Vol 33, No 6 (2022)

The prevalence of hyperuricemia is increasing worldwide. Epidemiological studies have shown that uric acid levels are positively correlated with cardiovascular disease, including hypertension, atherosclerosis, atrial fibrillation, and heart failure. Hyperuricemia contributes to the onset and development of cardiovascular disease by regulating molecular signals such as inflammatory response, oxidative stress, insulin resistance, and endothelial dysfunction. Despite numerous studies, the underlying molecular mechanisms of hyperuricemia are still unclear. The xanthine oxidase inhibitor allopurinol is known to improve cardiovascular outcomes in patients with heart failure, coronary artery disease, type 2 diabetes mellitus, and left ventricular hypertrophy. Can febuxostat, another xanthine oxidase inhibitor, have a positive effect on the cardiovascular system? In addition, it is also unclear whether uric acid-lowering treatments can benefit patients with asymptomatic hyperuricemia. This review presents current data on the cellular and molecular relationships of cardiovascular diseases associated with hyperuricemia and clinical data on the effectiveness of urate-lowering therapy in patients with cardiovascular diseases.

A search for an optimal approach to diagnosing and treating osteoporosis (OP) in comorbid elderly patients is an important problem in modern medicine. The paper presents the results of the authors’ own studies of diagnosis and personalized therapy in patients with comorbid OP.

The presence of gallstones is a gallstone disease (cholelithiasis), one of the common pathologies of the hepatobiliary system, which affects up to 10% of the world's population. It is characterized by the formation of stones in the biliary tract: the gallbladder and bile ducts. Cholelithiasis is a condition in which hard stones consisting of cholesterol or bile pigments are formed in the gallbladder (cholecystolithiasis) or the common bile duct (choledocholithiasis). Clinical manifestations of gallstone disease in young people are attacks of biliary colic, often of a protracted nature with manifestations of jaundice. For elderly and senile people, the latent course of the gastrointestinal tract is more characteristic. Ultrasound (detection of biliary sludge) and the study of the physico-chemical properties of cystic and hepatic bile occupy a leading place in the diagnosis of gallstone disease. Treatment is based on operative and non-operative methods (lithotripsy, preparations of cholic acids).

The number of elder people is increasing every year in the world. To search for safe and effective therapeutic methods and agents that improve quality of life in people in this age group is the most important task of gerontology and geriatrics. The purpose of the review is to evaluate the possibility of using dance practices in geriatric programs. The review presents the molecular biological and geroprotective effects of dance practices. It describes the protective effect of dance practices on the synthesis of sex hormones, cognitive functions, immunity, and stress levels. There are also data on the positive impact of dancing on the cardiovascular and nervous systems in patients of older age groups with neurodegenerative and cardiovascular diseases.

Since December 2019, the world has been gripped by the coronavirus infection (COVID-19) pandemic caused by SARS-CoV-2. At the end of January 2022, there were 356,028,523 infections and 5,613,346 deaths with a significant proportion of deaths occurring in elderly and senile patients. Numerous studies have shown that the majority of elderly patients who experienced COVID-19 had comorbidities (diabetes mellitus (DM), hypertensive disease, and cardiovascular disease). About 10-20% of older patients with COVID-19 had generally DM. The investigations conducted by US scientists indicate that people with obesity and type 2 diabetes (T2D) are more vulnerable to coronavirus infection. Thus, elderly patients with DM need more attention to both the prevention during the pandemic and outpatient and inpatient treatment in the presence of COVID-19. The antioxidant, anti-inflammatory, immunomodulatory, and antiviral properties of metformin allow it to be considered as an additional therapy in elderly patients with T2D and COVID-19.

Objective. To evaluate the efficiency of lithokinetic therapy (LKT) in the localization of upper third ureteral stones and to establish the molecular mechanisms that modulate ureteral motility. Subjects and methods. The investigation was prospective and enrolled 61 patients with upper third ureteral stones. Within 7 days, the patients received standard LKT including non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics. According to the imaging control data, the patients were divided into 2 groups: 1) effective elimination of the calculus (n=40); 2) inefficient stone elimination (n=21). The activity of α2-adrenergic receptor and thromboxane A2 (TXA2) receptor was studied in vitro on platelet suspension after 24,48, and 72 hours and 7 days. Platelet aggregation was assessed by the turbidimetric method on a Chrono-Log analyzer (USA). Results. The hyperreactivity to TXA2 receptor and α2-adrenergic receptor was revealed in all the patients at the time of hospitalization. Group 1 achieved hyporeactivity to the TXA2 receptor during LKT; Group 2 failed. According to the results of modeling the risk of ineffective stone elimination, the critical activity threshold for the TXA2 receptor (TXA2-Rcrit) was >35%. Group 1 patients were also observed to have two waves of decreased α2-adrenoreceptor activity after 48 hours and 7 days; as a result, hyporeactivity to the receptor developed; in Group 2, α2-adrenergic receptor hyperreactivity persisted at all points of the study. The critical activity threshold for α2-adrenergic receptor (a.flR-Rcrit) with ineffective elimination was >52%. Conclusion. Hyperreactivity to the α2-adrenergic receptor and TXA2 receptor modulates the functional state of the ureter wall, resulting in the lower efficiency of elimination of >6-mm stones from the lumen of the upper third of the ureter during standard LKT.

