Аuthors: B. O. Shelest
The combination of essential hypertension (EH) with excess body weight or with abdominal obesity is considered as one of the most common associated pathologies, which lead to significant increase in the frequency of cardiovascular complications.
The aim of the work was to study the features of adipocytokine imbalance and metabolic disorders in patients with hypertension in combination with 2 type diabetes mellitus and obesity.
Material and methods. 48 patients with essential hypertension II stage were examined (22 men and 26 women). The average age of patients was 57.6 ± 4.7 years. The patients were divided into 2 groups: the 1st group consisted of 23 patients with isolated hypertension, the 2nd group – of 25 patients with hypertension in combination with diabetes and obesity. The level of chemerin, IL-6 and C-reactive protein (C-RB) was determined by the immune-enzymatic method.
Results. The results of the study show increased IL-6 levels in both groups compared with the control group (p ≤ 0.05), and the group with combined course of EH with diabetes and obesity had almost twice higher IL-6 level than in control. The level of C-RP in serum also exceeded the value of control values in both groups, the highest level was in patients with a combined course of hypertension with diabetes and obesity and was up to 2.3 higher. The level of serum chemerin increased in patients with essential hypertension with a combined pathology.
Conclusions. It has been established that patients with hypertension with diabetes mellitus have the most distinct imbalance of adipokines, hyperlipoproteinemia, carbohydrate disturbances and systemic inflammation, which should be taken into account in the appointment of pathogenetic therapy in this category of patients. The close pathogenetic relationships between metabolic disorders and increased serum chemerin level have been proven, therefore it must be considered as an unfavorable factor in the combined course of hypertension with diabetes and obesity. The results of the research can be applied to new and more effective methods of individual treatment of such cohort of patients with combined pathology.
Keywords: essential hypertension, diabetes mellitus, obesity, chemerin, inflammation.
Аuthors: O. S. Khukhlina, O. Ye. Mandryk, A. A. Antoniv, O. B. Kuzminska, I. V. Dudka, T. V. Dudka
The "Golden Standard" for the diagnosis of non-alcoholic fatty liver disease is a liver biopsy that allows a differential diagnosis between steatosis and nonalcoholic steatohepatitis (NASH), to assess the stage of fibrosis and, based on the results of the histological study, to make a prognosis for the further course of the disease, and to exclude other causes of liver damage.
The aim of the study was to find out the morphological characteristics of the NASH in patients with the comorbid obesity and hypertonic disease (HD) of stage II in comparison with the isolated course of NASH by studying the frequency and intensity of the leading clinical and biochemical syndromes of NASH, comparing the morphological characteristics of NASH depending on the presence of HD of stage II.
Material and methods. 140 patients with NASH were examined: 70 patients with NASH and I degree obesity (1 group), 70 patients with comorbid course of NASH, HD of stage II and I degree obesity (Group 2). All patients were randomized according to age, sex, degree of obesity. The average age of patients was 43.2 ± 5.31 years; 62 were men, and 78 persons were women. A transcutaneous or target biopsy of the right lobe of the liver was performed in 35 of the examined patients; 18 cases were obesity of the 1st degree and 17 cases were obesity of the 1st degree and HD of stage II.
As a result of the study, it was found that in patients with comorbid course of obesity and non-alcoholic steatohepatitis with hypertension of Stage II increases the degree of steatosis, the degree of balloon, hyaline-droplet dystrophy, dystrophic changes in hepatocytes. The comorbid course of NASH with HD of stage II is characterized by a significantly higher incidence and intensity of clinical syndromes, the degree of biochemical and histological activity, which leads to the progression of fibrotic changes in the liver.
Keywords: nonalcoholic steatohepatitis, hypertonic disease, liver fibrosis, balloon dystrophy, microvesicular steatosis.
