External application of sulfide mineral water in the restorative treatment of patients with osteoarthritis - pilot study.

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.

The aim of this study was to investigate the impact of the adjunct of leukocyte- and platelet-rich fibrin (LPRF) to root-end surgery (RES) on the patients' quality of life during the first week post RES. Patients in need of RES were recruited for an open randomized controlled clinical trial (RCT) with a 2 × 2 factorial design. They were randomly allocated to the test (+LPRF) and control (-LPRF) group. Each group was subsequently divided into two strata: with or without an occlusive membrane (Bio-Gide®, Geistlich Biomaterials, Switzerland; BG). After RES, the patients completed daily for 1week a visual analog pain scale (VAS) and a 5-point Likert-type scale questionnaire concerning activity impairment, occurrence of symptoms, and medication use. Fifty patients were included, equally divided between the test and control group. Only one patient in the "-LPRF+BG-group" had to take additional antibiotics due to a persistent jaw swelling. There was no evidence (p ≤ 0.05) for a difference between the test and control group in VAS, occurrence of pain symptoms, impairment of daily activities, and medication use, over the 7days and daily during the 7days post RES. There was no statistical significant evidence for improvement of patients' quality of life during the first week post RES with LPRF in comparison with RES without LPRF. Although LPRF seems to be an inexpensive and autologous agent to reduce pain and swelling post RES, this RCT does not provide a statistical significant evidence for that.

The prevalence of back pain in pregnant women is quite high nowadays. A special place is given to myofascial pain. They progress with the course of pregnancy and can lead to a decrease in a woman’s quality of life. However, the issues of back pain treatment, including the selection of methods and doctors training, still remain unresolved. The aim of our work was to identify the effect of manual therapy (in particular, myofascial release) on the dynamics of pain syndrome in pregnant women with low back pain. Material and methods. The study involved 90 patients of the MIRT Medical Center (Krasnoyarsk) with myofascial lumbosacral pain syndrome at different gestation phases. We used myofascial release techniques and training device to retrained their muscular system. We evaluated the effectiveness of treatment by using a visual analog scale of pain, test with two scales (patented model) and manual muscle testing methods. Results and discussion. The average pain score was 5 points before treatment and 0.6 points after treatment. Pain completely disappeared in most patients after treatment. The maximum decrease in pain score showed women in the third trimester. The pathological difference in the load on the limbs after treatment was 17 times less than before treatment, for all trimesters in general. In the first trimester it was not detected at all. The study revealed correlation between the pain syndrome and positive sacroiliac ligament compression test. Conclusions. We have developed a general scheme for examination and treatment of back pain in pregnant using patented technologies and myofascial release technics. It has proven to be effective in reducing lower back pain at different gestation phases. Tension in the sacroiliac ligaments should be investigated in the future and taken into account for back pain treatment of pregnant women, as well as at pregnancy planning stage.

Relevance: Today, the restorative treatment of patients
 with malignant neoplasms remains a relevant issue. This section of oncology is the most laborious and requires an integrated approach. The concept of Quality of Life (QoL) increasingly appears in clinical trials, along with survival.
 The purpose was to review the literature on various aspects of medical rehabilitation of cancer patients.
 Results: The selected sources analysis suggests the necessity of an integrated approach to the restorative treatment of cancer patients because the changes in these
 patients’ life status are often pronounced. These changes
 might involve the patient’s physical condition and its various functional indicators; psycho-emotional state, with
 the relationship between predictive perception, QoL and
 the patient’s mood; and the social status, which is decisive
 for the patient’s reintegration in society. Such a multilateral
 approach will cover all aspects of patients’ life activity and
 address the main focus of cancer patients’ medical rehabilitation – their QoL improvement.
 Conclusion: Implementation of an integrated medical
 rehabilitation program for cancer patients will promote a
 maximum possible restoration of these patients’ life conditions and facilitate their physical and psycho-social adaptation after specialized treatment.

Relevance: Today, the restorative treatment of patients with malignant neoplasms remains a relevant issue. This section of
 oncology is the most laborious and requires an integrated approach. The concept of Quality of Life (QoL) increasingly appears
 in clinical trials, along with survival.
 The study aimed to review the literature on various aspects of medical rehabilitation of cancer patients.
 Results: The selected sources analysis suggests the necessity of an integrated approach to the restorative treatment of cancer patients because the changes in these patients’ life status are often pronounced. These changes might involve the patient’s
 physical condition and its various functional indicators; psycho-emotional state, with the relationship between predictive perception, QoL and the patient’s mood; and the social status, which is decisive for the patient’s reintegration into society. Such
 a multilateral approach will cover all aspects of patients’ life activity and address the main focus of cancer patients’ medical
 rehabilitation – their QoL improvement.
 Conclusion: Implementation of an integrated medical rehabilitation program for cancer patients will promote a maximum
 possible restoration of these patients’ life conditions and facilitate their physical and psycho-social adaptation after specialized
 treatment.

