Assessment Of Treatment Results Research Articles

Accurate diagnosis and effective treatment of abnormal meridians in erectile dysfunction patients based on infrared thermography: an electrophysiological technique study.

An increasing body of research has demonstrated that appropriate stimulation of the meridians and acupoints in the human body can play a preventative and therapeutic role in diseases. This study combines the use of infrared thermography with intelligent electrophysiological diagnostic system (iEDS) to accurately diagnose and apply transdermal low-frequency electrical stimulation to treat abnormal meridians in patients with erectile dysfunction (ED). The treatment protocol included 6 treatments (each lasting 30 min and performed twice a week). The International Index of Erectile Function-5 (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Erection Hardness Scale were used to assess treatment results. A total of 62 patients were included in this study, with 31 patients in the treatment group and 31 patients in the sham therapy group. After six treatments, the treatment group improved significantly in IIEF-5 (15.52 ± 2.06 vs. 18.84 ± 2.67, p < 0.001), PHQ-9 (8.32 ± 6.33 vs. 4.87 ± 4.41, p < 0.001), GAD-7 (5.32 ± 5.08 vs. 2.94 ± 3.31, p = 0.003), and EHS (2.48 (2.00, 3.00) vs. 2.90 (2.00, 3.00), p = 0.007). After six sham treatment sessions, no improvements in any of the scores were reported in the sham therapy group. Following that, this group had an additional six treatments of regular therapy, which resulted in statistically significant improvements in IIEF-5 (16.65 ± 1.96 VS. 19.16 ± 2.40, p < 0.001), PHQ-9 (8.81 ± 6.25 VS. 4.97 ± 4.36, p < 0.001), GAD-7 (5.74 ± 5.18 VS. 3.68 ± 3.42, p < 0.001), and EHS (2.61 (2.00, 3.00) VS. 3.03 (2.00, 4.00), p = 0.003). No adverse events were reported regarding penile discomfort, pain, injury, or deformity. CLINICAL TRIALS: The study protocol is registered in the Clinical Trials Registry with the identification number ChiCTR2300070262.

Проблемы диагностики и лечения хронического эндометрита у женщин репродуктивного возраста

Aim. To study the controversial issues of diagnosis and treatment of chronic endometritis (CE) and its impact on fertility, according to foreign and domestic authors. Key points. Although immunohistochemical study for plasma cells is considered the gold standard for diagnosing CE, it has limitations. The need to achieve consensus on the diagnostic criteria for cholecystitis was noted in order to exclude the influence of heterogeneity of studies on the assessment of treatment results. An integrated approach based on knowledge about the pathogenesis of CE facilitates the selection of adequate treatment. The positive role of antibacterial therapy in resolving CE is undoubted. In recent years, the need to restore immune defense in CE has been widely discussed. The importance of a complex of natural antimicrobial peptides and cytokines in restoring fertility and improving pregnancy outcomes has already been proven in several publications. Physiotherapeutic methods continue to be studied, and the most popular currently are cavitated solutions, peloids, electropulse and magnetic therapy. Conclusion. The diagnostic criteria for CE require a clear definition. Treatment of CE should include broad-spectrum antibiotic therapy, immunomodulatory therapy, and physiotherapy. Keywords: chronic endometritis, infertility, recurrent miscarriage, antibiotics, immunomodulators, peloid therapy, ultrasonic cavitation, interference therapy, magnetotherapy, laser therapy.

Case Report: Metachronous bilateral upper tract and bladder urothelial carcinoma: a long-term follow-up

Background: Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to the ureteral orifice. Urothelial carcinoma is a multifocal malignant tumor which tends to reoccur after treatment. Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients. The occurrence of contralateral UTUC after nephroureterectomy is rarer with a prevalence of 0.5%. Case presentation: The case of a 43-year-old male with metachronous bilateral UTUC was reported. The patient had undergone gemcitabine-cysplatine neoadjuvant chemotherapy followed by radical cystectomy and orthotopic neobladder for urothelial carcinoma of the bladder cT2N0M0. Left hydronephrosis was discovered three months after the procedure. The patient was diagnosed with left UTUC cT4N0M0 of renal pyelum after a series of examinations. A left open radical nephroureterectomy was conducted to remove the mass followed by adjuvant chemotherapy. This was followed up with routine ultrasound and magnetic resonance imaging (MRI) every three months with a “tumor-free” period of 26 months. Meanwhile, the patient was re-admitted with fever and an increase in creatinine value of 4.3. After further workups, the patient was diagnosed with UTUC cT2N0M0 of the right renal pyelum. A kidney sparring approach with laser evaporation of the tumor was conducted followed by eight cycles of Gemcitabine intracavity antegrade per nephrostomy. After the regimen was finished, an MRI evaluation was conducted to assess treatment results, and the mass had decreased. Conclusions: This report showed a rare case of urothelial cell carcinoma recurrences. From bladder urothelial carcinoma to left UTUC and then to contralateral UTUC. It is important to evaluate the upper tract to reduce the risk of recurrence.

