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.

ObjectivesTo investigate the relationship between changes in circadian patterns of melatonin and clinical manifestations of polymorbid cardiovascular pathology (PCVP) in young men and to analyze the effectiveness of their complex treatment.Materials and methodsWe made the immunohistochemical (IHC) analysis of epiphysis tissues from autopsies of 25 men aged 32–44 with PCVP and metabolic syndrome (MS) who had died as a result of ischemic cardiomyopathy (IC) and 25 persons after the car accident as a control group. Then, 93 young men aged 35–44 with PCVP, metabolic syndrome, and depressive spectrum disorders (DSD) were divided into three groups: (1) standard therapy; (2) standard therapy and psychotherapy sessions; (3) standard therapy in combination with psychotherapeutic and psychophysiological visual and auditory correction sessions. The control group included 24 conditionally healthy male volunteers. Before and after the treatment, we studied the anthropometric status, lipid and carbohydrate metabolism indicators, the level of urinary 6-hydroxymelatonin sulfate, the degree of nocturnal decrease in blood pressure (BP), and the relationship of these indicators with circadian variations of melatonin excretion.ResultsYoung polymorbid patients who died from IC have a lower expression of melatonin type 1 and 2 receptors. All patients with PCVP showed a decrease in the nocturnal melatonin excretion fraction and a correlation with higher severity of depressive (r = −0.72) and anxiety (r = −0.66) symptoms. Reduced values of the 6-hydroxymelatonin sulfate (6-SM) in the 1st (r = 0.45), 2nd (r = 0.39), and 3rd (r = 0.51) groups before treatment was associated with periods of increased BP. The achievement of melatonin excretion reference values and normalization of biochemical parameters of carbohydrate and lipid metabolism, daily BP profile, and psychophysiological state were noted in all three patients’ groups, with a more pronounced effect in group 3.ConclusionLow nocturnal melatonin excretion levels are associated with greater severity of clinical symptoms and a higher risk of death in patients with PCVP. Therefore, comprehensive therapy may be more effective for correcting this disease.

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The results of a study aimed at assessing the potential use of millimeter therapy in the treatment of anxiety in elderly patients are presented. The aim of the study was to assess the potential use of millimeter therapy in the treatment of anxiety in elderly patients. Materials and methods. A comparative study of the effectiveness of EHF-therapy in the treatment of elderly patients with anxiety, against the background of chronic forms of coronary heart disease in the form of angina of tension of the first-third functional classes and arterial hypertension of the first or second degree of the fourth class of risk of cardiovascular complications. The total number of patients was 92 people. (men – 44, women – 48). Patients were divided into 2 groups. Patients of the clinical observation group (n = 45) during treatment of the main somatic disease additionally received EHF-therapy sessions, patients of the control group (n = 47) received only drug therapy for the somatic disease and phytotherapeutic drugs to alleviate anxiety symptoms. To assess the dynamics of anxiety and quality of life, a brief questionnaire SF-36 was used. Results and discussion. Before treatment, patients in the main group had reduced quality of life indicators on the scales: general health (GH) by 31.3 ± 2.0 points, role-based functioning (RP) - by 24.2 ± 3.1 points, pain (P) - by 20.6 ± 4.2 points, physical functioning (PF) - by 23.8 ± 2.0 points, vitality (VT) - by 26.1 ± 4.2 points, psychological health (MH) - by 37 , 8 ± 3.8 points, role-based emotional functioning (RE) - by 30.6 ± 3.5 points and social functioning (SF) - by 32.2 ± 2.1 points. At the end of treatment, there was a positive trend in the quality of life. It was noted that with concomitant alarming symptoms of cardiovascular pathology, the severity of cardiac pain syndrome was significantly (p < 0.05) compared with the value of the indicator before treatment, and indicators of physical and social functioning increased. Findings. It is shown that the inclusion of millimeter therapy in the treatment of anxiety in elderly patients with cardiovascular pathology contributes to a significant improvement in symptoms and quality of life. The inclusion of millimeter therapy in treatment programs improves their effectiveness, which consists in reducing the severity of anxiety symptoms in older people, and increases resistance to stress factors by forming an adequate behavioral stereotype.

Age-related changes in the body and concomitant somatic pathology can have a significant impact on the body adaptation processes to operational stress, which is associated with the development of adverse events in the intraoperative period, postoperative complications and long-term prognosis. Both the initial state of the body and the severity of changes in metabolism in response to operational stress, as well as the involvement degree of the body functional reserves, are important. Traditionally used methods for risk stratification, based on a patient’s survey or assessment of his daily activity, do not always provide a comprehensive, objective assessment of the body functional capabilities, especially in patients of older age groups. The prognostic value of cardiopulmonary exercise testing for determining the indications and the risk of complications in various types of surgical interventions has been proved. Based on the results of preoperative cardiopulmonary exercise testing, it is possible to make a more complete, comprehensive assessment of the patient’s body functional status, which is especially important for polymorbid patients. However, at present, there are no clearly defined normative limits for the indicators of cardiopulmonary exercise testing for patients of older age groups, which determines the future prospects for studying the use of this method for patients over 60 years of age with various pathological conditions. KEYWORDS: aging, operational stress, adaptation, functional reserve, prognosis, age-related features, cardiopulmonary exercise testing. FOR CITATION: Trotsyuk D.V., Medvedev D.S., Zaripova Z.A., Chikov A.E. Risks of perioperative complications in patients of older age groups: causes, mechanisms and prognostic possibilities. Russian Medical Inquiry. 2021;5(3):150–155. DOI: 10.32364/2587-6821-2021-5-3-150-155.