INTRODUCTION: Clinical manifestations of compressive vertebrogenic radiculopathies include pain disorders. This necessitates complex parameterization of individual components of pain syndrome and identification of the respective clinical and functional correlations. AIM: Comprehensive clinical and neurophysiological characteristics of patients with different effectiveness of conservative treatment of L5 and S1vertebrogenic radiculopathy. MATERIALS AND METHODS: The open prospective study included 61 patients. Based on the dynamics of pain syndrome on the visual-analog pain scale (VAS) at 3 weeks and 3 months, using cluster analysis, the patients were divided into groups with insignificant pain dynamics with conservative treatment (group 1 — 32 patients) and with significant pain regression (group 2 — 29 patients). In the patients, endogenous evoked potential of the contingent negative variation (CNV), somatosensory evoked potentials, late electroneuromyographic responses were recorded, and heart rate variability (HRV) was studied. RESULTS: In group 1, a higher CNV amplitude, higher HRV oscillation amplitude in the HF spectrum, and a lower amplitude of F-response on the affected side were revealed. There were found direct correlations between the CNV amplitudes and VLF HRV and VAS on day 1 of the visit, and negative correlations between the amplitude of somatosensory evoked potentials (SSEP) and VAS at 3 months. In group 2, direct correlations were found between the SSEP amplitude, stress index, and F-response from the VAS level on day 1 of the visit, as well as a correlation between heart rate variability and VAS on month 3 after treatment. A logit regression analysis model was created that permitted a highly sensitive distribution of patients into a group with high treatment effectiveness; the independent factors in this model were the CNV amplitude and the normalized HF HRV index. CONCLUSIONS: Correlates of the intensity of pain syndrome in the acute period are the severity of suprasegmental and sympathetic autonomic influences, the power of specific somatosensory afferentation, a high level of readiness for a motor response; upon that, predictor of alleviation of pain syndrome is an initially high level of specific somatosensory afferentation.

Nucleoplasty is a minimally invasive surgical procedure for disc decompression developed to treat patients with symptomatic contained herniated discs. Nucleoplasty uses nonheat-driven radiofrequency energy to ablate and coagulate the disc nucleus via a percutaneous "discography" trajectory under fluoroscopic guidance. In this study the authors evaluated pain, functioning, and quality of life (QOL) in patients with radicular leg and back pain who underwent nucleoplasty-based percutaneous disc decompression. The study was designed as a prospective nonrandomized longitudinal cohort study in an academic medical center. Sixty-seven patients (mean age 41 years) with primarily radicular pain due to a contained disc herniation underwent nucleoplasty-based decompression in an outpatient setting. Patients completed the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey, EuroQol 5D (EQ5D), and a visual analog scale (VAS) for pain preoperatively, and at 3 and 6 months after surgery. Postoperative QOL differences were assessed using the Wilcoxon signed-rank test. A surgical probe, the Perc-DLE SpineWand, was placed percutaneously into the disc after application of a local anesthetic or induction of general anesthesia to remove part of the disc (that is, a percutaneous discectomy). Nucleoplasty-treated levels were L2-3 (one case), L3-4 (five cases), L4-5 (44 cases), and L5-S 1 (40 cases); there were 22 multiple treatment levels and 42 bilateral treatments. There were no infections or nerve root injuries associated with the procedure. Compared with preoperative QOL, there was a statistically significant improvement in QOL at 3 months as measured using the SF-36 Physical Component Summary (PCS) scale (mean score improvement 4.4 [p = 0.014]), the EQ5D (mean score improvement 0.22 [p = 0.001]), and the VAS for pain (mean score improvement 0.13 [p = 0.021). Six-month results in 36 patients continued to reflect improvement as measured using the SF-36 PCS (mean score improvement 7.6 [p = 0.002]) and the EQ5D (mean score improvement 0.27 [p = 0.001]). Nucleoplasty-based percutaneous disc decompression in patients with symptomatic contained disc herniations is safe and improves QOL as measured by the SF-36, EQ5D, and VAS for pain, three generic QOL outcome instruments. Nucleoplasty is an effective minimally invasive surgical treatment alternative in patients with symptomatic contained disc hemiations. Further follow-up evaluation is underway to determine the durability of QOL improvement after nucleoplasty.

