scholarly journals MODERN APPROACHES TO MEDICAL AND PSYCHOLOGICAL SUPPORT OF FAMILIES WITH INFANTS WITH SEVERE CRANIOCEREBRAL TRAUMA

2017 ◽  
Vol 4 (3) ◽  
pp. 142-145
Author(s):  
O.E. Dukhovskyy
Keyword(s):  
Family Relationships ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Craniocerebral Trauma ◽  
Main Group ◽  
Psychological Support ◽  
Psychological State ◽  
Control Group ◽  
Family Interactions ◽  
Severe Craniocerebral Trauma

О. Dukhovskyy The study involved a comprehensive survey of 137 families (mother and father) of children with severe somatic disease aimed at the development and evaluation of the system of medical and psychological support of families with a somatically challenged child. The main group comprised 97 families participating in the program of medical and psychological support, and the control group included 40 families who did not receive psychological support. According to our findings, a serious disease of the child became a psychotraumatic situation for all the parents, resulting in the development of anxiety-depressive reactions and conditions. Psychodiagnostic examination showed that the parents had mild, moderate depressive and anxious episodes on the Hamilton Rating Scale; high levels of situational and personal anxiety according to the C.D. Spielberger Inventory, a high level of neuropsychic stress on T.A. Nemchin Scale. The couples under investigation noted tensions in family relationships, family conflicts, related to the treatment of the child and escalation of pre-existing interpersonal and marital problems that led to distancing and a decrease in internal family resource. Based on these data, we have developed a system of medical and psychological support of the families with somatically challenged child, which consisted of four consecutive phases and included the use of individual cognitive-behavioral therapy (Beck AT, 2006), family therapy (Eidemiller E. G., 2003), rational therapy (classic Dubois P., 1912) and psychological educational programs. Case monitoring in the main group following the employment of the proposed system of medical and psychological support showed a stable positive pattern of psychological state with a statistically significant total reduction of anxiety-depressive states and the harmonization of the marital relationship.Key words: Medical and psychological support, anxiety, depression, family interactions, infants with severe craniocerebral trauma. СУЧАСНІ ПІДХОДИ ДО МЕДИКО-ПСИХОЛОГІЧНОГО СУПРОВОДУ СІМ’Ї ДИТИНИ ПЕРШОГО РОКУ ЖИТТЯ З ВАЖКОЮ ЧЕРЕПНО-МОЗКОВОЮ ТРАВМОЮ.Духовський О.Є.У ході роботи з метою розробки та апробації системи медико-психологічного супроводу сім’ї дитини першого року життя з важкою черепно-мозковою травмою проведено комплексне обстеження 137 родини (мати та батько) дітей першого року життя які отримали важку черепно-мозкову травму. Основну групу склали 97 родин, які прийняли участь у програмі медико-психологічного супроводу, контрольну групу 40 родин, які не отримували психологічну підтримку. Як показали результати дослідження черепно-мозкова травма дитини стала психотравмуючою ситуацією для усіх батьків, яка приводила до розвитку тривожно-депресивних реакцій та станів. За даними психодіагностичного обстеження у батьків відмічалися легкій помірний депресивний та тривожний епізоди за шкалою Гамільтона; високі рівні ситуативної й особистісної тривожності за методикою Ч.