Saratov JOURNAL of Medical and Scientific Research

Regional Hospital for War Veterans, Saratov

Psychological background of prevention and treatment in geriatrics

Year: 2015, volume 11 Issue: №1 Pages: 056-058
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Nazarov M.l., Denisova I.P., Yuanov А.А.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Confidentiality as the component of an interpersonal "patient — medical practitioner" contact formation can be considered as a corner stone of geriatric practice. Major psychological pitfalls of geriatric practice have been reviewed. The main issue of the paper is psychological substantiation of treatment and prevention of elderly.

AttachmentSize
2015_01_056-058.pdf375.58 KB

Strategy and tactics of surgical treatment in elderly patients with ischemic form of diabetic foot syndrome

Year: 2015, volume 11 Issue: №1 Pages: 049-052
Heading: Gerontology and geriatrics Article type: Review
Authors: Shapkin Yu.G., Yuanov A.A., Efimov E.V.
Organization: Saratov State Medical University, Regional Hospital for War Veterans, Saratov
Summary:

The article analyzes the Russian and foreign publications on the issue of treatment of elderly and senile patients with critical limb ischemia and diabetes mellitus. It is shown that the topic is relevant, and, despite its wide coverage in the press, does not have the final decision. Currently unresolved issues include the terms and indications for reconstructive surgery, the amount and the method of amputation, postoperative care.

AttachmentSize
2015_01_046-052.pdf376.49 KB

The senile kidney

Year: 2015, volume 11 Issue: №1 Pages: 046-049
Heading: Gerontology and geriatrics Article type: Lecture
Authors: Denisova Т.Р., Lipatova Т.Е., Chernenkov Yu.V., Nazarov M.l.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

The given work summarizes external data and self-obtained results on development and diagnostic of kidney involution modifications. Article discusses definition of "senile kidney" as a clinical and pathomorphological term. Major statements on pathophysiological causes of age-associated renal disorders and their prognosis, specifics of chronic kidney disease in elderly and senile patients have been reviewed. Phenomenon of renal "multimorbidity" in eldely maximizes worsening risk of unmodifiable kidney function.

AttachmentSize
2015_01_046-049.pdf396.13 KB

Natriuretic peptides and Galectin-3 in senile heart failure patients with preserved ejection fraction.

Year: 2015, volume 11 Issue: №1 Pages: 041-046
Heading: Gerontology and geriatrics Article type: Original article
Authors: Malinova L.I., Podbolotov R.A., Povarova T.V., Pletneva G.F.
Organization: Saratov State Medical University, Saratov Road Clinical Hospital, Regional Hospital for War Veterans, Saratov
Summary:

Purpose: to characterize biomarker panel in senile patients with heart failure with preserved ejection fraction (HF-pEF). Material and Methods. 356 senile patients with chronic heart failure with preserved ejection fraction (HFpEF) were examined to form the study sample of 48 male patients without atrium fibrillation, anemia, diabetes mellitus, onco-pathology and missing clinical data. NT-proBNP, galectin-3 (gal-3) and proANT assay was performed by commercially available ELISA kits. Results. In patients without left ventricular (LV) regional wall motion abnormalities (RWMA). gal-3 (2,13 (0,98; 3,50) vs 5.16 (4,34;9.63) ng/mL, p = 0.011) and NT-proBNP (5,59 (1,00; 10.13) vs 32,04 (15,40; 46,18) fmol/mL, p=0,006) levels were significantly lower than in patients with LV RWMA. Contrarily proANP level was lower in patients with LV RWMA (3,24 (2,47; 3,75) vs 1,38 (0,83; 2,29) nmol/mL, p=0.071). proANP was the only biomarker to increase significantly in long livers (7,30 (4,52; 7,63) vs 2,68 (1,88; 3,32) nmol/mL, p=0.006). NT-proBNP positively correlated with glucose level and negatively with hsCRP (R=0,52, p=0,007). Conclusion. Biomarker panel in senile heart failure patients with preserved ejection fraction has characterized: increase in NT-proBNP and galectin-3 is associated with more severe clinical course and presence of regional wall motion abnormalities in senile patients.

AttachmentSize
2015_01_041-046.pdf939.62 KB

Heart ischemic disease and longevity: unsolved problems

Year: 2015, volume 11 Issue: №1 Pages: 037-041
Heading: Gerontology and geriatrics Article type: Original article
Authors: Markova T.Yu., Malinova L.I., Denisova Т.Р.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

The purpose of the study was to estimate clinical signs and course of coronary heart disease in long-livers and centenarians. Material and Methods. The study included overall population of Saratov — Engels agglomeration's long-livers (>=90 years old, n=198). Results. The rates of major clinical forms of coronary heart disease were detected: atrial fibrillation — 10.6%, chronic heart failure (with preserved ejection fraction) — 10.1 % and angina — 5.1 %. Myocardial infarction was verified in 9.6% of long-livers. Myocardial scar criteria prevailed over myocardial infarction history. Received data corroborated dissolving phenomena of coronary heart disease and noninsulin dependent diabetes mellitus in long-livers. Gender differences in electrophysiological parameters were detected in long-livers. Centenarians with the history of myocardial infarction preserved a satisfactory level of physical activity. Conclusion. Received data confirm a presence of an excessive security: prevention of coronary heart disease manifestation and progression in longevity. Long-livers should be considered as a natural model of an antiatherogenic factors and mechanisms.

