[Application of immunomodulators in the treatment of mandibular fractures in elderly patients with incomplete secondary adentia].

The aim of the work was to study the experience of using complex pharmacotherapy in the treatment of mandibular fractures in elderly patients with incomplete secondary periodontitis, which were divided into two groups. In the first group, patients (n = 46; average age 69.0 ± 3.6) were treated using the authors' original device combined with application of antimicrobial MetrogilDenta gel onto gums two times a day during ten days. Patients in the second group (n = 52; average age 61.0 ± 3.1) were treated with the same device combined with (i) application of MetrogilDenta antimicrobial gel onto gums two times a day during ten days, (ii) application of 1.5 ml of Cycloferon 5% liniment by cotton pellet for 20 min during the same 10 days (30 minutes after the antimicrobial gel), and (iii) intramuscular injections of 6 mg of synthetic immunomodulator Polyoxidonium once a day for 3 days, then once every two days (for a total of 17 days). It is established that the use of the combination of interferon inducers of immunomodulator group--Cycloferon in the form of liniment and synthetic immunomodulator Polyoksidonium together with MetrogilDenta antimicrobial gel--led to the most pronounced regression of inflammatory and destructive processes in periodontal tissues (in 7.1%, d = 0.05), optimized the state of local immunity of the oral cavity, and normalized microflora in periodontal pockets in elderly patients with incomplete secondary adentia.

[The structure of psychopathology associated with addictive disorders, against alcohol addiction and the possibility of its neurometabolic correction of the elderly].

The article considers the actual problem in modern medicine, the study of psychiatric symptoms associated with addictive disorders on the background of alcohol abuse in the elderly. It is shown that neurotic pathology in elderly patients with alcohol dependence is characterized by the presence of six major symptoms, reflecting the excitation processes, overcoming compensation, deficit symptoms, irritation and stabilization of the pathological state. It is proved that Cytoflavin, maintaining a certain level of excitement in the cerebral cortex, provides the optimal voltage of compensatory mechanisms in older people in overcoming their psychiatric symptoms, connected with addictive disorders.

[Citoflavin in the complex therapy of elderly patients with alcohol dependence syndrome]. / Tsitoflavin v kompleksnoi terapii bol'nykh pozhilogo vozrasta s sindromom alkogol'noi zavisimosti.

Objective. Alcoholism in the elderly age determines the protracted nature of the pathological craving for ethanol in post-abstinent period, limits the arsenal of active pharmacotherapy and updates the search for new pharmacological therapeutic strategies. Authors studied the efficacy of cytoflavin in the outpatient complex therapy of post-abstinent disorders. Material and methods. One hundred and seven patients, mean age 64.4±8.5 years, with transition (II-III) stage of alcoholism (F10.2 in CD-10) were examined. A battery of psychometric scales was administered. Results. The effect of cytoflavin on affective, somato-autonomic and neurological manifestations of alcohol withdrawal syndrome and craving for ethanol was found. Conclusion. The findings suggest that cytoflavin provides a significantly more efficient reduction of psychopathological symptoms of alcohol addiction in elderly patients.

[Indicators of treatment of schizophrenia in different stages of psychiatric care]. / Pokazateli lecheniia shizofrenii na raznykh étapakh psikhiatricheskoi pomoshchi.

Objective. To study indicators of treatment of schizophrenia in different stages of psychiatric care, to reveal prognostic factors of the dynamics of psychopathological symptoms in treatment of schizophrenia and to estimate the risk of schizophrenia relapse. Material and methods. Three hundreds of patients, aged 18-65 years, diagnosed with schizophrenia (ICD-10) were included in data analysis. Patients were stratified into 4 groups by the type of psychiatric care: inpatients (n=68), outpatients of day hospital (n=71), outpatients of psychoneurological dispensary rehabilitation department (n=75) and outpatients supervised by psychoneurological dispensary local doctor. Treatment characteristics (use of 1st and 2nd generation antipsychotics) of these groups were compared. Results and conclusion. The positive effect of modern antipsychotics on schizophrenia course, frequency of relapses and hospitalizations was identified. The results can help in improvement of psychiatric care due to wide implementation of 2nd generation antipsychotics.

[Treatment of alcohol addiction syndrome with cytoflavin].

Forty-seven hospital patients with alcohol-related mental and behavioral disorders were treated at the stage of abstinence syndrome and post-abstinence disorders. Patients were split into two groups: patients of the control group (n=17) received standard therapy. Patients of the second group (n=30) additionally received antihypoxant/antioxidant - cytoflavin. The results revealed that cytoflavin effectively reduced psychopathological symptoms of alcohol addiction.

[The structure of psychopathology associated with addictive disorders, against alcohol addiction and the possibility of it's neurometabolic correction in the elderly].

The article presents the analysis of the structure and dynamics of psychopathology associated with addictive disorders in elderly patients with alcohol dependence. In terms of syndromic approach the structure of neurotic disease in elderly patients with a verified diagnosis of mental and behavioral disorders associated with alcohol consumption was evaluated. In the overall structure of neurotic pathology in these patients the analysis of symptoms of neurotic diseases, the research of the structure of syndromes and their dynamics were carried out, as well as the patient's attitude to the disease and to its manifestations was determined. A factor model of the pathogenesis of neurotic pathology connected with mental and behavioral disorders due to alcohol use in elderly patients was developed. The high clinical effectiveness of the drug "Cytoflavin" used in the reduction of psychiatric symptoms in patients aged from 62 to 74 years with a diagnosis of mental and behavioral disorders associated with alcohol consumption has been shown.

