2018, volume 14

Aim: evaluation of the injection reflexotherapy on the pain syndrome and level of anxiety-depression disorders in patients with chronic tension-type headache (CTTH). Material and Methods. An open controlled trial was conducted on 95 patients with CTTH. The patients were divided into 2 groups by a method of adaptive randomization: patients of comparison group received amitriptyline 35-70 mg/day and tolperisone 450mg/day; patients of basic group were assigned to 2-4 courses of injection reflexotherapy by the developed method. The obtained results were assessed on the basis of scores on the Visual Analogous Scale, McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory. Results. Patients of both groups had a positive view on the receiving treatment. According to McGill Pain Questionnaire determined both affective and sensory descriptors of pain, with dominated by sensory descriptors. For psychological status, according to Beck Depression Inventory, moderate depressive symptoms were noted in both groups. Prevalence of trait anxiety was determined by State-Trait Anxiety Inventory. As a result of the treatment, the intensity of pain by VAS reduced from 5,26±0,87 to 1,7±0,78 points (p<0,05) in the comparison group and from 5,17±0,78to 1,65±0,79 (p<0,05) in the basic group. Improvement of parameters of anxiety and depression were found. Conclusion. As the results show, it is very promising to use injection reflexotherapy in treatment of patients with CTTH.

Aim: to analyze polymorphic variants of genes of connective tissue remodeling, biotransformation and their role in the development of cardiovascular comorbidity and osteoarthritis (OA). Material and Methods. The study included 70 patients with OA. As a control group, 30 patients without OA of comparable sex and age were included in the study. All patients were assessed total (absolute) cardiovascular risk according to the SCORE scale. The pain was assessed by visual analog pain scale. The physical dysfunction was assessed on a WOMAC scale. Single-nucleotide polymorphisms of the genes COL1A1 (rs1107946), EPHX1 (rs1051740), MMP12 (rs652438) were studied by PCR-RT. Results. In patients with OA, there is a twofold increase in the frequency of the heterozygous genotype of the GT gene COL1A1. The presence of the T allele of the COL1A1 gene is a risk factor for the development of OA. Patients with OA have a fourfold increase in the frequency of genotype AG of the MMP12 gene. The patients with severe pain significantly present the difference in the distribution of allele frequencies of the polymorphic locus G1997T of the COL1A1 gene from the control sample. The frequencies of heterozygous genotypes COL1A1 and MMP12 differed significantly in patients with different cardiovascular risk. Conclusion. The results partially confirm the integration theory of the pathogenesis of OA, suggest the existence of general mechanisms of connective tissue remodeling.

Aim: to evaluate the effect of different types of hypoglycemic therapy on the level of leptin, interleukin-6, C-reactive protein, tumor necrosis factor-alpha, as well as body mass index. Material and Methods. The study involved 250 people. 200 case histories of patients with the main diagnosis Gastroesophageal Reflux Disease were analyzed. Group I consisted of 50 suffering from diabetes type II diabetes in combination with obesity of varying severity and GERD. Treatment of diabetes in this group was carried out with the help of Metformin. Group II consisted of 50 patients with type II diabetes mellitus combined with obesity of varying severity and gastroesophageal reflux disease. Patients in this group took exenatide. Group III consisted of 50 patients suffering from obesity of different severity and gastroesophageal reflux disease. The comparison group (IV) consisted of 50 patients with gastroesophageal reflux disease without overweight and comorbidities. For the treatment of GERD in the study subjects used — omeprazole. The control group (V) consisted of 50 healthy volunteers. Laboratory tests (General blood test, biochemical, immunological parameters) were performed on automated hematological (Ruby), immunochemical (Architect 2000) and biochemical (Architect 4000) analyzers (Abbott, USA). Results. In the course of assessing the indicators before therapy, we can note an increase in the level of leptin in the group of patients with obesity, while against the background of type 2 diabetes. Assessing the level of interleukin-6, C-reactive protein, tumor necrosis factor-alpha statistically significant increase in indicators was observed in the groups of patients with obesity (I, II, III study group). As a result of treatment, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF. Conclusion. As a result of treatment with exenatide, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF, indicating a decrease in the metabolic activity of visceral fat, which consists in the activation of lipolysis, release of free fatty acids and adipocytokines

The goal is to study the morphofunctional changes in the kidneys under the influence of light desynchronosis, an analysis of the degree of reversibility of these changes. Material and Methods. The study was carried out in two stages on 72 white male rats. In the first series of experiments, animals underwent round-the-clock light exposure for 10 and 21 days. In the second series after round-the-clock exposure to light for 10 and 21 days, the beings were exposed to natural light for 21 days. The animals of the control group were kept in a natural light regime. Morphological and morphometric analysis of histological sections of kidneys stained with hematoxylin and eosin was performed. Results. It was found that on the 10th day of the experiment, cellular infiltration of the cortex occurs, and the edema of the interstitial tissue develops. These changes progress to the 21st day of the experiment and are combined with a significant decrease in the area of the glomerular capillary network and expansion of the lumen of the capsule of the glomerulus of cortical nephrons. When assessing the long-term consequences after 10-day illumination, the diameter of the renal corpus is reduced along the long and short axis. The changes registered on the 21st day do not reach the control values, which indicate that they are irreversible. Conclusion. The revealed structural and functional changes in the kidney indicate a negative effect of light desynchronosis: 10-day lighting leads to a breakdown of compensatory possibilities and the development of distant morphological changes; long-term light exposure (within 21 days) leads to the development of pronounced irreversible structural disorders.

