ПОЖИЛОЙ ВОЗРАСТ, ЗАПОР И ДЕПРЕССИЯ: КАК ЛЕЧИТЬ?

Constipation is one of the key problems of modern therapy for elderly people. The research aim was to study the features of the psychological and microbiological status of the advanced and senile age patients with functional constipation and to see the effect of educational programmes on compliance of the patients with the therapy in the out!patient departments. The investigation showed that depression was more frequent in the patients of group 1 (68.4 % of the cases) with compensated function of the large gut whereas in the 2nd group – 34.6 % (compensated) and in the 3rd group – 41.5 % (subcompensated)cases. The 3rd degree dysbiosis was found in all patoents irrespective of the extern of disorder of the motor!kinetic function in the large gut.Запор является одной из ключевых проблем современной терапии в пожилом возрасте. Целью исследования явилось изучение особенностей психологического и микробиологического статусов у пациентов пожилого и старческого возраста с функциональным запором, а также влияние образовательных программ на приверженность к терапии в амбулаторных условиях. Как показали результаты исследования, чаще всего депрессия встречалась у пациентов 1 группы - в 68,4 % случаев - с компенсированной функцией толстой кишки, тогда как во 2 группе - в 34,6 % (компенсированная) и 3 группе - в 41,5 % (субкомпенсированная) случаев. Независимо от степени нарушения моторно-кинетической функции толстой кишки, у всех пациентов выявлялась 3-я степень дисбиоза. Проведение обучающих программ, дающих знание о физиологических особенностях толстой кишки, оказывало положительное влияние на приверженность пациентов к соматической и фармакопсихологической терапии

COVID-19 Pandemic and IBS. Results of the All-Russian Observational Non-interventional Program to Study the Effectiveness of the Drug Kolofort® in Real Clinical Practice in Patients with Irritable Bowel Syndrome After a New Coronavirus Infection (VESNA)

Aim: to study the effectiveness and safety of using the drug Kolofort® in outpatients with irritable bowel syndrome (IBS) after a new coronavirus infection.Materials and methods. An observational non-interventional program was conducted in patients with exacerbation of IBS symptoms after a new coronavirus infection. One hundred forty-one patients took part in the study. The final efficacy analysis included data from 127 study participants. All patients complained of increased/appearing gastrointestinal symptoms that appeared within 1–6 months after the infection (all patients had a history of COVID-19 infection). To assess the presence and severity of symptoms of the disease, the “7 × 7” questionnaire was used before the start of treatment and three months after the start of treatment.Results. At the stage of inclusion in the program, the average total score on the “7 × 7” questionnaire was 17.36, which corresponded to a moderately severe disorder. During the treatment period, the average total score decreased to 6.14, which corresponded to borderline disorder. In addition, significant improvement was observed for each symptom separately. After three months of therapy, doctors rated the overall impression of the treatment on a 5-point Likert scale from “very effective” to “ineffective”. The average score was 4.24. In addition, no serious adverse events were identified while taking the drug.Conclusion. In real clinical practice, the drug Kolofort® demonstrated high clinical efficacy in the treatment of patients with IBS after COVID-19 infection

Исследование системной гемодинамики методом объемной компрессионной осциллометрии у лиц молодого возраста