[Features of psychopharmacotherapeutic correction of alcohol dependence in the elderly].

The article is devoted to the actual in modern medicine problem as the study of the prevalence of alcohol dependence and its psyhofarmacological correction in the elderly. It is shown that elderly and old age as a result of reduction of the reserve capacity of the organism for clinical pathology becomes addictive specific psychopathological features that affect the course of disease and maintenance of preventive treatment. On the basis of empirical evidence the authors prove that at the border severity of alcohol withdrawal syndrome the drug "Cytoflavin" has a fairly pronounced psyhofarmacological activity for older people with alcohol dependence.

[Psycho-physiological peculiarities of stomatologists aged 50-65 with essential hypertension].

The article presents the results of studying of psycho-physiological peculiarities in stomatologists in the age before 65, that is actual in modern medicine. Certain specificity of psycho-physiological indices in stomatologists with essential hypertension is shown. The proposition is justified that alexithimia and susceptibility to illnesses of psychosomatic origin (particularly, essential hypertension) in stomatologists are essentially influenced by withdrawal, absence of inclination to partnership, cooperation, compromise at solution of problems and in conflict situations, and irresponsible attitude to other people, reduced empathy and sympathy to other people.

[Peculiarities of professional burnout of anaesthetists-experts in resuscitation in various age periods].

The article is devoted to consideration of the problem of professional burnout with anaesthetists-experts in resuscitation in various age periods that is very actual in modern medicine. It is shown that peculiarity of the doctors' activity provokes formation of professional burnout in them. Psycho-emotional tension born by the sense of responsibility before the patients determines formation of responsible attitude of the doctors towards therapy, but it also has negative consequences in concern with disorder of homeostatic balance and unreasonable energetic expenditure. It is proved that formation of professional burnout in anaesthetists-experts in resuscitation has age specificity. At the age of 30-55 it develops according to two subfactors: motivational-adjusting (reduction of professional achievements) and depersonalizational-derealizational one. Doctors at the age of 56-68 expose asthenic symptomatology of professional burnout.

[Clinical psychophysiological markers of maladaptive neuropsychic conditions in polyclinic doctors of old and middle age with professional burnout syndrome].

The article presents the actual in modern medicine problem of professional burnout of polyclinic doctors of middle and elderly age. It is shown that the specificity of the polyclinic doctors' activity provokes the formation of professional burnout syndrome, paired with maladaptive neuro-psychic conditions. We studied the prevalence of this syndrome in polyclinic doctors of middle age and older; its specific versions among the middle-aged doctors were defined, where the level of burnout is associated with aggressive tendencies, and the elderly doctors, where professional burnout is associated with the instability of affective response. Pathogenic markers of compensatory redistribution of information saturation of indicators of electroencephalography to the occipital cortex at professional burnout in polyclinic doctors of the elderly age, reflecting the involution processes in prefrontal areas of the cerebral cortex of the brain were identified.

[Age-dependent occupational stress in doctors of various specialties].

A comparative assessment of the extent and structure of the various forms of professional burnout among doctors-organizers as well as therapeutists and surgeons depending on age was given. It is shown that the professional burnout in doctors-organizers conjugates with a high level of emotional tension manifested in avoidance of over-saturated emotional and professional communication outside professional activities, increased irritability and temper, reluctance to exercise empathy towards colleagues and compassion for patients. The comparison of three age groups of physicians to each other in terms of the level and features of the burnout was adduced; the results demonstrate the significant differences between the age periods of 30 and 40 years and over 41 years old. Physicians in the age group of 30-40 years old are inclined to depersonalization at a relatively low level of reduction of professional achievement. It was found that age specificity of formation of the syndrome of professional burnout among surgeons was caused by the increased tendency to development of professional burnout syndrome of young and middle-aged surgeons at low levels of professional burnout among older people.

[Psychophysiological characteristics of professional burnout syndrome in doctors of various specialties and different age groups].

Based on clinical psychopathology, psycho-physiological and medical tests the risk factors of professional burnout among medical professionals of all ages were revealed and the assessment of their impact on the formation of adverse functional status of physicians under research was conducted. The role of psycho-physiological factors (neuro-psychological stability, coping strategies, psychological defense mechanisms, psychosemantic self-relation space, asthenic, obsessive-phobic, hypothymic, anancastic symptoms, the dynamic characteristics of the inhibitory processes, and emotional lability) in the formation of professional burnout among medical specialists of young, middle and elderly age was defined. Neurophysiological markers of professional burnout among medical specialists of young, middle and old age, which are characterized by lower levels of reserve capacity of the cerebral cortex of alpha-rhythm, the prevalence and strength of excitation and balance of beta-rhythm were examined. It was shown that clinical examination of medical specialists of different age groups with symptoms of professional burnout should include the clinical-psychopathological and psychophysiological examinations to determine the psychopathological and personal features, psychological and emotional states of the border areas, which help to identify reactive neurotic disorders and conduct its targeted correction.