scholarly journals POST-INFLATED GLENOHUMERAL PAIN

Author(s):  
T. M. Muratova ◽  
D. M. Khramtsov ◽  
S. A. Kotov

The aim of the study was to assess the prevalence of post-storoke glenohumeral pain and the effectiveness of its diagnosis and treatment in a university clinic. It was shown that pain in the shoulder joint of the parectic limb is recorded in 28.3% of inpatients and 20.3% during the first weeks after discharge. At controlled visits 3 and 6 months later, in 61.5% of cases, satisfactory clinical effects were achieved by reducing the intensity of pain to 1.8 ± 0.1 scores, and in the rest of the patients to achieve complete control of the pain. It was established that the use of preventive measures can reduce the number of patients with post-venous glomerular syndrome, moral pain.

Author(s):  
T. M. Muratova ◽  
D. M. Khramtsov ◽  
S. A. Kotov

The aim of the study was to assess the prevalence of post-storoke glenohumeral pain and the effectiveness of its diagnosis and treatment in a university clinic. It was shown that pain in the shoulder joint of the parectic limb is recorded in 28.3% of inpatients and 20.3% during the first weeks after discharge. At controlled visits 3 and 6 months later, in 61.5% of cases, satisfactory clinical effects were achieved by reducing the intensity of pain to 1.8 ± 0.1 scores, and in the rest of the patients to achieve complete control of the pain. It was established that the use of preventive measures can reduce the number of patients with post-venous glomerular syndrome, moral pain.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.


2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Carlo Fusco ◽  
◽  
Vincenzo Leuzzi ◽  
Pasquale Striano ◽  
Roberta Battini ◽  
...  

Abstract Background Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare and underdiagnosed neurometabolic disorder resulting in a complex neurological and non-neurological phenotype, posing diagnostic challenges resulting in diagnostic delay. Due to the low number of patients, gathering high-quality scientific evidence on diagnosis and treatment is difficult. Additionally, based on the estimated prevalence, the number of undiagnosed patients is likely to be high. Methods Italian experts in AADC deficiency formed a steering committee to engage clinicians in a modified Delphi consensus to promote discussion, and support research, dissemination and awareness on this disorder. Five experts in the field elaborated six main topics, each subdivided into 4 statements and invited 13 clinicians to give their anonymous feedback. Results 100% of the statements were answered and a consensus was reached at the first round. This enabled the steering committee to acknowledge high rates of agreement between experts on clinical presentation, phenotypes, diagnostic work-up and treatment strategies. A research gap was identified in the lack of standardized cognitive and motor outcome data. The need for setting up an Italian working group and a patients’ association, together with the dissemination of knowledge inside and outside scientific societies in multiple medical disciplines were recognized as critical lines of intervention. Conclusions The panel expressed consensus with high rates of agreement on a series of statements paving the way to disseminate clear messages concerning disease presentation, diagnosis and treatment and strategic interventions to disseminate knowledge at different levels. Future lines of research were also identified.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e44-e45 ◽  
Author(s):  
Hana Mijovic ◽  
Yossef Al-Nasser ◽  
Ghada Al-Rawahi ◽  
Ashley Roberts

