Vol 22, No 1 (2019)

The study of cognitive functions in patients with type II diabetes mellitus (type II diabetes. at the outpatient stage was carried out. A total of 44 patients with type II diabetes who applied for outpatient admission were examined. The mean age of patients was 64.68±1,52 years. In the course of the work the influence of cognitive impairment on the level of patient compliance was studied. The contribution of comorbid pathology, micro - and macrovascular complications of diabetes mellitus, the duration of the disease to the level of cognitive deficit was also evaluated. It was found that the increase in cognitive dysfunction is accompanied by a decrease in the level of compliance in the study cohort of patients, as well as an increase in anxiety-depressive traits examined. The obtained data once again emphasize the importance of timely diagnosis and competent correction of possible cognitive impairment in patients with diabetes mellitus within the outpatient link.

The article is devoted to the problem of sleep disorders among patients in the practice of district therapist. According to the obtained results, according to the results of the study, a low risk of OSA was encountered in 24% of cases, an average risk - in 28 %, a high risk - in 48% of patients; excessive daytime sleepiness was absent in 35% of patients, moderate daytime sleepiness - in 52% of patients, significant daytime sleepiness - in 13%. Given the wide prevalence of OSA, it is necessary to diagnose it in a timely manner and to treat and prevent it; to prevent recommended weight loss and maintaining ideal weight, quitting Smoking and alcohol, maintenance of stable sleep, exercise to exercise the muscles of the nasopharynx, avoiding sleep in the supine position.

The article is devoted to the problem of anemic syndrome in an outpatient patient, which, along with other chronic non-infectious diseases, requires early detection during dispensary and diagnostic measures in the primary health care, adequate appointment of a complex of therapeutic and preventive measures. According to the results, anemic syndrome in the therapeutic area of the city polyclinic was more often detected in women, persons in the age range over 55 years, anemia of mild severity was detected in patients, the predominant cause of the anemia syndrome is chronic blood loss.

We analyzed the effectiveness of management of patients with pain in various forms of spinal osteochondrosis, on the basis of work with outpatient cards, evaluation of the scale "Visually Analog Scale", survey and examination of patients. Also, the sex and age of patients and the effectiveness of the therapy were determined. In the course of the work it was found that more women prevailed in the handling of pain syndrome, the age range was 31-50 years and 51-70 years, the pain localization in the first place is the lumbosacral region, on the scale "Visually Analog Scale" the intensity of pain syndrome in women the pain threshold is higher than in men. It was also found that drug therapy in the form of NSAIDs and muscle relaxants, prescribed to the studied patients for the purpose of relieving pain in osteochondrosis, led to a significant reduction in pain.

50 patients of elderly and senile age, observed at the district therapist of the district polyclinic, were examined. The assessment of cognitive impairment using The mini-Cog test, the severity of symptoms of depression on the geriatric scale of depression, the presence of frailty. 100% of the subjects showed signs of dementia, signs of mild and moderate depression were diagnosed in 78% of patients, the diagnosis of frailty was established in 82% of patients. Women are characterized by a greater severity of depressive disorder in comparison with men. Significant dependences of the increase in the degree of cognitive impairment, the severity of depression and frailty with an increase in the age of patients, as well as the mutually aggravating effects of the syndrome of frailty, cognitive impairment and depression in elderly patients were revealed.

The article deals with the risk factors of insomnia among the elderly. In order to identify the risk factors of insomnia in the elderly, a survey of patients who applied for an appointment with a General practitioner in the Department of General practice №1 of the city of Saratov was conducted. The questionnaire included 39 questions and did not cause difficulties in patients when filling out. The study involved 100 elderly people. The study allowed to establish the risk factors of insomnia in elderly patients. On the basis of the obtained results, the methods of correction of the identified risk factors are developed. The defining conditions of prevention were: refusal to watch TV before going to bed, Smoking and taking caffeine drinks in the afternoon, timely treatment of the underlying disease, the symptom of which is a sleep disorder.

The article is devoted to the current topic-eating behavior, it discusses the idea of the relationship between the eating behavior of man and his type of temperament through a survey of an independent group of persons.the Work is interdisciplinary, written at the intersection of the collision of psychological, gastroenterological and cardiac spheres. After statistical processing of the obtained data, the regularities were revealed and the results were analyzed, the conclusion was made about the direct influence of the type of temperament on food behavior, the relationship between the main features of temperament and eating disorders. The study revealed the proportion of rational nutrition. The problem of the influence of psychological factors on human physiology is one of the leading and requires further study.

