PECULIARITIES OF GERIATRIC STATUS OF PATIENTS WITH AGE-AGE MACULAR DEGENERATION

В пожилом возрасте вследствие иволютивных процессов и соматической патологии происходит ухудшение гериатрического статуса и преждевременное старение. Присоединение зрительного дефицита, вызванного возрастной макулярной дегенерацией, еще в большей cтепени снижает функциональную активность пациентов. Цель исследования - изучение особенностей гериатрического статуса пациентов с возрастной макулярной дегенерацией. На базе офтальмологического центра проведено обследование свыше 200 пациентов с возрастной макулярной дегенерацией. Контролем служили пациенты с отсутствием данной офтальмологии. Всем пациентам выполнено комплексное офтальмологическое и гериатрическое обследование, включающее оценку зрительных функций и основных клинических гериатрических синдромов. В ходе исследования установлено, что возрастная макулярная дегенерация статистически значимо ухудшает гериатрический статус пациентов по таким позициям как личностная и ситуативная тревожность синдром гипомобильности, ограничения в бытовой активности по шкале Гронингена. У пациентов с возрастной макулярной дегенерацией гериатрический статус отягощен также синдромом полиморбидности, представленным преимущественно артериальной гипертензией, ишемической болезнью сердца, сопутствующий офтальмологической патологией. Среди пациентов пожилого возраста с возрастающей макулярной дегенерацией статистически значимо выше распространённость. Все это указывает на важность оценки гериатрического статуса для его корреляции In old age, due to evolutive processes and somatic pathology, there is a deterioration in geriatric status and premature aging. The addition of visual deficit caused by age-related macular degeneration further reduces the functional activity of patients. The aim of the study was to study the features of the geriatric status of patients with age-related macular degeneration. On the basis of the ophthalmological center, more than 200 patients with age-related macular degeneration were examined. Patients with the absence of this ophthalmology served as control. All patients underwent a comprehensive ophthalmological and geriatric examination, including an assessment of visual functions and the main clinical geriatric syndromes. In the course of the study, it was found that age-related macular degeneration statistically significantly worsens the geriatric status of patients in such positions as personal and situational anxiety, hypomobility syndrome, limitations in everyday activity according to the Groningen scale. In patients with age-related macular degeneration, the geriatric status is also aggravated by polymorbidity syndrome, represented mainly by arterial hypertension, ischemic heart disease, concomitant ophthalmic pathology. Among elderly patients with increasing macular degeneration, the prevalence is statistically significantly higher. All this points to the importance of assessing geriatric status for its correlation

Some psychophysiological parameters of a person during a passive orthostatic test

The study involved 14 volunteer students. Situational anxiety was determined, tests were carried out to determine simple and complex sensorimotor reactions, the cardiac rhythm of the subjects was recorded. Oxygen saturation was determined using an oximeter. Dynamic parameters were recorded: lying in a state of functional rest (background 1), vertical at 65-70° (vertical), lying after verticalization (horizontal), lying in a state of functional rest (background 2). The analysis of the data obtained was carried out using the Excel and StatPlus Pro programs. It was revealed that during verticalization, changes in the regulation of the heart activity of the subjects are carried out mainly due to the central mechanisms of regulation through the sympathetic nervous system. The transfer from a vertical to a horizontal state is accompanied by a restructuring of the regulatory system towards the activation of subcortical nerve centers and a shift in the balance of the SNS/PSNS towards the parasympathetic nervous system. Key words: passive orthostatic test, cardiac rhythm, simple sensorimotor reaction.

THE EFFECTIVESS OF EVALUATION OF OSTEOPATHIC SUPPORT OF PATIENTS SUFFERING FROM THE DISTURBED OCCLUSION AT THE DENTAL ALVEOLAR LEVEL

The eff ectiveness of simultaneous use of braces and methods of osteopathic correction was evaluated while treating 48 patients suff ering from occlusion disorders at the dental alveolar level. The indicators of osteopathic status, situational anxiety, and satisfaction with the aesthetic result of treatment were studied. It was found that the most typical somatic dysfunctions were the dysfunctions of the bones of the skull base, facial skull, cervical spine, chest, and of internal organs of the chest and neck. The inclusion of methods of osteopathic correction in the comprehensive treatment resulted in the better mobility of the structures of the skull, cervical spine, and chest, a decreased anxiety level and, consequently, an increased satisfaction with the aesthetic result of treatment.