Аuthors: T. O. Loboda, K. M. Radych, O. O. Yezhova
Introduction. One of the reasons of the central nervous system disorder is a long coma after clinical death, which is characterized by heterogeneous hypoxic and ischemic damage of the brain. The constant care of such patients is a social and economic burden of the society. Reducing the degree of disability due to disturbances in the functioning of the central nervous system, especially among young people, is associated with the use of intensive neurorehabilitation. It involves the inclusion of a variety of physical therapy methods into the complex treatment.
Purpose. To present to the wide medical community a clinical case of the effective application of the programme of physical therapy for a patient with severe hypoxic and ischemic affection of the central nervous system after a clinical death in an inpatient psychic and neurological department of the children's regional hospital.
Materials and Methods. The programme of physical therapy was divided into three stages and aimed at the maximum correction of persistent motor and cognitive disorders. The duration of the programme of physical therapy was four weeks; the duration of each session, usually, was 3-4 hours daily, according to the functional state of the patient. The effectiveness of the programme was evaluated comprehensively: by changes in a muscle tone, mobility of the joints, physiological bends of the spine, tactile and pain sensitivity, indicators of consciousness, psychic and emotional state; by restoration of the control of the act of urination and defecation; by improvement of cognitive abilities (speech and reaction to the speech of others, ability to draw, read, write and count); by the amount of independent living skills. Used tools: positioning, stretching-out, general, drainage and postural massages, breathing gymnastics, physical therapy equipment, passive and active exercises for muscles strengthening, training for controlling the stereotypical movements, improving their coordination, restoring the balance in an upright position and independent sitting and walking skills.
Discussion. The active usage of the physiotherapy methods along with the medical treatment allowed to achieve maximum recovery of motor and cognitive disorders, to avoid severe disability and socialize the patient. The obtained results confirm the hypothesis that the best functional results are observed under the condition of early start and continuous implementation of programmes of physical therapy in a complex with intensive medical treatment. It is believed that this clinical case illustrates the importance and need for the systematic usage of physical therapy for patients with severe damage of the nervous system in the healthcare institutions that should be provided with physiotherapists and ergotherapists.
Keywords: physical therapy, neurorehabilitation, method of Proprioceptive Neuromuscular Facilitation, hypoxic-ischemic lesions of the central nervous system, post-comatose condition, motor disorders.
Аuthors: V. Vizir, O. Nasonenko
Nowadays the interest on the role of androgens in lipid regulation increases due to proven correlation of low testosterone with cardiovascular morbidity and mortality. It was shown that testosterone level is inversely associated with total cholesterol, LDL, triglycerides, while the interrelation between androgens and HDL remains contradictory. The correlation between androgens and remnant cholesterol was not described. The aim of this study was to investigate the peculiarities of lipid profile in male hypertensive patients depending on their serum testosterone level.
Materials and methods. The study included 62 hypertensive men and 15 healthy male subjects as the control group. Physical examination, evaluation of serum lipids (total cholesterol, LDL, HDL, triglycerides), assessment of total and free testosterone in the serum were performed for all participants. Remnant cholesterol was calculated using the formula: remnant cholesterol = total cholesterol-LDL-HDL. 27 subjects among hypertensive patients had low level of serum testosterone (group 1), and 35 men with normal testosterone concentration were included to the group 2.
Results. All study participants were comparable by age and body mass index. The patients who had low total testosterone level were characterized by unfavorable lipid profile. Patients of the lowest quartile of total testosterone were vulnerable to hypercholesterolemia (25 %) and hypertriglyceridemia (87.5 %). In addition, they had decreased HDL levels (43.7 %), elevated LDL (93.8 %) and also had higher remnant cholesterol concentrations. The strongest correlation revealed between total testosterone and remnant cholesterol.
Conclusion. This study demonstrates that hypertensive men with androgen deficiency are characterized by an unfavorable lipid profile. The negative correlation has been found between total testosterone concentration and the level of total and remnant cholesterol in the examined cohort of patients.
Keywords: hypertension, cholesterol, testosterone.