Д. Спілбергера, високій рівень виразності нервово-психічної напруги по шкалі Т.А. Немчина. Обстежені родини відзначали наявність напруженості в сімейних відносинах, сімейні конфлікти, як пов’язані з лікуванням дитини, так і ескалації існуючих раніше міжособистісних та подружніх проблем, що призводило до дистанціювання та зниження внутрішньосімейного ресурсу. Базуючись на отриманих даних нами розроблена система медико-психологічного супроводу сімʼї дитини першого року життя з важкою черепно-мозковою травмою, яка складалася із чотирьох послідовних етапів та включла використання індивідуальної когнітивно-поведінкової терапії (Бек A. T., 2006), сімейної терапії (Ейдміллер Е. Г., 2003), раціональної психотерапії (класичний варіант Дюбуа П., 1912) та псих освітніх програм. Як показали результати динамічного спостереження, на фоні застосування запропонованої системи медико-психологічного супроводу в основній групі відзначена стійка позитивна динаміка психологічного стану з повною редукцією тривожно-депресивних та гармонізацією подружніх відносин.Ключові слова: Медико-психологічний супровід, тривога, депресія, родинна взаємодія, дитина з важкою черепно-мозковою травмою. СОВРЕМЕННЫЕ ПОДХОДЫ К МЕДИКО-ПСИХОЛОГИЧЕСКОМУ СОПРОВОЖДЕНИЮ СЕМЬИ РЕБЕНКА ПЕРВОГО ГОДА ЖИЗНИ С ТЯЖЕЛОЙ ЧЕРЕПНО-МОЗГОВОЙ ТРАВМОЙ.Духовской А.Э.В ходе работы с целью разработки и апробации системы медико-психологического сопровождения семьи ребенка первого года жизни с тяжелой черепно-мозговой травмой проведено комплексное обследование 137 семей (мать и отец) детей первого года жизни получивших тяжелую черепно-мозговую травму. Основную группу составили 97 семей, принявших участие в программе медико-психологического сопровождения, контрольную группу 40 семей, не получавшие психологическую поддержку. Как показали результаты исследования, черепно-мозговая травма ребенка стала психотравмирующей ситуацией для всех родителей, которая приводила к развитию тревожно-депрессивных реакций и состояний. По данным психодиагностического обследования у родителей отмечались легкой умеренный депрессивный и тревожный эпизоды по шкале Гамильтона; высокие уровни ситуативной и личностной тревожности по методике Ч.Д. Спилбергера, высокий уровень выраженности нервно-психического напряжения по шкале Т.А. Немчина. Обследованные супруги отмечали наличие напряженности в семейных отношениях, семейные конфликты, как связанные с лечением ребенка, так и эскалацией существующих ранее межличностных и супружеских проблем, чт приводило к дистанцированию и снижению внутрисемейного ресурса. Основываясь на полученных данных нами разработана система медико-психологического сопровождения семьи ребенка первого года жизни с тяжелой черепно-мозговой травмой, которая состояла из четырех последовательных этапов и включала использование индивидуальной когнитивно-поведенческой терапии (Бек AT, 2006), семейной терапии (Ейдмиллер Е. Г., 2003), рациональной психотерапии (классический вариант Дюбуа П., 1912) и психобразовательных программ. Как показали результаты динамического наблюдения, на фоне применения предложенной системы медико-психологического сопровождения в основной группе отмечена устойчивая положительная динамика психологического состояния с полной редукцией тревожно-депрессивных состояний и гармонизацией супружеских отношений.Ключевые слова: Медико-психологическое сопровождение, тревога, депрессия, семейное взаимодействие, ребенок с тяжелой черепно-мозговой травмой.

Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial

2012 ◽  
Vol 30 (33) ◽  
pp. 4124-4133 ◽  
Author(s):  
Saskia F.A. Duijts ◽  
Marc van Beurden ◽  
Hester S.A. Oldenburg ◽  
Myra S. Hunter ◽  
Jacobien M. Kieffer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Exercise ◽  
Cognitive Behavioral Therapy ◽  
Physical Functioning ◽  
Effect Size ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Menopausal Symptoms ◽  
Control Group ◽  
Endocrine Symptoms

Purpose The purpose of our study was to evaluate the effect of cognitive behavioral therapy (CBT), physical exercise (PE), and of these two interventions combined (CBT/PE) on menopausal symptoms (primary outcome), body image, sexual functioning, psychological well-being, and health-related quality of life (secondary outcomes) in patients with breast cancer experiencing treatment-induced menopause. Patients and Methods Patients with breast cancer reporting treatment-induced menopausal symptoms (N = 422) were randomly assigned to CBT (n = 109), PE (n = 104), CBT/PE (n = 106), or to a waiting list control group (n = 103). Self-report questionnaires were completed at baseline, 12 weeks, and 6 months. Multilevel procedures were used to compare the intervention groups with the control group over time. Results Compared with the control group, the intervention groups had a significant decrease in levels of endocrine symptoms (Functional Assessment of Cancer Therapy–Endocrine Symptoms; P < .001; effect size, 0.31-0.52) and urinary symptoms (Bristol Female Lower Urinary Tract Symptoms Questionnaire; P = .002; effect size, 0.29-0.33), and they showed an improvement in physical functioning (36-Item Short Form Health Survey physical functioning subscale; P = .002; effect size, 0.37-0.46). The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats (problem rating scale of the Hot Flush Rating Scale; P < .001; effect size, 0.39-0.56) and an increase in sexual activity (Sexual Activity Questionnaire habit subscale; P = .027; effect size, 0.65). Most of these effects were observed at both the 12-week and 6-month follow-ups. Conclusion CBT and PE can have salutary effects on endocrine symptoms and, to a lesser degree, on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause. Future work is needed to improve the design and the planning of these interventions to improve program adherence.

scholarly journals Efficacy of Sertraline Combined with Cognitive Behavioral Therapy for Adolescent Depression: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wenliang Liu ◽  
Gongying Li ◽  
Congjie Wang ◽  
Xiuzhen Wang ◽  
Lin Yang
Keyword(s):  
Combination Therapy ◽  
Cognitive Behavioral Therapy ◽  
Scale Score ◽  
Adolescent Depression ◽  
Adverse Reactions ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Depression Score ◽  
Control Group

Objective. The efficacy of antidepressant drugs combined with psychotherapy is controversial; hence, this meta-analysis was conducted to assess the efficacy of the combination therapy. Methods. Relevant literature was searched in PubMed, Web of Science and Embase, Chinese databases CNKI, and WanFang Data. We included the literature on the comparison of the sertraline combined with cognitive behavioral therapy (CBT) and each treatment alone for adolescent depression published in 2000-2021. Meta-analysis was performed using Stata16.0 software. Results. A total of 421 relevant articles were retrieved, and 14 studies were finally included. In comparison with the control group (sertraline), sertraline combined with CBT achieved higher response rate ( OR = 5.07 , 95% CI: 3.00, 8.58) and lower incidence of adverse reactions ( OR = 0.43 , 95% CI: 0.24, 0.75). Before treatment, there were no significant differences in depression score, anxiety score, and symptom self-rating scale score between the two groups. After treatment, depression score ( SMD = − 2.79 , 95% CI: -3.64, -1.94), anxiety score ( SMD = − 1.22 , 95% CI: -1.96, -0.47), and symptom self-rating scale score ( SMD = − 1.73 , 95% CI: -3.19, -0.27) were significantly lower in the combined treatment group than in the control group. Conclusion. Although the number of comparative trials is small, this study shows that sertraline is effective for adolescent depression, but sertraline combined with CBT is more effective. The latter can significantly reduce the incidence of depressive symptoms, anxiety, and adverse reactions in patients. Therefore, this combination therapy is recommended for the clinical treatment of adolescent depression.

scholarly journals TO THE QUESTION OF THE NEED FOR THE DEVELOPMENT OF INTEGRATED REHABILITATION MEASURES IN PATIENTS WITH NEURODEGENERATION

2019 ◽  
Vol 85 (4) ◽  
pp. 72-77
Author(s):  
M.E. Chernenko
Keyword(s):  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Behavioral Therapy ◽  
Clinical Manifestations ◽  
Biological Rhythms ◽  
Rehabilitation Program ◽  
Main Group ◽  
Control Group ◽  
The Central Nervous System ◽  
The Individual