Objective: Traditional Chinese Medicines (TCMs), as well as physiotherapy and chemical drugs, are recommended for the treatment of cervical spondylosis by Chinese guidelines for cervical spondylosis diagnosis and treatment. The aim of this study was to evaluate whether TCM Jingshu Granules are cost-effective in patients with cervical radiculopathy in China. Methods: A multicenter, double-blinded, randomized placebo-controlled trial was performed. A total of 480 patients were recruited from 14 tertiary hospitals in China and were randomly divided into an experimental group (Jingshu Granules) or control group (placebo) at a 3:1 ratio. All patients received 4 weeks of treatment. Clinical outcomes and cost data were collected during the trial, including the neck disability index (NDI), visual analog scale (VAS) of pain, VAS of numbness, 36-Item Short Form Health Survey (SF-36) score, willingness to pay (WTP) for VAS of pain, direct medical costs, and transport costs. From a social perspective, a decision-tree model and cost-effectiveness analysis were conducted. Results: The treatment group has a significant advantage in reducing NDI (9.41 ± 10.51 vs. 4.83 ± 8.43, p < 0.05), VAS of pain (22.72 ± 15.08 vs. 12.86 ± 13.45, p < 0.05), and VAS of numbness (16.96 ± 17.53 vs. 11.64 ± 16.54, p < 0.05), respectively, while there was no significant difference in the improvement of quality of life (QoL; SF-36 score, p > 0.05). The expected mean cost of the experimental group was 1144.34 yuan, and the effective rates were 57.9% for NDI and 72.9% for VAS of pain. The expected mean cost of the control group was 767.41 yuan, and the effective rates were 33.3% for NDI and 51.6% for VAS of pain. For the primary indicators (VAS of pain and NDI), the incremental cost-effectiveness ratio was 17.69 and 15.32, respectively. The WTP per efficacy for pain resolution of patients was 19.10 yuan. Setting the WTP as threshold, Jingshu Granules were found to be a cost-effectiveness strategy, and sensitivity analysis showed that the effective rates and inspection fees of both groups had a greater impact on the results of both groups. Conclusions: Jingshu Granules were shown to be effective for treating patients with cervical radiculopathy. This treatment was found to be cost-effective when considering VAS of pain and NDI as clinical outcome indicators compared to no treatment (placebo). A clinical study with longer duration or real world study is needed to determine the impact on QoL of patients in the future.

In the study of 93 patients with osteoarthritis of the knee joint (OAKS), dynamics was assessed using a visual analog scale (VAS), the WOMAC and Leken index, goniometry and microcirculation by laser Doppler flowmetry. In patients with OAKS, the combined effect of pharmacopuncture with Alloplant biomaterial and low-frequency magnetic therapy with pulsed magnetic field against the background of basic drug treatment showed a pronounced positive effect on the dynamics of pain syndrome, an increase in the functionality of the knee joint and improvement of microcirculation.

The aim the study is to assess relationships between caregiver burden, quality of life, arm disability, grip strength, and lymphedema symptoms in women with postmastectomy lymphedema. Fifty-two patients with postmastectomy lymphedema were recruited. Burden Interview, Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-30 and EORTC QLQ BRE-23) were used for the assessments of caregiver burden, arm disability, and quality of life. Lymphedema symptoms were questioned by Visual Analogue Scale (VAS) for pain, heaviness, and tension. Grip strength and arm volumes of the affected and unaffected sides were measured. Statistically significant positive correlations were detected between Burden Interview scores and DASH scores, VAS for pain and EORTC QLO-30 symptom scores. There were statistically negative correlations between Burden Interview and grip strength of affected side and unaffected side and lymphedema duration. Multiple linear regression was calculated to predict Burden Interview and EORTC QLO-30 functional and symptom scores based on age, DASH, stage, and duration of lymphedema. DASH score was significant predictors of Burden Interview while DASH score and Burden Interview scores were significant predictors of quality of life. Arm disability indicates caregiver burden and quality of life in patients with postmastectomy lymphedema while caregiver burden predicts the quality of life. These findings have implications for the management of lymphedema. We suggest that arm disability should be diagnosed and treated to improve caregiver burden and quality of life.

