2020, volume 16

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.

Elderly people are a high-risk group for developing tuberculosis, with difficulties in diagnosis and treatment with an uncertain prognosis. We present a clinical case of tuberculosis with a favorable outcome in a patient aged 86 with a large numerous comorbid pathologies, including an organic brain disease with intellectual and behavioral disorders. This clinical observation demonstrates an atypical course of tuberculosis in the elderly, a slow reverse dynamics of the process and a cure with large residual changes in the lungs.

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.

A literature review analyzes published data on geroprotective nutritional options. Nutrition is one of the fundamental factors that determine longevity and quality of life. Intestinal microbiota and its changes in the elderly and long-livers are being actively studied. The food selection and the calorie intake are directly related to the formation of microbiota.

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.

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.

Some aspects of the activities of employees of the Saratov State Medical Institute, related to the search and implementation of effective methods of hospital treatment during the Great Patriotic War, are examined. An attempt has been made to identify the relationship of scientific research conducted by Saratov medical scientists with all-Union trends and to show their regional characteristics. The conclusion is made about the significant contribution of SSMI scientists to the development of regional health care and the medical and evacuation support system of the Red Army.

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.

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.

The article follows losif Z. Neyman's career and evaluates his contribution to the development of orthopedics. I.Z. Neyman's scientific work was devoted to the investigation of scoliotic spine disease pathogenesis, improvement of diagnostic methods and surgical management of both idiopathic and dysplastic scoliosis in adolescents and adults.