scholarly journals Conservative treatment of the longitudinal flatfeet in children

2021 ◽  
Vol 11 (7) ◽  
pp. 298-309
Author(s):  
O. Shulga
Keyword(s):  
Conservative Treatment ◽  
Muscle Tone ◽  
Clinical Manifestations ◽  
Physiological Effect ◽  
Traditional Methods ◽  
Treatment And Prevention ◽  
Serial Casting ◽  
Long Term Result ◽  
Two Stages ◽  
Severity Degree

Introduction. A significant percentage of the musculoskeletal system pathology in children is currently fall on the foot pathology – longitudinal flatfeet, which is not only a medical, but also a social problem. The incidence of this pathology is up to 58% of the total orthopedic foot pathology. Traditional methods of treatment and prevention of mild (I– II severity) longitudinal flatfeet (LF), which are known today (massage, physiotherapy exercises, the use of orthopedic devices, electromyostimulation) do not give a significant effect and a stable, long-term result. This makes us look for more effective methods of conservative treatment of LF of the I– II severity degree, which have a pathogenic orientation and physiological effect. Purpose of the work: to develop the most effective algorithm for the complex conservative treatment of LF, depending on the severity, hemodynamic disorders, deformity options, foot rigidity. Materials and methods. Conservative treatment was carried out in 62 patients aged 10– 18 years with LF of the I– II severity degree. Depending on the clinical manifestations and examination results, the treatment was carried out in two stages. At the first stage, serial casting was used (in the presence of concomitant deformations – silicone pelottes were used). Results. The results of the two-stage conservative treatment of LF demonstrate the effectiveness of serial casting in combination with the use of silicone pelottes and biostimulators in comparison with traditional methods of foot correction. Conclusions. Algorithms for conservative treatment of LF were developed, depending on the severity, nature of the deformity, hemodynamic disorders and muscle tone of the lower leg and foot.

scholarly journals Features of the clinical course of a new coronavirus infection in students who were observed in the observator in the first and second wave of morbidity increasing

2021 ◽  
Vol 25 (1) ◽  
pp. 27-33
Author(s):  
Olga Yu. Kuznetsova ◽  
Anna V. Lubimova ◽  
Karina V. Ovakimyan ◽  
Olga I. Frolova ◽  
Olga S. Zamyatina ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Clinical Course ◽  
Nasal Congestion ◽  
Clinical Manifestations ◽  
The North ◽  
Treatment And Prevention ◽  
General Weakness ◽  
Coronavirus Infection ◽  
Two Stages ◽  
Second Wave

INTRODUCTION: The sudden appearance of a new coronavirus infection in the world has posed difficult challenges for science to determine the main clinical manifestations of this disease, as well as to approve standards for diagnosis, treatment and prevention. Research of the symptoms of mild COVID-19 is continuing. The data obtained in such studies are particularly relevant for primary care physicians. THE AIM: To evaluate the features of the clinical course of COVID-19 among students of the North-Western State Medical University named after I.I. Mechnikov, placed in the observatory, during the first and second waves of rising morbidity. MATERIALS AND METHODS: The study was conducted on the basis of the observatory of the NWSMU named after I.I. Mechnikov in two stages: in the period from 21.04.2020 to 31.08.2020 (the first wave) and from 16.09.2020 to 31.12.2020 (the second wave). Demographic, epidemiological, and clinical-anamnestic data were recorded in all participants of the study. RESULTS: The study involved 309 people: 39.8% men (n = 123) and 58.9% women (n = 182). The average age of the respondents was 21.5 2.6 years. The number of participants in the first and second waves was 113 and 196 people, respectively. The average age of participants with COVID-19 in the first wave was 1.5 years less and was 21.2 2.5 years (р 0.001). There was a significant increase in the frequency of the following symptoms: dry cough, loss of smell, headache, general weakness, increased body temperature to 38.0 С, nasal congestion (р 0.05) in students who were monitored in the second wave of increased incidence of COVID-19 compared to the first. The frequency of symptoms such as chest congestion, lower back pain, and fever above 38.0 С significantly decreased (р 0.05). There was a significant decrease in the incidence of viral pneumonia in patients who were observed during the second wave, compared with the data obtained during the first wave (р 0.001).

