[Status and prospects for improving geriatric care in the Russian Federation.]

The data on legal support, resources, structure, staffing of the geriatric service are given. The state of the geriatric service during the COVID-19 pandemic is discussed, as well as plans and directions for development in the post-COVID period. At the end of 2022, the geriatric service in its development reached the following indicators: 1 303 outpatient rooms; 75 geriatric centers; about 2 000 geriatricians trained; 9,2 million citizens older than working age underwent professional examinations; more than 16.0 million citizens older than working age were under dispensary observation; 106,8 thousand citizens older than working age were hospitalized in geriatric beds. It emphasizes the need to organize the provision of multi-level geriatric care and the need to reorganize geriatric care in general.

[Efficacy of newly developed kombucha-based specialized food product for treatment of constipation-predominant irritable bowel syndrome].

According to studies, the prevalence of constipation in the population can reach 27% due to the low intake of dietary fiber. Increasing dietary fiber intake can improve bowel movements. The aim of the study was to assess the efficacy of a non-alcoholic fermented pasteurized kombucha drink enriched with inulin and vitamins in patients with constipation-predominant irritable bowel syndrome (IBS). Material and methods. The study (NCT05164861) was approved by Local Ethics Committee and enrolled subjects with IBS (according to ROME IV). The subjects were randomized to receive either 220 ml of a non-alcoholic drink, based on pasteurized kombucha (KG), enriched with inulin (1.15 g/100 ml) or 220 ml water (control group, CG), for 10 days. Standard examination included evaluation of stool frequency (bowel movements per day), stool form (with the Bristol stool scale) and evaluation of concomitant symptoms (abdominal pain/discomfort, abdominal fullness, bloating, and feeling of incomplete bowel emptying) with the use of 5-point Likert scale before (BL) and 10 days after the start of intervention (EOT). Using visual analog scales (VAS), the palatability of the studied food was assessed at the beginning and end of the observation period. Results. Significant increase of stool frequency was found at the EOT compared to BL in KG (n=20), Mean±SD: 0.60±0.31 to 0.85±0.19 times/day; p=0.004, while there was no change in CG (n=20): 0.63±0.33 vs 0.72±0.28, p=0.6. Mean values of stool scale form increased in KG (3.0±1.2 to 4.4±1.0, p=0.001), while remained unchanged in CG (2.9±1.2 vs 3.4±1.2, p=0.6). Mean values of the Bristol stool scale in KG and CG differed significantly at EOT (p=0.018). Significant decrease in mean values of incomplete bowel emptying feeling was found in KG (1.88±0.78 at BL vs 1.41±0.56 points at EOT, p=0.015), but not in the control group. There were no statistically significant differences between patient's reports of the studied groups for other symptoms (bitterness and dryness in the mouth, heartburn, nausea, abdominal pain and heaviness in the stomach after eating). Conclusion. The effectiveness of a pasteurized fermented non-alcoholic drink based on kombucha enriched with inulin has been proven by reducing the intensity of complaints significant for constipation, normalizing the frequency and consistency of stools.

[Time perspective, sleep and wellbeing of the elderly during COVID-19 pandemic.]

The purpose of this study was to analyze the association between the time perspective and the psychophysiological state of the elderly during the pandemic COVID-19. 433 residents from 11 Russian cities aged 60,8±9,8 years (range - 50-94 years, women - 78,7%) took part in the study. During the online survey, each participant of the study provided personal data (place of residence, sex, age, height, and weight) and completed the Zimbardo Time Perspective Inventory, the Munich Chronotype Questionnaire, the Beck Depression Inventory and the Yale Food Addiction Scale. It was found that elderly people with a balanced time perspective had the lowest level of depression during the pandemic COVID-19 and less expressed sleep inertia at work days, while those with a past negative time perspective had the highest level of depression, high frequency of detection of food addiction and low sleep efficiency. The other types of time perspective (past positive, present hedonistic, present fatalistic and future) had intermediate values of indicators between these two extreme options. Thus, the conducted studies have shown that elderly people with a balanced time perspective showed the highest level of resistance to psychoemotional stress caused by the pandemic COVID-19.

[Association of nutritional patterns and arterial hypertension in Russia: does it exist?]

