[Analysis of age-related incidence (by circulation) of age-associated pathology in 2018-2023 on the example of the municipal polyclinic of Saint-Petersburg.]

From the age of 25-30, the likelihood of developing pathological processes associated with aging begins to increase. Age-associated diseases (AAD) are a heterogeneous group of pathologies that are more likely to develop as they age. Clinically, the early development of AAD is identical to premature aging with all the ensuing consequences. Timely targeted detection of AAD will slow down age-related processes. In order to study the peculiarities of age-related morbidity (by circulation), age-associated pathology, the study included 5 600 people with a newly diagnosed diagnosis who applied to the municipal polyclinic of St. Petersburg in 2017-2023. During the study, heterogeneity of the timing of the manifestation of AAD at the population level was found. In addition, the median age of patients was comparable to the value of the developed age-specific incidence index, which serves as a basis for continuing research in order to comprehensively assess the properties and limitations of the considered indicator.

[Economic index - predictor of premature aging.]

It is widely known that in economically developed countries there is an increase in the proportion of older people. However, the problem of the influence of territorial features of economic development on the rate of population aging is not sufficiently covered. The goal was to study the impact of economic development indicators (EDI) on the processes of premature aging of the population. The materials were statistical collections of the Ministry of Health of Russia and Russian Statistics Service for 2011-2019. The highest incidence was characteristic of cataracts and glaucoma. A direct correlation has been established between the EDI and the age-specific incidence index (ASII) of cataracts (r=0,31; p=0,00436). A group of regions with a high level of economic development was characterized by a higher value of ASII, which, as a rule, corresponds to the later development of the disease.

[Accelerated population aging as a consequence of the COVID-19 pandemic (review).]

The COVID-19 pandemic has had an impact on many aspects of human life. One of the consequences of the coronavirus period was the accelerated aging of the population. This fact is confirmed in the works of many scientists. Here are some of the results of the impact of SARS-CoV-2 infection on human health: telomere shortening, increased neurodegenerative disease, dysfunction of the executive system, cognitive impairment, increased risk of cardiovascular and cerebrovascular disease, depression, dementia, disability, lack of involvement in healthy behavior, increased levels of circulating troponin I and natriuretic peptides, problems with coagulation, low expression of angiotensin-converting enzyme 2, DeltaAge acceleration, early vascular aging, external signs of accelerating human aging processes, increased urea and creatinine concentrations. The list is extensive, and it is constantly being replenished. It is important to continue to disclose the mechanisms that underlie certain consequences of coronavirus infection in order to try to reverse them and ensure people healthy biological aging.

[Prognostic potential of inflammatory factors in older patients diagnosed with COVID-19.]

The COVID-19 pandemic requires a quick and accurate diagnosis and assessment of the condition of patients, correctly chosen by the tactics of treatment and prediction of the course of the disease, especially in older patients. The most promising direction is the study of the potential of inflammatory factors among people over 60 years of age. This paper analyzed serum level characteristics of analytes such as C-reactive protein, procalcitonin, IL-6, troponin, ferritin and brain natriuretic peptide. The findings demonstrate the prognostic value of IL-6 and procalcitonin in both middle-aged and older-aged individuals. For people of senile age, the diagnostic informativity of both IL-6 and Pct reached an acceptable level. C-reactive protein is statistically significantly higher in fatal patients.

[Features of the coefficient of variation of hematological indicators in persons of middle, elderly and senile age with pneumonia.]

Pneumonia is the leading mortality rate among all infectious diseases. It has been established that the reliable risk group for morbidity and mortality from this nosology includes persons over 60 years of age, and with age the severity of the disease only increases. According to literary data, one of the reasons for the decline in adaptation capabilities of older persons is the phenomenon of «age desinhronosis¼, which manifests itself in significant fluctuations in the parameters of the internal environment of the body. The purpose of this work was to compare the coefficients of intra- and interindividual biological variation. For this purpose, a retrospective study of clinical blood analysis in patients suffering from pneumonia of unspecified etiology was carried out in terms of three age groups: medium, elderly and senile. Features of biological variation depending on age have been found, the differences identified have been justified according to available theories.

Results and Prospects of Using Activator of Hematopoietic Stem Cell Differentiation in Complex Therapy for Patients with COVID-19.

The paper presents the results of a standard and complex treatment method using the peptide drug thymus thymalin in patients with COVID-19. One of the mechanisms of the immunomodulatory effect of thymalin is considered to be the ability of this peptide drug to influence the differentiation of human hematopoietic stem cells (HSCs). It was found that, as a result of standard treatment, patients in the control group showed a decrease in the concentration of the pro-inflammatory cytokine IL-6, C-reactive protein, D-dimer. The addition of thymalin to standard therapy accelerated the decline in both these indicators and the indicators of the T cell system. This has helped reduce the risk of blood clots in COVID-19 patients. The revealed properties of the thymus peptide preparation are the rationale for its inclusion in the complex treatment of coronavirus infection. Peptideswith potential biological activity against SARS-CoV-2 virus [29]. Note: Nitrogen atoms are shown in blue, oxygen atoms - in red, carbon atoms - in gray, hydrogen atoms - in white, and phosphorus atoms - in yellow.