Аuthors: A. V. Kamenshchyk
Introduction: The bicuspid aortic valve (BAD) is one of the most widespread congenital heart anomalies. The disease in many cases has asymptomatic course with later consequences beyond the pediatric age as a severe heart complications, sudden death and dissection of aorta. In addition, the ECG patterns remain unchanged to the time of aortal stenosis development and the signs of myocardial hypertrophy take place only in 30 % of children.
Purpose of the study: Detection of Sokolow–Lyon and Cornell ECG-indexes, as well as systolic lengthening and R wave height in aVL lead with establishing of their diagnostic values in children with bicuspid aortic valve.
Materials and methods: The study was conducted in 47 children with BAV diagnosed by doppler echocardiography, not having the signs of heart failure and in 44 healthy children of control group. The values of Sokolow–Lyon and Cornell voltage indexes, systolic lengthening and R wave height in avl lead were detected. Cardiographic hypertrophic Sokolow–Lyon Index (SLI) was calculated as the sum of bioelectric potentials of the S1 wave and the maximal R5 or R6 waves (mV) in the thoracic leads. The obtained data were processed statistically with Statistica 6.0 program using the Student’s test, quartile assessment, correlations and ROC-analysis.
Discussion: In children with BAV compared to control group the significant increasing of SLI, RaVL, SL values and tendency to CVI values increasing were detected. The correlation analysis revealed positive interrelations of the values of SLI with the left ventricle posterior wall depth and the ventricular septum depth and negative ones with the ejection fraction in children with BAV. At the same time, CVI had positive correlation with the systolic volume and the right ventricle transversal dimension, and, negative interrelation with the pulmonary artery valve velocity. RaVL had a fairly strong correlation with the pressure gradient at the aortic valve, and negative interrelation with left ventricle posterior wall depth and the ventricular septum depth. It should also be noted that the SL had no significant correlations with the volumetric Doppler echocardiography parameters at the aortic valve and with the left ventricle posterior wall depth and ventricular septum depth. It was established that in children with BAV the most predictive value for the development of further left ventricle myocardial hypertrophy which is detected by Doppler echocardiography has the Sokolow–Lyon index exceeding 30 mV as well as the height of the R wave in the aVL lead more than 9 mV may serve as predictor of an increase pressure gradient at aortic valve.
The obtained data testifies about the development of disadaptive functional changes and disorders of contractile activity of the left ventricle in the early stages of myocardial hypertrophy development in children with BAV and could be used to stratify the risk of further cardiac complications.
Keywords: Sokolow–Lyon index, Cornell voltage index, children, Doppler-echocardiography, bicuspid aortic valve, ROC-analysis.
Аuthors: O. O. Potapov, O. P. Kmyta, O. O. Tsyndrenko, E. S. Khomenko, I. I. Tereshchenko
Purpose of the work was to study clinical features and diagnosis of amyotrophic lateral sclerosis (ALS) in Sumy region and to analyze the therapeutic approach to patient treatment and its outcome.
Materials and methods. We analyzed 11 medical records of patients with ALS and ALS-like syndromes, which underwent inpatient treatment at Neurological Departments of Sumy Regional Clinical Hospital and Municipal Clinical Hospital No.4 in 2014–2016. Disease severity, progress and course were determined by means of a revised ALS functional rating scale (ALSFRS-R). Statistical data were processed using licensed version of IBM SPSS Statistics17 program.
Results. Most of the patients were residents of the regional centers of Sumy region – 8 (72.7 %) patients. Men dominated – 6 (54.5 %). The patients ranged in age from 47 to 81 years, the average age was 60.8 ± 10.5 years. The onset of the disease was registered at 57.5 ± 10.1 years. The cervico-thoracic form prevailed – 8 (72.7%) patients. Disease onset in the cervico-thoracic region was noted in 8 (72.7%) patients. Among the subjects, ALS syndrome (8 patients – 72.7%) prevailed over ALS disease. The score of 45 points by ALSFRS-R scale significantly prevailed irrespective of the age of disease onset.