Intrusion of the maxillary posterior teeth with a single buccal mini-implant positioned bilaterally in young adults with a tendency towards hyperdivergence: A clinical study.

Skeletal anchorage systems have been used for intrusion of the posterior teeth with satisfactory results. To achieve this, mini-implants are placed at anatomically challenging sites such as the palate or require several mini-implants to produce the desired effect. To determine the magnitude of intrusion of the maxillary posterior teeth achieved on a continuous arch wire using a single buccal mini-implant placed bilaterally in young patients with a tendency towards hyperdivergence and to evaluate its influence on the skeletal, dental and soft-tissue structures. A total of 17 patients with proclination of the anterior teeth, tendency towards hyperdivergence and clockwise rotation of the mandible were selected. First premolars were extracted as part of treatment protocol. A 0.022-MBT bracket prescription was used. Mini-implants were placed bilaterally on the buccal aspect at the mucogingival junction or slightly gingival to it between the maxillary second premolar and first permanent molar. A total of 200 g of intrusive force was placed from a continuous 0.019 × 0.025 inch stainless-steel arch wire to the mini-implant by means of an elastomeric thread on both sides. Lateral cephalograms and study models were taken before the start of intrusion and six months later. Parametric and non-parametric tests were done to assess treatment results. Significant intrusion was observed in the maxillary molar and premolar region with tendency towards intrusion in the anterior region. There was significant decrease in lower anterior facial height (LAFH) with anti-clockwise mandibular rotation, decrease in facial proportion index and total facial height. No changes were observed in the transverse plane. Intrusion of the permanent maxillary molar can be achieved on a continuous arch wire with a single buccal mini-implant placed bilaterally with improvement in facial aesthetics, especially in the vertical plane. This method may be beneficial in patients with borderline vertical discrepancy treated with conventional friction mechanics during space closure after first premolar extractions.

Case Report: Metachronous bilateral upper tract and bladder urothelial carcinoma: a long-term follow-up

Background: Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to the ureteral orifice. Urothelial carcinoma is a multifocal malignant tumor which tends to reoccur after treatment. Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients. The occurrence of contralateral UTUC after nephroureterectomy is rarer with a prevalence of 0.5%. Case presentation: The case of a 43-year-old male with metachronous bilateral UTUC was reported. The patient had undergone gemcitabine-cysplatine neoadjuvant chemotherapy followed by radical cystectomy and orthotopic neobladder for urothelial carcinoma of the bladder cT2N0M0. Left hydronephrosis was discovered three months after the procedure. The patient was diagnosed with left UTUC cT4N0M0 of renal pyelum after a series of examinations. A left open radical nephroureterectomy was conducted to remove the mass followed by adjuvant chemotherapy. This was followed up with routine ultrasound and magnetic resonance imaging (MRI) every three months with a “tumor-free” period of 26 months. Meanwhile, the patient was re-admitted with fever and an increase in creatinine value of 4.3. After further workups, the patient was diagnosed with UTUC cT2N0M0 of the right renal pyelum. A kidney sparring approach with laser evaporation of the tumor was conducted followed by eight cycles of Gemcitabine intracavity antegrade per nephrostomy. After the regimen was finished, an MRI evaluation was conducted to assess treatment results, and the mass had decreased. Conclusions: This report showed a rare case of urothelial cell carcinoma recurrences. From bladder urothelial carcinoma to left UTUC and then to contralateral UTUC. It is important to evaluate the upper tract to reduce the risk of recurrence.

