scholarly journals Problems of diagnosis and treatment of aseptic necrosis of the femoral head in contemporary traumatology and orthopedics (literature review)

2021 ◽  
Vol 27 (2) ◽  
pp. 270-276
Author(s):  
D.I. Odarchenko ◽  
◽  
G.G. Dzyuba ◽  
S.A. Erofeev ◽  
N.K. Kuznetsov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Femoral Head ◽  
Literature Review ◽  
Randomized Clinical Trials ◽  
Core Decompression ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Aseptic Necrosis ◽  
Early Stages

administration of corticosteroids or blood diseases. Early diagnosis is difficult, there is no conservative treatment protocol with proven effectiveness, and the organ-preserving surgical treatments which have been used may not always postpone hip arthroplasty. Arthroplasty provides good results in the short and long-term postoperative period, but the prevalence of this disease among young people requires developing new methods of conservative and operative treatment. Objective To determine the problems of diagnosis and treatment of aseptic necrosis of the femoral head; to study the experience of current approaches and concepts in the diagnosis and treatment of ANFH; determine the range of the most effective methods for treating this pathology; to establish the relevance of further research on this issue. Materials and methods Literature review was conducted of the sources from PubMed and Google Scholar databases. The material was selected that corresponded to the stated purpose of the research topic. For describing some aspects of the aetiology, pathogenesis and development of methods for diagnosing and treating ANFH, earlier publications (2009–2014) were also used. Results The main views on the aetiology and pathogenesis of ANFH have been studied. Classical and current diagnostic methods for ANFH were reviewed as well as current operative and conservative approaches to the treatment of this pathology. A review of the main classifications was conducted. Discussion Early detection and examination of at-risk patients plays an important role in the diagnosis of ANFH. The results of clinical trials on the use of bisphosphonates seem mixed, as the meta-analysis in five randomized clinical trials (RCTs) in 2016 showed no statistically significant improvement in patients with ANFH. Hyperbaric oxygenation reduces interstitial ischemia by increasing extracellular oxygen concentration and shows encouraging results. Core decompression is recognized as the standard care in the early stages of ANFH. At present, the use of combined treatment with bisphosphonates, core-decompression and mesenchymal stem cells has been investigated. Combined therapy may be effective in slowing the progression of collapse at an early stage of ANFH, but further research is needed to have long-term results. Conclusion Aseptic necrosis of the femoral head is a severe polyetiological disease that has not been sufficiently studied. For its diagnosis, it is necessary to take into account the possible risk factors and to ensure an early MRI study. At present, there is no data on a conservative method of treating the early stages of ANFH, which would have high evidence and effectiveness not only in the immediate, but also in the long-term follow-up. It is necessary to conduct additional prospective randomized clinical trials to determine the effectiveness of already known and developed methods of cell therapy in the treatment of ANFH.

scholarly journals COMBINED IMPACTION AUTOPLASTY OF THE FEMORAL HEAD IN THE TREATMENT OF PATIENTS WITH EARLY STAGES OF ASEPTIC NECROSIS

2017 ◽  
Vol 2 (3) ◽  
pp. 39-44
Author(s):  
DS S Kudashev ◽  
SD D Zuev-Ratnikov ◽  
IS S Shorin
Keyword(s):  
Femoral Head ◽  
Pain Syndrome ◽  
Pathological Process ◽  
Diagnostic Methods ◽  
New Method ◽  
Harris Hip Score ◽  
Aseptic Necrosis ◽  
Early Stages ◽  
Functional Capabilities ◽  
Results Of Treatment

Aseptic necrosis of the femoral head refers to the number of severe, rapidly progressing destructive-dystrophic hip joint lesions. In the overwhelming majority of cases, the disease develops in young and most active age group. In the absence of necessary treatment, the result of the disease is the early disability retirement with the need for radical reconstructive interventions on the joint. The use of modern diagnostic methods makes it possible to detect the beginning of the pathological process in the femoral head in the early stages and to conduct the most effective treatment of patients of this category. Aim - to improve the results of treatment of patients with early stages of aseptic necrosis of the femoral head due to the development and introduction into clinical practice of a new method of combined impaction autoplasty of the femoral head. Materials and methods. A new method of combined impaction autoplasty of the femoral head was used, including decompression, intraosseous resection and excision of the focus of osteonecrosis followed by combined autoplasty of the postresection defect (RF patent No. 2583577 dated 13.04.2016). Intraosseous resection of the focus of destruction of the femoral head was performed with the help of a specially developed device - milling cutters for bone tissue resection (RF patent for utility model No. 171951 dated 21.06.2017). Evaluation of the effectiveness of the treatment was carried out on the basis of the severity of the pain syndrome and functional capabilities of patients defined by the Harris scale (Harris Hip Score). Results. The analysis of the medium-term results of the conducted treatment showed that good results were obtained in 67.4% of cases in which the proposed method was used.