Conclusions. The study of clinical features of ALS in Sumy region showed that the predominant number of patients were males, most of the patients ranged in age from 50 to 60 years. The most common form of the disease was cervico-thoracic one. The following clinical signs predominated: spastic-type muscle tone increase, motor function disorder and atrophy/hypotrophy of upper extremity muscles; and patients with bulbar form had asymmetry of nasopharyngeal folds, dystonia, dysarthria, dysphagia. It was found that in most patients, motor impairments prevailed over sensation and speech disorders. It was established that disease severity and clinical progression did not depend on ALS onset age.
Keywords: ALS, clinical features, ALSFRS-R, Riluzole.
Аuthors: O. M. Chernatska
No doubt that the coexistence of arterial hypertension and type 2 diabetes mellitus is connected with increased risk of heart failure and stroke compared with hypertensive patients. Furthermore, dyslipidemia plays a main role in atherosclerosis.
The purpose of our study was the analysis of structural peculiarities of dyslipidemia, assessment of the severity of lipid profile changes, determination of relationship between the degree of type 2 diabetes mellitus compensation and quantitative markers of lipid profile in patients with arterial hypertension and coexistent type 2 diabetes mellitus.
We examined 136 patients in our clinical trial. They were treated in Sumy City Clinical Hospital № 1 during 2014−2017: 96 people from the first group had coexistent pathology, 25 people from the second group had arterial hypertension only, 15 persons from the third group were practically healthy. We used biochemical methods for determination of general cholesterol, high density lipoproteins, triglycerides. We calculated low density lipoprotein and very low density lipoprotein levels and coefficient of atherogenicity. All data were analyzed with the help of statistical methods (Microsoft Excel 2016).
As the result, the levels of general cholesterol, low density lipoproteins, very low density lipoproteins, triglycerides were significantly higher, while high density lipoproteins were significantly lower. The study showed that the combined type of dyslipidemia was present in patients with arterial hypertension and type 2 diabetes mellitus, which confirmed the greater disorders in lipid metabolism in persons with coexistent pathology. If the level of glycated hemoglobin was more then 8.0 %, the levels of triglycerides were significantly higher (p = 0.0018), and high density lipoproteins were significantly lower (p = 0.0367). Finally, it is the confirmation of important role of dyslipidemia in the development of type 2 diabetes mellitus with such criteria of compensation as glycated hemoglobin.
Further study is required to improve treatment of dyslipidemia in patients with arterial hypertension and type 2 diabetes mellitus.
Keywords: dyslipidemia, coefficient of atherogenicity, glycated hemoglobin, arterial hypertension, type 2 diabetes mellitus.
Аuthors: N. Y. Emelyanova
Introduction and purpose. This article is devoted to the actual problem of dentistry, namely, cytomorphometric changes in the gingival epithelium of patients with cardio-respiratory pathology. The purpose is to study the cytological and morphometric parameters of gingival epitheliocytes in patients with chronic obstructive pulmonary disease in combination with coronary heart disease.
Materials and methods. 239 patients were examined: the main group, 130 patients with COPD in combination with chronic obstructive pulmonary disease with coronary heart disease; comparison group 1: 38 patients diagnosed with chronic obstructive pulmonary disease; and the comparison group 2: 71 patients with coronary heart disease. The control group is represented by 20 somatically healthy patients.
Morphometric and cytological studies were performed on scrapings of gingival epithelium according to standard procedure with staining with azur-eosin and studying under light microscope.
Results and discussion: It is noted that in patients with co-morbid pathology, the cells at in the late stages of differentiation are more common. Clear leukocyte infiltration is noted in the preparations, and morphometric analysis shows significant decrease in the nuclear-cytoplasmic ratio in patients of all groups due to an increase in the epithelial cell nucleus (p < 0.05), with no significant changes in the cell cytoplasm.
Conclusions: This fact justifies the need for early diagnosis of possible violations in the oral cavity, as well as the development of an algorithm for their prevention and treatment.
Keywords: periodontal, gingival epitheliocytes, coronary heart disease, chronic obstructive pulmonary disease, morphometry.
