The effect of body mass index on quality of life indicators in elderly and senile patients with diseases of the cardiovascular system

The purpose of the study is to determine the effect of body mass index on quality of life indicators in elderly and senile patients with diseases of the cardiovascular system.Цель исследования – определить влияние индекса массы тела на показатели качества жизни у пациентов пожилого и старческого возраста с заболеваниями сердечно-сосудистой системы

Condition of the excretory function of pancreas and microbiocenosis of a large intestine in patients with chronic pancreatitis in the dependence of severity of the course of the disease

The aim of the research is the analysis of the excretory function of pancreas and microbiocenosis of a large intestine in patients with alcoholic and biliary chronic pancreatitis in the dependence of severity of the course of the disease. 96 patients were examined during the research work. Traditional clinical laboratory methods were used, and the excretory function and the microbiocenosis of the intestine were studied. According of the M-ANNHEIM mark scale, patients with alcoholic chronic pancreatitis had a moderate and medium severity degree of the disease, patients with biliary chronic pancreatitis had a minimal severity. The decrease of the level of elastase-1 in the feces and the amylase in the urine were in patients with severe course of the disease. The invert moderate correlation was set between the severity degree and the level of elastase-1 and the moderate direct connection was established between the severity degree and the level of the amylase in the urine. Disbiotic disorders were revealed in 92,3 % of patients. The results of bacteriologic research coincided with the data of gas-liquid chromatography test. Disbiotic disorders were more apparent in patients with the severe course of the disease.Цель исследования - анализ экскреторной функции поджелудочной железы и микробиоценоза толстой кишки у больных алкогольным и билиарнозависимым хроническим панкреатитом в зависимости от степени тяжести заболевания. Проведено комплексное обследование 96 больных. Использованы традиционные клинико-лабораторные методы, изучена также экскреторная функция и микробиоценоз кишечника. В соответствии с бальной шкалой оценки M-ANNHEIM у больных алкогольным хроническим панкреатитом преобладали умеренная и средняя степени тяжести заболевания, с билиарнозависимым - минимальная. Снижение уровня эластазы-1 в кале и повышение - амилазы в моче чаще наблюдали при тяжелом течении. Дисбиотические нарушения выявили в 92,3% случаев. Результаты бактериологического обследования как правило совпадали с данными газожидкостной хроматографии. Алкогольная форма хронического панкреатита отличалась более тяжелым течением. Между степенью тяжести и уровнем эластазы-1 установлена обратная умеренная коррелятивная связь, - амилазы в моче - умеренная прямая. Дисбиотические нарушения более выражены на фоне тяжелого течения

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

Vaginal hormonal ring: a modern method for prolonged contraception

Protection of women’s reproductive health and fertility is one of the priorities for the modern medicine. The prevention of an unintended pregnancy is critical for successful solving of this problem. Prevention of unwanted pregnancy and abortion, medical and social counselling are an integral part of the obstetrician-gynecologist activities. The effectiveness of preventing an unwanted pregnancy is a major factor in choosing a remedy, as well as the ease of use. The article presents information on the new modern contraception methods, including prolonged forms of combined hormonal contraception. A comparative analysis of oral and parenteral contraceptives is provided. The authors gave criteria of efficacy and principles for rational choice of contraceptives. The mechanism of action of a hormonal contraceptive drug containing etonogestrel and ethinyl estradiol is described. The article reviews the main advantages, indications for use and side effects of hormonal releasing systems, which contraceptive effect is provided by a combination of various factors. The suppression of ovulation is the most important of these factors. The researchers provided an analysis of the effect of the vaginal hormonal ring on the biocenosis of vagina and cervical mucosa, on the course of background cervix diseases and the possibility of preventing the development of pathogenic flora, as well as the benefits of its use in women with uncomplicated ectopia of the cervix: the effect on the epithelization of ectopia of columnar epithelium and the beneficial effect on endometrioid heterotopia. The article presents data on the frequency of adverse effects associated with the use of the contraceptive method, as well as risk factors that may become a contraindication to the use of the vaginal hormonal ring. Clear guidelines for postabortion contraception are provided