Hepatitis C treatment and quality of life – You can’t always get what you want, but you might get what you need

Health Education and Symptom Flare Management Using a Video-based m-Health System for Caring Women With IC/BPS

ObjectiveThis study aimed to determine the quality of life (QOL), in patients with endometriosis ± infertility (B and C groups) and compare those to healthy women, and also infertile groups without endometriosis as a control groups (A and D), considering the fact that endometriosis and infertility reduces the quality of life in patients.MethodsThe present prospective comparative study was carried out between January 2018 and September 2020. A total of 400 women were included (100 women in each group). The participants filled in a validated questionnaire of quality of life, Endometriosis Health Profile-30 (EHP-30), and a visual analog scale of pain used, at the first visit, and 3 months after the medical or surgical treatment in the endometriosis group without infertility, additionally.ResultsThe majority of the patients were married, categorized in the middle-class of socio-economic state and housewives. They were of Persian descent. BMI was high in the infertile groups; however, the time of infertility was not different between the two groups of B and C (P = 0.054). The mean score of QOL was significantly lower in B, C, and D groups in comparison to the healthy women as the control group (A) (P < 0.001). Moreover, the infertile group (B), in comparison to endometriosis ± infertility groups (C and D), had the lowest mean score of QOL (P < 0.001). In each group, those who were older and had better educational level reported a better quality of life than other participants in that group. Social support plays a very important role in reducing the endometriosis related pain symptoms both before and after treatment. Three months after the treatment of endometriosis (D), a significant improvement was observed in all the aspects of QOL-related endometriosis. Nonetheless, the improvement of the quality of life in the surgical group was significantly higher than that in the medical treatment. The mean visual analog score of pain decreased from 62.22 ± 22.78, to 5.15 ± 2.73 following the surgical treatment (P < 0.001).ConclusionThe lowest quality of life belonged to the infertile group, followed by the endometriosis group. The quality of life of the endometriosis group improved after the treatment. Thus, endometriotic patients’ treatment in terms of improvement of quality of life should be considered by all professional health care teams.

We compared the morbidity and quality of life of military policemen ("gendarmes") infected with chikungunya virus (CHIKV+) 30 months after contamination. We categorized the subjects in 3 groups: healed patients (n = 48), non-healed patients (n = 37, 44% of CHIKV+), and uninfected subjects (CHIKV-, n = 297). Data were self-recorded in this retrospective cohort study; they included sociodemographic information, clinical symptoms, and the Medical Outcome Study 36-item short-form health survey (MOS-SF36) quality of life questionnaire. The study population was mostly men (92%), with a median age of 42.8 years, regardless of CHIKV status. The main complaints were rheumatic symptoms (pain, stiffness, and swelling), reported 5 times more often by non-healed CHIKV+ subjects and 2-3 times more often by healed CHIKV+ subjects than by CHIKV- subjects, and fatigue. The CHIKV+ patients reported more use of health care services. Thirty months after infection, all rheumatic symptoms were more frequent and intense among CHIKV+ than among CHIKV- subjects, with a gradient of severity between healed and non-healed CHIKV+ subjects. Non-healed CHIKV+ subjects reported subsequent limitation in their activities. All dimensions of MOS-SF36 as well as physical and mental component summaries were impaired in CHIKV+ compared to CHIKV- subjects, with a decreasing gradient of impairment from non-healed to healed CHIKV+ subjects, then to CHIKV- subjects. These observations confirm the long-term impact of CHIKV infection on both physical and mental health. Questions persist regarding the duration of this impairment and the possibility of a return to "before CHIKV" health status for infected patients.

To demonstrate the immediate and medium-term results of the surgical treatment of patients with first metatarsophalangeal (MTP) joint osteoarthritis (OA) using the autologous matrix-induced chondrogenesis (AMIC) technique and to evaluate the effectiveness. Preoperatively the range of motion (ROM) in the first MTP joint was determined, and the following questionnaires were used: Visual Analogue Scale (VAS) of pain, American Orthopedic Foot & Ankle Society (AOFAS) score, and Functional Foot Index (FFI). All of the patients experienced a significant restriction of the ROM in the first MTP joint. The VAS of pain median was 70, AOFAS 52, and FFI 5.8. AMIC was performed in 19 patients with first MTP joint OA. All the patients experienced a significant restriction of ROM in the first MTP joint. The VAS of pain median was 70, AOFAS 52, and FFI 5.8. By the third month, VAS of pain decreased to 25, FFI to 2.2; AOFAS median increased to 77, ROM to 60°. Six months after the surgery VAS of pain decreased to 10, FFI to 1.1; AOFAS median increased to 90, ROM to 65°. After a year of observation, VAS of pain decreased to 5, FFI to 1,0; AOFAS median increased to 92.5, ROM to 71.5°. The results showed that a first MTP joint AMIC procedure can be a fairly effective method of surgical treatment that can relieve pain and significantly improve the quality of life of patients with first MTP joint OA.