[Association between emotional disorders and ophthalmopathology in residents of the Arkhangelsk region at the age of 60-74 years.]

A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly people. The study included 678 participants of the ESSE-RF3 population study in the Arkhangelsk region in the age of 60-74 years. We used a questionnaire, including the hospital scale of anxiety and depression score (HADS), and the assessment of the ophthalmological status. It was found that all the study participants had diseases of the visual organ. Elevated depression scores were associated with sex, age, marital status (being single), and disability, elevated anxiety scores - with sex. The scores on the anxiety scale were on average 25% higher in participants whose visual acuity decreased to 0,5 units, and showed no independent associations with diagnosed ophthalmological diseases. The scores on the depression scale were on average 33% higher in participants with visual acuity 0,5 units, and 22% higher in the presence of retinopathy. In conclusion, anxiety and depression in the elderly people were more associated with visual deficits rather than with the presence of ophthalmological diseases underlying a decrease in functional status.

RS4673 and pon1 level in blood plasma - new prospects in prediction and early diagnostics of anthracycline-mediated cardiotoxicity.

The purpose of this study was to research the effectiveness of molecular genetic tests based on the determination of the rs4673 CYBA polymorphism (c.242C>T) and the level of paraoxonase 1 (PON1) in the blood plasma of patients with breast cancer (BC) for predicting and diagnosing anthracycline-mediated cardiotoxicity (AMC). The genotyping of rs4673 CYBA (c.242C>T) and the study of the PON1 level in the blood plasma of 280 patients of the Caucasian type with a histologically verified diagnosis of breast cancer, who received complex treatment on the basis of the National Medical Research Center of Oncology, were carried out. Based on the results of observation for at least 8 months, two groups were identified: group 1 (257 people) without diagnosed cardiovascular changes; group 2 (23 people) - patients with subacute and early chronic AMC. It was found that carriers of the rs4673 polymorphism increase the likelihood of developing AMC by 6.8 times (p = 0.001). In the blood plasma of both groups of patients, an increase in the level of PON1 was described after the fourth course compared to the initial level (group 1 - p = 0.036, group 2 - p = 0.048). The level of the studied enzyme was higher in the blood plasma of patients with diagnosed AMC compared with patients without cardiovascular complications (before chemotherapy - p = 0.001, after the fourth course - p = 0.023). The test based on the measurement of the concentration of PON1 in the blood plasma of patients after the fourth course of chemotherapy was distinguished by high quality metrics: sensitivity - 100%, specificity - 70.8%, area under the ROC-curve (AUC) - 0.825 with a threshold level of PON1 equal to 2, 9 ng/µL. The presence of the T/T genotype caused a high level of PON1 in the blood plasma after the fourth course of chemotherapy (p = 0.012). The results of our work are of undoubted practical importance, since they allow us to obtain data on the prognosis and diagnosis of a patient in a short time, which can later be verified using clinical and instrumental methods.

[Relationship between mental and physical disorders in old age and senility.]

In order to identify the relationship between mental and physical disorders in the elderly and senile age, 70 patients were examined in one of the clinics in Arkhangelsk, including 56 (80%) persons aged 60-74 years and 14 (20%) people aged 75 years and older. A questionnaire was conducted, data from outpatient records were studied, and the clinical status assessment was used, as well as methods for determining mental and physical condition. The most frequent mental and physical disorders were the cognitive and depressive disorders presence, a high risk of malnutrition syndrome, sarcopenia and falls syndrome, reduced functional capabilities, while senile patients had significantly more pronounced disorders. It has been shown that the cognitive and depressive disorders presence in the elderly and senile increases the falling syndrome risk and reduced functional capabilities, and in old age - sarcopenia syndrome.

[The modern characteristics of quality of ambulatory polyclinic medical care of patients of elderly age].

The organization of out-patient care of elderly people has its own clinical and organizational characteristics. The study was carried out to establish quality factors of ambulatory polyclinic medical care of elderly people from the position of attending physician. The sampling consisted of 80 physicians interviewed. Out of them 70 were females (87.5%), 50 local therapists and general practitioners and 30 physicians of various specialties. The genuinely elaborated questionnaire was applied. Results and discussion. It is established that most physicians are aware of the need of improving quality of medical care of elderly patients and developing geriatric care. The percentage of elderly patients in ambulatory polyclinic network makes up to 50%, and in particular cases up to 60-70%. The majority of elderly patients visit their physician 1-2 times per month. More than 50% of physicians consider elderly patients have to be observed by physicians of geriatric profile that confirms actual need in this medical specialty. The social and organizational factors of quality of medical care are identified: insufficient duration of physician admission, low level of preferential medications support, lacking of cash resources in patients to purchase prescribed medications, difficulties in making an appointment to medical specialist and district physician, difficult access of medical organization. The orientation of doctors in provision of care to elderly patients only to medication therapy is established. Conclusion. The specific characteristics of identified factors of quality of medical care of elderly patients are to be considered in developing directions of optimizing medical care for this contingent.