[Age and nosological structure of ophthalmological diseases of patients of the ophthalmological center of Saint-Petersburg in 2015-2019.]

About 1,3 billion people live on our planet with visual disorders such as cataract and glaucoma, the prevalence of which is significantly higher in the elderlypopulation. Eye diseases remain a global medical, social and economic problem, associated with both the progression of the disease to blindness and the lack of pathogenetic therapy methods. A retrospective analysis of the long-term dynamics and structure of cases of ophthalmological diseases of patients treated in a large multidisciplinary hospital was carried out. The age and nosological structure of eye diseases is described. Natural features of the structure of diseases relative to different age groups have been revealed, as well as patterns in dynamics have been found.

[Features of the picture of blood cells in elderly persons with primary open-angle glaucoma.]

Around 1,3 billion people live worldwide with visual analyzer disorders such as glaucoma and cataract. These diseases are particularly common among the elderly. From glaucoma every year 10 million people completely lose vision, one of the factors of which is untimely diagnosis. Donosological diagnosis and laboratory screening can play a key role in detecting this pathology and significantly improving the quality of life of the older generation. The article presents the results of comparative analysis of the general blood analysis of glaucoma patients with a control group. The hematological indices are also compared by sex and age. Changes in some indicators consistent with existing theories of glaucoma pathogenesis have been identified. Promising directions of application of general blood analysis as a routine method of additional diagnostics of glaucoma in the future are planned.

[Laboratory predictors of glaucoma in patients with middle and old age - a tool to improve the quality of life (literature review).]

There are about 1,3 billion people worldwide with visual disorders such as cataract and glaucoma, the prevalence of which is significantly higher in elder persons. Eye diseases remain a global medical, social and economic problem, associated with both the progression of the disease up to blindness and the lack of pathogenetic therapy methods. Timely detection of pathology is secondary prevention of glaucoma. At present, a number of diagnostic techniques have been developed, including mainly instrumental techniques. Undoubtedly, laboratory indicators should be used as screening methods of early diagnosis. Today, a group of biomarkers with different degrees of sensitivity and specificity has been identified. However, these markers have some difficulty in indicating. Finding signs of glaucoma in complete blood count is an important task. Glaucoma is recognized as a systemic disease, which should be reflected in the change in morphofunctional properties of blood elements.

[Algorithm to stratify the risk of myocardial infarction in patients with acute coronary syndrome at primary examination.]

The episode of acute coronary syndrome is most often preceded by the development of systemic and local inflammation, which plays a significant role in the pathogenesis of the disease. General clinical blood analysis, directly or indirectly reflecting systemic pathological processes in the patient's body based on quantitative and morphological assessment of blood composition, is one of the most affordable methods of laboratory diagnostics in modern public health. Taking into account the growing number of digital data obtained by diagnosticians from analytical systems, there is a growing potential for the use of machine learning methods to increase the effectiveness of provided diagnostic information in the interests of the patient. The aim of this study was to create an algorithm for stratifying the risk of myocardial infarction based on the methods of machine learning in patients with acute coronary syndrome at primary examination. A prospective pilot study was conducted. In total 307 patients with acute coronary syndrome (169 men and 138 women) were examined. The average age of patients was 68.6 ± 12.5 years. Retrospectively, the patients were divided into two groups: the main group - patients with the final diagnosis "Myocardial infarction" and the control group with the diagnosis "Unstable angina pectoris". All patients at hospitalization at the primary laboratory examination along with the study of the concentration of cardiac troponin I by a highly sensitive method were examined by a general clinical bloodanalysis on an automatic hematological 5-diff analyzer. As a result of the application of the ensemble method as a method of machine learning and artificial neural networks as 6 independent models of the ensemble it was possible to achieve the area under the ROC curve = 0.77 on the test set when assessing the quality of patient stratification. Taking into account the volume of the training sample in 214 patients and the results of similar studies, the achieved stratification quality can be considered acceptable and promising for further accumulation of the database with the purpose of additional training of the developed algorithm and improvement of the disease prognosis accuracy characteristics.

[The value of in vitro diagnostic testing in the provision of medical care to patients with cardiovascular diseases.]

