availability of paid medical services.
Psychological background of prevention and treatment in geriatrics
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Nazarov M.l., Denisova I.P., Yuanov А.А.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Confidentiality as the component of an interpersonal "patient — medical practitioner" contact formation can be considered as a corner stone of geriatric practice. Major psychological pitfalls of geriatric practice have been reviewed. The main issue of the paper is psychological substantiation of treatment and prevention of elderly.
Modern strategy of diagnostics and treatment of NSAID-induced enteropathy in elderly
Heading: Gerontology and geriatrics Article type: Original article
Authors: Lipatova Т.Е., Dudaeva N.G.
Organization: Saratov State Medical University
The aim of the research is to improve the efficiency of diagnosis and treatment of NSAID-induced enteropathy at elderly patients with chronic pain (osteoarthritis, dorsopathy). Material and Methods. 300 elderly with osteoarthritis or dorsopathies regularly (8 weeks or more) receiving diclofenac at 75 mg per day were inspected. Clinical features, morphology, components of the diffuse endocrine system of the small intestine were studied. Results. It is defined, that at elderly patients with regular use of NSAIDs in 25% of cases postbulbar erosive duodenitis, in 75% of cases inflammatory and atrophic changes of the distal duodenum were diagnosed. Diagnosis of NSAID-induced enteropathy at elderly should include faecal calprotectin and morphology analysis of postbulbar area of the duodenum. Use meloxicam and sulfasalazine at older patients helps to eliminate or reduce intestinal dyspepsia, malabsorption, and intestinal inflammation on the results of faecal calprotectin and of histology of the small intestine. Conclusion. Elderly patients are at high-risk group for NSAID-induced enteropathy due to functional disturbances in the neuroendocrine system of the small intestine.
Strategy and tactics of surgical treatment in elderly patients with ischemic form of diabetic foot syndrome
Heading: Gerontology and geriatrics Article type: Review
Authors: Shapkin Yu.G., Yuanov A.A., Efimov E.V.
Organization: Saratov State Medical University, Regional Hospital for War Veterans, Saratov
The article analyzes the Russian and foreign publications on the issue of treatment of elderly and senile patients with critical limb ischemia and diabetes mellitus. It is shown that the topic is relevant, and, despite its wide coverage in the press, does not have the final decision. Currently unresolved issues include the terms and indications for reconstructive surgery, the amount and the method of amputation, postoperative care.
The senile kidney
Heading: Gerontology and geriatrics Article type: Lecture
Authors: Denisova Т.Р., Lipatova Т.Е., Chernenkov Yu.V., Nazarov M.l.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
The given work summarizes external data and self-obtained results on development and diagnostic of kidney involution modifications. Article discusses definition of "senile kidney" as a clinical and pathomorphological term. Major statements on pathophysiological causes of age-associated renal disorders and their prognosis, specifics of chronic kidney disease in elderly and senile patients have been reviewed. Phenomenon of renal "multimorbidity" in eldely maximizes worsening risk of unmodifiable kidney function.
Natriuretic peptides and Galectin-3 in senile heart failure patients with preserved ejection fraction.
Heading: Gerontology and geriatrics Article type: Original article
Authors: Malinova L.I., Podbolotov R.A., Povarova T.V., Pletneva G.F.
Organization: Saratov State Medical University, Saratov Road Clinical Hospital, Regional Hospital for War Veterans, Saratov
Purpose: to characterize biomarker panel in senile patients with heart failure with preserved ejection fraction (HF-pEF). Material and Methods. 356 senile patients with chronic heart failure with preserved ejection fraction (HFpEF) were examined to form the study sample of 48 male patients without atrium fibrillation, anemia, diabetes mellitus, onco-pathology and missing clinical data. NT-proBNP, galectin-3 (gal-3) and proANT assay was performed by commercially available ELISA kits. Results. In patients without left ventricular (LV) regional wall motion abnormalities (RWMA). gal-3 (2,13 (0,98; 3,50) vs 5.16 (4,34;9.63) ng/mL, p = 0.011) and NT-proBNP (5,59 (1,00; 10.13) vs 32,04 (15,40; 46,18) fmol/mL, p=0,006) levels were significantly lower than in patients with LV RWMA. Contrarily proANP level was lower in patients with LV RWMA (3,24 (2,47; 3,75) vs 1,38 (0,83; 2,29) nmol/mL, p=0.071). proANP was the only biomarker to increase significantly in long livers (7,30 (4,52; 7,63) vs 2,68 (1,88; 3,32) nmol/mL, p=0.006). NT-proBNP positively correlated with glucose level and negatively with hsCRP (R=0,52, p=0,007). Conclusion. Biomarker panel in senile heart failure patients with preserved ejection fraction has characterized: increase in NT-proBNP and galectin-3 is associated with more severe clinical course and presence of regional wall motion abnormalities in senile patients.
Heart ischemic disease and longevity: unsolved problems
Heading: Gerontology and geriatrics Article type: Original article
Authors: Markova T.Yu., Malinova L.I., Denisova Т.Р.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
The purpose of the study was to estimate clinical signs and course of coronary heart disease in long-livers and centenarians. Material and Methods. The study included overall population of Saratov — Engels agglomeration's long-livers (>=90 years old, n=198). Results. The rates of major clinical forms of coronary heart disease were detected: atrial fibrillation — 10.6%, chronic heart failure (with preserved ejection fraction) — 10.1 % and angina — 5.1 %. Myocardial infarction was verified in 9.6% of long-livers. Myocardial scar criteria prevailed over myocardial infarction history. Received data corroborated dissolving phenomena of coronary heart disease and noninsulin dependent diabetes mellitus in long-livers. Gender differences in electrophysiological parameters were detected in long-livers. Centenarians with the history of myocardial infarction preserved a satisfactory level of physical activity. Conclusion. Received data confirm a presence of an excessive security: prevention of coronary heart disease manifestation and progression in longevity. Long-livers should be considered as a natural model of an antiatherogenic factors and mechanisms.