[Clinical and socially significant consequences of falls in elderly and senile persons (analytical review).]

Falls refers to geriatric syndromes, which is accompanied by a significant number of adverse clinically and socially consequences. For the rational organization of medical, social, psychological and other types of assistance and rehabilitation measures, separate groups of consequences developing as a result of a fall are distinguished: physical, functional, psychological, social. Every year, every fourth elderly and older person faces a fall, while about half of the victims seek medical help. Among people of older age groups who have suffered a fall episode, 20-30% have complications in the form of injuries, which further increase the risk of premature death. With two or more falls per year, the risk of complications increases significantly. This requires a comprehensive assessment of risk factors in each individual case.

[Assessment of cognitive and motor functions in older age groups: clinical significance, diagnostic tools, promising directions.]

Assessment of cognitive and motor function in older age groups is carried out to identify neurological deficits, clinical and functional prognosis, determination of rehabilitation potential, organization of accessible environment, prevention of progression of geriatric syndromes. The development of an applied methodology aimed at assessing both cognitive and motor functions, as well as cognitive-motor interaction in aging in normal and pathological conditions, is at the initial stage of formation. This article presents an overview of the methods used to assess cognitive and motor functions in clinical practice, analyzes the possibilities of their use for older age groups, and considers promising areas.

[Age-related features of expression of melatonin and its receptors in myocardial tissues in patients with dilated cardiomyopathy.]

In recent years, more and more attention of researchers has been paid to the study of dilated cardiomyopathy (DCMP). The prevalence of this disease in older age groups is higher than previously thought, and the course of the disease is associated with a worse prognosis and treatment difficulties. Researchers are considering various signaling molecules whose expression changes are associated with myocardial damage and the development of DCMP; evaluation of changes in the expression of melatonin and its receptors in DCMP requires further study. The aim of the study was to study the age-related features of the expression of melatonin and its receptors (MT1, MT2) in the myocardium and their changes depending on the presence of dilated cardiomyopathy. Immunocytochemical and immunohistochemical methods were used to evaluate the expression of melatonin and its MT1, MT2 receptors in myocardial autopsy material and cardiomyocyte cultures of people of different ages with and without cardiovascular pathology. The study revealed age-associated changes in the form of a decrease in the expression of melatonin and its MT1 and MT2 receptors in the myocardium. In individuals with DCMP of all age groups, a more significant decrease in expression was noted: melatonin by 1,6-1,7 times in old age and 3,2 times in old age; MT1 by 1,8 and 2 times, respectively; MT2 by 1,4 and 4 times, respectively. The relationship between the decrease in the expression of melatonin and its receptors in myocardial tissues with age and the presence of DCMP was revealed. The data obtained allow us to clarify age-dependent changes in melatonin and its receptors, as well as to assume their important role in the development of DCMP, which requires further study.

[Prevention of falls syndrome (analitic review).]

Falls in people over 60 years of age is usually interpreted as geriatric syndrome, which is one of the leading problems in geriatrics due to complications. In recent years, the frequency of falls has increased., Every third person faces a fall in old age, and every second person falls in the age over 85 years. Only a multifactorial and personalized approach to each patient will be able to reduce the risk of falling due to the peculiarities of this category of patients and the multidirectional genesis of the fall syndrome. The decision on the choice of tactics should be made by a group of specialists, and the assessment of the effectiveness of the measures used should be carried out in dynamics with due adjustment if necessary.

[Possibilities of estimation postural function in normal and pathological conditions: focus on age-related aspects.]

Age-associated disorders of the function of maintaining balance lead to an increase in the frequency of falls and related complications (injuries, limited mobility, decreased independence and autonomy, etc.). In addition, motor disorders of various genesis in most cases are accompanied by changes in postural function. An analytical review of the literature over the last decade devoted to methods of assessing postural balance in older age groups has been conducted. Computer stabilometry is recognized as the best method for an objective assessment of postural function and dynamic monitoring of the effectiveness of therapy. At the same time, the stabilometric characteristics of postural disorders in older age groups and the relationship between the indicators of stabilography and age remain insufficiently studied.

[Signaling molecules as biomarkers for predicting implant survival in people of different ages.]