Abstract BACKGROUND Tuberculosis (TB) is a rare but potentially devastating infection among Canadian children. Accurate diagnosis and initiation of treatment are limited in part by the fact that it takes 2–6 weeks for culture results to be confirmed. Xpert MTB/RIF (Xpert) is a rapid, automated molecular assay that has been validated for diagnosing pulmonary but not extra-pulmonary TB in children. OBJECTIVES This was a retrospective study of children investigated for active TB at our facility in order to: 1.Outline demographic characteristics and describe clinical presentations of children diagnosed with active TB. 2.Compare performance of molecular testing (Xpert) to stain and Mycobacterium tuberculosis culture on pulmonary and extra-pulmonary specimens. DESIGN/METHODS We conducted a retrospective chart review of all paediatric patients investigated for active TB at our facility with stain, culture and molecular (Xpert) testing between January 2015 and August 2017. Due to a small number of patients, our data analysis was limited to narrative summary and descriptive statistics. RESULTS A total of 10 children were diagnosed with active TB, including 3 cases of pulmonary, 4 extra-pulmonary and 3 disseminated disease. Age range at diagnosis was 2 months to 16 years, with 3 children younger than 1 year. Most children contracted TB while travelling to and/or being exposed to an index case from endemic areas, including East Asia/Western Pacific (5), South Asia (2) and Africa (1). All children were HIV negative. Time from symptom onset to TB diagnosis and treatment ranged from approximately 4 days to 5 months. Multi-drug resistant TB was confirmed in 1 child. Sadly, 1 child passed away from TB related complications. AFB stain was positive on at least one specimen in 4/10 cases, cultures were positive in 8/10 and molecular testing (Xpert) in 7/10 cases. Time to positive cultures ranged from 10 to 35 days, with an average of 19 days. All cases positive on Xpert were also culture positive. Xpert test diagnosed TB in 5/6 of extra-pulmonary specimens submitted, including pericardial fluid, lymph node tissues and cerebrospinal fluid. CONCLUSION Many paediatric TB patients at our facility are children who have traveled to/have contacts from TB endemic regions, emphasizing the need for obtaining thorough exposure and travel history. Culture and molecular testing demonstrated similar TB detection rates, albeit based on a small patient population. While cultures remain the most reliable diagnostic method, molecular testing may facilitate rapid diagnosis and treatment of pulmonary and extra-pulmonary paediatric TB in a non-endemic setting.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1536-1536
Author(s):  
Z.-J. Zhang

Herb-drug interactions are an important issue in drug safety and clinical practice. The aim of this epidemiological study was to characterize associations of clinical outcomes with concomitant herbal and antipsychotic use in patients with schizophrenia. A total of 1795 patients with schizophrenia who were randomly selected from 17 psychiatric hospitals in China were interviewed face-to-face using a structured questionnaire. Association analyses were conducted to examine correlates between Chinese medicine (CM) use and demographic, clinical variables, antipsychotic medication mode, and clinical outcomes. The prevalence of concomitant CM and antipsychotic treatment was 36.4% [95% confidence interval (95% CI) 34.2%–38.6%]. Patients using concomitant CM had a significantly greater chance of improved outcomes than non-CM use (61.1% vs. 34.3%, OR = 3.44, 95% CI 2.80–4.24). However, a small but significant number of patients treated concomitantly with CM had a greater risk of developing worse outcomes (7.2% vs. 4.4%, OR = 2.06, 95% CI 2.06–4.83). Significant predictors for concomitant CM treatment-associated outcomes were residence in urban areas, paranoid psychosis, and exceeding 3 months of CM use. Herbal medicine regimens containing Radix Bupleuri, Fructus Gardenia, Fructus Schisandrae, Radix Rehmanniae, Akebia Caulis, and Semen Plantaginis in concomitant use with quetiapine, clozapine, and olanzepine were associated with nearly 60% of the risk of adverse outcomes. Our study suggests that concomitant herbal and antipsychotic treatment could produce either beneficial or adverse clinical effects in schizophrenic population. Potential herb-drug pharmacokinetic interactions need to be further evaluated.


2020 ◽  
Vol 22 (97) ◽  
pp. 125-129
Author(s):  
V. О. Yevstafieva ◽  
Y. S. Starodub