scholarly journals Drug-Induced Heart Failure (Part 2: Mechanisms of Development, Clinical Signs, Differential Diagnosis, Risk Factors, Treatment and Prevention)

2020 ◽  
Vol 8 (2) ◽  
pp. 57-65
Author(s):  
O. D. Ostroumova ◽  
I. V. Goloborodova
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Channel Blockers ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Developing Heart

Heart failure is a complex clinical syndrome caused by an impaired pumping function of the heart muscle, etiologically associated with cardiovascular disease and, in the vast majority of cases, requiring complex therapeutic regimens and simultaneous prescription of several drugs. To date, we know several classes of drugs (including those used for heart failure) which can induce development/progression of heart failure in both patients with left ventricular dysfunction, and in patients who do not have cardiovascular diseases. The aim of the study was to analyse and systematize data on development mechanisms, as well as methods of prevention and treatment of drug-induced heart failure when using diff erent groups of drugs. It has been established that drug-induced heart failure is most often associated with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers, antiarrhythmic drugs (disopyramide, fl ecainide, propafenone, amiodarone, ibutilide, dofetilide, dronedarone), anthracyclines (doxorubicin) and other antitumor drugs (trastuzumab, bevacizumab, infl iximab), hypoglycemic drugs (thiazolidinediones, saxagliptin, alogliptin), and nonsteroidal anti-infl ammatory drugs, including selective cyclooxygenase-2 inhibitors. The study revealed various mechanisms of heart failure development following drug treatment. In some patients, heart failure development is associated with the cardiotoxic eff ect of a particular drug, in others with adverse eff ects on hemodynamics. Much depends on risks of developing heart failure, including specifi c risks attributable to groups of drugs and individual drugs. The identifi cation of drugs that can contribute to the development/ progression of heart failure, and possible clinical manifestations of drug-induced heart failure, as well as provision of timely information to physicians, and engagement of clinical pharmacologists with the aim of optimizing treatment of patients can facilitate timely diagnosis, treatment and prevention of drug-induced heart failure. 

scholarly journals Experience in treatment and prevention of respiratory diseases relapses in children with the use of the phytotherapeutic complex «Alpicol»: feedback of doctors in Ukraine

2021 ◽  
pp. 12-22
Author(s):  
О.К. Koloskova ◽  
◽  
A.L. Kosakovskyi ◽  
T.M. Bilous ◽  
I.B. Horbatiuk ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Therapeutic Efficacy ◽  
Respiratory Diseases ◽  
Conflicts Of Interest ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Herbal Medicines ◽  
Upper Respiratory Tract ◽  
Treatment And Prevention ◽  
Parents And Children

Infectious and inflammatory diseases of the respiratory tract in children are the «leaders» among all pathologies of childhood. Optimization of therapeutic and prophylactic approaches for infectious and inflammatory pathologies of the respiratory system by reducing the frequency of unreasonable antibiotic therapy and eliminating polypragmatic use is a relevant problem of modern pediatrics and otolaryngology. According to WHO guidelines, modern standardized herbal medicines are not inferior in efficiency to synthetic ones. The aim — to analyze the results of assessment by doctors of the preventive and therapeutic efficacy of the remedy «Alpicol» on the basis of a questionnaire, as well as clinical examination of patients before using the medication and after completion of the course of treatment. Materials and methods. The advantages of «Alpicol» were analyzed through a questionnaire offered by first contact practitioners to children in order to receive feedback on the assessment of the preventive and therapeutic efficacy of this medication. Doctors from 9 regions of Ukraine were involved, and 6,093 questionnaires of children of different ages were analyzed. Results. The frequency of registration of a pronounced paediatric pain (3 scores) with the use of the «Alpicol» medication significantly decreased (23.7 times), a moderate manifestation of the disease (2 scores), was 17 times less at the same time, mild manifestations of paediatric pain remained at the same level. Patients with a comorbid pathology of the respiratory tract in the form of recurrent lesions of the upper and lower airways during the 2nd visit received a zero score (no symptoms) significantly less frequently than children with pathology of the upper respiratory tract with 62.6% of cases versus 72.2% of observations, respectively (p<0.05). As a result of the use of the course of «Alpicol» medication, a statistically significant decrease in the severity of the catarrhal symptom complex was achieved, since the proportion of the course of disease, assessed by the maximum number of scores, decreased by 29.6 times, moderate (score 2) — 13.3 times, and zero scores appeared 5.7 times more often. At the same time, the proportion of patients with a mild course of catarrh practically did not change. Conclusions. «Alpicol» has a multi;vector efficacy against the complex of symptoms that accompany infectious and inflammatory exacerbations of recurrent respiratory diseases. This is manifested by a decrease in the severity of clinical manifestations of the disease, as well as in an increase in cases of clinical stabilization of the patient's condition, which demonstrates the therapeutic and prophylactic effect of the drug «Alpicol» on the course of recurrent respiratory diseases in children. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Ethics Committee of all institutions indicated in this research. The informed consent of parents and children was obtained. The authors declare that they have no conflicts of interest. Key words: ecurrent respiratory diseases, treatment and prevention, children, phytocomplexes.