[Efficiency of chronic apical periodontitis treatment with use of Granulotec endodontic sealer]. / Éffektivnost' lecheniia khronicheskogo periodontita s ispol'zovaniem materiala Granulotec dlia postoiannoi obturatsii kornevogo kanala.

AIM: Efficiency assessment of Granulotec (PD) endodontic sealer for root canal permanent obturation in patients with apical granuloma basing on clinical and radiological data. MATERIAL AND METHODS: Endodontic treatment of 35 teeth with apical granuloma was performed in 22 patients with root canal obturation by means of lateral condensation with Granulotec sealer. Bone remodeling in periapical area has been estimated in 1, 3, 6 and 8 months with PAI index. RESULTS: Endodontic post-operative pain has been observed in 5 (14.3%) cases of 35, pain duration varied 1 to 5 days, NSAIDs use hasn't been required. During observation period 2 teeth have been excluded from the test group (one case of periapical abscess with sinus tract and one case periapical abscess without sinus tract). In the end of observation period complete bone remodeling was observed in 30 cases, the periapical lesion size significant reduction was achieved in 2 cases, periapical lesion stabilization - in 1 case. The overall success rate was 91.4%. The mean PAI value decreased from 4.2±0.2 to 1.4±0.2. CONCLUSION: The Granulotec (PD) use for one visit chronic apical periodontitis treatment allows achieving positive results with low complications risk.

[Cognitive and affective disorders in the elderly].

To develop algorithm of diagnostics of cognitive and affective disorders in elderly and senile age 98 representatives of this age group were examined (1st group - 68 persons 60-74 years, 2nd group - 30 patients older than 75 years). For the diagnosis of cognitive disorders the developed and adapted «Short rating scale of cognitive functions¼, to diagnose emotional disorders - «Ðospital scale of anxiety and depression HADS¼ were used. Cognitive impairment was revealed in 39,8% of the elderly (1st group - 28,7% in 2nd group - 61,6%). Affective disorders 51,6% of respondents had; however, signs of anxiety - 40,9% and depression - 27,7%. Algorithm for the diagnosis of cognitive and emotional disorders in elderly and senile age, comprising the steps of: screening and diagnostic, clinical and pathopsychological, laboratory and instrumental diagnostic, psychodiagnostic, can be recommended for use in general medical practice (therapists, general practitioners, geriatrics) for an earlier secondary prevention and, if necessary, early correction of mental health disorders.

[DIAGNOSIS OF EMOTIONAL SPHERE DISORDERS IN ELDERLY].

The article describes the structure of criteria of severity and recommendations for the diagnosis of emotional sphere disorders in elderly. An algorithm for diagnosis of emotional sphere is described, which includes four phases: screening and diagnostic, clinical and patho-psychological, laboratory and instrumental diagnostic, psycho-diagnostic; it can be applied as to estimate the prevalence of various forms of emotional disorders, and for their early correction and prevention at the individual level. The criteria of anxiety expression evaluation and asthenic disorders are presented. The recommendations can be used in the activities of somatic practices doctors (therapist, general practitioners, neurologists).

[THE LONG NON-CODING RNA ASSOCIATED WITH CANCEROGENESIS: BIOLOGICAL SIGNIFICANCE AND PERSPECTIVES OF APPLICATION IN DIAGNOSTIC].

The last decade is characterized by development of such technologies as RNA-sequencing and biochips which resulted in discovery of new perspective biomarkersfor personalized diagnostic of cancer. Among them, the long non-coding RNA (IncRNA) are of special interest because according the recent studies they are positioned as important regulators of gene expression on epigenetic, transcription and post-transcription levels. The review considers the role of long non-coding RNA in cancerogenesis. The corresponding of their application in diagnostic is evaluated. A number of examples ofperspective diagnostic and prognostic markers. Their degree of implementation in oncological practice is discussed.