It is known that sleep disorders adversely affect the processes of brain neuroplasticity. Wakefulness and night sleep are functional states that are closely interrelated and equally mediate and provide the adaptive activity of the individual. Human biological rhythms are hierarchically dependent on the main pacemaker located in the suprachiasmatic nuclei of the hypothalamus. The role of a mediator that delivers regulatory signals to organs is played by the hormone melatonin, which is synthesized by pineal gland cells. Sleep disorders seriously affect a person's quality of life: emotional stress, anxiety, irritation increase and, as a result, stress resistance decreases, the need for communication, entertainment decreases. In the vast majority of cases, insomnia is secondary, that is, it is formed against the background of the development of diseases and/or adverse circumstances. Quite often, sleep disturbances occur in demyelinating/ neurodegenerative diseases of the central nervous system. We examined 30 patients with a diagnosis of multiple sclerosis, which were divided into two groups. The main group received therapy with a melatonin- containing drug in combination with cognitive-behavioral therapy. Patients in the control group received only therapy with melatonin-containing drug. It was shown that cortisol levels in patients of the main group decreased more than in patients who did not receive CBT. Reduction of clinical manifestations, along with improvements in laboratory indices of day and night melatonin expression, as well as cortisol expression, were already observed on the 14th day of treatment, and on the 21st day of the study, these indices improved significantly. Clinical efficacy in the main group was achieved in 86,6 % of cases, in the control group - in 60,0 % of cases. It is planned to use this method in the development of a comprehensive rehabilitation program in patients with neurodegeneration.

Using a pharmacogenetic clinical decision support system to improve psychopharmacotherapy dosing in patients with affective disorders

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Michael Zastrozhin ◽  
Valentin Skryabin ◽  
Alexander Sorokin ◽  
Oleg Buzik ◽  
Inessa Bedina ◽  
...  
Keyword(s):  
Decision Support ◽  
Side Effects ◽  
Clinical Decision Support ◽  
Affective Disorders ◽  
Alcohol Use Disorder ◽  
Rating Scale ◽  
Clinical Decision ◽  
Main Group ◽  
Control Group ◽  
Psychometric Scales

AbstractObjectivesAlthough pharmacogenetic tests provide the information on a genotype and the predicted phenotype, these tests do not themselves provide the interpretation of data for a physician. Currently, there are approximately two dozen pharmacogenomic clinical decision support systems (CDSSs) used in psychiatry. Implementation of the CDSSs forming the recommendations on drug and dose selection according to the results of pharmacogenetic testing is an urgent task. Fulfillment of this task will allow increasing the efficacy of therapy and decreasing the risk of undesirable side effects.MethodsThe study included 118 male patients (48 in the main group and 70 in the control group) with affective disorders and comorbid alcohol use disorder. To evaluate the efficacy and safety of therapy, several international psychometric scales and rating scales to measure side effects were used. Genotyping was performed using the real-time polymerase chain reaction with allele-specific hybridization. Pharmacogenetic testing results were interpreted using free software PGX2 (LLE Medicine, Russian Federation, Biomedical Cluster of Skolkovo, Moscow Innovative Cluster; www.pgx2.com).ResultsThe statistically significant differences across the scores on psychometric scales were revealed. For instance, the total score on the Hamilton Rating Scale for Depression by day 9 was 9.0 [8.0; 10.0] for the main group and 11.0 [10.0; 12.0] (p<0.001) for the control group and by day 16 it was 4.0 [2.0; 6.0] for the main group and 14.0 [13.0; 14.0] (p<0.001) for the control group. The UKU Side-Effect Rating Scale (UKU) also revealed a statistically significant difference. The total score on the UKU scale by day 9 was 4.0 [4.0; 5.0] for the main group and 5.0 [5.0; 6.0] (p<0.001) for the control group and by day 16 this difference grew significantly: 3.0 [0.0; 4.2] for the main group and 9.0 [7.0; 11.0] (p<0.001) for the control group.ConclusionsPharmacogenetic-guided personalization of the drug dose in patients with affective disorders and comorbid alcohol use disorder can reduce the risk of undesirable side effects and pharmacoresistance. It allows recommending the use of pharmacogenetic CDSSs for optimizing drug dosage.