AIM: To evaluate nutritional patterns in patient with arterial hypertension (AH) compared to the control group without elevated blood pressure. MATERIALS AND METHODS: Retrospective search for unique records of the patients aged 1875 y.o. with complete data on usual nutrition with food frequency methods who had no mentions of diabetes mellitus, food intolerance or allergies, and history of major abdominal surgery, as well as signs of secondary reasons of AH. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Ststistical analysis was performed with the use of SPSS 13.0 for Windows software (SPSS Inc., USA). RESULTS: The data of 711 patients were available for the final analysis (595 of them in AH group). Both groups consumed lower compared to the recommended amounts of fruits, dairy and higher amounts of meat. Those with AH consumed larger amounts of vegetables (1.130.74 compared to the values of healthy eating pyramid vs 0.940.63 in the control group; p=0.004), fruits (0.800.66 vs 0.520.57; p=0.001), meat (1.851.05 vs 1.620.91; p=0.002) and fats (0.770.60 vs 0.490.55; p=0.001). On the other hand, there were lower rates of consumption of sugars, and confectionaries in the structure of nutritional patterns in patients with AH compared to the control group: (0.350.44 of the healthy eating pyramid in AH vs 1.930.98, in the control group; p=0.0001). CONCLUSION: Nutritional patterns of patients with arterial hypertension significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

[Association of thermal food processing methods and small intestinal bacterial overgrowth syndrome].

Small intestinal bacterial overgrowth (SIBO) is a widespread disease which antibiotic therapy is not effective enough and the relapse rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIBO or its relapses after treatment. The aim: to compare the patterns of thermal food processing methods in patients with and without SIBO. Material and methods. We performed retrospective single center database search to identify unique depersonalized records of patients with SIBO and the data of lactulose breath test and nutritional assessment with the use of 24-hours dietary recall. Inclusion criteria were complete data on patient's demography, adequate data of nutritional assessment and the lactulose breath test, absence of previous history of SIBO treatment in a special form of the database. In accordance with the results of lactulose breath test, patients were assigned into groups with the presence of SIBO with excess production of hydrogen (H2), methane (CH4), both gases (CH4-H2) or without SIBO (control group). According to the data of 24 h dietary recall, we divided all dishes and products consumed by a patient to 6 categories (Cat) depending on thermal food processing method: those that were not processed (raw) (Cat-r), boiled (Cat-bl), fried (Cat-f), stewed (Cat-s), baked in the oven (Cat-bk) or grilled (Cat-g). To analyze the structure of thermal food processing, we divided the weight of all products or dishes that underwent specific method of processing to the total weight of the food eaten. We did not take into the account the weight of thermally stable components like water and salt. The pattern of thermal food processing within each patients group was obtained as a quotient of the total percentage (by weight) of the food processed with the certain method by the number of patients in the group. Results and discussion. The data of 1108 patients were available for the final analysis: 602 patients in the SIBO-H2 group, 140 in the SIBO-CH4 group, 248 in the SIBO-CH4-H2 group, and 118 patients in the control group. The distribution of thermal food processing categories was in patients with SIBO-H2 as follows: Cat-r - 45.8±17.3%, Cat-bl - 31.9±15.7%, Cat-s - 3.5±7.7%, Cat-f - 6.3±10.4%, Cat-bk - 12.2±10.2%, Cat-g - 0.3±3.3%); in patients with SIBO-CH4: Cat-r - 47.9±17.4%, Cat-bl - 29.6±15.6%, Cat-s - 4.4±7.6%, Cat-f - 5.8±9.8%, Cat-bk - 12.3±10.4%, Cat-g - 0,2±2,7%; in patients with SIBO-CH4-H2: Cat-r - 45.6±16.3%, Catbl - 31.5±16.2%, Cat-s - 4.0±8.0%, Cat-f - 5.1±9.3%, Cat-bk - 13.4±10.8%, Cat-g - 0.4±2.3%. Similar results were obtained in the control group (Cat-r - 44.7±17.0%, Cat-bl - 32.6±16.5%, Cat-s - 2.7±6.0%, Cat-f - 5.5±8.0%, Cat-bk - 14.2±10.6%, Cat-g - 0.3±2.0%). There were no significant differences between the SIBO and control groups by mean percentage of raw, boiled, stewed, fried, baked and grilled food intake. Conclusion. We found no association between thermal food processing patterns and SIBO. It seems that thermal food processing patterns has no influence on SIBO and its variants.