Аuthors: O. I. Smiyan, P. I. Sichnenko, E. G. Vasilyeva, T. P. Bynda, V. A. Gorbas, O. K. Romanyuk, K. O. Smiian-Horbunova, V. A. Suhareva, O. P. Moschich, O. O. Moshich
Introduction. Pertussis is an acute infectious disease of bacterial etiology, with an airborne mechanism of transmission, the causative agent of which is V. pertussis and with a high index of contagiousness. In recent years, the incidence rate of the pediatric population for pertussis remains rather high and tends to increase, which may be due not only to low postvaccinal immunity, but also an increase in the age of children under 18 years of age.
Despite the fact that in most developed country in the world, the percentage of children covered by vaccination against pertussis is quite high and reaches 90–95%, whilst infectious diseases, according to WHO, affect about 60 million people in the world and about 1 million children die, mainly at the age of 1 year. In Ukraine, 90–95% of children are vaccinated against pertussis every year, while in the country, 3–4,000 cases of the disease are registered among children, mostly up to 1 year old, and from 2 to 10 deaths annually. There is a tendency for an increase in the structure of the diseased portion of vaccinated children.
Therefore, for the timely diagnosis of a whooping cough, a very important combination of understanding of the epidemiological and clinical features of the disease at the present stage, especially among the children's population.
Purpose. Study of epidemiological features of a pertussis in children at the present stage in Sumy.
Materials and Methods. 238 cases of pertussis disease that were registered during the reporting period in Sumy were analyzed. The data were subjected to an epidemiological analysis, which included: studying the long-term dynamics of the disease from 2000 to 2016; seasonal dynamics of morbidity; distribution by age, vaccine status.
Discussion. It has been established that in the past 15 years a certain cyclicity of the pertussis disease has been observed with periods of reduction of the incidence of the disease to a significant increase. At the same time, in recent years there has been a tendency towards an increase in the incidence rate among children, with the incidence rate among the children of the vaccinated children being at a rather high level and is 51.4%. Children more than 1 year are more vulnerable. It is likely that an increase in the proportion of children under one year in the structure of the disease is due to the lack of transplacental transmission of antibodies, incomplete course of vaccination against pertussis, unformed postvaccinal immunity and, moreover, an increase in the incidence of disease among older children, which can be considered as a potential source of infection for children. infancy The increase in the incidence of pertussis in pre-school and school-age children is due to unreasonably broad contraindications to vaccination and the allegedly limited exposure of the current ACP vaccine to the epidemic disease process.
It was revealed that the highest morbidity was observed in the autumn-winter-spring period, which is associated with an increase in the circulation of respiratory viruses, since it is known that pertussis in 24.5–60% of children is combined with acute respiratory viral infections.
The decrease in the rate of vaccination against pertussis in the city of Sumy during the last 10 years has been shown, which reduces collective immunity, promotes the constant circulation of the causative agent among the children and influences the morbidity.
In general, data on the epidemiological course of a pertussis in the city of Sumy repeats the course of the pattern of pertussis morbidity in Ukraine as a whole and in the world.
Keywords: pertussis, children, epidemiology, vaccination.
Аuthors: A. Ye. Demkovych, Yu. I. Bondarenko, V. R. Machogan
Introduction. One of the most urgent problems of modern dentistry is periodontitis; it concerns, first of all, modern treatments. Development of inflammation in the periodontal complex includes numerous links that lead to generalization and chronicity of it, loss of teeth and complications of other organs.
Purpose of this research was to investigate the pathomorphological changes in the periodontal complex in experimental bacterial-immune periodontitis formation and treatment effect of the flavonol quercetin.
Materials and Methods. The study was conducted with the use of non-breeding clinically healthy male rats. Experimental bacterial-immune periodontitis in experimental animals was caused by introducing complex mixture of microorganisms diluted with egg protein into periodontal tissue near the lower central incisors. Quercetin was used by intramuscular injection (100 mg/kg body weight) for 7 days. The transverse sections on a microtome were made in the thickness of 5-6 microns. The resulting preparations were stained with hematoxylin and eosin.