AttachmentSize
2015_01_037-041.pdf409.25 KB

Polybiomarker approach in myocardial dysfunction assessment in senile patients

Year: 2015, volume 11 Issue: №1 Pages: 031-036
Heading: Gerontology and geriatrics Article type: Original article
Authors: Malinova L.I., Podbolotov R.A., Povarova T.V., Avdienko I.V.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Purpose: to evaluate interaction of obesity, inflammation and myocardial dysfunction in senile myocardial infarction survivors. Material and Methods. Patients aged 70 and older were involved in the study (n=108) and divided into 2 groups according to the history of myocardial infarction (Ml) — 5 years before involvement: senile Ml survivors (n=26) vs senile patients without history of Ml (n=82). Measurements of serum levels of adipokines (leptin, adiponectin), myocardial dysfunction markers (BNP, NT proBNP, proANP, galectin 3) and inflammatory cytokines (TNF, interleukin 6) were performed. Results. Both groups were comparable by age and major clinical characteristics. Ejection fraction was preserved in both groups under the study (67 (64; 70) %vs67 (64; 68) %, p=0,655). Frequency of diastolic dysfunction was comparable in both groups. However it was more severe in Ml survivors. BNP and NT proBNP levels were significantly lower in patients without the history of Ml (p=0,021; 0,004, respectively). On the contrary serum levels of proANP had tendency to increase in patients with the history of Ml, but not significantly: p=0,821. Adiponectin and galectin-3 were significantly higher in patients with the history of Ml (p=0,019and p=0,011). Conclusion. Pathogenetic peculiarities of chronic heart failure with preserved ejection fraction in senile patients with and without myocardial infarction history were revealed. More expedient biomarker panel appropriate for senile patients with probable heart failure should include NT-proBNP, galectin-3 and adiponectin.

AttachmentSize
2015_01_031-036.pdf893.87 KB

Age-dependent dynamics of screening metabolic parameters in long-livers and its biophysical estimation

Summary:

The purpose of the study: to examine age-dependent dynamics of parameters of biochemical screening in long-livers. Material and methods. The study included 201 long-livers divided (Saratov) into two groups: the main group (centenarians) and the control group (90-99 y.o.). Basic parameters of biochemical screening were analyzed. Results. The suited sample of centenarians characterized by significantly lower levels of total cholesterol, triglycerids, glucose and creatinine. All studied parameters progrediently decreased from early long-livers age to centenarians. Maximal rates of age dependencies allowed us to confirm maximal weight of lipids in early longevity and glucose and creatinine in centenarians. Conclusion. All present results are most likely explained by the combined effects of genetic, environmental and "hundred years" factors leading to dynamic remodeling of control systems. Major result of such remodeling is age-dependent optimal level of metabolic factors as a mechanism of successive ageing.

AttachmentSize
2015_01_028-031.pdf527.24 KB

Cardiovascular disease prevalence and clinical characteristics in Great Patriotic War veterans

Year: 2015, volume 11 Issue: №1 Pages: 023-027
Heading: 70 Years of Victory in the Great Patriotic War Article type:
Authors: Lipatova Т.Е., Denisova Т.Р., Shuldyakov V.A., Alipova L.N., Haybekova T.V., Yuanov A.A.
Organization: Regional Hospital, Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Present article summarizes the results of long-term studies of cardiovascular health parameters in war veterans of Saratov region admitted to Saratov regional hospital for war veterans. Cardiovascular disease spectrum and its prevalence dynamics were studied in war veterans. Clinical signs and disease course features of cardiovascular pathology were systematized including Great Patriotic War veterans, who successfully had reached the state of longevity.

AttachmentSize
2015_01_023-027.pdf437.87 KB

The most important parameters of life quality of the Great Patriotic War veterans

Year: 2015, volume 11 Issue: №1 Pages: 019-023
Heading: 70 Years of Victory in the Great Patriotic War Article type:
Authors: Yuanov A.A., Denisova Т.Р., Shuldyakov V.A., Lipatova Т.Е.
Organization: Saratov State Medical University, Regional Hospital for War Veterans, Saratov, Regional Hospital
Summary:

Purpose of the study was to estimate current state of quality of life of Great Patriotic War veterans. Materials and methods. The study included 368 veterans of the Great Patriotic War according to Federal State "Concerning veterans" #5, 1995. Protocol of the study included adapted fragments of WHOQOL, WHOQOL-Old, SF-36, SIP questioners as well as visually-analog scale of self-assessment of quality of life with further going quality of life index calculations. Re-sults. In the studied sample of the Great Patriotic War (GPW) veterans including long-livers comparably was detected high level of quality of life (QOL) by physical criteria and independence level. It was revealed that QOL by self-service criteria in the GPW veterans was low and extremely variable by other criteria groups. Both ageing and gender influenced upon physical activity, self-service and QOL self-assessment. Women were outstanding by psychological criteria and independence with no association with age group. Conclusion. QOL indication in the GPW veterans of studied sample elucidated a satisfactory level of healthcare in the region, which allows veterans in certain way preserve both physical and psychological health, as well as grounds positive self-assessment of personal position in society and values system according to their life-goals and expectations.

Keywords: quality of life
AttachmentSize
2015_01_019-023.pdf440.86 KB

Science-based healthcare organization for Great Patriotic War veterans

Year: 2015, volume 11 Issue: №1 Pages: 015-019
Heading: 70 Years of Victory in the Great Patriotic War Article type: Original article
Authors: Lipatova Т.Е., Denisova Т.Р., Shuldyakov V.A., Yuanov А.А., Dudaeva N.G.
Organization: Regional Hospital, Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

The article summarizes the results of healthcare management of Great Patriotic War veterans for the last 20 years. This period included approbation and improvement of high-technology science-based and efficient healthcare system for war veterans. Healthcare managerial, medical and diagnostical activities are based on original analytical development including population system approach, biophysical approach to human organism, ageing, and senile and stress-induced disorders.

AttachmentSize
2015_01_015-019.pdf513.45 KB