[The role of dietary diversity in the formation of syndrome intestinal bacterial overgrowth].

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease of the quality of life. Antibiotic treatment of SIBO is usually effective, however, the recurrence rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIBO or its relapses after treatment. The aim of the study was to compare nutritional diversity in patients with SIBО-H2 and in healthy controls. MATERIAL AND METHODS: Оne thousand twenty three patients with suspected SIBО were examined. Hydrogen-methane breath test with lactulose was performed in 973 patients, the results of which identified groups with SIBO-H2 (n=522), with SIBO-CH4 (n=340) and without signs of SIBO (n=108). Data on food intake was collected with 24 h recall from all participants. Dietary diversity was assessed using method of calculation of unique values (count base diversity) for 11 groups of food: cereals, meat and eggs, fish and non-fish seafood, fat containing products, dairy products, nuts, vegetables, fruits and berries, confectionery, drinks, sauces and spices. The pattern of food diversity for each patient was obtained by counting the items in each of the studied food groups. Comparison of the mean values of the number of items in each of the studied food groups was used to compare food diversity in patients with and without SIBО-H2. RESULTS AND DISCUSSION: A comparison of nutritional diversity in patients with SIBO-H2 revealed a lower count base diversity in the groups of dairy products (2.70±1.37 vs 3.19±1.34, p<0.001), vegetables (5.50±2.22 vs 6.29±1.90, p<0.001), fruits (1.54± 1.38 vs 1.99±1.69, p=0.018) in compare with controls. Count base diversity in grains, meats, fishes, fat products, nuts and legumes and sweets did not demonstrate significant differences. CONCLUSION: Significant differences in the diversity of dietary patterns in patients with SIBО were found in dairy products, vegetables and fruits and berries. The obtained data may be used to develop diet for SIBO patients additionally to the treatment and prevention of its relapses.

[Features of nutrition pattern of patients with small intestinal bacterial overgrowth resistant to therapy].

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease in the quality of life. Antibiotic treatment with SIBO is not effective enough and the recurrence rate is high. Long-term dietary patterns can shift the composition of the microbiota. The aim of the study was to compare the pattern of nutrition of patients with SIBО, resistant to therapy and cured patients. Materials and methods. SIBO H2 has been identified in 458 patients using hydrogenmethane breath test with lactulose, and therapy with intestinal antiseptics and control breath test after 2 months was prescribed. 24 hour recalls or three-day food records were collected from all participants. The photographs were used to estimate the size of the portions eaten. According to food composition and portion all dishes in food diary were converted into constituent products by food groups, which were summed by weight per day and compared with the norms of consumption of the pyramid of healthy nutrition for a given caloric intake. The study compared dietary patterns of patients with resistance to the therapy of SIBO and those who had successful therapy. Results and discussion. Control of the hydrogen content in the exhaled air was performed only in 79 re-appeared patients, 38 (48.9%) of them in 2 months after therapy revealed the presence of SIBO H2>20 ppm. A comparison of the nutrition of these patients showed that patients resistant to therapy had higher consumption of buckwheat (0.41±0.47 vs 0.14±0.35 relative to the rate of consumption of cereals, p<0.001) and millet (0.036±0.11 vs 0.007±0.021, p=0.047), poultry meat (0.80±0.64 vs 0.54±0.62, p=0.01) and butter (0.54±0.24 vs 0.39±0.22, p<0.01). The diet of patients with resistant to SIBO therapy was also сharacterized by a lower consumption of mono- and disaccharides (75.2±32.7 vs 95.5±41.5 g/day; p=0.015) and cottage cheese (0.07±0.08 vs 0.17±0.19, p=0.018). Consumption of fruits and vegetables did not have significant differences. Conclusion. Treatment is ineffective in roughly half the patients with SIBO H2. According to the results of the study, significant differences in the nutrition pattern of patients resistant to SIBO therapy with respect to the consumption of cereals, poultry, butter, added sugars and cottage cheese were established. The obtained data may be used to develop dietetic maintenance of SIBO therapy and prevention of its relapses.