The CARe Burn Scale—Adult Form: Translation and linguistic validation into Finnish

BackgroundBurn injury can dramatically deteriorate health-related quality of life. Effective burn care may minimize the impact of the burn injury and ensure optimal functional outcome. This requires continuous improvement in burn care and assessment of treatment results. The aim of this study was to translate, culturally adapt and linguistically validate the CARe Burn Scale—Adult Form, a burn-specific patient-reported outcome measure, into Finnish. MethodsThe translation process followed the International Society for Pharmacoeconomics and Outcomes Research guidelines consisting of forward and backward translations, pilot-testing and cognitive debriefing interviews of five burn patients, and proofreading before finalizing. The process involved expert panel meetings and continuous discussion between the developers of the Scale and the research group. ResultsIn the forward translation 10 amendments were required. After the backward translation, 12 items were reworded. Cognitive debriefing interviews led to three alterations enhancing the comprehensiveness and accuracy of the translation. The translation was reviewed by burn occupational therapists for practicality, resulting in 12 modifications. Minor grammatical changes were made after proofreading. ConclusionThe Finnish version is the first foreign translation of the CARe Burn Scale. It is equivalent to the original Scale and ready for psychometric validation with burn patients in Finland.

Diagnostic role of positron emission tomography in patients with ovarian cancer

The review deals with the effectiveness of the use of positron emission tomography (PET) with 18F-fluorodeoxyglucose in the diagnosis, staging, assessment of treatment results, prognosis and monitoring of ovarian cancer. It is shown that the adequate use of PET in diagnostic algorithms can improve the accuracy of complex diagnostics, optimize the tactics of examination and treatment of patients. The opinions of researchers on the limitations of the method are presented, leading to false positive and false negative conclusions. Key words: ovarian cancer, positron emission tomography, 18F- fluorodeoxyglucose.

Manual ability in hand surgery patients: Validation of the ABILHAND scale in four diagnostic groups.

BackgroundPatients treated in hand surgery (HS) belong to different demographic groups and have varying impairments related to different pathologies. HS outcomes are measured to assess treatment results, complication risks and intervention reliability. A one-dimensional and linear measure would allow for unbiased comparisons of manual ability between patients and different treatment effects.ObjectiveTo adapt the ABILHAND questionnaire through Rasch analysis for specific use in HS patients and to examine its validity.MethodsA preliminary 90-item questionnaire was presented to 216 patients representing the diagnoses most frequently encountered in HS, including distal radius fracture (n = 74), basal thumb arthritis (n = 66), carpal tunnel syndrome (n = 53), and heavy wrist surgery (n = 23). Patients were assessed during the early recovery and in the late follow-up period (0–3 months, 3–6 months and >6 months), leading to a total of 305 assessments. They rated their perceived difficulty with queried activities as impossible, difficult, or easy. Responses were analyzed using the RUMM2030 software. Items were refined based on item-patient targeting, fit statistics, differential item functioning, local independence and item redundancy. Patients also completed the QuickDASH, 12-item Short Form Survey (SF-12) and a numerical pain scale.ResultsThe rating scale Rasch model was used to select 23 mostly bimanual items on a 3-level scale, which constitute a unidimensional, linear measure of manual ability with good reliability across all included diagnostic groups (Person-Separation Index = 0.90). The resulting scale was found to be invariant across demographic and clinical subgroups and over time. ABILHAND-HS patient measures correlated significantly (p<0.001) with the QuickDASH (r = -0.77), SF-12 Physical Component Summary (r = 0.56), SF-12 Mental Component Summary (r = 0.31), and pain scale (r = -0.49).ConclusionABILHAND-HS is a robust person-centered measure of manual ability in HS patients.

Bioactive concentrate from small sea fish: evaluation of the efficacy and safety of the drug on the basis of the analysis of 37 clinical trials

Injectable Alflutop® (the bioactive concentrate from small sea fish (BCSSF)) belongs to the pharmacological group of symptomatic slow-acting drugs for osteoarthritis. This drug has been widely used in our country for 25 years. During this time, 37 of its clinical trials (n=3676) have been conducted in Russia and post-Soviet countries, mainly in patients with knee osteoarthritis (OA) and nonspecific back pain. These are mainly open-label trials, a major portion of which has been performed at the good methodological level, by using active control and up-to-date methods to assess treatment results. Two works are double-blind placebo-controlled trials (DBPCTs) conducted in compliance with the modern requirements of evidence-based medicine – this is an evaluation of the efficacy of BCSSF in knee OA and vertebrogenic lumbar ischialgia. All the trials have shown a good therapeutic potential of BCSSF: on the average, after the cycle use of the agent, there is a 40–60% decrease in pain intensity as compared to the baseline level. A two-year DBPCT of the efficacy of BCSSF in knee OA has also confirmed that the concentrate has a structure-modifying effect. At the same time, all the trials have demonstrated that BCSSF is well tolerated and very rarely causes adverse reactions that require discontinuation of treatment.