In vitro diagnostics are used at all stages of patient care. The aim of this study was to assess the impact of laboratory examination on clinical decision-making in providing medical care to patients with a cardiovascular profile. We also took into account the level of financing for the laboratory industry in the Russian Federation. We divided our study on three sequential steps: literature review, survey of clinicians and test-survey of clinicians. The share of costs for the laboratory tests in 2017 amounted to about 8% of the total funding for Russian health care. About 80% (70; 90) of the visits of the attending physicians are associated with the appointment of laboratory tests. Among patients who were prescribed any laboratory test - in 62.1% (95% CI 16.9-24.9) cases, the results of these tests influenced clinical decision making related to the initiation, modification or termination of any treatment. All visits of clinicians were divided by purpose: tests were prescribed in almost 100% (90; 100) cases during the initial examination, in 40% (20; 60) cases during repeated visits, and in 40% (15; 40) cases when patients were examined before discharge. In more than half of cases (57,4%; n=31), doctors correctly assumed about the about the share of financing of the laboratory industry. The majority of respondents considered the amount of expenses adequate and recommended to maintain the current level in the future. According to attending physicians, new laboratory markers should demonstrate additional information about clinical relevance to improve patient outcomes. Thus, in current economic realities, future laboratory tests should be financially maximally available and at the same time be clinically highly effective auxiliary instruments. It creates new challenges in finding laboratory biomarkers and putting them into clinical practice.

[Evaluation of hyperglycemia impact on outcomes of acute coronary syndrome in elderly and senile patients.]

Acute coronary syndrome (ACS) in elderly and senile patients has a number of features and requires special attention to providing medical care. These patients is associated with significant comorbidity and atypical symptoms in the course of the disease. Diabetes mellitus is a common background disease in patients with ACS.A retrospective cohort study was performed, 2945 patients with ACS were examined. Patients were divided into three age groups: group 1 - patients aged 18 to 63 years; group 2 - patients aged 64 to 75 years; group 3 - patients older than 75 years. Number of patients with glucose concentrations above 11.1 mmol/L is significantly higher in elderly and senile groups than in group of patients from 35 to 59 years old. The number of patients with impaired renal function after administration of a contrast medium in the study group with ACS increased with increasing age. Significant difference was revealed between the middle and senile age groups, as well as between the elderly and senile age groups. An increase in the relative number of patients with fatal outcomes in groups with a significant increase in glucose levels was revealed. The connection between the pathological level of glucose and repeated myocardial infarction is proved. Conclusion. The presented statistical picture suggests a particularly high risk of recurring cardiovascular events among patients with ACS and pathological glucose levels. The correlation between the number of deaths and glucose levels during the initial examination allows the use of glucose tests as an additional criterion in the stratification of risks and outcomes in patients with ACS.

[Results of troponin I testing by high sensitive method in three age groups of healthy population].

Article is about troponin I testing by high sensitive method in healthy population group. 165 people (employees of hospital) were examined, 71 % - women and 29 % - men. Inclusion criteria were as follows: absence of active complaints at the time of health examination and during the previous 30 days. All the examinees were divided into three age groups: 18-34 years (middle age, I period), 35-54 years (middle age, II period), above 55 years (old age). Research of correlation between cardiac troponin I and age of healthy population group was the main aim of investigation.

[Digoxin in elderly patients: therapeutic drug monitoring to increase the efficiency of therapy (a review)].

The focus of this review is on cardiac and non-cardiac effects of digoxin, a drug used for treating the heart failure, and on link between these effects and the serum digoxin concentration (SDC) in different dosing regimens. Elderly patients are at the spotlight, as they are both at high risk and high potential benefit from digoxin therapy, explaining potential usefulness from SDC monitoring in this cohort of patients. The laboratory and clinical approaches used to prevent digitalis intoxication are reviewed, with regard to their fidelity, clinical value, and practical usefulness. The role of endogenous cardiotonic steroids, sharing structural and functional similarity to digoxin and affecting the diagnostic value of laboratory tests, is also discussed.

[The lipids peroxidation and atherogenesis level in aged patients].

The data presented have described the diagnostic possibilities of chemioluminescence' intensity research in patients with atherosclerosis. The investigation has been conducted on 48 aged patients with ischemic heart disease. Statistically significant correlation between chemoluminescence' intensity and atherogenesis factor as an atherosclerosis indicator was revealed.

[The first successful bilateral lung transplantation in Russia].

Lung transplantation is one of the most difficult fields of contemporary transplantology. The operation was performed on a 53-year-old female who had been suffering from terminal stage COPD. The period of cold ischemia for the right and left lung was 1 hour 30 minutes and 2 hours 25 minutes respectively. The total operation time was 4 hours and 40 minutes. There were no surgical complications. There were no signs of transplant rejection 6 weeks after the operation. The considerable decrease in dispnea and increase in quality of life were registered during the follow-up. FEV1 was increased by 80% and 6 minute walk test distance was increased by 200 meters.