An Insight into the Polymeric Nanoparticles Applications in Diabetes Diagnosis and Treatment

2021 ◽  
Vol 21 ◽  
Author(s):  
Parisa Dehghani ◽  
Monireh Esameili Rad ◽  
Atefeh Zarepour ◽  
Ponnurengam Malliappan Sivakumar ◽  
Ali Zarrabi
Keyword(s):  
Polymeric Nanoparticles ◽  
Synthetic Polymers ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Diabetes Diagnosis ◽  
Transport Mechanisms ◽  
Different Types ◽  
Treatment And Diagnosis ◽  
Insight Into

: Diabetes mellitus (DM) is a type of chronic metabolic disease that has affected millions of people worldwide and is known with a defect in the amount of insulin secretion, insulin functions, or both. This deficiency leads to an increase in the amounts of glucose, which could be accompanied by long-term damages to other organs such as eyes, kidneys, heart, and nervous system. Thus, introducing an appropriate approach for diagnosis and treatment of different types of DM is the aim of several researches. By the emergence of nanotechnology and its application in medicine, new approaches were presented for these purposes. The object of this review article is to introduce different types of polymeric nanoparticles (PNPs), as one of the most important classes of nanoparticles, for diabetic management. To achieve this goal, at first, some of the conventional therapeutic and diagnostic methods of DM will be reviewed. Then, different types of PNPs, in two forms of natural and synthetic polymers with different properties, as a new method for DM treatment and diagnosis will be introduced. In the next section, the transport mechanisms of these types of nano-carriers across the epithelium, via paracellular and transcellular pathways will be explained. Finally, the clinical use of PNPs in the treatment and diagnosis of DM will be summarized. Based on the results of this literature review, PNPs could be considered one of the most promising methods for DM management.

Empirical and long-term therapy for endometriosis-associated pelvic pain

2021 ◽  
pp. 8-12
Author(s):  
I. V. Kuznetsova
Keyword(s):  
Literature Review ◽  
Medical Treatment ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Current Data ◽  
Diagnosis And Treatment ◽  
Term Therapy ◽  
Common Disease ◽  
Long Term Therapy

Endometriosis is a common disease, the diagnosis and treatment of which is still a matter of debate. One of the main symptoms of endometriosis -pelvic pain is a particular problem due to the difficulties in identifying the cause and the lack of sufficient effect from surgical and medical treatment. The literature review presents current data on the prevalence, clinical characteristics and methods of individualized therapy in patients with pelvic pain established or presumably associated with endometriosis.

Ocular Tuberculosis: Clinics, Diagnosis and Treatment (Literature Review)

The Eye ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 41-45
Author(s):  
O. E. Russkikh ◽  
N. Y. Nikolenko
Keyword(s):  
Literature Review ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Ocular Tuberculosis ◽  
Treatment Regimens ◽  
The Russian Federation ◽  
Serious Disease ◽  
Suggested Classification

Ocular tuberculosis is a serious disease with a long recurrent course, often leading to a significant decrease in the visual functions and quality of life of patients as well as disability. In recent years, the incidence rate of the ocular tuberculosis in the Russian Federation has been declining: in 2016, according to a number of authors, its incidence amounted to 5.2%.Purpose. To systematize literature data on the topic of ocular tuberculosis.Materials and methods. We reviewed literature available on elibrary.ru, cyberleninka.ru websites and in “Clinical Ophthalmology” journal. Results. We suggested classification of the ocular tuberculosis lesions, analyzed modern diagnostic methods and treatment regimens and evaluated their effectiveness.Conclusions. Literature review revealed that in order to improve the quality of detection, diagnosis and treatment of ocular tuberculosis, joint efforts of ophthalmologists and phthisiologists as well as use of modern methods of tuberculinodiagnosis are essential.

scholarly journals Effect of Orthodontic Treatment on Tooth Autotransplantation: Systematic Review of Controlled Clinical Trials

2020 ◽  
Vol 14 (03) ◽  
pp. 467-482
Author(s):  
Rogério Lacerda-Santos ◽  
Rhaíssa Ferreira Canutto ◽  
José Lucas dos Santos Araújo ◽  
Fabiola Galbiatti de Carvalho ◽  
Eliseu Aldrighi Münchow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Risk Of Bias ◽  
Significant Heterogeneity ◽  
Controlled Clinical Trials ◽  
Periodontal Tissues ◽  
Orthodontic Movement ◽  
Anterior Teeth

AbstractThis systematic review was focused on evaluating tooth autotransplantation, considering its impacts on the teeth, bone, soft tissues, and aesthetics in orthodontic patients. A bibliographic search was conducted without limitations on year of publication or language in the databases of PubMed, Web of Science, Scopus, Medline Complete, Cochrane, Clinical Trials, and Trials Central. For triage of articles, indications, surgical planning, orthodontic movement, risk factors for treatment, and long-term follow-ups were considered. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The results showed 10 controlled clinical trials, and no randomized clinical trials were found. The selected studies included 715 patients and 934 autotransplanted teeth among which there were premolars, molars, and anterior teeth evaluated in the long term, indicating that orthodontics associated with autotransplantation indicated a result that was generally clinically acceptable. The quality of the set of evidence was considered medium due to the presence of different methodological problems, risk of bias, and significant heterogeneity in the evaluated studies. There was a sufficient body of evidence that justified autotransplantation in patients who needed orthodontic movement. In teeth, there was an increase in root resorption influenced by orthodontics, but without impacting on the general clinical result in the long term. Bone and periodontal tissue do not appear to be affected by orthodontics. The patient’s aesthetic satisfaction was not considered in the studies.

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