The Role of Prognostic Factors in Salivary Gland Tumors Treated by Surgery and Adjuvant Radio- or Chemoradiotherapy - A Single Institution Experience.

PurposeSalivary gland neoplasms are rare cancers of the head and neck region. Radical treatment in tumors of large salivary glands is surgery. Adjuvant treatment depends on the presence of risk factors that worsen the prognosis, but the role of these factors in patients treated by surgery with radio- or radiochemotherapy still remains unclear. The aim of the study is assessment of treatment results and identification of the risk factors affecting the prognosis in patients with tumors of large salivary glands subjected to adjuvant radio- or radiochemotherapy.Patients and MethodsThe study included 126 patients with local stage large salivary gland cancer who were treated surgically with adjuvant radio- or radiochemotherapy. The study excluded inoperable patients, patients with distant metastases, patients in a poor general condition and patients with contraindications to adjuvant treatment. They were treated between 2006 and 2016 and evaluated in terms of OS (overall survival), CSS (cancer-specific survival), RFS (relapse-free survival) and LRFS (local relapse-free survival).ResultsDuring a 44-month follow-up, 5-OS, CSS, RFS and LRFS were 55%, 68%, 60% and 73%, respectively. Multivariate analysis showed that OS was influenced by the following parameters: WHO performance status, TNM stage (T and N parameters), radicality of surgery, histopathological type, applied method of radiotherapy planning and tumor volume. WHO performance status, T and N parameters of the TNM stage and large volume of elective area influenced CSS, and the T parameter of the TNM stage, the dose below 60Gy and tumor volume influenced RFS and LRFS. Chemoradiotherapy can be used in N-positive patients.ConclusionThe analysis indicates that the TNM grade, histopathological type, patient’s condition, radicality of the procedure, technique and dose of radiotherapy are the most important prognostic factors in these patients.

Does regression in treatment-induced liver fibrosis reflect noninvasive tests? Assessing treatment results of hepatitis B patients who took potent antiviral drugs for 5 years.

Chronic liver disease may be reversed through treatment, and it is crucial to have a definitive diagnosis of liver fibrosis for this treatment. Aims: In this study, we aimed to determine whether regression of liver fibrosis in naive patients undergoing strong antiviral therapy is reflected in noninvasive tests. We systematically reviewed and monitored medical records of patients with chronic hepatitis B who underwent liver biopsy for patient qualification. We selected patients with a liver fibrosis score of two or more who had not previously received antiviral treatment. We used previously described formulas to compute the indirect indicators of fibrosis for the patients and noted the values of Aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), age-platelet index (API), fibrosis index-based 4 factor (FIB-4), AST-platelet ratio index (APRI), mean platelet volume (MPV) and platelet count (PLT). We found a significant difference between the three measurements for APRI, AAR and FIB-4 scores and MPV and PLT distributions in patients who were administered entecavir and tenofovir (Friedman P < 0.05). In the post-hoc binary comparison for both entecavir and tenofovir, we found significant differences between the baseline measurements and the 3rd- and 5th-year measurements in terms of APRI, AAR, FIB-4, MPV, and PLT. Liver biopsy is considered the gold standard for the treatment and follow-up of hepatitis B but may not be appropriate in all cases. Non-invasive tests may be effective in monitoring antiviral therapy. We demonstrated that non-invasive tests improved with antiviral therapy, which may be a reflection of treatment-regression in liver histopathology.

OPTIMIZATION OF SURGICAL-ORTHODONTIC TREATMENT TACTICS IN PATIENTS WITH IMPACTED TEETH

Introduction: Impacted teeth is complex anomaly of teeth eruption that requires a balanced approach not only in the differential diagnosis of its forms, but choice of rational methods of treatment. The aim: Optimization of the tactics of orthodontic-surgical treatment of patients with impacted teeth based on the development and implementation of computed tomographic indices (KT) and photometric indices (FM) of opening of surgical access (OSA) to crowns of impacted teeth. Materials and methods:The results of treatment of 48 patients with delay of permanent teeth eruption have been analyzed. For an objective assessment of treatment results, a group of 24 (aged from 9 to 19 years old ) was formed. All 24 patients had typical clinical situation. Results: Orthodontic correction of patients envisaged, first of all, the elimination of obstacles in the way of teeth eruption, if necessary to provide space in dental arch and simultaneous treatment of associated bite malocclusions. Surgical exposure of impacted tooth crown was carried out and at the same time a triangular shaped guiding channel was formed, base of channel was at the impacted tooth and its angle finished into the dental arch. Precise dimensions and depth of the channel were preliminary planed on computed tomography slices with 3D reconstruction. Mean values of CT width (7,13±0,54mm), and length (6,42±0,78mm) of OSA and CT index (130,79±8,19%) of OSA to impacted teeth crowns were determined. Conclusion: To improve the quality of diagnosis and optimization of methodological approaches to treatment of patients with teeth impaction, we have proposed CT and FM OSA indices to the crowns of impacted teeth. The developed indices serve as specific reference points for optimization of diagnostic process, for reducing of probability of repeated surgical interventions and choosing the optimal path for instrumental orthodontic treatment of patients with impacted teeth.