Successful development of poultry farming can be achieved not only as a result of the creation of highly productive new breeds of geese, the improvement of diets for nutrients, but also in the conditions of stable epizootic well-being of infectious and invasive diseases. Parasitic diseases of domestic waterfowl account for a large proportion of other diseases and cause significant damage to geese farming. Among helminthiases of geese, infections caused by nematodes parasitizing in the gastrointestinal tract of birds, in particular Trichostrongylus tenuis, are quite common. The aim of this study was to study the distribution of trichostrongylosis among populations of domestic geese in the territory of Poltava region, Ukraine (Velyka Bahachka, Hlobyne, Hrebinka, Zinkiv, Karlivka, Poltava, Myrhorod, Shyshaky districts). The conducted scatoscopical studies showed that the average extensity and intensity of trichostrongylosic infestation was respectively 22.9 % and 89.7 ± 8.2 eggs per 1 g of poultry feces. Invasiveness in the region studied ranged from 17.2 to 26.7 % and from 20 to 380 eggs per 1 g of feces. At the same time, it was found out that the degree of affliction of domestic geese by the agent of trichostrongylosis in farms with different capacity and technology of keeping was significantly different. In individual farms and farms, the extensity and intensity of the invasion of geese is higher (24.4 % and 97.7 ± 10.7 eggs per 1 g of feces) than in the specialized geese farms (16.1 % and 70.3 ± 15.1 eggs in 1 g of feces). It has been found that goose trichostrongylosis is more frequently present in the mixinvasions of the digestive canal of the bird along with protosooses and nematodoses. Extensity of mixinvasions reaches 18.1 %, which is 78.9 % of the total number of patients at geese trichostrongylosis. Extensity of trichostrongylosic mono-invasion was 4.8 % (21.1 % of the total invasion of T. tenuis birds). The results of the conducted studies lead to a further, deeper study of the issues of epizootic features of trichostrongylosis of geese, taking into account the seasonal and age dynamics of invasion, as well as the effectiveness of therapeutic and preventive measures.


Author(s):  
S.S. Strafun ◽  
I.S. Zanko

Relevance. Shoulder prosthetics is the method of choice in the treatment of patients with traumatic injuries that significantly impair joint function and are accompanied by prolonged pain. Objective: to investigate the main causes of injuries of the shoulder joint that led to its prosthetics. Materials and Methods. The clinical group consisted of 162 patients who underwent shoulder prosthetics in the Department of Microsurgery and Reconstructive Surgery of the Upper Limb of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. There were 44.4% male and 55.5% female patients. The average age of male patients was 62±11.4 years; the average age of female patients was 66±10.1 years. The average period of seeking specialized medical care after an acute injury was 24±10.9 days and 50.6±81.1 months in patients with post-traumatic consequences. In most cases, patients underwent unipolar prosthetics of the shoulder joint (126 patients, 78.7%); 27 patients (15.6%) underwent reversible prosthetics and 9 (5.6%) – total prosthetics, respectively. Results. In most cases, shoulder prosthetics were performed in patients with acute (up to 3 weeks from the date of injury) and old fractures and fractures of the proximal epimetaphysis of the humerus – 35 (21.6%) and 48 (29.6%) patients, respectively. The number of patients with posttraumatic aseptic necrosis of the humeral head was 49 (30.2%) (p<0.005), which indicates a high frequency of complications after osteosynthesis etc. The number of patients with massive traumatic injuries of the tendons of the rotator cuff who needed shoulder prosthetics was 18 (11.1%) and with false joints – 12 (7.4%). Unipolar prosthesis systems predominated in the general structure of the prosthesis type (126 patients, 78.7%), since reversible and total prosthesis in Ukraine were registered not so long ago. Conclusions. The analysis of our observations showed that the causes of shoulder prosthetics are severe injuries that occur with high-energy injuries (101 patients, 62.3%) and post-traumatic aseptic necrosis (49 patients, 30.2%). Acute and old fractures and fractures of the proximal metaepiphysis of the humerus are one of the most common injuries according to the analysis (35 patients, 21.6% and 48 patients, 29.6%), and their number and complexity continues to increase with age. Understanding the etiological factors that led to shoulder endoprosthetics makes it possible to predict long-term functional results and work to reduce the number of such patients.


