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.

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-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.

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.

У большинства пациентов старше 50 лет диагностируют заболевания зубочелюстного аппарата, в частности нарушения костной ткани, что приводит к снижению процента приживаемости имплантов. Выявление причин, а также разработка методики прогнозирования приживаемости малоинвазивными методами являются актуальными проблемами. Цель исследования - изучение маркеров плотных контактов в буккальном эпителии у людей разного возраста. Соскоб буккального эпителия брали до и после имплантации у пациентов, разделенных на пять возрастных групп - от молодого возраста до долгожителей. Иммуноцитохимическим методом изучали маркеры к белкам плотных контактов - клаудину-1, -7 и -10. Показано, что с возрастом происходит снижение интенсивности экспрессии молекул адгезии, в частности клаудина -1, -7 и -10, в слизистых оболочках, минимальные значения зафиксированы в группе долгожителей. В исследовании установлено, что после дентальной имплантации снижается экспрессия клаудинов-1 и -10 и увеличивается - клаудина-7. Изменение экспрессии клаудинов может свидетельствовать о развитии патологического процесса в организме, в том числе об успехе имплантации, особенно у людей старших возрастных групп. 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.

To understand the pathogenesis of dilated cardiomyopathy (DCMP), it is necessary to establish the molecular and cellular mechanisms of myocardial aging, including those associated with programmed cell death, the molecular mechanisms of which have not been extensively 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. 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 two 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 (3.2-fold) differences were obtained when comparing the expression of Bax in the cell culture of cardiomyocytes from the group with DCMP in the “young” culture compared with the control. 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.

Цель работы - исследование экспрессии сируинов-1 и -6 и кисспептина в ткани яичников человека, взятых в разные периоды онтогенеза - от формирования пула фолликулов в антенатальном периоде до угасания функции яичников в постменопаузе. Выявлено, что сиртуины экспрессируются в ткани яичника человека во всех возрастных группах. Максимальный уровень экспрессии SIRT1 в ткани яичника наблюдали в периоды внутриутробного развития и перименопаузы, SIRT6 - в репродуктивный период и перименопаузу. Показано участие SIRT1 в пренатальном отборе ооцитов у плодов человека, так как именно в этой группе выявлена повышенная экспрессия данного маркера. Уровень экспрессии маркера кисспептина растет по мере формирования яичников и включения репродуктивной функции, пик экспрессии наблюдается в период перед наступлением климакса. Проведенное исследование по выявлению экспрессии этих белков в яичнике человека расширяет представление о регуляции фолликулярного резерва яичников и репродуктивном старении. 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.

Сахарный диабет 1 типа (СД1) является аутоиммунным заболеванием, а беременность при наличии СД1 сопряжена с рисками как для здоровья матери, так и для плода. Поскольку у женщин с СД1 может наблюдаться неблагоприятный исход беременности в связи с аберрантной иммунологической адаптацией к беременности, изучение иммунологических взаимодействий у беременных женщин с СД1 является одной из приоритетных задач. В рамках данного исследования нами были изучены образцы, полученные от 80 пациентов: 40—от группы с СД1, 40—от группы контроля. Каждая из групп также была разделена на возрастные подгруппы, а также на подгруппы перво- и повторнородящих. В качестве молекул интереса нами были выбраны маркер макрофагов CD68, маркер В-лимфоцитов CD20, а также маркер NK-клеток CD57. Наше исследование позволило выявить отличия в экспрессии маркеров иммунокомпетентных клеток между группой пациенток с СД1 и контрольной группой. Данные результаты говорят о высокой значимости исследованных маркеров для оценки течения беременности и состояния здоровья плода и матери.

Placenta is a temporary organ that performs multiple functions to provide a normal course of the intrauterine development of the child. However, immune interactions in placenta are not well understood. Since women with type 1 diabetes mellitus have a greater risk of adverse pregnancy outcomes due to aberrant immunological adaptation, the study of immunological interactions in placenta of these women is of particular interest. In this study a comparative analysis of the age-related expression parameters of marker of NK-cells (CD57) in placenta in patients with type 1 diabetes mellitus was performed. The current study revealed differences in the expression parameters of NK-cells marker between two age subgroups of the patients and compared to healthy controls. The results indicate the high significance of inflammatory markers in women with type 1 diabetes mellitus for assessing the course of pregnancy and the possible development of somatic pathology in newborns, especially from older women.

