Tongue reconstruction in cancer patients: current state of the problem (literature review)

Tongue repair after radical surgical removal of malignant tumors with subsequent rehabilitation of patients and their return to normal life and work has been a challenging issue for decades.This review aims to give an up to date summary of existing literature on different methods of tongue repair in cancer patients depending on the type of defect. We describe advantages and disadvantages of local and regional free autologous grafts.

Short- and Long-Term Effects of Rehabilitation after Perimesencephalic Subarachnoid Hemorrhage

In about 25% of patients with spontaneous subarachnoid hemorrhage (SAH), a bleeding source cannot be identified during radiological diagnostics. Generally, the outcome of perimesencephalic or prepontine (PM) SAH is known to be significantly better than after non-PM SAH. Data about long-term follow-up concerning physical and mental health are scarce, so this study is reports on long-term results. We measured the influence of PM SAH on a quality-of-life modified Rankin (mRs) scale after six months. For long-term follow-up, a SF-36 questionnaire was used. Questionnaires were sent out between 18 and 168 months after ictus. In 37 patients, a long-term follow-up was available (up to 14 years after SAH). Data detected with the SF-36 questionnaire are compared to reference applicability to the standard population. In total, 37 patients were included for further analysis and divided in 2 subgroups; 13 patients (35%) received subsequent rehabilitation after clinical stay and 24 (65%) did not. In the short-term outcome, a significant improvement from discharge until follow-up was identified in patients with subsequent rehabilitation, but not in the matched pair group without rehabilitation. When PM SAH was compared to the standard population, a reduction in quality of life was identified in physical items (role limitations because of physical health problems, physical functioning) as well as in psychological items (role limitations because of emotional problems). Subsequent rehabilitation on PM SAH patients probably leads to an increase in independence and better mRs. While better mRs was shown at discharge in patients without subsequent rehabilitation, the mRs of rehabilitants was nearly identical after rehabilitation. Patients with good mRs also reached high levels of health-related quality of life (HRQoL) without rehabilitation. Thus, subsequent rehabilitation needs to be encouraged on an individual basis. Indication criteria for subsequent rehabilitation should be defined in further studies to improve patient treatment and efficiency in health care.

Back Into the Wild: Feces DNA Analyses Track the Return of a Beluga Whale Back to Its Natural Environment

Following the sudden appearance, and subsequent rehabilitation of an assumed previously captive beluga whale off the coast of Norway, we investigate the animal’s ability to readapt to life in the wild. Using DNA analysis, a survey was set up to assess diet throughout the rehabilitation process, and during a return to wild foraging when rehabilitative feeding had ceased. Metabarcoding of collected feces, confirmed the diversification of the beluga whale’s diet to local prey. These findings are indicative of improved foraging behavior, and the ability of this individual to readapt to life in the wild following a period of rehabilitation. Beyond the case study presented here, we demonstrate the power of DNA analysis as a non-intrusive tool to assess the diet of large mammals, and assess progress adapting to life in the wild following release from captivity and rehabilitation programs.

Age, anamnestic and clinical and therapeutic characteristics of patients with breast malignant neoplasms

Annotation. Results of the analysis of the data of 2173 patients with breast malignant neoplasms treated in the Podillian Regional Oncology Center during 2015-2017 are presented in this article. A detailed analysis of the characteristics of this contingent of patients was carried out with the study of the age structure, classification of breast malignant neoplasms according to ICD-10, the structure of concomitant neoplasms, the stage of the oncological process at the time of detection of the disease, the presence and localization of metastases, the structure of the treatment procedures. The obtained data were processed using the statistical software package SPSS 20.0 for Windows. The age structure of the contingent of patients with breast malignant neoplasms, the structure of localization and stages of the oncological process indicate the extreme urgency of this pathology. Most of the patients of reproductive age (24.67%) require a careful choice of a set of therapeutic procedures and subsequent rehabilitation to preserve reproductive function and working capacity.

Propionibacterium acnes causing non-contiguous, multifocal spondylodiscitis in an immunosuppressed patient

This report describes a case of a spondylodiscitis in an immunocompromised patient with an HIV infection caused by Propionibacterium acnes. The patient was admitted to hospital with a sudden loss of motor function and sensation in both of the patient’s legs. A biopsy taken during the first debridement operation proved to be negative for Mycobacterium tuberculosis DNA and growth, but was positive for the growth of P. acnes. Following a course of antibiotic therapy and the aforementioned debridement, the patient was moved to a specialised clinic for physical therapy. The patient’s condition quickly deteriorated, and the patient once again required extensive debridement. Repeated spinal surgery, antibiotics for 12 weeks and subsequent rehabilitation resulted in almost complete recovery of sensorimotor limb function.

Fear of Movement/(Re)Injury: An Update to Descriptive Review of the Related Measures

The prevalence of fear of movement (kinesiophobia) in persistent pain ranges from 50 to 70%, and it may hinder the subsequent rehabilitation interventions. Therefore, the evaluation of fear of movement/(re)injury plays a crucial role in making clinical treatment decisions conducive to the promotion of rehabilitation and prognosis. In the decision-making process of pain treatment, the assessment of fear of movement/(re)injury is mainly completed by scale/questionnaire. Scale/questionnaire is the most widely used instrument for measuring fear of movement/(re)injury in the decision-making process of pain treatment. At present, the most commonly used scale/questionnaire are the Tampa Scale for Kinesiophobia (TSK), the Fear-Avoidance Beliefs Questionnaire (FABQ), the Kinesiophobia Causes Scale (KCS), the Athlete Fear-Avoidance Questionnaire (AFAQ), and the Fear-Avoidance Components Scale (FACS). In order to provide necessary tools and references for related research and rehabilitation treatment, this descriptive review is designed as an introduction to the background and content, score system, available language versions, variants of the original questionnaire, and psychometric properties of these scales/questionnaries.

