Periarticular lesions as actual problem of general practice: modern possibilities of diagnosis and boosting effectiveness of treatment

Background. Lesions of extra-articular soft tissues occupy a leading place in the structure of diseases of the musculoskeletal system in primary health care. At the same time, insuffcient attention is paid to this pathology, which leads to a decrease in the quality of care for patients with extra-articular pathology.Objective. Increasing the awareness of general practitioners about the clinical forms of extra-articular soft tissue diseases, current approaches to diagnosis and treatment.Basic provisions. The article presents the characteristics of the main forms of periarticular lesions: periarthritis, incl. painful shoulder, tendonitis, tenosynovitis, capsulitis, bursitis. The leading mechanisms of periarticular disorders are presented, the clinical picture and diagnostic signs of particular forms are described. The role of modern methods of visualization of periarticular lesions using ultrasound and MRI is noted. The main approaches to the drug therapy of periarticular disorders are presented, including use of slow-acting symptom-modifying drugs (SYSADOA). The authors present their own data demonstrating the connective tissue metabolism disturbance in periarticular disorders as well as the effectiveness of the drug Alflutop in the treatment of periarticular lesions of a ‘mechanical’ nature.Conclusions. Primary forms of periarticular disorders are a consequence of microtraumatization and can be attributed to ‘mechanical’ types of damage. The ultrasound is pivotal in the diagnosis and evaluation the severity of the lesion and its origin. Biomarkers of connective tissue damage can be detected in the blood of patients with periarticular disorders. The treatment results can be improved with drugs from the SYSADOA group.

The Application of Chitosan Nanostructures in Stomatology

Chitosan (CS) is a natural polymer with a positive charge, a deacetylated derivative of chitin. Chitosan nanostructures (nano-CS) have received increasing interest due to their potential applications and remarkable properties. They offer advantages in stomatology due to their excellent biocompatibility, their antibacterial properties, and their biodegradability. Nano-CSs can be applied as drug carriers for soft tissue diseases, bone tissue engineering and dental hard tissue remineralization; furthermore, they have been used in endodontics due to their antibacterial properties; and, finally, nano-CS can improve the adhesion and mechanical properties of dental-restorative materials due to their physical blend and chemical combinations. In this review, recent developments in the application of nano-CS for stomatology are summarized, with an emphasis on nano-CS’s performance characteristics in different application fields. Moreover, the challenges posed by and the future trends in its application are assessed.

The problem of chronic wounds and the possibility of using mesenchymal stem cells in their treatment

Annotation. A review of scientific publications on the problems of chronic wounds and issues of innovative use of mesenchymal stem cells in the treatment of patients with chronic wound defects is presented. We have conducted a systematic review of PubMed and Google Scholar database articles over the past 34 years (1985–2019), more than half of which over the past 5 years. The search terms “chronic wound”, “mesenchymal stem cells” were used during the search. It should be noted that despite the fact that the treatment of wounds and wound infection belongs to the category of the oldest branches of medicine, the treatment of chronic wounds in Ukraine today remains one of the important problems in the treatment of inflammatory soft tissue diseases. None of the many proposed methods and techniques for the treatment of chronic wounds satisfies practical surgeons completely. The results of the treatment of chronic wounds to date remain unsatisfactory. Prospects for the use of mesenchymal stem cells in the treatment of chronic wounds is important and further research.