scholarly journals THE ASSESSMENT OF COMORBID PATHOLOGY IN CLEAN-UP WORKERS OF THE ACCIDENT CONSEQUENCES AT THE CHORNOBYL NPP HAVING CARDIOVASCULAR DISEASES

2020 ◽  
Vol 25 ◽  
pp. 402-420
Author(s):  
D. Belyi ◽  
◽  
O. Nastina ◽  
G. Sydorenko ◽  
Z. Gabulavichene ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Quantitative Assessment ◽  
Rating Scale ◽  
Vascular Diseases ◽  
Mean Value ◽  
Main Group ◽  
Control Group ◽  
Mean Values ◽  
Organ Systems ◽  
The Mean

Objective. Analysis of comorbid pathology based on the use of methods for its quantitative assessment in persons who were exposed to radiation because of the Chornobyl accident. Materials and methods. Comorbid pathology was studied in 608 men, including 420 clean-up workers (CW) of the accident consequences at the Chornobyl NPP (main group) and 188 non-irradiated persons (control group – CG). All patients had cardiovascular diseases as their main pathology and were examined in the cardiology department of the NRCRM hospital during 2011–2019. The groups did not differ by age, either at the beginning of the accident or at the time of their last examination. Patients of both groups before the accident were practically healthy people and were not registered at the dispensary. The Cumulative Illness Rating Scale (CIRS) was used to quantify comorbid pathology. Results. Comorbid pathology was detected in 418 CW (99.5 %) and 183 patients of CG (99.3 %). The total score in CW (10.3 ± 2.9) units significantly (р = 0.000) exceeded the same index in non-irradiated patients (8.8 ± 3.0) units, as well as the mean number of CIRS categories, whose level severity was 1 point (3.3 ± 1.7 vs. 2.6 ± 1.5, р = 0.000), 2 points (1.8 ± 1.0 vs. 1.6 ± 1.0, p = 0.032) and 3–4 points (1.2 ± 0.8 vs. 1.0 ± 0.9, р = 0.062). In contrast, the mean value of the categories with zero score, i.e. without diseases, was more common in CG (7.8 ± 1.8 vs. 8.8 ± 1.7, р = 0.000). The most common pathology in CW and CG were heart (98.3 % vs. 94.7 %, р < 0.05) and vascular diseases (92.9 % vs. 87.8 %, р > 0.05), followed by diseases of nervous system (79.0 % vs. 57.4 %, р <0.001), musculoskeletal system and skin (69.8 % vs. 56.9 %, р < 0.01), endocrine (56.0 % vs. 49,5 %, р > 0.05) and the respiratory system (53.8 % vs. 53.7 %, р > 0.05) and liver (51.2 % vs. 36.2 %, р < 0.001), which were detected more than in half patients of the main group. Diseases of the kidneys (3.3 % vs. 4.8 %, р > 0.05) and lower gastrointestinal tract (3.3 % vs. 0.5 %, р < 0.01) were quite rare. The incidence of the other four CIRS categories was 18.6–34 %. The total score in subgroups with different ages varied in descending order of mean values as follows: CW > 65 years (10.5 ± 2.9) units, CW < 65 years (9.9 ± 2.8) units, CG > 65 years (9.5 ± 2.8) units and CG < 65 years (7.8 ± 2.9) units with significant differences both between age subgroups in each of the groups and between CW and CG older subgroups. Conclusions. Quantitative assessment of comorbidity by CIRS showed that in persons irradiated during their emergency work due to the Chornobyl accident, the incidence of combined pathology of such organ systems as cardiovascular, nervous, endocrine, hematopoietic, urogenital, musculoskeletal, gastrointestinal, liver and kidneys was significantly higher than in non-irradiated patients. In irradiated patients, the course of comorbid pathology was more severe for each system and in general, reflecting higher values of the total CIRS score. Both among CW and non-irradiated controls, higher values of the total comorbidity score were observed in patients 65 years and older, compared with younger individuals. In both age subgroups of CW the total score was higher than in patients of the control group. Key words: clean-up workers of the accident consequences at the Chornobyl NPP, ionizing radiation, comorbid pathology, chronic diseases.