Optimization of the pre-starting state of athletes in rhythmic gymnastics at the initial stage of basic training

Against the background of intensifying competition in the international arena, the demands placed on female athletes in rhythmic gymnastics are growing, which requires the formation of female athletes' ability to self-control and self-regulation. The purpose of the article is to substantiate and develop an algorithm for optimizing the pre-start condition of young gymnasts at the stage of preliminary basic training. Research methods: analysis, systematization and generalization of data of scientific literature, methods of assessment of Spielberger-Khanin situational anxiety, statistical analysis. The study involved 10 gymnasts who train at the stage of basic preliminary training (8-12 years), who took part in the International Competition "Dmitrash Cup 2021". Result. It is proved that the average assessment of situational anxiety of young gymnasts in the pre-competition period is statistically significant (p <0.05) increases from 19.3 to 35.1 points. The most effective in the training process of gymnasts at the stage of initial basic training methods and techniques to combat the state of pre-start overstrain: psychological and pedagogical, hardware means of influence, methods of relaxation and mobilization and psychophysiological influences. An algorithm for optimizing the pre-start state of female athletes in rhythmic gymnastics at the initial stage of basic training, namely the establishment of the type of temperament of the athlete, the diagnosis of her pre-start state, the application of methods of regulation of pre-start states. The prospect of further research is the development of methods for optimizing the pre-start condition of athletes in rhythmic gymnastics and the formation of their skills of self-regulation in the training process at the stage of initial basic training.

Determination of factors affecting cognitive function in patients with chronic kidney disease stage 5

Objective. Patients with stage 5 chronic kidney disease.Study objective. Determination of factors affecting cognitive function in patients with CKD-5.Design and methods. The study included young and middle-aged patients (18 to 60 years old) (n = 40), there is a terminal stage of chronic kidney disease (CKD). Exclusion criteria: history of diseases of the central nervous system, brain injury, episodes of cerebrovascular accident with severity, coronary artery disease, chronic heart failure, pregnancy, abuse of alcohol, refusal to participate in the study. In a previous work, patient examination data were obtained on the Status PF hardware complex. Neurodynamic indicators were estimated, including the determination of the time of a simple visual-motor reaction (MTCM) and a complex visual-motor reaction (MPSM), reaction to a moving object (RDO), memory and attention. Using Spearman’s correlation analysis, we evaluated the impact on cognitive functions of a number of factors, presumably related to neurodynamics. The following factors were selected: age, creatinine level, NSE and S100 proteins, hemoglobin level, Beck’s depression points, indicators of personal and situational anxiety.Results. All patients examined on the Status PF software package had mild cognitive impairment in terms of neurodynamics, attention, and memory. The average positive relationship between the level of depression and various indicators of RDO was established: with RDO_average (ρ = 0.405; p = 0.018), with RDO_total delay (ρ = 0.540; p < 0.001), with RDO_average delay (ρ = 0.421; p = 0.007), as well as weak positive – with CEMR average exposure (ρ = 0.358; p = 0.023). An average positive relationship of creatinine level with RDO_O (ρ = 0.438; p = 0.005) is noted. A weak positive relationship between the level of personal anxiety and RDO_total delay (ρ = 0.334; p = 0.035) was revealed. The average negative relationship between hemoglobin level and RDO_total delay (ρ = –0.535; p < 0.001) was revealed. A weak positive relationship between situational anxiety and SEMR is determined by the number of errors (ρ = 0.364; p = 0.021), as well as a weak negative one with the attention volume (ρ = –0.357; p = 0.024). A weak negative relationship of age with visual memory per word was revealed (ρ = –0.362; p = 0.022).Domain of usage. Outpatient and hospital treatment stages of patients with chronic kidney disease case management

Influence of psychological characteristics of military services on the features of adaptation to the conditions of the Far North