Objective: to analyze the prevalence of digestive diseases during social stress among the population of different age groups (young, mature, elderly / old). Material and Methods. We studied data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures / deaths of patients in the surgical and gastroenterology clinics of the city for 1990-2006. Social stress was considered as a factor in the breeding population system from the equilibrium state. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time were applied. The number of time moments when the sign of the rate of change in the prevalence of the studied parameters changed to the opposite was estimated. Results. The change in the sign of the rate of prevalence of acute pathology of the digestive system was most often observed during the period of maximum severity of social stress, which emphasizes the importance of the social component in the emergence and development of digestive pathology. The increase in the prevalence of diseases of the digestive system in all age groups was revealed. The increase in the prevalence of individual nosological forms, as well as the greatest number of times when the sign of the rate of prevalence of the pathology changed to the opposite, were most often registered among the population of young and elderly / senile age. The population of the mature age was characterized by greater stability of the studied parameters, that is, higher resistance to social stress. Conclusion. The prevalence of diseases of the digestive system during the period of social stress varied among the population of different age groups asynchronously: the most significant changes in the studied parameters were observed among the population of two extreme age groups: young and elderly / old people. These groups of people need closer attention of the doctor than patients of mature age, because they have a higher risk of developing diseases of the digestive system.

Objective: identification of risk groups for development of complications of ulcerous disease of stomach and duodenum.Material and Methods. We used data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures/deaths of patients in the surgical and gastroenterology clinics of the city (1976-2006). The parameters of the prevalence of gastric ulcer and duodenal ulcer and its complications in the population of different age groups are analyzed. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time (mean, minimum, maximum speed, range of the dynamics of the studied parameters, the number of changes in the sign of the speed of change in the prevalence of the studied parameters) were applied. Results. It was found that the probability of complications of the disease is higher among those age groups, which are characterized by a frequent change in the sign of the rate of change in the prevalence of the pathology. The necessity of age accounting in stratification of the risk of complications of gastric ulcer and duodenal ulcer and the multiplicity of medical observation of persons of different ages with this pathology, taking into account the analytical parameters of the disease. Conclusion. The scheme of determining the multiplicity of dispensary examinations of patients with gastric ulcer and duodenal ulcer is proposed.

Objective: to analyze the number of patients, patients' opinions about the work of the medical institution in 2005 and 2017. Material and Methods. The data of the survey of patients of the Saratov Regional Hospital for Veterans of Wars in 2005 and 2017 are analyzed. Results. From 2005 to 2017, there was a change in the sex (decrease in the proportion of hospitalized men) and age (increase in the proportion of hospitalized patients over the age of 60 years) composition of hospital patients. The increase of the general educational level of patients, the increase of the share of patients who are in this hospital not for the first time is revealed. The share of patients satisfied with medical work and work of the power supply unit in this hospital has increased. The preference of paternalistic style of interaction between a doctor and a patient, typical for both patients in 2005 and patients in 2017, was revealed. Conclusion. Despite the increase in the educational level of patients and the increase in satisfaction with the work of the hospital, patients of this medical institution prefer a paternalistic style of interaction with the doctor.

The purpose of the study was an assessment of erythrocyte system age-dependent characteristics in elderly population dwelling in the same territory during the time period equal to the average life span in the region. Material and Methods. We perform the compare of hematological parameters of 800 patients with hypertension and coronary heart disease hospitalized during 25-years period. Results. In senile patients, red blood cells and hemoglobin levels signifi- cantly decrease, but platelet characteristics remain intact. Revealed differenced are similar during all 25-year period of observation. Conclusion. Over the past 25 years, the trend of age-related decline in the number of red blood cells and hemoglobin has been preserved. The average hemoglobin content in erythrocyte (MCH) during the aging process tends to decrease, which has become statistically significant in recent years. The principal difference of the obtained data from the results of obtained 25 years ago is the absence of an age-related increase in the volume of erythrocytes and a higher level of the average concentration of hemoglobin in the erythrocyte.

Purpose: to analyze the prevalence of acute abdominal pathology in the period of social stress. Material and Methods. The data of official statistical reports of the Saratov city health Committee and the logs of patients admitted and discharged / deceased in the surgical clinics of the city were studied. The prevalence of acute appendicitis, acute cholecystitis, acute pancreatitis, acute intestinal obstruction, gastrointestinal bleeding, perforation of ulcers during 1990-2006 among the population of different age groups (young, mature, elderly /old) was investigated. The significance of differences between the groups was assessed using white's T-test. Results. A decrease in the prevalence of acute appendicitis, an increase in the prevalence of acute pancreatitis and gastrointestinal bleeding. Differences in the prevalence of acute abdominal diseases in patients of different age groups were found: an increase in the prevalence of acute pancreatitis mainly in the young population. There is a tendency to gradual Erasure of sexual differences in acute cholecystitis and acute pancreatitis in this period. Conclusion. The analyzed time interval was characterized by changes in the structure of the "acute abdomen", which may be associated with social changes in society during this period.

The term of "Healthy Ageing" is about creating the environments and opportunities that enable people to be and to do what they value throughout their lives. Healthy ageing require multipurpose policy framework with biological, social, economic, cultural and ecological aspects. The long-term experience of Saratov Regional Hospital for War Veterans in development and management of competencies required for healthy ageing programs is generalized in the article. Science evidence base of healthy ageing was formulated including results of the original studies with veterans of Great Patriotic War involved.