Aim. To investigate the state of systemic hemodynamics (SHD) in young people to assess the potential impact of its disorders in the formation of arterial hypertension (AH) and to carry out preventive measures.Methods. A random sample of 91 young people from 17 to 25 years old was examined; 27 of them were men (average age 23.7±1.6 years) and 64 women (average age 20.4±1.1 years). The study involved clinical residents and students who, according to preliminary and periodic medical examinations, excluded the presence of cardiovascular diseases. The indicators of SHD were investigated by the method of volumetric compression oscillometry using a portable automated software and hardware complex for non-invasive research of central hemodynamics (Device “CAP TsG osm-“Globus”).Results. AH was detected in 4.4%; “white coat” AH in 8.79%; arterial hypotension – in 5.49%. In individuals with normal blood pressure (BP) (75 people), an increase in specific peripheral vascular resistance was most often revealed in 30.6%. An unchanged hemodynamic profile in the group with a normal BP level was recorded only in 28.0% of the examinees.Conclusion. The obtained results indicate that even among “healthy” young people aged 18- 25 years with a normal BP level, the proportion of people with impaired SHD values is 72%. People with hypertension and with altered SHD indicators should be included in the regular medical check-up observation group. Цель. Исследовать состояние системной гемодинамики (СГД) у лиц молодого возраста для оценки потенциального влияния ее расстройств на формирование артериальной гипертензии (АГ) и проведения профилактических мероприятий.Материалы и методы. Обследован случайной выборкой 91 человек в возрасте от 17 до 25 лет; из них 27 мужчин (средний возраст 23,7±1,6 года) и 64 женщины (средний возраст 20,4±1,1 года). В исследовании приняли участие клинические ординаторы и студенты, у которых по данным предварительного и периодических медицинских осмотров исключены сердечно-сосудистые заболевания. Показатели СГД исследовали методом объемной компрессионной осциллометрии с помощью портативного автоматизированного программно-аппаратного комплекса неинвазивного исследования центральной гемодинамики КАП ЦГосм-«Глобус» (ООО «Глобус», Белгород, Россия).Результаты. АГ выявлена у 4,4% участников, АГ «белого халата» – у 8,79%, артериальная гипотония – у 5,49%. У лиц с нормальными показателями артериального давления (АД) (n = 75) наиболее часто отмечено увеличение удельного периферического сосудистого сопротивления – 30,6%. Неизмененный профиль гемодинамики в группе с нормальным уровнем АД зарегистрирован лишь у 28,0% обследуемых.Заключение. Полученные результаты свидетельствуют о том, что даже среди людей в возрасте 18–25 лет с нормальным уровнем АД доля лиц с нарушенными показателями СГД составляет 72%. В группу диспансерного наблюдения необходимо включать лиц не только с АГ, но и измененными показателями СГД.

Rebirth, devastation and sickness: analyzing the role of metaphor in media discourses of nuclear power

International audienceNuclear power plays an important but controversial role in policies to ensure domestic energy security, fuel poverty reduction and the mitigation of climate change. Our article construes the problem of nuclear power in terms of social discourse, language and public choice; specifically examining the role that metaphors play in the policy domain. We empirically analyze metaphors as framing devices in nuclear energy policy debates in the UK between April 2009 and March 2013, thereby capturing the impact of the Fukushima nuclear disaster in 2011. We employ documentary analysis of major UK national broadsheet and tabloid newspapers, using electronic bibliographic tools to extract the metaphors. We then map these metaphors using a Type Hierarchy Analysis, which examines how elements of the target domain (energy technologies and policies) originate from a different source domain. Type hierarchies identify and categorize metaphors, defining the affectual and emotional responses associated with them, providing us with grounded insight into their role in shaping discourse and as a consequence influence public engagement with energy policy. Our analysis highlights three emergent domains of discourse metaphors and discusses the implications of their deployment. Metaphors were found to be classified into three different categories: Rebirth (Renaissance), Devastation (Apocalypse, Inferno, Genie and Bomb) and Sickness (Addiction and Smoking)

COMPLEX ASSESSMENT OF EFFICACY OF STATINS PRESCRIBED AT MOST BY CLINICIANS

Aim. To evaluate a complex clinical efficacy, tolerability and safety of statin drugs — simvastatin, atorvastatin, rosuvastatin in patients with hyperlipidemia (HL).Material and methods. The assessment of clinical efficacy was done in 90 patients with HL and arterial hypertension of the grades 1 and 2, age 40-75 y.o.; some of them had coronary heart disease.Results. In 90 patients with cardiac pathology and HL, selected to 3 groups by 30 persons, the clinical efficacy of the listed statins was assessed. A significant hypolipidemic effect was noted as a decline of atherogenicity of the blood, with slight more prominent effect of rosuvastatin.Conclusion. The data makes it to conclude the simvastatin, atorvastatin and rosuvastatin are equally effective hypolipidemic drugs in HL type IIA and IIB patients. The time frame, type and grade of positive changes in lipid profile are almost the same, and in rosuvastatin just slightly more prominent