Most patients over 50 years of age are diagnosed with diseases of the dentoalveolar apparatus, in particular, bone tissue disorders, which leads to a decrease in the survival rate of implants. Identification of the causes, as well as the development of a methodology for predicting survival by minimally invasive methods, is relevant. The aim of the study was to study the markers of tight junctions in the buccal epithelium (BE) in people of different ages. BE scrapings were taken before and after implantation in patients divided into 5 age groups, from young to centenarians. Immunocytochemical method was used to study markers for tight junction proteins - claudin-1, -7 and 10. It has been shown that with age there is a decrease in the intensity of expression of adhesion molecules, in particular claudin -1, -7 and -10 in the mucous membranes, the minimum values were recorded in the group of centenarians. The study found that after dental implantation, there was a decrease in the expression of claudin-1 and -10 and an increase in the expression of claudin-7. Changes in the expression of claudins may indicate the development of a pathological process in the body, including the success of implantation, especially in people of older age groups.

[Age-associated features of the expression level of apoptosis markers in cardiomyocytes of patients with dilated cardiomyopathy.]

To understand the pathogenesis of dilated cardiomyopathy (DCMP), it is necessary to establish the molecular-cellular mechanisms of myocardial aging, including those associated with programmed cell death, the molecular mechanisms of which have not been practically studied. The aim of this work is to study markers of apoptosis in cardiomyocytes of patients with DCMP in vitro. We used the method of primary dissociated cell cultures and the method of immunofluorescence confocal laser microscopy. Cells of the 3rd and 14th passages, corresponding to «young» and «old» cultures, were used to simulate cellular senescence. Results. At the molecular level, aging of cardiomyocyte cells was accompanied by a twofold increase in the expression of p16INK4a compared to «young cultures» both in the control group and in the group with DCMP. It was also found that the expression of p16INK4a in cultures taken from patients with pathology was 2 times higher than in similar cultures from healthy patients. The expression of p21 was increased in the group with DCMP compared to the control; however, with aging of the culture, the expression of p21 did not change, remaining at a significant level. The most significant differences were obtained when comparing the expression of Bax in the cell culture of cardiomyocytes from the group with DCMP in a «young» culture compared with the norm, 3,2 times. Aging of myocardial cells at the molecular level was manifested in an increase in the expression of the Bax protein, which is the triggering mechanism of the mitochondrial apoptosis pathway. It is possible that this pathway of cell death is prevalent in DCMP.

[Implication of sirtuins and kisspeptin in ovarian aging.]

The aim of the work was to study the expression of sirtuins 1 and 6 and kisspeptin in human ovarian tissue taken in different periods of ontogenesis: from the formation of a pool of follicles in the antenatal period to the extinction of ovarian function in postmenopausal women. It was revealed that sirtuins are expressed in human ovary tissue in all age groups. The maximum expression level of SIRT1 in ovarian tissue was observed during intrauterine development and during the perimenopause, SIRT6 during the reproductive period and perimenopause. The participation of SIRT1 in prenatal selection of oocytes in human fetuses was shown, since it was in this group that increased expression of this marker was revealed. The expression level of the kisspeptin marker increases with the formation of the ovaries and the inclusion of reproductive function; the peak of expression is observed in the period before the onset of menopause. The study conducted to identify the expression of these proteins in the human ovary expands the understanding of the regulation of the ovarian follicular reserve and reproductive aging.

[Parametres of cardiopulmonary exercise testing in patients with lung and esophagus cancer according to their gender and age.]

Cardiopulmonary exercise testing is a diagnostic method, which can be used for oncological patients. It shows its perspectives in measuring reserve capacity of the human organism, determining the risk of postoperative complications, and long-term prognosis. The method is also useful for optimization of rehabilitation measures, which is actual for polymorbid aged patients. In this article we present data of cardiopulmonary exercise testing of 362 patients, men and women of different ages with lung and esophagus cancer. We performed a comparative analysis of aerobic ability of gerontological patients and patients from the other age groups. The patients showed higher ranges at rest in comparison to normal population, and lower rates on anaerobic threshold. Patients from the 40-49 age group showed the best values of aerobic exchange. Aged patients had lower oxygen uptake on anaerobic threshold than other groups. Women of all ages had higher values of peak oxygen uptake then men; aged patients showed better results in comparison to the normal ranges.

[The sirtuin family of proteins: the role in the aging processes and regulation of cell metabolism.]