Discussion. The histological study showed that the experimental periodontitis course was characterized by increased inflammatory response by the 14th day of experiment, and its spread throughout the periodontium with accumulation of sufficiently large number of different cells, including neutrophils, macrophages, fibroblasts. The inflammatory reaction was accompanied with distinct structural changes. The analysis of the microscopic examination of the periodontal tissues in the animal group with experimental periodontitis showed positive dynamics of structural organization as compared with animals that were not treated during this period by the quercetin. At the same time, there was improved structuring of the gingival epithelial plate, its vertical and horizontal differentiation. The linearity of the epithelial layer became clearer and the number of dystrophic altered cells was decreased. The use of the flavonol quercetin during this period of the experimental bacterial-immune periodontitis development improved to normalization of the morphological state of periodontal tissues.
Keywords: periodontitis, inflammation, periodontium, pathomorphologic, cementoblasts, cementocytes.
Аuthors: T. Thea, V. Arved
One of the unsolved problems for the medical research in the occupational health service is the objective examination of the condition of the skeletal muscles. Current methods: palpation, anamnesis, etc. give us subjective estimations and therefore forming the diagnosis is complicated and, in many cases, disputable.
The aim of this study was to clarify the application possibilities of the myometrical method in studies for skeletal muscles in occupational health service.
During the study anthropometrical values were collected from 1976 employees of Estonian companies and simultaneously with, but independently from the traditional health study the data about the tone, elasticity and stiffness of skeletal muscle were collected also, using myometrical method. Characteristics of the skeletal muscles’ parameters (tone, elasticity and stiffness values) were measured in the person’s state of relaxation, for both right and left side of the body at the centre of the muscle belly from the following muscles: m.tibialis anterior, m.extensor digitorum, m.adductor pollicis, m.abductor pollicis brevis, m.flexor carpi radialis, m.gastrocnemius c.m., m.trapezius from two regions – (upper region, middle region) and m.erector spinae.
The employees participating in the study were divided into eight groups by sex (men and women), by age (up to 35 years and older than 35) and the body mass index (BMI) (up to 25 and over 25). When comparing the groups with each other it was found that for majority of cases there exists a statistically significant difference (p < 0,05). Thus the normal values for the examined muscles must be calculated for eight groups, taking into account sex, age and BMI values.
In conclusion, we can say that myometrical method gives complementary information for the occupational health medical research that simplify the formulation of the diagnosis and monitoring the changes in skeletal muscles induced by a work process and preventing overuse trauma. The existence of normal values facilitates the assessments and specifies in what danger zone the examined muscle is.
Keywords: skeletal muscle, cumulative trauma disorder, study of occupational health, myometry, normal values.
Аuthors: I. V. Marchenko
Introduction. Analysis of single-nucleotide polymorphisms (SNP) of genes is one of the modern diagnostic methods, which allows revealing hereditary predisposition to multifactorial diseases, including type 2 diabetes mellitus (T2D). Considering that in most of the populations under investigation, the ENPP1 gene polymorphic rs997509 site is in a non-equilibrium relationship with another well-studied locus rs1044498 of this gene, our studies were aimed at studying the complex effect of rs997509 and rs1044498 polymorphic sites on T2D in Ukrainian population.
Purpose. To study the complex effect of rs997509 and rs1044498 polymorphic sites of the ENPP1 gene on T2D.
Materials and Methods. Venous blood of 317 patients with type 2 diabetes mellitus and 302 controls. All subjects were genotyped using the method of polymerase chain reaction with further analysis of restriction fragment length.