scholarly journals CONSERVATIVE TREATMENT OF HEMORRHOIDS. AN ALTERNATIVE TO SURGICAL METHODS OR COMPONENTS? CHORUS PROGRAM RESULTS

2018 ◽  
pp. 27-35
Author(s):  
E. A. Zagryadskiy ◽  
A. M. Bogomazov ◽  
E. B. Golovko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Entire Observation Period ◽  
Surgical Methods ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction ◽  
Observational Group ◽  
Grade Iii ◽  
Observation Period

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.

scholarly journals The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’

2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk
Keyword(s):  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Recent Experience ◽  
Treatment And Prevention ◽  
State Recovery ◽  
Group 2 ◽  
State Examination ◽  
Group 1

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.

scholarly journals The analysis of complex influence of the adverse ecological/ professional factors on reproduction health of the women

2003 ◽  
Vol 52 (2) ◽  
pp. 35-46
Author(s):  
Vitaly F. Bezhenar ◽  
Evgeny F. Kira ◽  
Yuri V. Tsvelev ◽  
А. E. Antushevich ◽  
А. M. Nikiforov
Keyword(s):  
Reproductive Health ◽  
Clinical Manifestations ◽  
Toxic Chemical ◽  
Radiation Accident ◽  
Chemical Production ◽  
Occupational Factors ◽  
Treatment And Prevention ◽  
Comprehensive Examination ◽  
Health Disorders ◽  
Complex Influence

As a result of the study and generalization of the results of a comprehensive examination of 3339 women, the main mechanisms of occurrence, clinical manifestations and dynamics of reproductive health disorders in women under the combined influence of unfavorable environmental and occupational factors (radiation accident, toxic chemical production) were established and the main directions for their diagnosis, treatment and prevention were substantiated.

Hepatic Haemorrhage in the Newborn

PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 604-604
Keyword(s):  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Review Of The Literature ◽  
Therapeutic Measure ◽  
Neonatal Deaths ◽  
Liver Bleeding ◽  
Abdominal Hemorrhage ◽  
Sudden Collapse

Gross hemorrhage under the capsule of the liver or from rupture of the parenchyma appears to be a direct cause or a significant factor in 1.2 to 5.6% of stillbirths and neonatal deaths, according to the author from this review of the literature. This form of intra-abdominal hemorrhage has not been readily recognized during life judging from the nature of the reports, nearly all of which are based on necropsy. The clinical manifestations are distinctive. The infants generally appear normal for the first 48 hours of life and then develop pallor and a decreasing concentration of hemoglobin in the blood, rapidly progressing to sudden collapse. A swelling may be palpated in the vicinity of the liver. Bleeding may be severe, and prompt recognition and treatment are imperative. Transfusion is obviously the most important therapeutic measure. The amount of blood required should not be underestimated. The occasional indications for surgical laparotomy are discussed but conservative treatment is generally preferable.