[Features of diagnosis and clinical picture of common dermatoses in the elderly and senile age.]

The review article presents data on common dermatoses in elderly patients. At present, this topic is practically not discussed in the Russian geriatrics. The urgency of the problem is increasing due to the increase in life expectancy and the deterioration in the availability of specialized care (in particular, dermatological care), especially for elderly patients. The review discusses a number of clinical cases in elderly patients. This article is addressed to geriatrics, general practitioners, general practitioners (family doctors).

[Association of food patterns with different forms of small intestinal bacterial overgroth syndrome and treatment efficacy].

AIM: To assess food patterns in patients with different types of SIBO and their impact onto the course and treatment outcomes. MATERIALS AND METHODS: The data of 988 patients who signed informed consent surved as a source data. On the basis of lactulose breath test (LBT; GastroCH4eck, Bedfont, UK), the patients were selected into one of the studied groups: SIBO-H2, SIBO-CH4, SIBO-CH4-H2 and control. Twenty - four hours food recall test was used to analyze nutritional habits. In patients with SIBO-H2, standard treatment with Tilichinol 100 mg/Tilbrochinol 200 mg (Intetrix, Beaufour-Ipsen International, France) 2 caps BID for 10 days) was provided. Efficacy of treatment was assessed on the bass of the result of LBT 2 month after treatment completion. Mann-Whitney T test (Statistica 10, StatSoft, USA) was used to compare nutritional patterns in patients with or without SIBO, in different types of SIBO and in accordance to the results of treatment. RESULTS AND DISCUSSION: Nine hundred eighty eight patients were enrolled. On the basis of hydrogene breath test they were divided into 4 main groups: SIBO of hydrogen - producing flora (SIBO-H2, n=526), methane - producing flora (SIBO-CH4, n=129), SIBO with hyperproduction of methane and hydrogene (SIBO-CH4-H2, n=225). The control group consisted of 108 patients with no no excessive gas production on LBT. In contrast to controls, nutritional patterns of patients with SIBO were characterized by low dietary fiber and amount of red meat dishes in the rations. Those with SIBO-CH4 consumed more fruits (p=0.03), vegetables (p=0.003), and fish (p=0.026), compared to those with other variants of SIBO and the control group. Nutritional patterns of SIBO-H2 group were characterized by larger amount of poultry meat consumption (p=0.026) compared to other SIBO groups and controls. In SIBO-H2 "cured" group greater amounts of buckwheat (p.

[Methanobrevibacter smithii in irritable bowel syndrome: a clinical and molecular study].

AIM: To assess the role of Methanobrevibacter smithii in patients with irritable bowel syndrome associated with small intestinal bowel overgrowth. MATERIALS AND METHODS: Sixty - seven patients with IBS according to Rome IV were enrolled into the study in whom hydrogen breath test was performed. Thirty - two healthy subjects with negative breath test was used as a control. All IBS symptoms assessed daily with 5 grade Lykert scale for 7 days, stool was assessed by Brystol stool scale. M. smithii was confirmed in stool samples by PCR. RESULTS AND DISCUSSION: In 67 IBS patients CH4 overproduction was found in 32 (47.7%), H2 overproduction in 31 (46.2%) and normal values in 4 (5.9%) by hydrogen breath test. M. smithii was confirmed by stool PCR in all patients with CH4 overproduction. Severity and prevalence of main clinical features of IBS were similar in both SIBO groups but were significantly higher than in control (p.

[The role of the intestine microbiota in the development of obesity].

Medical societies all around the world have been alarmed by the problem of obesity and the diseases related to it. You can call it pandemic. Nowadays, obesity is viewed as a chronic condition that requires proper treatment. People suffering from it typically consume a larger amount of food, which in turn leads to changes in intestinal microbiome. Furthermore, obese people possess a specific kind of microflora, which might influence on the structure of human genome. Changes of intestine microflora depend on age, point of residence, culture specifics, lifestyle and socio-economic status. Currently, we can adjust intestinal micloflora by presenting pro- and prebiotics, which we believe might help in improving obesity level.