Pathological Mineralization: The Potential of Mineralomics

Pathological mineralization has been reported countless times in the literature and is a well-known phenomenon in the medical field for its connections to a wide range of diseases, including cancer, cardiovascular, and neurodegenerative diseases. The minerals involved in calcification, however, have not been directly studied as extensively as the organic components of each of the pathologies. These have been studied in isolation and, for most of them, physicochemical properties are hitherto not fully known. In a parallel development, materials science methods such as electron microscopy, spectroscopy, thermal analysis, and others have been used in biology mainly for the study of hard tissues and biomaterials and have only recently been incorporated in the study of other biological systems. This review connects a range of soft tissue diseases, including breast cancer, age-related macular degeneration, aortic valve stenosis, kidney stone diseases, and Fahr’s syndrome, all of which have been associated with mineralization processes. Furthermore, it describes how physicochemical material characterization methods have been used to provide new information on such pathologies. Here, we focus on diseases that are associated with calcium-composed minerals to discuss how understanding the properties of these minerals can provide new insights on their origins, considering that different conditions and biological features are required for each type of mineral to be formed. We show that mineralomics, or the study of the properties and roles of minerals, can provide information which will help to improve prevention methods against pathological mineral build-up, which in the cases of most of the diseases mentioned in this review, will ultimately lead to new prevention or treatment methods for the diseases. Importantly, this review aims to highlight that chemical composition alone cannot fully support conclusions drawn on the nature of these minerals.

Сomprehensive treatment of the complicated phlegmona of the top limb on the background of sugar diabetes under hiv coinfection and virus hepatitis

Despite the active development and introduction into clinical practice of new groups of antibacterial drugs, the basis for the treatment of purulent-septic diseases of soft tissues is the opening and surgical treatment of a purulent focus. When we analyzing the literature data on the treatment of purulent soft tissue diseases, the following factors can be identified that determine the progression of the purulent-inflammatory process even with an adequately uncovered purulent focus: the presence of common co-morbid diseases that reduce the body's resistance (infectious diseases and metabolic disorders) and attachment to the pathological process multidrug-resistant virulent hospital flora [1, 2]. Progression of the purulent-necrotic process takes place along anatomically determined paths of pus spread, and therefore the absolute necessity of firm knowledge of the topographic anatomy of the human body is obvious. Perhaps the most complete and thorough description of the clinical picture and methods of surgical treatment of phlegmon of the upper limb and thorax, based on anatomical principles, is given in the classic work of V.F. Voino-Yasenetsky [3], since the first publication of which it has been almost a century. Currently, due to the prevalence of antibiotic resistance even of "wild" microorganisms, the prevalence among infectious diseases affecting the immune status of the organism (hepatitis, tuberculosis, HIV), as well as the pandemic of diabetes, the urgency of surgical treatment of common purulent processes in the region upper extremity and thorax again increased. We present the clinical case of progression of the purulent process on the left upper limb from the lower third of the arm in the distal direction to the Pirogov-Paron space and in the proximal direction to the submentoral and pre-lobular cell spaces.

Public social security burden of musculoskeletal diseases in Brasil-Descriptive study

SUMMARY BACKGROUND: To present data on the social security burden of diseases of the musculoskeletal system and connective tissue (DSOTC) in Brasil in 2014, and evolution of these social security expenditures between 2009 and 2014. METHOD: Compilation and analysis of data on the granting of disability pensions and sickness benefits in the year 2014, available on the official website of Social Security, classified according to ICD 10. It was evaluated the evolution between 2009 and 2014, using the F test to compare the curves with the growth of the active age population (PIA). RESULTS: Among the 22 disease groups classified according to ICD-10, the DSOTC group led benefits grants in 2014, with 19% of the sickness benefits and 13.5% of the disability pensions. The main causes of sickness benefit and disability retirement were, respectively: dorsopathies (43.3% and 41.2%), soft tissue diseases (27.3% and 19.7%), osteoarthritis (7.6% % And 27.8%) and chronic inflammatory arthropathies (2.8% and 7.9%). In the evolution of the number of sickness benefits granted between 2009 and 2014, both INSS and DSOTC totals showed an increasing tendency (35.9 and 35.3%, respectively, with p = 0.000 for both). As for disability retirement, there was a 5.9% increase in the INSS total (p = 0.039), while for the DSOTC there was a decrease of 7.6% (p = 0.005). CONCLUSIONS: These data point to a progressive increase in the granting of sickness pensions and disability benefits in the country, superior to the growth of the PIA, as well as a high participation of DSOTC in these benefits.