The aim of the study: to consider the main personality types, indicators of personal and situational anxiety in military personnel of fixed-term and contractual service, depending on the duration of their stay in the Arctic region, and also to assess the influence of the psychological characteristics of military personnel on the processes of adaptation to the conditions of the Far North.Materials and methods. Psychological testing was carried out on 249 male servicemen aged 18-31 years (average age 21.5±4.8 years) who served in the Far North (158 people) and in the Western Military District (91 people). Testing was carried out at the beginning of the service, as well as 6 months after the start of service in various regions. To study personality typology, the Abbreviated Multifactorial Questionnaire for Personality Research (SMOL) and the Luscher test were used, and the Spielberger-Khanin test was used to assess personal and situational anxiety.Results and discussion. The survey showed predominantly asthenoneurotic and epileptoid-excitable personality types among conscripts, which was combined with high rates of personal and situational anxiety. The six-month period of service in the Far North for conscripts was not accompanied by a significant decrease in situational anxiety, which may indicate a low potential for psychological adaptation to the harsh conditions of service in the polar latitudes. And, on the contrary, among contract servicemen, a 6-month service in the Arctic led to an almost complete return of the indicators of situational anxiety to the values of a temperate climate. Thus, the preferential direction for service in the Arctic for contract servicemen will speed up the adaptation process. To assess the dynamics of situational anxiety during service in the Arctic region, it is justified to conduct psychological testing with a frequency of 6 months, which will identify servicemen with low adaptive potential.

Seborrheic dermatitis: the choice of topical treatment tactics, taking into account the characteristics of the skin microbiome

Objective — to study the clinical efficacy and safety of Betasalic, Triacutan and Psoricap drugs in the treatment of patients with seborrheic dermatitis. Materials and methods. The study included 75 patients with seborrheic dermatitis (main group). The control group consisted of 56 healthy individuals of the same age. The severity of seborrheic dermatitis in patients was assessed on a point scale, which included the assessment of the intensity of erythema, edema, oozing lesions, excoriation, scaling, skin oiliness. The study of skin microbiocenosis was carried out by the method of its direct qualitative and quantitative assessment. The level of anxiety was assessed using the Spielberger—Khanin self-assessment scale. Depending on the proposed treatment, patients with seborrheic dermatitis were divided into 2 groups: Group I (experimental group) — 43 patients who received Betasalic for 5 days, Triacutan — for 5 days, Psoricap — for 18 days starting from the 11th day of therapy; Group II (comparison group) — 32 patients who received topical corticosteroids. Results and discussion. The course of seborrheic dermatitis is accompanied by disorders of the skin microbiocenosis with an increase in the number of fungi of Malassezia and Candida genus in the affected areas, which requires appropriate treatment. Patients with seborrheic dermatitis are characterized by the presence of high personal and situational anxiety. The inclusion of Betasalic and Triacutan in the standard therapy of seborrheic dermatitis contributed to the recovery of the majority of patients and a significant improvement in different localizations of the pathological process. In contrast to the experimental subgroup, in the subgroup with standard treatment, these rates were significantly lower. Additional inclusion of Psoricap in the treatment regimen of patients with seborrheic dermatitis led to the recovery of 100 % of patients with the localization of the pathological process on the scalp and face. Conclusions. Complex therapy of seborrheic dermatitis with the use of Betasalic ointment, Triacutan cream or ointment and Psoricap cream is pathogenetically proved, since it provides a quick clinical effect, normalization of skin microbiocenosis.

Features of responding to stress of elderly patients with chronic brain ischemia

The aim of the study. To study the peculiarities of responding to stress, the stress resistance and adaptation of older men and women with chronic brain ischemia, as well as the stressboard effect of Mexidol.Material and methods. 124 patients aged 60–74 years old are surveyed: 72 men and 52 women (average age, respectively, 65.3 ± 0.4 and 64.7 ± 0.7 years) with Chronic Brain Ischemia I–II stage against the background of arterial hypertension and its combinations with atherosclerosis of cerebral vessels. The level of psychosocial stress was determined on the Holmes-Ray scale. Features of the response of patients to stress was studied using the methodology Scale of Psychological Stress PSM-25 and S. Rogenzweig. Stress resistance was investigated using S. Kuhlen's stress resistance self-resistant test and Villianson. The level of anxiety was determined using a scale of Ch.D. Spilberger and Yu.L. Khanin, depressed – backup questionnaire. The type of adaptation reactions was studied in the leukocyte blood formula on the percentage ratio of lymphocytes and segmented neutrophils, taking into account the representation of other formed elements.Results. The level of stress in older women with Chronic Brain Ischemia was higher than in men. The predominance of the intrinsic orientation of the reaction to stress and resolving the type of response to men, and the extrapunitive or self-defense type among women, which may indicate the largerness of the latter. The level of stress resistance was lower in women than in men, which correlated with higher indicators of situational anxiety. Adverse adaptation reactions were more often registered in women than in men. The course of treatment with Mexidol of elderly patients with chemical leads to a decrease in the severity of subjective and objective symptoms, alarming disorders, increases the stress resistance and adaptive capabilities of the body, which is confrmed by an increase in the number of persons with favorable adaptation reactions. The high effciency and safety of sequential therapy with Mexidol (injections, then the tableted form of Mexidol Forte 250) is shown.