In recent years, the key role of sirtuins in the regulation of the most important cellular processes has been established. Sirtuins are involved in histone deacetylation, regulation of fat and glucose metabolism. Violations of their synthesis and secretion can induce carcinogenesis, aging and cell death. The wide range of processes in which sirtuins are involved indicates their possible role in the pathogenesis of many diseases including metabolic syndrome, neurodegenerative diseases, inflammation associated diseases and tumor growth. All of these diseases are associated with aging. In this article, we analyze the existing data on sirtuins and their role in the pathogenesis of aging, as well as their possible verification as markers for the diagnosis of age-related diseases and as targets of geriatric therapy and prevention.

[Indicators of lipid exchange as early markers of development calcific aortic valve disease.]

A comprehensive study of lipidograms of 36 patients with initial signs of calcification of aortic semilunium was performed. It was determined that the content of apolipoprotein A-1 was significantly lower in comparison with the control groups, which requires further studies of the evaluation of the effect on the process of early development of calcification of drugs capable to increasing its content. If the concentration of apolipoprotein A-1 is less than 1,1 mg/dl and/or the apoB/apoA ratio is increased by more than 1, it is advisable to recommend dispensary follow-up with regular (no less than 1 time in 5 years) echocardiographic study with a detailed study of the functional state of the aortic valve.

[Endovascular intervention in central venous stenosis and obstructions in the middle aged and elderly hemodialysis patients: a Single-center Experience.]

Central vein stenosis and obstruction is one of the main risk factors in vascular access failure among hemodialysis patients. The elderly patients are in a particularly group because of some problems of arteriovenous fistula creation and maintenance. To evaluate the effectiveness and safety of percutaneous transluminal angioplasty for the treatment of central vein stenosis and obstruction in the middle aged and elderly hemodialysis patients. Forty eight hemodialysis patients with central vein stenosis and obstruction were treated from 2010 to 2016. The patients were divided into two groups, younger 60 years (27 people) and older 60 years (21 people). Fifty three vascular accesses were treated in common (the first group is twenty nine pieces, the second group is twenty one pieces). The first group: the technical success was 85%, the primary patency rates were from 1 to 24 months with an average month of 7,7, the secondary patency rates were from 1 to 30 months with an average month of 11,2. The second group: the technical success was 98%, the primary patency rates were from 4 to 13 months with an average month of 7,2, the secondary patency rates were from 1 to 49 months with an average month of 13. There two complications, one in every group. One case of unsuccessful left brachiocephalic vein recanalization was in the middle aged group. The percutaneous interventions are effective and safety in central vein stenosis and obstruction among hemodialysis patients in all ages for saving hemodialysis vascular access for long period of time.

Effects of Millimeter-Wave Electromagnetic Radiation on the Experimental Model of Migraine

Effects of millimeter-wave electromagnetic radiation (40 GHz frequency, 0.01 mW power) on the spontaneous fi ring of convergent neurons of the spinal trigeminal nucleus and their responses to electrical stimulation of the dura mater were studied in neurophysiological experiments on rats. Irradiation of the area of cutaneous receptive fields of spinal trigeminal nucleus reversibly inhibited both spontaneous discharges and activity induced by electrical stimulation of the dura mater. The second and third exposures to electromagnetic radiation with an interval of 10 min were ineffective. These results suggest that suppression of neuronal excitability in the spinal trigeminal ganglion can be a mechanism of the anti-migraine effects of electromagnetic radiation observed in clinical practice.

[INFLUENCE OF MILLIMETER-WAVE ELECTROMAGNETIC EMISSION ON NITRIC OXIDE SYNTHESIS DURING VESSEL ENDOTHELIUM AGING IN VITRO]

The applying of millimeter-wave electromagnetic emission (EHF-therapy) is an effective method for various age-related pathologies treatment, among other cardio-vascular diseases. During the EHF-emission of aging human endothelial cell cultures it was obtained changing of NO-synthase (eNOS), endothelin-1, angiotensin-2 and vasopressin expression dependence of irradiation exposition. These data have shown that EHF-emission has activated endothelium functional activity, which can play the important role to search for approaches to treatment of arterial hypertension and atherosclerosis.