Anemia in elderly women. Rational prevention. Evidence base

Iron deficiency anemia is a frequent companion in postmenopausal women and those who have reached adulthood. Anemia in mild form in elderly women often occurs almost asymptomatically. Over time, iron deficiency progresses: severe complications occur, the quality of life decreases significantly, and the prognosis for life becomes unfavorable. A cross-section of the literature data in recent years shows that iron, folate, vitamin B12 deficiency, gastrointestinal diseases, pathologies in the processes of erythropoiesis and other somatic diseases come to the fore in terms of the etiological factors of anemia in elderly women. An important role in the development of anemia in older women is played by an irrational diet throughout life, which causes a lack of iron and folate in food. That is why therapy with a complex drug, which includes iron (II) fumarate in combination with folic acid is a rational choice in comparison with iron monotherapy for the prevention and treatment of anemia in elderly women. The administration of oral iron preparations for the correction of iron deficiency and for the purpose of selecting an effective pathogenetic therapy for anemia solves the problem of complications and improves the quality of life of older women. Iron (II) fumarate + folic acid - a tablet form of iron preparation in combination with folic acid for oral use, which has good tolerability, quickly replenishes iron reserves in the body of elderly patients, reducing mortality in this age group

Modern approaches to the treatment of postpartum purulent-septic diseases

The cohort prospective comparative study showed improvement of the management of patients with various forms of purulentseptic diseases (PSD). The study included 276 women with PSD admitted to the gynecological hospital from January 1, 2014 to December 31, 2016. The patients were divided into two cohorts depending on the clinical course, management, and outcomes, which corresponded to the clinical forms of PSD: uncomplicated and complicated. The parameters that were evaluated in patients in both groups included complaints, pregnancy course and childbirth, duration of manifestations of the disease, the clinical picture, laboratory parameters. The study resulted in the development of an algorithm for management of patients with PSD including lavage of the site of infection, adequate antibiotic therapy depending on the type of pathogen, infusion and anticoagulant therapy, and treatment of vaginitis. The developed algorithm for management of patients with various forms of postpartum PSD allowed all 276 (100%) participants to preserve reproductive function and avoid early postoperative complications

Multidisciplinary approach in the treatment of cervical-cervical and cervical pregnancies with the use of modern low-invasive x-ray endovascular technology

Multidisciplinary approach in the treatment cervical ectopic pregnancy has been developed, it includes the systemic use of methotrexate, the embolization of uterine arteries and follow-up fetal egg remove. The new method of combination treatment of cervical pregnancy of one-stage use of embolization uterine artery and temporary balloon occlusion of the internal iliac arteries was applied for the first time in Russia. This algorithm helps to preserve the reproductive function of women

Prophylaxis of рurulent-septic diseases of postpartum period for high-risk puerperas

Background. Postpartum purulent-septic diseases are one of the topical issues of modern obstetrics due to high prevalence and absence of downward trend toward reduction in the disease incidence.Objective: improve the management of high risk puerperas to prevent the development of purulent-septic complications in the postpartum period.Materials and methods. The cohort prospective comparative study included 78 puerperas, who experienced spontaneous labour complicated by injuries to birth canals. The patients were divided into two groups according to the risk of developing purulentseptic complications and the management of patients. Group 1, control group, (n = 20) included the puerperas, who did not show any signs of inflammatory diseases of the genital tract during pregnancy. Group 2 included patients, who were diagnosed with various forms of vaginal dysbiosis based on the results of bacterioscopic and bacteriological examination of the genital tract. The group was further divided into two subgroups depending on the type of treatment. Subgroup 1 of Group 2 (n = 28) only received standard hygiene care, and subgroup 2 (n = 30) received standard hygiene procedures combined with vaginal irrigation using benzidamine hydrochloride solution (Tantum Rosa) for 3 days in the obstetric hospital.Results. The study resulted in improving postpartum care of high-risk puerperas to prevent purulent-septic complications. Discussion The test results showed that the use of benzidamine hydrochloride (Tantum Rosa) in the postpartum period prevents the purulent-septic complications of puerperium, such as inflammation and disruption of perineal muscle sutures and endometritis, as well as relieves pain and discomfort, and improves the puerperas’ quality of life.Conclusion: Based on the study results, we recommend the use of this drug in the early postpartum period to prevent purulentseptic complications in the high-risk groups