Assessment of the state of personal and situational anxiety and indicators of stress-implementing and stress-limiting systems of the organism as marker efficiency the antenatal preparation

As a result of research conducted on the basis of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova NAMS of Ukraine», the issue of the transcranial electrostimulation introduction in preparation for partnership labor was shown. Purpose — to study the features of changes in the state of personal and situational anxiety, stress-implementing and stress-limiting systems of the body in healthy women depending on the method of prenatal training. Materials and methods. 120 somatically healthy women without severe extragenital and obstetric pathology with a physiological course of singleton pregnancy were examined. In the first group — 45 women set up for partner childbirth, the second group also included 45 patients who underwent a course of transcranial electrical stimulation (TES) of mesodiencephalic structures of the brain in comprehensive preparation for partner childbirth. The control group included 30 women who did not receive prenatal training, did not have individual support in childbirth and were tuned to traditional methods of pain relief as needed. Results. Following the results of the determination of pain rate in the dynamic of the TES procedure, a progressive growth of the pain tolerance threshold was recorded with the subsequent stabilization of this value after the 5th procedure of electrical stimulation. Methods of psychophysical preparation for childbirth using transcranial electrostimulation and partner support made it possible to reduce medical induced pain relief during childbirth, which is what the data we obtained indicate. Conclusions. The use of TES in complex prenatal preparation for partner labor allows to achieve and maintain a stable psycho-emotional adaptation of pregnant women and increases the tolerance of the consonant to labor pain without additional medication load, which helps to make more physiological course of labor. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: labor, prenatal preparation, transcranial electrostimulation, pain threshold, anesthesia, partnership labor.

Leading typological characteristics of temperament and psychodynamic features of personality in men with various forms of eczema

Annotation. The problem of causation in the formation of eczema in terms of psychosomatic relationship is currently relevant and virtually unresolved. The application of the complex principle of research determines a multifaceted assessment of the psychological state of the personality of patients with eczema and the possibility of its optimal correction. The aim of the study was to study the differences between the indicators of the leading typological characteristics of temperament and psychodynamic features of personality between healthy and/or eczema patients depending on the severity of dermatosis. Men aged 22 to 35 years, with a diagnosis of true and microbial eczema, were evaluated for the leading typological characteristics of temperament according to the Eysenck questionnaire and psychodynamic personality traits according to the Spielberger-Khanin questionnaire. As a control from the data bank of the research center of National Pirogov Memorial Medical University, Vinnytsya indicators of the level of subjective control of 82 practically healthy men of the same age group were selected. Statistical processing of the results was performed in the license package “Statistica 5.5” using non-parametric evaluation methods. In general, it was found that among patients with eczema 5.6 % are introverts, potential introverts – 12.3 %, ambiverts – 44.6 %, potential extroverts – 29.0 % and extroverts – 8.5 %. Compared with healthy individuals, the percentage of patients with various forms and severity of eczema is higher due to subjects with low (all groups of patients) and potentially low levels of neuroticism (true eczema of mild course), low situational (true eczema of mild course eczema and microbial eczema of severe course) and personal (truth of severe eczema) anxiety, and lover – due to patients with potentially high levels of neuroticism (truth of severe eczema), moderate (severe microbial eczema) and high (truth of eczema mild) level and situation level of personal anxiety (the truth of mild eczema). Patients with severe disease are characterized by a higher level of neuroticism (true eczema) and a higher level of personal anxiety (microbial eczema) compared to patients with mild disease. Patients with severe microbial eczema have a higher level of situational anxiety compared to patients with true eczema of similar severity. Thus, psychodiagnostics, which is based solely on patients' self-description of their behavior, emotional and volitional state, leads to inconsistency, subjectivity, uninformativeness of the results of the study and does not reveal the dynamics of the disease or treatment features.