scholarly journals Sleep Terrors: An Updated Review

2020 ◽  
Vol 16 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Amy A.M. Leung ◽  
Alex H.C. Wong ◽  
Kam Lun Hon
Keyword(s):  
Parental Education ◽  
Muscle Tone ◽  
English Literature ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Nrem Sleep ◽  
Medical Intervention ◽  
Sleep Episode ◽  
Sleep Terror ◽  
Sleep Terrors

Background: Sleep terrors are common, frightening, but fortunately benign events. Familiarity with this condition is important so that an accurate diagnosis can be made. Objective: : To familiarize physicians with the clinical manifestations, diagnosis, and management of children with sleep terrors. Methods: A PubMed search was completed in Clinical Queries using the key terms " sleep terrors" OR " night terrors". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: It is estimated that sleep terrors occur in 1 to 6.5% of children 1 to 12 years of age. Sleep terrors typically occur in children between 4 and 12 years of age, with a peak between 5 and 7 years of age. The exact etiology is not known. Developmental, environmental, organic, psychological, and genetic factors have been identified as a potential cause of sleep terrors. Sleep terrors tend to occur within the first three hours of the major sleep episode, during arousal from stage three or four non-rapid eye movement (NREM) sleep. In a typical attack, the child awakens abruptly from sleep, sits upright in bed or jumps out of bed, screams in terror and intense fear, is panicky, and has a frightened expression. The child is confused and incoherent: verbalization is generally present but disorganized. Autonomic hyperactivity is manifested by tachycardia, tachypnea, diaphoresis, flushed face, dilated pupils, agitation, tremulousness, and increased muscle tone. The child is difficult to arouse and console and may express feelings of anxiety or doom. In the majority of cases, the patient does not awaken fully and settles back to quiet and deep sleep. There is retrograde amnesia for the attack the following morning. Attempts to interrupt a sleep terror episode should be avoided. As sleep deprivation can predispose to sleep terrors, it is important that the child has good sleep hygiene and an appropriate sleeping environment. Medical intervention is usually not necessary, but clonazepam may be considered on a short-term basis at bedtime if sleep terrors are frequent and severe or are associated with functional impairment, such as fatigue, daytime sleepiness, and distress. Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors. Conclusion: Most children outgrow the disorder by late adolescence. In the majority of cases, there is no specific treatment other than reassurance and parental education. Underlying conditions, however, should be treated if possible and precipitating factors should be avoided.

scholarly journals General Anesthesia for a Patient With Pelizaeus-Merzbacher Disease

2016 ◽  
Vol 63 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Nobuhito Kamekura ◽  
Yukie Nitta ◽  
Shigeru Takuma ◽  
Toshiaki Fujisawa
Keyword(s):  
General Anesthesia ◽  
Clinical Symptoms ◽  
Muscle Tone ◽  
Clinical Manifestations ◽  
Psychomotor Retardation ◽  
Cerebral White Matter ◽  
Airway Complications ◽  
Wisdom Teeth ◽  
History Of Epilepsy ◽  
Pelizaeus Merzbacher Disease

We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone, seizures, and cognitive impairment. General anesthesia for a patient with PMD may be difficult mainly because of seizures and airway complications related to poor pharyngeal muscle control. In addition, the possibility of exacerbation of spasticity should be considered. A 20-year-old man with PMD required removal of impacted wisdom teeth under general anesthesia. General anesthesia was induced with thiamylal, fentanyl, and desflurane. Anesthesia was maintained with desflurane and continuous intravenous remifentanil under bispectral index and train-of-4 monitoring. Anesthesia lasted 1 hour 20 minutes and was completed uneventfully. Airway complications, seizures, and exacerbation of spasticity did not occur postoperatively. Preoperatively, our patient had no history of epilepsy attacks or aspiration pneumonia, and no clinical symptoms of gastroesophageal reflux disease. Therefore, exacerbation of spasticity was one of the most likely potential complications. Identification of these associated conditions and evaluation of risk factors during preoperative examination is important for performing safe anesthesia in these patients.

Sign in / Sign up

Export Citation Format

Share Document