卷 27, 编号 1 (2024)

BACKGROUND: Social isolation and loneliness can affect individuals of all ages, but in many countries, they are particularly prevalent among older adults. Despite this, the social isolation of patients with sensory impairments, especially visual deficits, has not been extensively studied.

AIM: To study the social isolation in patients with age-related visual pathology.

MATERIALS AND METHODS: 136 patients aged 60–74 with non-operated cataract and 136 age-matched individuals without any form of cataract were examined. When identifying the social isolation syndrome, a modified version of the social isolation index was used, consisting of five points: marital status or living situation, interaction with children, interaction with relatives, interaction with friends, and societal participation. Relative risk indicators (OR) and 95% confidence intervals (CI) were calculated to study the association with social isolation.

RESULTS: Elderly patients with non-operated cataracts showed a significant increase in social isolation associated with the duration of the condition (OR=2.21; 95% CI 2.03–2.54; p <0.01), average per capita income of patients (OR=1.82; 95% CI 1.63–2.15; p <0.01), presence of arterial hypertension (OR=1.53; 95% CI 1.41–1.82; p <0.01), and type 2 diabetes mellitus (OR=1.47; 95% CI 1.38–1.69; p <0.01). A higher risk of social isolation in patients with non–operated cataracts is observed in severe visual impairment (OR=3.56; 95% CI 3.17–3.82; p <0.001).

CONCLUSION: Social isolation among elderly patients with non-operated cataract is associated with the duration of age-related cataract and per capita income. The strongest association with social isolation was observed in patients with severe visual impairment caused by age-related cataracts.

BACKGROUND: Valvular heart defects are prevalent globally, ranging from 5 to 10 cases per 1,000 people, with the incidence increasing with age. Aortic stenosis, primarily due to aortic valve calcification, is the most common lesion. In Russia, the aging population has led to a rise in disability rates in this group.

AIM: To study the characteristics and nosological structure of recurrent disability due to non-rheumatic aortic valve disease among people over working age in Moscow in order to develop preventive measures for morbidity and disability in this group, and to provide recommendations for improving comprehensive medical and social rehabilitation.

MATERIALS AND METHODS: The study focused on individuals over working age with non-rheumatic aortic valve disease who were re-evaluated by the bureau of the branch of the Federal Governmental Institution “Main Bureau of Medical and Social Expert Evaluation in Moscow” of the Ministry of Labor of the Russian Federation. The study covered a 7-year period from 2017 to 2023. Descriptive statistics and statistical analysis were employed.

RESULTS: Recurrent disability due to non-rheumatic aortic valve disease among people over working age in Moscow in 2017–2023 showed a rise in the number of individuals re-recognized as disabled (593 cases, average growth rate of 45.7%, average level of 0.24±0.05 per 10 000 of the corresponding population). There was a predominance of male disabled individuals (311 cases), though their share tended to decrease (52.4%, average growth rate of +15.1%) and their incidence declined to 0.12 per 10 000. Conversely, the proportion of women with disabilities increased (47.6%, average growth rate +16.2%) along with their incidence level (0.11 per 10 000). According to the severity, Group III disability prevails (517 cases), with a growing share (87.5%) and incidence level (0.21 per 10 000), while Group II disability cases declined (12.5%) with an incidence of 0.03 per 10 000. Aortic stenosis accounted for a significant portion of disabilities (298 cases), representing 50.3% of all aortic valve damage issues.

CONCLUSION: The results of the study indicate the need for screening programs to identify this pathology among the working age population using modern diagnostic methods. When developing comprehensive medical and social rehabilitation measures, it is necessary to take into account age-related physiological changes to maintain preserve functional activity and improve the quality of life of people older than working age after surgical correction of aortic valve defects.

Rehabilitation of cancer patients and minimizing the complications of antitumor treatment are important modern goals with significant medical, social and economic implications. The development of complications following complex treatment of colorectal cancer depends on the patient’s comorbidities, such predisposing factors as pelvic floor muscle weakness, preoperative treatment, surgical extent, and a multidisciplinary approach from the moment of diagnosis of a malignant neoplasm and preparation for every stage of special treatment. As a result of analysis using the International Classification of Functioning, leading structural disorders were identified in the early postoperative period: qualitative changes in the structure of the large intestine, gastrointestinal continuity disruption with terminal transversostomy (s 5401.3), qualitative changes in the bladder structure, violation of integrity with defect suturing and epicystostomy removal (s 6102.3), qualitative changes in the pelvic floor structure, consequences of advanced surgery on the rectum, and repeated surgery (s 620.2). Functional impairments included moderate disturbances in night sleep (b 134.2), tenderness around the postoperative scar (b 280.2), body image perception (b 1800.2), tactile sensitivity (b 2702), peristomal skin sensations (b 840.2), and bloating (b 5351.2). Three-point rating was attributed to severe disorders in bowel movements frequency (b 5252.3), urination (b 6200.3), and bowel movements regulation (d 5301.3). When assessing “activity and participation,” changes were observed in coping with stress (d 2401.2), and regulating bowel movements (d 5301.3) and urination (d 5300.3). Positive aspects were identified when assessing the patient’s environment, their social status (family and immediate relatives, e 310.+2). The peristomal area was assessed, and individualized technical rehabilitation aids were selected (products and training technologies, e 300.+3).