According to statistics, approximately 75-80% of cases of diabetes mellitus in women during pregnancy show the presence of a urogenital infection in which the development of the inflammatory process is conducive to the elimination of the pathogen and the appearance of necrotic tissue. Such inflammatory processes, as a rule, occur with the participation of macrophages attracted by B-lymphocytes and NK-cells. The main goal of this study was to evaluate the expression ratio of immunocompetent cells: macrophages, NK cells and B lymphocytes in the placenta in women with diabetes mellitus who are in different age groups. Molecular markers were visualized using an immunoistochemical method. Were used antibodies to CD68 (1:300, Dako, USA) for macrophages, CD20 (1:300, Dako, USA) for B-lymphocytes and CD57 (1:300, Dako, USA) for natural killer cells. The results were visualized on a confocal microscope (FluoView 1000 (Olympus)). For scoring of microphotographs program “Morphology 5.2” was used. On the microphotographs the relative area of expression was evaluated, signified as the ratio of the area of the immunopositive reaction to the total area of the slide and the optical density. Then a statistical evaluation of the obtained data in the “Statistic 10.0” program was carried out. During the experiment, a sharp decrease in the expression of the CD68 marker in the placenta was detected. A decrease in the expression of the CD20 marker with an increase in the age of patients with diabetes mellitus was also demonstrated, while in healthy women an increase was observed in the middle age group. For natural killers, there was no difference between healthy and sick women. The result indicates a weakening of the reaction of the immune system in diabetes mellitus.

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.

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.

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 (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.

The combined effect of electromagnetic radiation at the extremely high frequency (EHF) and infrared (IR) ranges on the expression of cell renewal markers (Ki67 and p53) and the proinflammatory cytokine TNF-α was studied by investigating the buccal epithelium of patients with chronic periodontitis from different age groups. After a course of EHF and IR therapy, an increase in the expression of the proliferotropic protein Ki67, along with a decrease in the synthesis of the proapoptotic protein p53 and the proinflammatory cytokine TNF-α, were observed in young, middle-aged, and elderly patients suffering from chronic periodontitis. The data confirm the possible effect of the EHF and IR therapy on the pathogenetic mechanisms of chronic periodontitis in patients of different age groups.

Millimeter-wave electromagnetic radiation (EHF-therapy) is an effective method for treating various age-related pathologies, including cardiovascular diseases. Multidirectional changes in the synthesis of NO-synthase (eNOS) and endothelin-1 and the expression of angiotensin-2 and vasopressin were observed during EHF irradiation of aging human endothelial cell cultures, depending on the duration of the irradiation. These data showed that the EHF irradiation stimulates the functional activity of endotheliocytes, which could be of importance in the search for new approaches to the treatment of arterial hypertension and atherosclerosis.

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.

311 детям от 2 до 17 лет с затяжным обострением бронхиальной астмы и длительным кашлевым синдромом (более 3, но менее 8 недель) проведено иммунологическое (ИФА) и молекулярно-генетическое (ПЦР) обследование для выявления Chl. pneumoniae и M. pneumoniae. У 150 детей (48 %) диагностирована хламидийная или микоплазменная инфекции, в 42 и 53 % случаев, соответственно, были положительны оба метода. В этой же группе зарегистрировали увеличение содержания общего IgE в плазме крови не только у детей с бронхиальной астмой, но и с инфекционным бронхитом. Обострение бронхиальной астмы на фоне Chl. pneumoniae и M. pneumoniae характеризовалось длительным применением β2 агонистов и ингаляционных глюкокортикостероидов. Результаты ингаляционного проверочного теста с возрастающими концентрациями гипертонических растворов NaCl через 4 недели и 6 месяцев после начала медикаментозного и восстановительного лечения, подтвердили формирование неспецифической гиперреактивности бронхов на фоне Chl. pneumoniae и M. pneumoniae