[Visual deficit as a marker of cognitive impairment.]

Glaucoma and cataract continue to be the leading causes of visual deficits, especially in older age groups, but the association of visual deficits with cognitive impairments has not been sufficiently studied. The aim of this study is to study visual impairment as a marker of cognitive impairment in patients with cataracts and glaucoma. The study included 326 elderly patients with cataracts and 318 elderly patients with primary open-angle glaucoma. The degree of cognitive impairment was determined using the Mini-Mental State Examination (MMSE) scale. Visual deficit was assessed by visual acuity without correction and maximum corrected visual acuity, and the severity of visual deficit was assessed by the scale we proposed. It was found that with low visual deficit (visual acuity without correction 0,51-0,60 and over 0,61) in the examined patients, the average score on the MMSE scale varied from 28,4±0,6 to 28,7±0,8 points (p>0,05), corresponding to subjective cognitive disorders. However, with a pronounced visual deficit (visual acuity without correction to 0,20 and 0,21-0,30), the average score is 13,9±0,3 and 16,5±0,4 (p<0,001), which indicates moderate dementia. Practically similar patterns about the association of cognitive impairments with the magnitude of visual deficit were also obtained when assessing visual deficit by maximum corrected visual acuity. The associativity of cognitive impairment with visual defect in patients with cataract and glaucoma was confirmed by the correlation method, according to which the correlation coefficient with visual acuity without correction is r=+0,428 (p<0,05), and with maximum corrected visual acuity - r=+0,385 (p<0,05). The results of the study allow us to consider visual deficit as a marker of cognitive impairment.

[The effect of sarcopenic obesity and age-associated ophthalmopathology on patients' daily activities.]

Along with an increase in the number of elderly and senile populations, there will simultaneously be an increase in the prevalence of age-associated ophthalmopathology and sarcopenic obesity, which can potentially contribute to a decrease in patients' activities in everyday life, but the latter remains practically unexplored, and if analyzed, then without the use of special scales for patients with visual organ pathology or quality of life indicators. The aim of the study was to study the effect of sarcopenic obesity and age-associated ophthalmopathology on the activities of patients in everyday life. 125 mature and elderly patients suffering from sarcopenic obesity combined with cataract and 138 patients of similar age with sarcopenic obesity combined with glaucoma were examined. Sarcopenic obesity was detected by the presence of obesity with a body mass index ≥30 kg/m2 and sarcopenia on the scale of the European Working Group on Sarcopenia in older people, supplemented by carpal dynamometry. It was found that, in comparison sarcopenic obesity with age-related cataracts, it has a more significant effect on changing activities in daily life, contributing to the formation of complete dependence on outside help (12,18 points) compared with sarcopenic obesity and glaucoma (10,18 points), p<0,001, when moderate dependence on others was found. However, regardless of the nosology of the ophthalmic disease, in both clinical groups, the leading limitations of activities in daily life were needle threading (1,84±0,03 vs 1,52±0,02 points), nail clipping - 1,75±0,03 vs 1,43±0,04 points, respectively. The results obtained can be used in gerontology in the implementation of measures to correct and maintain functionality in the daily life of patients with sarcopenic obesity combined with glaucoma and cataracts.

[Telmisartan chronotherapy and its influence on the indicators of the daily profile blood pressure.]

Arterial hypertension is one of the most common life-threatening diseases, adequate control of which is largely achieved by antihypertensive drugs, including the use of telmisartan. The aim of the study was to evaluate the effect of telmisartan chronotherapy on the parameters of daily monitoring of blood pressure during the daytime and at night in elderly patients with hypertension. The study is based on a comprehensive examination of 150 patients aged 60-74 years suffering from hypertension, who are divided into 2 groups: the main (n=76) and control (n=74). Patients with hypertension in the main group received telmisartan at a dose of 80 mg/day in the evening (20.00-22.00 hours), and in the control group - in the morning at the same dose (80 mg/day). Before treatment, after 3 months and after 6 months, patients of both groups underwent daily monitoring of blood pressure with the «BPLab monitor Mn SDP-3¼. It was found that the evening intake of telmisartan at a dose of 80 mg/day has a more significant effect than the morning intake of the same dose of telmisartan on the indicators of daily monitoring of systolic blood pressure and diastolic blood pressure in the evening, the systolic blood pressure time index in the evening. Chronotherapy with telmisartan in elderly patients with hypertension more effectively normalizes the daily blood pressure profile with the transfer of «non-dipper¼ to «dipper¼, reduces the hypertensive load and contributes to the achievement of target blood pressure levels.

[Complex treatment results in a congenital glaucoma patient (case report)]. / Rezul'taty kompleksnogo lecheniia patsienta s vrozhdennoĭ glaukomoĭ (klinicheskiĭ sluchaĭ).

Early diagnosis of congenital glaucoma allows surgery to be performed at the stage of reversible glaucomatous alterations of the optic disc and retina. In primary congenital glaucoma, the main reason for visual acuity reduction following surgical stabilization of the intraocular pressure are corneal changes. These include an increased corneal diameter, Haab's striae, areas of thickening and a greater posterior elevation. The resultant irregular astigmatism leads to amblyopia and a marked decrease in visual acuity. Active pleoptic treatment started from a very early age in children operated on for compensated congenital glaucoma provides them an opportunity to achieve high visual acuity and full rehabilitation.

[The characteristics of the immune status of patients with Alzheimer's disease]. / Nekotorye osobennosti immunnogo statusa patsientov s bolezn'iu Al'tsgeimera.

Disorders seen in patients with Alzheimer's disease are also related to the pathology of immunity. In order to study it in a more detailed manner, some immunity parameters were examined in 30 patients with Alzheimer's disease, 15 patients with Huntington's chorea which may have similar mechanisms of immunologic defects, and 15 healthy donors. A study was also made of the capacity of peripheral blood lymphocytes to respond to polyclonal mitogens in blast transformation test and according to the production of immunoglobulins in vitro. The subpopulation composition of these cells was investigated as well. A significant rise of the count of C 8+ lymphocytes, depression of proliferative response, low spontaneous and high Phytolacca mitogen-stimulated immunoglobulin production have been revealed. The changes recorded in Huntington's chorea had the same nature of development. The disorders revealed allow a conclusion about an important role that may be played by the immune system in these degenerative diseases of the brain.

[Comparison of proliferative and immunoglobulin-secreting capacity of peripheral blood lymphocytes of healthy persons and patients with B-cell immunoproliferative diseases]. / Sravnenie proliferativnoi i immunoglobulin sekretiruiushchei sposobnosti limfotsitov perifericheskoi krovi zdorovykh liudei i bol'nykh s B-kletochnym immunoproliferativnym zabolevaniem.

The proliferative response and in vitro immunoglobulin production induced polyclonal activators were studied in 12 patients with multiple myeloma (MM) and in 15 healthy individuals. The spontaneous production of IgM was decreased. PWM-induced immunoglobulin production of the peripheral blood lymphocytes was the same.