The clinical and morphological features of the course of bladder cancer (BC) were studied in 152 middle-aged, elderly, and senile male (86.9%) and female (13.1%) patients diagnosed with Stage I-IV BC: stage I in 116 (76.3%) patients and Stages II, III, IVin 36 (23.7%). Most patients underwent transurethral resection. Moderately differentiated bladder tumor was observed in 54.6% of patients. Microscopic examination of the tumor revealed an ordered histological and cellular structure with minor signs of nuclear atypia. Carcinomas consisted of cells with impaired polarity, which had lost intercellular contacts with large hyperchromatic nuclei. There were commonly mitotic figures, often atypical ones. There were no tumor histologic differences in different age groups (middle-aged, elderly and senile patients).

The state of sarcopenia is based on the quantitative and qualitative skeletal muscle losses mediated by the microenvironment, i.e. the losses of bone and surrounding adipose tissues. In order to complete the medical and social assessments of elderly patients, in addition to traditional methods, geriatric assessments of the condition should be used. The SARC-F questionnaire is applied for the timely detection of muscle dysfunction in the elderly. Objective. To study laboratory and instrumental data in elderly patients depending on the variant of sarcopenia development in accordance with the SARC-F questionnaire. Subjects and methods. The investigation enrolled 2,145 elderly patients who were divided into 5 groups depending on the variant of sarcopenia development in accordance with the SARC-F questionnaire. The investigators analyzed the following parameters: glycosylated hemoglobin (HbA1c), total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG), homocysteine, total protein, creatinine, potassium, and 25-hydroxyvitamin D (25[OH]D). They also used instrumental techniques: tonometry, electrocardiography, and echocardiography. Results and discussion. The biochemical status of elderly people with symptoms of sarcopenia was characterized by an elevated level of HbA1c; TC > 5.7 mmol/l; LDL > 3.6 mmol/l; TG > 1.8 mmol/l; homocysteine > 10 pmol/l; creatinine > 115 mmol/l; as well as a reduced level of total protein; potassium < 3.4 mmol/l; and 25[OH]D < 30 ng/ml in blood serum. The biogerontological study demonstrated disturbances at the molecular, tissue, and organ levels. Biochemical and metabolic changes caused various disorders at the macro levels. The discovered age-associated disorders of carbohydrate and lipid metabolism affect the risk of atherosclerosis, hypertension, type 2 diabetes mellitus and their complications. The identified pathological morphofunctional changes increase the risk of adverse cardiovascular events in the short term in elderly patients with signs of sarcopenia. Conclusion. The sarcopenia course differentiated using the SARC-F questionnaire did not substantially affect the variety of the above abnormal anatomical and physiological conditions. Hypertension is the most characteristic pathological condition that is common in people with sarcopenia. At the same time, the primary component in the pathophysiological gerontological continuum is hypertension, in which prerequisites are created for the development of dynapenic, and later sarcopenic processes, while osteopenic processes are observed in parallel.

The development of a diagnostic panel of biomarkers to improve the survival rate of dental implants is an urgent scientific and applied problem. The recovery rate for bone tissue innervation and vascularization is one of the important criteria for the success of implantation. Objective. To develop a diagnostic panel of biomarkers to assess the success of implantation in patients of older age groups Subjects and methods. The buccal epithelium was investigated in people of different ages. The sample size was 210 patients (5 age groups) and 420 observations (before and after implantation). Results. It was found that with increasing age, there were significant decreases in the expression level of the vascularization markers VEGF, VEGFR1 before implantation and in the level of the marker for the rate of innervation recovery in the implantation zone of NO synthase before and after implantation. After implantation, the level of VEGFR1 expression decreased in all studied groups; that of VEGF expression increased in all the groups, except for the group of long-livers, in whom the level of VEGF reduced after implantation compared to that before implantation. Conclusion. This investigation makes it possible to approach the solution of the problem of creating a differential diagnostic model to predict the survival rate of implants and to choose a habilitation method. The development and implementation of a diagnostic panel of biomarkers will be able to proceed to personalized medicine, high-tech healthcare, and health-saving technologies.

With an increase in life expectancy, the issue of society's perception of elderly and senile people becomes relevant. A negative attitude towards older and younger generations affects both the elderly and young people themselves and their quality of life. Objective. To study the prevalence of ageism in Russia in case of the Republic of Adygea. Subjects and methods. During the study, 300 respondents (171 women and 129 men) aged 22 to 67years were interviewed by random sampling (age categories: 19-21; 22-30; 31-40; 41-45; 46-60; over 60 years old) using the original questionnaire consisting of 10 questions, which had been developed by the authors, The survey was conducted simultaneously on the Instagram social network on January 14 to January 26,2022. The residents of the Republic of Adygea participated in the study. Results. The majority (82%) of respondents was familiar with the concept of "ageism". Age discrimination in employment or performance of any activity was more often observed in young (from 21 to 26 years old) and older and elderly (5867 years old) people than in other age groups. When receiving a refusal of being employed, most of older people faced the stereotype that it was more difficult for them to perceive new information and to resist changes. Conclusion. Summing up the results of the study performed can lead to the conclusion that the majority (82%) of respondents faced age discrimination in any event. There was a high level of stereotypes and prejudices against young and older people. Examples of specific people experiencing ageism in everyday life allowed the authors to visualize its manifestations in society. Ageism is most commonly encountered in employment, but nevertheless, age discrimination is not the reason for the most of respondents to lower the evaluation of the organization’s image.