2019 ◽  
pp. 18-23
Author(s):  
E. A. Krivykh ◽  
E. A. Revyakin ◽  
M. V. Malkhasyan

Introduction. In the world (and in the Russian Federation) the situation caused by the increase in the number of socially significant diseases continues to be quite tense. The most important in this group is tuberculosis, which causes significant damage to society, due to the loss of temporary and permanent disability, an increase in the number of disabled people and destabilization of the demographic situation in the country. In this regard, an integrated approach to the implementation of therapeutic and preventive measures in patients suffering from tuberculous lesions is a priority in addressing the spread of this pathology. Purpose of the study. Analysis of data on the epidemiological situation, morbidity, prevalence, mortality, prevention and treatment of tuberculosis patients in the Khanty-Mansiysk Autonomous District – Ugra in 2017, comparing the figures for the first half of 2017 and 2018. Materials and methods. To assess the parameters characterizing the organization of early diagnosis of tuberculosis, hospitalization of patients of the relevant cohort of the population, the effectiveness of therapeutic measures taken, the quality of preventive measures among the population of the Khanty-Mansiysk Autonomous District – Ugra, the data of annual reports of relevant medical organizations for 2017–2018 are used. Results. In 2017, the coverage of examinations for tuberculosis of the population with the use of all survey methods amounted to 78,6%, while the target indicator of the state program «Health Development 2014–2020» was 78,0%. The number of patients effectively treated at the studied stages was more than 50% of cases for each. Conclusion. In the Autonomous District – Ugra, the work of all services and institutions for the treatment and prevention of tuberculosis is recognized as systematic and effective according to the results of events held.


2020 ◽  
Vol 13 ◽  
pp. 117954762095663 ◽  
Author(s):  
Alicja Krakowiak ◽  
Jakub Kuleta ◽  
Iwona Plech ◽  
Maciej Zarębiński ◽  
Małgorzata Wojciechowska ◽  
...  

With a growing number of patients on ticagrelor therapy after stent implantation, we observe many cases of side effects of the drug, mostly dyspnoea and bradycardia. In our article we present 2 patients, in which the symptoms were particularly severe. Then we describe possible mechanisms of these complications, explain how to carry out differential diagnosis, discuss when to switch ticagrelor to other antiplatelet drug and finally we present the way to deal with the symptoms.


2019 ◽  
Vol 160 (5) ◽  
pp. 762-782 ◽  
Author(s):  
Jerome R. Lechien ◽  
Lee M. Akst ◽  
Abdul Latif Hamdan ◽  
Antonio Schindler ◽  
Petros D. Karkos ◽  
...  

Objective To review the current literature about the epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux (LPR). Data Sources PubMed, Cochrane Library, and Scopus. Methods A comprehensive review of the literature on LPR epidemiology, clinical presentation, diagnosis, and treatment was conducted. Using the PRISMA statement, 3 authors selected relevant publications to provide a critical analysis of the literature. Conclusions The important heterogeneity across studies in LPR diagnosis continues to make it difficult to summarize a single body of thought. Controversies persist concerning epidemiology, clinical presentation, diagnosis, and treatment. No recent epidemiologic study exists regarding prevalence and incidence with the use of objective diagnostic tools. There is no survey that evaluates the prevalence of symptoms and signs on a large number of patients with confirmed LPR. Regarding diagnosis, an increasing number of authors used multichannel intraluminal impedance–pH monitoring, although there is no consensus regarding standardization of the diagnostic criteria. The efficiency of proton pump inhibitor (PPI) therapy remains poorly demonstrated and misevaluated by incomplete clinical tools that do not take into consideration many symptoms and extralaryngeal findings. Despite the recent advances in knowledge about nonacid LPR, treatment protocols based on PPIs do not seem to have evolved. Implications for Practice The development of multichannel intraluminal impedance–pH monitoring and pepsin and bile salt detection should be considered for the establishment of a multiparameter diagnostic approach. LPR treatment should evolve to a more personalized regimen, including diet, PPIs, alginate, and magaldrate according to individual patient characteristics. Multicenter international studies with a standardized protocol could improve scientific knowledge about LPR.


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