[DIAGNOSIS COGNITION IN ELDERLY].

This article provides recommendations for the diagnosis of cognitive in the elderly. An algorithm for the diagnosis of cognitive impairment, including four stages (clinical psychopathological, express psycho-diagnostic, clinical psycho-diagnostic, instrumental), which can be used to identify elderly patients with preclinical forms of cognitive impairment and implementation of primary and secondary prevention efforts is presented; determination of the degree of cognitive impairment (mild, moderate, severe) in the elderly can recommend the future directions of medical and rehabilitation care. Recommendations can be used to provide guidance to general practitioners.

[Epidemiological characteristic of non-psychotic mental disorders in elderly persons in Arkhangelsk region].

The epidemiological characteristic of non-psychotic mental disorders (NMD) in elderly persons in the Arkhangelsk region in 1999-2010 has been studied. The results of the study show that the NMD prevalence among the elderly persons in the Arkhangelsk region was 07-1.1%; in the morbidity dynamics, there has been registered an increase in the number of the NMD cases among the elderly persons with the increase peak in 2007 and the tendency of development beginning from 2009. In NMD structure the organic nonpsychotic disorders and neurotic and somatoform disorders predominated. Since 2010, a tendency of a decrease in the share of organic non-psychotic disorders (up to 58.5%), an increase in the share of neurotic and somatoform disorders (up to 32.2%) and personality disorders (up to 4.2%) are observed. An analysis of specificity of psychotherapy delivery has been done, a necessity of registration of the NMD prevalence and structure, the comorbide pathology, the age and social-economic characteristics of the elderly persons has been grounded.

[The activity of peroxidation of lipids in biologic samples of patients with recurrent diseases of upper respiratory tracts].

The parameters of peroxidation of lipids in blood and saliva were analyzed on sampling of 60 patients with recurrent diseases of upper respiratory tracts during period of remission. It is established that the content of primary and secondary products of peroxidation of neutral lipids in blood plasma is lower as compared with healthy persons. The content of end products of peroxidation of neutral lipids and products of oxidation of phospholipids in blood plasma is higher as compared with healthy persons. The characteristics of alterations of intermediates of peroxidation of lipids in various biologic samples depend on the localization of inflammatory process.

[Lipid peroxidation and antioxidant defense in patients with severe herpetic infection].

Lipid peroxidation and antioxidant defense were studied in 42 patients with severe herpetic infection. The higher plasma and red blood cell levels of intermediate (trienic conjugates) and end (Schiff's bases) lipid peroxidation products were revealed during remission and disease recurrences. At the same time, there were increases in the content of ceruloplasmin in the plasma and in that of superoxide dismutase and catalase in the red blood cells. In the patients with herpetic infection, there were different correlations between the values of lipid peroxidation and antioxidant defense, which were absent in the group of donors. There was a direct correlation between the level of oxidation of intermediate products (ketodienes) of neutral lipids in the plasma and the concentrations of ceruloplasmin and negative correlations with red blood cell superoxide dismutase in patients in remission. There were negative correlations between the red blood cell level of oxidation of intermediate phospholipid peroxidation products and the concentration of ceruloplasmin.

[Leukocyte nitric oxide status in patients with chronic recurrent furunculosis].

The basal and in vitro pyrogenal-stimulated nitric oxide-producing capabilities of leukocytes versus their oxygen-producing and phagocytic activity were studied in patients with chronic recurrent furunculosis during remission (n=62) and exacerbation (n=12). The basal nitric oxide-producing activity of leukocytes was found to be similar. The stimulated leukocyte cultures from the patients showed mainly a perverted reaction--suppression of nitric oxide production instead of its increase detectable in donors. A direct correlation was found between the nitric oxide-producing activity of leukocytes and the results of HCT test in healthy individuals and patients during exacerbation rather than remission.

[A screening procedure for health factors].

A health environment screening procedure has been developed, which is a questionnaire assessing the significance of factors, such as lifestyle, habitat, genetics, public health care, mentality. The developed procedure can ascertain the contribution of each factor to the health of man or a group of individuals, thus defining the factors that may cause diseases, optimize, and individualize the organization of prophylactic care.

[Laboratory prognosis of a risk of rejection of autodermotransplant].