Results. In the study of the complex effect of rs997509 and rs1044498 polymorphic sites of the ENPP1 gene on type 2 diabetes mellitus in the comparison groups, it was found that the locus of these SNPs is in strong non-equilibrium adhesion (D'=0.970, r2=0.157). The AC haplotype was more common among healthy individuals and had statistical significance (OR = 0.698; 95% CI = 0.530-0.920; P = 0.011). Haplotype CT was significantly more common in the group of patients with type 2 diabetes than in control, and increased the risk of type 2 diabetes in 1.9-fold (95% CI = 1,045-3,44; P = 0.035 respectively). There was no difference in the frequency of the haplotype CC between the comparison groups (P = 0.128). It has been found that the coincidence of the heterozygotes and homozygotes of the minor Q-allele for SNP rs1044498 and one of any possible genotypes for SNP rs997509 is associated with a high risk of type 2 diabetes. In addition, the coincidence of homozygotes of major K-allele of the 4th exon with carriers of the minor T-allele of the polymorphic site of the 1st intron of the ENPP1 gene leads to a significant increase in the risk of type 2 diabetes. The analysis of inter-locus interactions revealed a weak neutralizing effect (-0.79%) between the studied polymorphisms of the ENPP1 gene (P = 0.022).
Conclusion. Predictor of an increased risk of type 2 diabetes is the combination of one of the variants of genotypes (K/K, K/Q or Q/Q) for rs1044498 with heterozygote (C/T) for rs997509; and a combination of carriers of the minor Q-allele of 4th exon with homozygote (C/C) of the 1st intron ENPP1 gene.
Keywords: type two diabetes mellitus, Ectonucleotide Pyrophosphatase/Phosphodiesterase 1, allelic polymorphism.
Аuthors: I. Н. Mudrenko
Topicality. The urgency of the study is stipulated by high level of suicides in the world, particularly in Ukraine. It is known that one of the peaks of suicidal activity occurs in the elderly people. Many researchers emphasize differences in the peculiarities of the psyche, attitude to psychotrauma, system of values in men and women. The gender aspect of the formation of suicidal behavior in dementia has not yet been studied.
Purpose of the work. The aim of the work was to study the gender peculiarities of cognitive functions and the level of social functioning in patients with high suicidal risk in different clinical types of dementia (due to Alzheimer's disease, vascular dementia, of mixed type).
Materials and methods. 105 people with different clinical types of dementia (vascular, due to Alzheimer's disease, of mixed type) were examined. The clinical-anamnestic method (clinical interview, observation, collection of complaints, anamnesis), psychometric (MMSE scale, CDR, method for determining suicide risk), Method of Statistical Processing of results were used.
Results of the study. Gender differences of the features of the cognitive functions state (thinking, memory, orientation, ability to count, perception, visual-spatial orientations) and social functioning in patients with high suicidal risk in different types of dementia are highlighted in the article. The differentiated markers of high suicidal risk in men and women are formed separately for each clinical type of dementia on the basis of statistics analysis. It is established that in Alzheimer's disease the informative signs of high suicidal risk are as follows: in women – lower level of social functioning; violation of the ability to orientate; in particular, disorientation in time; more pronounced deficiency of mnestic functions, inability to perform counting operations. In vascular dementia, the gender characteristics of high suicidal risk are: in women – the presence in clinical picture of more pronounced cognitive deficiency (DK = 8.568; MI = 11.888) compared with men due to violation of the ability to orient in time (DK = 1.35; MI = 2; 40); in space (DK = 0.67; MI = 0.94); ability to perform account operations (DK = 2.86; MI = 6.42); execution of commands (DK = 0.970; MI = 1.198), visual-spatial disturbances (DK = 1.62; MI = 0.482). In mixed dementia the informative gender signs of high suicidal risk are as follows: in women – disorientation in place (DK = 1.029; MI = 1.716); marked violation of the ability to perceive and reproduce information (DK = 0.657; MI = 0.657) in comparison with men; in men – unsatisfactory level of self-service ability (DK = 0.750; MI = 0.750).
Keywords: gender differences, suicidal risk, predictors, dementia in Alzheimer's disease, vascular dementia, mixed dementia.
On August 24, 2018, we celebrate the 60th birthday of Boyko Vladimir Ivanovich – the Head of the Department of Obstetrics and Gynecology, Medical Institute, Sumy State University.