scholarly journals Clinical indications and methods of application of modified crowned cutters in surgical treatment of the patients with severe craniocerebral trauma

2014 ◽  
Vol 21 (1) ◽  
pp. 30-33
Author(s):  
I. V. Koksharev
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Craniocerebral Trauma ◽  
Main Group ◽  
Results Of Treatment ◽  
Craniocerebral Injuries ◽  
Intracranial Hematomas ◽  
Different Diameters ◽  
Severe Craniocerebral Trauma ◽  
Methods Of Application

The aim of the research was to improve the results of treatment of severe craniocerebral traumas by development of the scientifically based technology of surgical management of various intracranial hematomas using modified crowned cutters of different diameters. Comparative analysis of the surgical treatment of the patients with craniocerebral injuries in the main group and in the control one showed clinical and practical efficiency of the modified structures of the crowned cutters in the surgical treatment versus the traditional cutters - 50 % shorter time of the bone stage craniotomy in the main group, 4.3 % lowered blood loss, and 14.7 % shorter period of hospitalization.

scholarly journals Pathogenetically substantiated complex therapy program of anxiety disorders in internally displaced persons

2021 ◽  
Vol 11 (11) ◽  
pp. 188-193
Author(s):  
T. Tolstaya
Keyword(s):  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Psychological Trauma ◽  
Main Group ◽  
Armed Conflicts ◽  
Psychological State ◽  
Control Group ◽  
Internally Displaced ◽  
Therapy Program ◽  
Complex Therapy

Victims of local armed conflicts have suffered psychological trauma, in connection with which they have specific clinical and psychological characteristics of experiencing crisis situations.Forced resettlement is accompanied by transformation of the entire system of socio-psychological relations, which ultimately risks the formation of a psychological state of maximum disintegration and maladaptation. Material and methods. A comprehensive examination of 150 patients with anxiety disorders was conducted to address this goal. Patients were both sexes, aged 20-55 years. The main group consisted of 84 patients (44 women and 40 men) who participated in the developed comprehensive therapeutic program, the control group - 66 patients (34 women and 32 men) who received standard regulated therapy. The following examination methods were used in the study: clinical-psychopathological, psychodiagnostic and statistical. A complex therapy program was developed and tested, based on the data obtained during this study. It was made for the treatment of anxiety disorders with differentiated use of psychopharmacotherapy and psychotherapy. Pharmacotherapy included differentiated use of anxiolytics, selective serotonin reuptake inhibitors (sertraline) and combined serotonin and norepinephrine reuptake inhibitors (venlafaxine, mirtazapine). During our research it was developed and tested a personalized system of psychotherapy for anxiety disorders. Analysis of indicator’s quality dynamics showed that improvement of perception of physical condition in the main group increased by 39.8% of examined, in the control - by 21.1%; the sense of action independence improved by 59.8% and 36.3%, respectively; job satisfaction by 69.8% in the main and in the control – 32.2%; feeling of spiritual realization – 71.1% and 22.1% – respectively.

scholarly journals INFLUENCE OF SPINOPELVIC PARAMETERS ON THE DEVELOPMENT OF SACROILIAC JOINT PAIN SYNDROME AND EFFICACY OF ITS TREATMENT

2018 ◽  
Vol 25 (2) ◽  
pp. 13-20
Author(s):  
I. V. Volkov ◽  
I. Sh. Karabaev ◽  
D. A. Ptashnikov ◽  
N. A. Konovalov ◽  
O. A. Lapaeva
Keyword(s):  
Sacroiliac Joint ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Main Group ◽  
Control Group ◽  
Sacral Slope ◽  
Lumbosacral Spine ◽  
Leg Length ◽  
Spinopelvic Parameters ◽  
Treatment Prognosis