The authors have analyzed results of autodermoplasty of wound defects of the skin obtained by burns, mechanical injuries and trophic ulcers in 90 patients. It was shown that engraftment or lysis of autodermotransplants depends on the preoperative level of lipid peroxidation indices and antioxidant defense--diene conjugates, Schiff basis and ceruloplasmin. The levels of these indices in blood plasma of patients are established which have great prognostic importance.

[Lipid peroxidation parameters in the prediction of autodermatoplastic outcomes].

The authors have studied the significance of lipid peroxidation parameters for the prognosis and control of reparation during autodermatoplasty. Fifty-five patients with local granulated wounds of different origin were examined over time. The considerably activated formation of neutral and phospholipids peroxidation products - diene conjugate, cetodiene and Schiff base--in the plasma and erythrocytes of patients before surgery. The high informative value of the determination of blood Schiff base concentrations as a predictor of dermal autograft lysis.

[The burnout syndrome in communicative professional workers].

To study the specific features of the burnout syndrome (BOS) in communicative professional workers, the authors examined 138 communicative workers (94 females and 44 males); of them there were 51 physical education masters, 43 elementary school teachers, 20 consulting shop assistants, and 24 legal officers. BOS was detected in more than two thirds of elementary school teachers and more than a third of physical education masters, consulting shop assistants, legal officers, and practitioners. The completely developed BOS was most frequently encountered in elementary school teachers (in every four individuals), slightly less frequently in practitioners, consulting shop assistants, and legal officers (in every ten persons). The highest BOS levels were observed in elementary school teachers having a service length of less than 5 years and in legal officers and practitioners having a service length of more than 10 years. The paper provides evidence for the expediency of complex preventive measures for the representatives of these professions and for psychological support of their professional activities.

[Main risk factors of psychosomatic diseases].

AIM: To reveal main risk factors (RF) of psychosomatic diseases and to design models of prediction of each nosological entity. MATERIAL AND METHODS: For design of a model of predicting the risk of different nosological entities of psychosomatic diseases, a standard linear regression model was used. The study included 482 patients with arterial hypertension (AH, n = 96), ischemic heart disease (IHD, n = 99), duodenal ulcer (DU, n = 60), bronchial asthma (BA, n = 52), diabetes mellitus type 1 (DM-1, n = 84) and 2 (DM-2, n = 91). RESULTS: The stress factor was essential in the onset of all the diseases and was registered in more than 90% cases. The other leading prognostic RF in AH were the following: heredity, age, hypodynamics, history of craniocerebral traumas. In IHD--AH, age over 50, dislipidemia, behavior pattern 1. In DU--alcoholism, malnutrition, Helicobacter pylori infection. In BA--reaction to atopic and infection allergens, physical and meteorological factors, allergic diseases. In DM-1--heredity and prior virus infections. In DM-2--obesity, IHD, AH, dislipidemia. CONCLUSION: A stress factor plays an important role in development of all the diseases studied. This confirms a psychosomatic nature of these diseases and point to necessity of rendering psychotherapeutic and psychological aid to such patients at early stages of the disease. The models proposed for prognosis of the risk to develop psychosomatic diseases can predict probability of the disease onset.

[Special features of mental and somatic status of the employees of law-enforcement bodies of the Chechen Republic].

With the purpose of study of features of psychical and somatic prosperity of employees of organs of internal affairs of Chechen Republic the inspection of 64 employees was conducted. It is set that a posttraumatic stress disorder (PTSR) was exposed for 3% inspected employees-contracters. The separate symptoms of PTSR were observed for 2/5 contracters and at 1/4 workings on permanent basis. Complaints about somatic disfunctions were present at more than 1/2 employees, dischargings official duties by contract, and 2/5--workings on permanent basis. Presence of intercommunications of complaints with the subscales of questionnaire of traumatic stress, specifies on psychosomatic nature of violations of somatic health because of finding in extreme battle conditions.

[Effect of staphylococcal toxin on lymphocyte receptors and function]. / Vliianie stafilokokkovogo toksina na retseptory i funktsiiu limfotsitov.

Staphylococcal toxin at a concentration of 10(-3) inhibits in vitro the rosette-formation of lymphocytes, taken from healthy donors and patients with purulent septic diseases, with sheep and mouse red blood cells, changes the ratio of lymphocyte subpopulation, modifies the spontaneous antigen- and mitogen-dependent migration of leukocytes. The latter phenomenon is not linked with disturbances in the lymphokine-producing activity of lymphocytes, but results from changes in the migration properties of granulocytes.