20 patients with syncope history were examined, among whom were 7 men and 13 women aged from 18 to 75 years. The types of syncope and their causes were studied in patients depending on age. Older women were diagnosed with cardiogenic and orthostatic syncope, in 60% and 40% of cases, respectively. All men of old age had fainting of cardiogenesis. The causes of cardiogenic syncope in patients with elderly men were: dysfunction of the sinus node and AV block III, in 2 (66.7%) and 1 (33.3%) cases, respectively. AV-block III and supraventricular tachycardia were detected in 2 (40.0%) and 1 (20.0%) sick women, respectively, as a cause of sudden short-term loss of consciousness. Timely diagnosis and differential diagnosis of a sudden short-term loss of consciousness by a primary care physician will save health care resources associated with the cost of hospitalization of patients.

The article deals with the issues of medical examination of the adult population in the Orenburg region. the number of citizens of the Orenburg region who passed the first stage of medical examination in 2017 amounted to 91.3% of the plan. 29.9% were sent to the second stage of medical examination, 98.5% of them completed it. As can be seen from the indicators of coverage of the population in both stages of medical examination, they were close to 100%. At the second stage, 5.3% were examined by a neurologist and 0.9% by a proctologist. The study of indicators of quality of medical examination of the adult population in the Orenburg region showed that there are reserves for their improvement. CCP should reduce the likelihood of each individual developing dangerous chronic non-communicable diseases, and in persons already suffering from such diseases, significantly reduce the severity of the course.

This article discusses the issue of falls in old age. The main purpose of the study was to assess the incidence of falls in elderly patients and the arrangement of their apartments, as a factor affecting the fall. Senile asthenia was detected in 31.8%, preasthenia - in 54.5% of patients 60 years and older, and the presence of a positive correlation of senile asthenia and falls indicates the need for close attention to this category of patients, because they are at high risk of falls and subsequent complications. In 50% of patients when assessing the arrangement of apartments there were more than 10 factors that increase the risk of falls.

The paper analyzes the data of 1634 outpatient cards of patients of the therapeutic area to assess the prevalence of smoking (taking into account the gender factor) and the frequency of diseases associated with smoking: chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), laryngeal cancer, lung cancer, lip skin cancer. A comparison of the prevalence and severity of this pathology in the group of smokers in comparison with the equivalent in number group of non-smokers was made. It was found that 22.6% of the patients attached to the site are smokers, males predominate among smokers (92.7%), among smokers the prevalence of COPD, coronary artery disease, lung cancer is much higher in comparison with non-smokers. Cancer of the larynx, cancer of the skin, the lip srin cancer were identified only in smokers. Smoking patients had a more severe course of COPD and lung cancer in comparison with non-smokers.

The unsuccessful state of environment affects health of the population. A noninvasive method of efferent therapy is the enterosorbtion. The purpose - development of the tableted sorbent form on the basis of powder of an apple residue and assessment of its sorption properties. Methods: Technical characteristics on powder defined in accordance with GOST 12597-67 (humidity) and OFS.1.4.2.0016.15 (a pressuyemost and degree of flowability). As excipients used starch and a kaolin. Tablets received by method of stamp pressing. Determined by a photocolorimetric method sorption activity of dosage forms (powder, tablets) in relation to methylene blue, to gelatin and cyanocobalamine. Results: It is established that powder from an apple residue has flowability - 20.0 ± 0.3 with / 100, the corner of a natural slope - 40.0º ± 1.0, bulk volume - 1.4 ± 0.2, and can be pressed without granulation. However, the tablet from this powder weighing 1.00 g with height relation to diameter of 38.46% meeting requirements of industry standard 64-072-89 did not conform to requirements OFS.1.4.2.0009.15, was fragile with erose edges. The tablet of structure of 0.50 g of an apple residue, 0.25 g of starch and 0.25 g of a kaolin corresponded to all process parameters. It is established that the received dosage form is capable to occlude methylene blue, gelatin and B12, sorption activity makes 192.6 ± 4.2 mg/g, 167.3 ± 3.9 mg/g and 89.3 ± 5.1 mg/g, respectively. The received sorbent does not concede, and sometimes and surpasses the registered medicines in sorption activity: Карбосорб (MS - 243.68 ± 1.3 mg/g; gelatin - 40.5 ± 1.3), Polisorb (MS - 47.7 ± 2.9 mg/g; gelatin - 328.2 ± 3.3 mg/g), Polifepan (MS - 28.9 mg/g, gelatin - 32.5 mg/g, B12 - 1 mg/g) and Smekta (MS - 125 mg/g, gelatin - 113 mg/g, B12 - 1.2 mg/g). Conclusion: The structure of a tablet at which it was succeeded to reach its compliance on pharmatsevtiko-process parameters is defined: 0.5 g of an apple residue, 0.25 g of starch and 0.25 g of a kaolin. It is established that the offered medicine has the high sorption activity which is not conceding to the registered medicines: Карбосорб and Polisorb concerning toxins and metabolites of the proteinaceous nature, low-molecular and high-molecular substances.