Vol 25, No 6 (2014)

The paper analyzes the present status of the problem of senile asthenia as a characteristic of the health status of an elderly or senile patient and his needs for care. It considers the definition, classification, clinical picture, diagnosis, and prevention of senile asthenia. The presented materials may be used by healthcare and social care facilities to improve the quality of management in patients with senile asthenia.

The paper considers the epidemiology, pathogenesis, and etiology of sarcopenia (the generalized loss of skeletal muscle mass with aging) and basic methods for its diagnosis and prevention.

Involutional changes in the body affect the complex pathogenesis of arterial hypertension (AG) with aging, which involves the processes of oxidative stress, apoptosis, sarcopenia, and fibrosis, by causing reduced vascular wall elasticity, increased pulse blood flow velocity, myocardial stiffness, and diastolic dysfunction. An AG correction program for elderly and senile patients should include multitargeted monotherapy or rational drug combinations that directionally affect the leading components of the pathogenesis, on organ-sparing and comorbidities.

The paper outlines the present views on falling syndrome as an important geriatric problem that can be solved with the active participation of therapists and general practitioners while following up elderly and senile people.

The paper gives data on optimizing the diagnosis and treatment of osteoporosis in the elderly. X-ray absorption was used to measure bone mineral density and cavitary mass sizes before and after therapy. Comparison of 3 medications could determine the most effective drug for the treatment of osteoporosis in elderly patients with androgen deficiency.

The paper presents the results of examining blood and prostate tumor tissues by scanning electron microscopy and elemental analysis in elderly patients. It is shown that scanning microscopy may serve as an additional test to diagnose prostate cancer.

The paper presents an original algorithm for the diagnosis of lower extremity vein lesions in elderly patients with chronic heart failure for its use in outpatient facilities that render primary health care. The use of this algorithm in outpatient practice can identify chronic venous insufficiency in elderly patients with chronic heart failure at early stages, which permits one to initiate timely treatment, to lower the proportion of patients with end-stage chronic venous insufficiency, to improve prognosis, to reduce the degree of disability in the elderly patients and pulmonary thromboembolism mortality rates and to improve quality of life in these patients.

Ademetionine (Heptral®, Abbott) in alcoholic liver cirrhosis improves the subjective health status of patients, diminishes the manifestations of asthenic and dyspeptic syndromes and the degree of jaun-dice, and positively affects the biochemical indicators of cytolysis and cholestasis. Ademetionine has been experimentally shown to have a hepatoprotective effect in chronic ethanol intoxication.

Neurological status, the level of depression and anxiety, the quality of life, the intensity of pain, as well as the results of diagnostic transcranial magnetic stimulation have been assessed in patients with tension headache. The reduced posttreatment response amplitude may suggest the decreased excitability of the cortex by involving its less area.

The paper describes the clinical features and early and differential diagnosis of sensorineural deafness of varying etiology (congenital, or associated with ototoxic drugs, in-plant noise, and vascular or atherosclerotic changes). It describes the principles of current pathogenetically sound therapy with combined drugs containing group B preparations, as well as the use of nootropics.

Professional contact and allergic dermatitis of the hand is the most common skin pathology in a number of healthcare workers who would have to contact aggressive chemical and physical agents. New-generation agents with the nanoliposomal structure provide comprehensive transepidermal barrier protection.

The cost-efficiency ratio has been estimated using 2 therapy regimens in patients with metastatic colorectal cancer (mCRC): 1) a standard regimen: all patients with mCRC receive chemotherapy (CT) with panitumumab and FOLFOX and 2) a novel regimen: a surgeon selects patients for combined CT after additional counseling. The novel treatment regimen elaborated by the researchers of the Acad. B.V. Petrovsky Russian Surgery Research Center can increase the proportion of operated patients, by considerably reducing the costs.

Combination prevention of aspiration pneumonia (AP) in elderly and senile ages involves the timely detection of pulmonary risk factors, the early recognition of extrapulmonary factors that contribute to the development of AP, and adequate modification of behavioral and iatrogenic risk factors for the disease.

Community-acquired pneumonia in the elderly is one of the important problems of modern medicine since its clinical features are interwoven with microbiological diagnostic difficulties. The absence of identification of an etiologically relevant pathogen cannot substantiate rational antimicrobial chemotherapy.

The paper gives data on possible age-related differences in the changes of the cytokine status of patients with chronic gastritis, particularly on differences in the level of anti-inflammatory and proinflammatory factors in chronic herpes-associated gastritis. These data are virtually of importance in objectively evaluating the symptomatology of chronic gastritis and in elaborating corrective measures in the therapy of chronic gastritis.