Purpose: to study the influence of spinopelvic parameters on the risk of sacroiliac joint (SIJ) dysfunction development and prognosis of its treatment in patients with degenerative-dystrophic diseases of lumbosacral spine. Patients and methods. Prospective nonrandomized study included 197 patients: 79 patients with SIJ syndrome verified by the test block (main group) and 118 patients with other causes of low back pain (control group). In the main group the treatment tactics consisted of intraarticular injections of glucocorticosteroids and radiofrequency SIJ denervation. The result was deemed positive when pain intensity reduction made up 50% by Numerical Rating Scale (NRS-11) and/or 20% by Oswestry Disability Index (ODI) with effect preservation for 12 months and more. Pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL) were measured. PI-LL difference was calculated as well as PT/PI and SS/PI ratio, type of posture by P. Roussouly and leg length discrepancy were assessed.Results. Positive treatment results were achieved in 63 (79.75%) patients from the main group. The comparison of 2 groups showed that the main risk factor was the index of PT/PI ratio the odds ratio 6.39 (95% confidence interval (CI) 2.19-8.33; p=0.021) for the risk of SIJ dysfunction development and 4.1 (95% CI 1.98-5.86; p=0.031) for the negative treatment prognosis with that index threshold of 0.28 and 0.32, respectively.Conclusion. The detected reliable dependence between the retroversion degree and SIJ dysfunction development and treatment prognosis may become the basis for new additional studies

Impact of an educative program on dialysis patients’ knowledge and mental health: controlled before and after program

2018 ◽  
Vol 10 (2) ◽  
pp. 20204
Author(s):  
Laetitia Idier ◽  
Aurélie Untas ◽  
Nicole Rascle ◽  
Michèle Koleck ◽  
Maider Aguirrezabal ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Vascular Access ◽  
Educational Program ◽  
Psychological State ◽  
Control Group ◽  
Dialysis Patients ◽  
Emotional Change ◽  
The Impact ◽  
Experimental Group

Introduction:Psychological impact of Therapeutic Patient Education (TPE) for dialysis patients is rarely evaluated since the focus of many studies is on medical variables (i.e., adherence).Objectives:The aims of this study were: 1) to estimate the impact of a TPE program on knowledge, depression and anxiety, 2) to examine change in knowledge as a mediator of the effects of a TPE program on mental health.Method:This study was conducted in three hemodialysis units and comprised two groups: an experimental group with education and a control group with routine care. The program was based of 5 educative sessions. Knowledge, depressive and anxious symptoms were assessed with self-reported outcomes measured before and 3 months after the program.Results:The sample comprised 125 patients. Knowledge about vascular access and nutrition (p < 0.01) and depressive symptoms increased in the experimental group (p < 0.01). Analysis of mediation showed that changes in knowledge about vascular access were a significant mediator of the effects of the program on depressive symptoms (F = 4.90;p = 0.01).Discussion:Knowledge acquired during an educational program could lead to an emotional change. Improving knowledge often leads to an awareness of the risks that can modify the psychological state of patients by reminding them of their vulnerability. This study shows that it is required to be attentive to the way of transmitting knowledge. It’s necessary adapting this transmission to the needs of patients and promoting the acquisition of psychosocial competence too.Conclusion:This study shows that knowledge acquired during an educational program can lead to an emotional change in the short term. A long-term follow-up of the population should be interesting to observe these emotional effects.

Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

2020 ◽  
pp. 97-105
Author(s):  
E. N. Simakova ◽  
O. V. Stenkova
Keyword(s):  
Intraocular Pressure ◽  
Drug Therapy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Randomized Study ◽  
Main Group ◽  
Control Group ◽  
Open Angle ◽  
Complex Treatment ◽  
Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

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