Prospects for Using Radionuclide Research Methods for Diagnosing and Evaluating Effectiveness of Treating Consequences of Coronavirus Diseasr (COVID-19

Purpose: to determine the role of nuclear medicine methods in the diagnosis and quality control of treatment and rehabilitation of patients with complications after coronavirus diseasr (COVID-19) The article provides a brief analysis of the incidence of COVID-19 and highlights the role of diagnosis, treatment and rehabilitation of patients suffering from the consequences of coronavirus diseasr after the end of the pandemic. The most common clinical manifestation of coronavirus diseasr is bilateral interstitial pneumonia, one of the complications of which is the development of acute respiratory distress syndrome, its pathogenesis is highlighted. It is also noted that the leading link in the development of the disease is a systemic lesion of the endothelial vascular wall, which is the cause of thrombosis and its complications, primarily pulmonary embolism, ischemic brain infarctions and cardiovascular catastrophes. Specific methods of radionuclide diagnostics are described for individual organs and systems: respiratory, cardiovascular, brain, and others. The need to diagnose and control the quality of treatment and rehabilitation of patients with post-inflammatory changes in the parenchyma of internal organs and a decrease in their functional ability due to sclerotic changes, patients with changes in the state due to the transition of inflammation to the chronic stage, as well as with an overactive immune response to inflammatory changes. Conclusion: at the stage of diagnosis and treatment of the consequences of a previous coronavirus diseasr and subsequent rehabilitation, molecular imaging methods are essential in a complex of studies.

Analysis of Problems in Making Rehabilitation Diagnosis in Persons With Disabilities With the Consequences of Brain Stroke in the Kyrgyz Republic

The Kyrgyz Republic holds one of the first positions in the world in terms of mortality and morbidity of brain stroke. Open sources provide data from the Kyrgyz Republic on the analysis of morbidity and mortality, and medication treatment of patients with various forms of brain stroke, but there are almost no studies on primary disablement and subsequent rehabilitation measures, which are based on setting a rehabilitation diagnosis and defining the goals of rehabilitation. The purpose of this study is to analyze problems in making a rehabilitation diagnosis for persons with disabilities with the consequences of brain stroke, based on the examination of the records of 3 medical and social expert commissions (MSEC) of the Kyrgyz Republic, out of 27 existing commissions. The authors present the results of a 2018–2019 study of the medical and rehabilitation documents of 328 persons with primary disablement in order to determine the rehabilitation diagnosis in these documents as a basic tool for the formation of a clinical rehabilitation route. Despite the availability of regulatory documents, clinical guidelines on the management of stroke patients, there is no evidence of a rehabilitation diagnosis in the documents reviewed, which affects the effectiveness of rehabilitation of persons with disabilities with the consequences of brain strokes. The authors recommend a set of measures to eliminate the barrier revealed and to develop rehabilitation services. Such rehabilitation services could be triggered by introducing the International Classification of Functioning, Disability and Health into the field of rehabilitation.

Approach to patients with hip fracture and concurrent stroke

We report a case of a 70-year-old man who presented with concomitant hip fracture and stroke. Our patient underwent surgical correction of a hip fracture despite the increased perioperative and postoperative risks associated with an acute stroke. He achieved good functional outcome after surgery and subsequent rehabilitation. There are no clear guidelines on the factors to determine whether a patient with concomitant stroke and hip fracture is a good candidate for surgical hip repair. Furthermore, there is also no consensus on the appropriate timing of surgical repair for such patients. We postulate that factors such as functional status, comorbidities, type and severity of stroke will affect the decision to proceed with surgical repair, and that there is a benefit in advocating for surgery in appropriate patients by a multidisciplinary orthogeriatric care team.

Small Warriors? Children and Youth in Colonial Insurgencies and Counterinsurgency, ca. 1945–1960

Child soldiers are often viewed as a contemporary, “new war” phenomenon, but international concern about their use first emerged in response to anti-colonial liberation struggles. Youth were important actors in anti-colonial insurgencies, but their involvement has been neglected in existing historiographies of decolonization and counterinsurgency due to the absence and marginalization of youth voices in colonial archives. This article analyses the causes of youth insurgency and colonial counterinsurgency responses to their involvement in conflict between ca. 1945 and 1960, particularly comparing Kenya and Cyprus, but also drawing on evidence from Malaya, Indochina/Vietnam, and Algeria. It employs a generational lens to explore the experiences of “youth insurgents” primarily between the ages of twelve and twenty. Youth insurgents were most common where the legitimate grievances of youth were mobilized by anti-colonial groups who could recruit children through colonial organizations as well as family and social networks. While some teenagers fought due to coercion or necessity, others were politically motivated and willing to risk their lives for independence. Youth soldiers served in multiple capacities in insurgencies, from protestors to couriers to armed fighters, in roles that were shaped by multiple logics: the need for troop fortification and sustained manpower; the tactical exploitation of youth liminality, and the symbolic mobilization of childhood and discourses of childhood innocence. Counterinsurgency responses to youthful insurgents commonly combined violence and development, highlighting tensions within late colonial governance: juveniles were beaten, detained, and flogged, but also constructed as “delinquents” rather than “terrorists” to facilitate their subsequent “rehabilitation.”