[Antipsychotics: features of undesirable adverse reactions in elderly and senile age]. / Antipsikhotiki: osobennosti nezhelatel'nykh pobochnykh reaktsii u lits pozhilogo i starcheskogo vozrasta.

This review summarizes and systematizes currently available literature on antipsychotics as one of the most frequently prescribed group of psychotropic drugs. Based on published data from clinical studies and meta-analyzes, the authors consider unwanted adverse reactions in patients taking antipsychotic medications. Mechanisms of development of undesirable drug reactions are discussed. Special attention is paid to those adverse reactions of antipsychotics that most often occur in old and very old age (increased risk of adverse cardiovascular and cerebrovascular events, sudden death, prolonged QTc interval, falls, fractures, orthostatic hypotension, extrapyramidal disorders, pneumonia, urinary tract infections, etc.).

The morphofunctional features of platelets against the background of metabolic syndrome in patients with generalized marginal periodontitis.

According to modern ideas, disorders in the system of hemostasis in cardiovascular diseases are mainly due to an increase in the functional activity of platelets, namely their increased ability to adhere and aggregate. Aim of the research was to evaluate morphofunctional platelets of patients with marginal periodontitis. Material and methods of the study involved 129 men aged 28-50 years (mean age 42.97 ±â€¯1.31 years) suffering from a MS with generalized periodontitis of mild and moderate degree. We also formed a control group of 90 practically healthy men (mean age 42.17 ±â€¯1.34 years). Exclusion criteria are symptomatic AH, unstable angina, myocardial infarction or stroke in history, severe chronic heart failure, severe liver and kidney disease, diabetes, complete secondary adentia. Patients were performed the dental examination with determination of community periodontal index of treatment needs (CPITN), X-ray examination, physical examination with determination of anthropometric data, as well as clinical, the definition of MS laboratory criteria, insulin resistance indices, 24-h blood pressure monitoring. Platelet morphology was studied using scanning electron [17 clauser] microscopy (PhilipsPSEM 550 h) on samples prepared by a special method. The results of the study of platelet morphology in patients with MS and control group revealed a non-uniform pattern. The number of platelets in both groups being almost equal (249,6 ±â€¯8,3х109/l and 256,8 ±â€¯8,7х109/l respectively). Conclusion: The presented data provide strong evidence for changes in the morphofunctional state of peripheral blood platelets in patients with generalized marginal periodontitis of mild and moderate degree against the background of metabolic syndrome.

[Dynamics of morphological structures of platelets in patients with ischemic heart disease in dependence on blood levels of fatty acids].

Levels of fatty acids in platelets of ischemic heart disease (IHD) patients (n = 39) has been compared with those in healthy subjects (n = 12). Increased content of arachidonic acid and thromboxane A2 in platelets of IHD patients forms thrombogenic picture of IHD. High level of fibrinogen and decrease in heparin and antithrombin III in IHD patients facilitates formation of blood clots. Morphological examination of platelets in IHD patients has demonstrated an increase of levels of discocytes and spherocytes as well as appearance of small and large platelet-erythrocyte aggregates promoting blood slot formation.

[The role of prostaglandins in platelet aggregation in metabolic syndrome].

The role of metabolic products of arachidonic acid and thromboxans in metabolic syndrome was evaluated in 42 patients and 16 healthy subjects. The levels of arachidonic acid and thromboxane were shown to be elevated in patients with metabolic syndrome which accounted for enhanced platelet aggregation in response to ADP, adrenaline, and collagen. It is concluded that that decreased level of cyclic nucleotides (cAMP) and prostacyclin in combination with a rise in the content of Willebrand factor in patients with metabolic syndrome is a major contributor to the development of platelet activity.

[Reactions of sympatho-adrenal system in patients with ischemic heart disease during emotional stress in dependence on the personality type].

The object of the study was to show the relationship between emotional stress and excitation of the sympathoadrenal system in healthy subjects and patients with coronary heart disease (CHD). Seventy eight healthy subjects and 40 CHD patients of the II-III functional class were under medical observation. Emotional tension was simulated by two methods: arithmetic under conditions of time deficit (Krepelin counting) and work in a homeostat. Homeostat simulation of emotional tension turned to be more stressogenic than Krepelin counting. In CHD patients, increase of adrenaline and noradrenaline levels was demonstrated in the condition of the emotional tension simulation. Two personality types were distinguished as type A (leaders) and type B (subordinates). The increase in the catecholamine level was especially pronounced in CHD patients of type A (leaders).