[Clinic-X-ray characteristics of periodontal disease in elderly patients.]

The significant prevalence of periodontal diseases in elderly patients makes the research relevant. By now, the issues of complex clinical and radiological semiotics of generalized periodontitis using high-tech research methods is not sufficiently studied. The research addressed the clinical picture and three-dimensional computed tomographic semiotics of severe chronic generalized periodontitis focusing 25 elderly patients with severe chronic generalized periodontitis. It verified the necessity to use an organ-oriented program of multiplanar (volumetric) cone-beam computed tomography coupled with the analysis of the research results, as well as a mandatory analysis of densitometry indicators of the jaw bone tissue in diagnostically significant periodontal zones.

[Predicting the development of adverse events in patients with acute coronary syndrome including genetics in the long-term follow-up].

Aim To study a relationship of several factors (clinical and genetical markers) with unfavorable outcomes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in long-term follow-up.Material and methods This full-design, prospective study included 415 patients with NSTE-ACS. 266 patients were evaluated for the presence of multifocal atherosclerosis (MFA). Typing of polymorphic variants rs1041981 LTA, rs1800629 TNF, rs4986790, and rs498679 TLR4, and also rs3024491 and rs1800872 IL10 was performed. Follow-up period lasted for 67±4 months. By the end of this period, information about clinical outcomes for 396 patients became available.Results During the entire follow-up period, unfavorable outcomes were observed in 239 (57.5 %) patients with NSTE-ACS. The following clinical signs were associated with unfavorable outcomes: history of myocardial infarction, age >56 years, left ventricular ejection fraction (LV EF) ≤50 % and GRACE score ≥100, significant stenosis of brachiocephalic arteries, MFA, carriage of genotype А / А rs1041981 LTA (OR, 6.1; р=0.02) and allele А (OR, 1.9; р=0.01). According to results of a multifactorial analysis, the most significant predictors included LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.Conclusion Stratification of patients with NSTE-ACS into groups of high or low risk for having an unfavorable outcome within the next 6 years is possible using the prognostic model developed and presented in this study. The model includes the following signs: LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.

[Effectiveness of a long-term education program in patients with prosthetic heart valves].

AIM: The current study was aimed at assessing the effectiveness and the impact of a long-term education program, in both inpatient and outpatient treatment settings, on adherence to treatment and the quality of life 5 years after heart valve replacement. MATERIALS AND METHODS: All the patients were randomly included into two study groups. The study group patients (n=176) underwent the long-term education program in both inpatient and outpatient treatment settings. The control group (n=108) consisted of patients who underwent only an inpatient education program. Adherence to treatment and the quality of life were assessed before education, at the end of the inpatient and outpatient education and 5 years after heart valve replacement. Patients' treatment adherence was estimated with the Davydov's questionnaire, and the quality of life - with the 36­Item Short Form Health Survey. RESULTS: After the completion of the education program, the integral index reflecting patients' adherence to treatment in the study group remained at the same level, but was 1.4­fold higher compared to the control group in the 5­year follow-up. The long-term education program is associated with improved quality of life, mainly due to emotional well-being. The study reported a correlation between physical functioning and emotional well-being and the integral index reflecting patients' adherence to treatment during the follow-up period. CONCLUSION: The long-term education program in both inpatient and outpatient treatment settings contributed to improved patients' adherence to treatment and the quality of life, mainly due to physical functioning. The inpatient education program was associated with poor patients' adherence to treatment and the quality of life 5 years after heart valve replacement.