[Molecular mechanisms of combined extremely radiofrequency and infrared therapy in various age patients with chronic parodontitis]

The influence of extreme radiofrequency millimeter microwave (EHF) and infrared (IR) electromagnetic emanation on the molecular markers of cell renovation (Ki67, p53) and proinflammatory cytokine TNF-α expression in the buccal cells of various age patients with chronic parodontitis was investigated. The results show that EHF- and IR-electromagnetic emanation increased Ki67 proliferative marker expression and decreased expression of proapoptosis protein p53 and proinflammatory cytokine TNF-α in the buccal epithelium of young, middle-aged and elderly people with chronic parodontitis. The data obtained open the new ability for patogenetic treatment of various age patients with chronic parodontitis using the EHF- and IR-electromagnetic emanation method.

[The role of the ECoG theta- and alpha-frequency oscillations in rat vibrissa active movements]

Characteristics of rat ECoG organization before and after vibrissa active movements were studied by means ofmicroelectrode recording. It was shown that different brain structures were recruited to a variable extent in planning and initiation of vibrissae active movements depending on a functional state.

[Neuroimmunoendocrine effects of ethanol in the development of pathology of internal organs]

Neuroimmunoendocrinology is a new science studying the interplay between major regulatory systems (nervous, endocrine, and immune) mediated through regulatory (signal) molecules. Its applied aspects concern elucidation of the influence of various exogenous factors on the organism manifested as alteration of signal molecule homeostasis. Effects of ethanol on organ systems are considered from the standpoint of neuroimmunoendocrinology.

[Peculiarities of management of the elderly patients suffering from chronic obstructive pulmonary disease]

The authors present the results of an open prospective study undertaken to elucidate the influence of combined treatment of 72 patients presenting with chronic obstructive pulmonary disease (COPD). It was shown that traditional therapy supplemented by physical rehabilitation procedures, psychotherapy, and patient education during 6 months resulted in significant improvement of physical working capacity and mobility of the patients; moreover, it reduced the severity of apnea in the elderly subjects. The combined treatment of patients with COPD modulated the neuroimuunoendocrine status of their respiratory apparatus, enhanced the production of signal bronchodilatory molecules of vasoactive intestinal peptide, and decreased the level of bronchoconstrictor endothelin-1. It is concluded that the observed positive clinical and neuroimmunoendocrine effects of combined therapy give reason to recommend the use of this approach when providing the medical care for the elderly patients presenting with moderately severe COPD.

[To the problem of organization in regions of rehabilitation of handicapped elders with gastroenterological diseases]

Authors have revealed that rehabilitation index in young and middle ages are higher, than in elders. Also the state of elder invalidis is rather stable and more severe. The reasons of such situation are discussed.

[Quality control criteria for hospital care of aged patients with otorhinolaryngologic pathology]

This article presents data about criteria of quality of hospital aid for aged patients with otorhinolaryngologic pathology worked out by the authors basing on analyses of 708 cases. The criteria of effectiveness, adequacy and satisfaction of aged patients are described.

[The role of the short-wave therapy in rehabilitation of elderly patents with chronic obstructive pulmonary disease]

The positive clinical effects of using the short-wave therapy in rehabilitation of patients with chronic obstructive pulmonary disease are presented in this article. 49 patients were included in this investigation. The criteria of successful rehabilitation were more expressive in the cases when the short-wave therapy was included in rehabilitative program.

Characteristics of the post-tetanic modification of synaptic transmission in the thalamocortical input of the somatosensory cortex in rats

The development of both long-term post-tetanic potentiation and depression of focal evoked potentials by identified columns in the somatosensory cortex of unanesthetized rats was shown to occur in conditions of stimulation of their thalamocortical afferents. Trains of theta stimulation induced the phase-dependent development of post-tetanic potentiation after tetanization on the negative phase of the theta wave, while depression occurred after stimulation on the positive phase. Continuous tetanization produced potentiation only with stimulation at optimum amplitude and duration; extremely strong tetanization generally induced depression of responses to test stimuli, evidently because of activation of recurrent inhibition.

[Specifics of post-theta modification of synaptic transmission in thalamo-cortical input of the rat's barrel cortex]

The possibility of the development of either the long-term posttetanic potentiation or the depression of focal evoked potentials in identified columns of the barrel somatic cortex of unanaesthetized rats during stimulation of their specific thalamocortical afferent fibers was shown. Phase-dependent potentiation developed after burst tetanization with the frequency of theta rhythm at the negative phase of a theta wave, whereas the stimulation at the positive phase produced the depression. Potentiation after continuous tetanization was observed only at the optimal selection of stimuli amplitude and duration. Excessively intense tetanization more frequently caused the depression of tested responses probably due to the involvement of recurrent inhibition.