Features of Imaging of Different Types of Hodgkin’s Lymphoma Using Combined Positron Emission and Computed Tomography

Background &amp; Aims. At present, PET-CT has an important clinical significance in Hodgkin's lymphoma (HL) and is used both for initial tumor staging and restaging and for the evaluation of treatment efficacy. Published data indicate the possible lack of radiotracer accumulation in the tumor tissue in HL before primary treatment. A low metabolic activity of the tumor tissue prior to treatment makes it difficult to assess the treatment dynamics during the anti-tumor therapy. The aim of this work is to determine the incidence of the low metabolic activity of tumor tissue in HL. Methods. Findings of 131 18F-fluorodeoxyglucose (FDG) whole body PET-CT scans of patients with histologically verified HL (over the period from 2011 to 2015) were studied retrospectively. Patterns of FDG accumulation in different histological types of HL, as well as the levels of metabolic activity in patients with tumor-related toxicity symptoms (B-symptoms) were studied. Results. The low metabolic activity was detected in 4 % of patients with de novo HL. The highest levels of metabolic activity were detected in nodular sclerosis and the lowest ones in nodular lymphocyte-predominant HL. Higher levels of radiotracer metabolic activity were observed in patients with general symptoms. Conclusion. In general, a high metabolic activity of the neoplasm is typical for HL. Primary staging before the treatment should be performed for a more accurate evaluation of dynamics of HL treatment outcomes, because in a number of cases a baseline low FDG accumulation in the neoplasm may imitate the absence of a viable tumor tissue in the affected lymph nodes at assessment of treatment results.

Significance of the correlation between serum-prostate specific antigen and the percentage of prostate cancer volume in postoperative biochemical progression

Introduction/Objective. Radical prostatectomy (RP) is the best form of treatment of patients with locally confined prostate cancer (PC). Biochemical progression (BP) of the disease occurs in 27?53% of patients after RP. The aim of our analysis was to assess the significance of the correlation of preoperative prostate-specific antigen (PSA) values and the percentage volume of PC in biochemical progression in patients with RP and the biopsy Gleason score of 6 and 7. Methods. The analysis included the results of treatment of 228 patients with the committed radical retropubic prostatectomy for localized PC in the 2007?2011 period. According to the Gleason grade system values, three groups were identified ? 6 (3 + 3), 7 (3 + 4) and 7 (4 + 3). According to the preoperative PSA values the following three groups were determined and monitored: ? 4 ng/ml, 4.1?10 ng/ml, and ? 10.1 ng/ml. Biochemical progression was defined as two consecutive increases of PSA values ? 0.2 ng/ml after RP. The percentage of tumor volume (PTV) is determined by a visual assessment of the percentage of PC in each microscopic sample. Four PTV groups were determined: 0?5%, 6?25%, 26?50%, and 51?100%. Results. Biochemical progression was registered in 19 patients. Most frequent PTV in the group of patients with BP and from biopsy and RP was 6?50%, an average of 30%. Conclusion. Our study showed predictive significant connections between preoperative PSA values and the values of PTV after operational treatment and that these are independent parameters in the assessment of treatment results.

Gamma Knife Radiosurgery for Hemorrhagic Brainstem Cavernomas.

To assess treatment results of gamma knife radiosurgery (GKRS) for hemorrhagic brainstem cavernous malformations (BSCMs). A retrospective review of patients with hemorrhagic BSCMs, who were treated at the Acıbadem Kozyatagi Hospital GKRS unit from May 2007 to October 2015 was performed. In total, 82 patients were identified. All patients had experienced at least one hemorrhagic event (range 1-3), and all of them presented with radiological evidence of hemorrhage. The median target volume was 0.3 ml, and the median marginal radiation dose was 12 Gy. The mean durations before and after surgery were 25.5 (range 1-204) months, and 50.3 (range 13-113) months, respectively. Pre-treatment hemorrhage rates were calculated from the date of first hemorrhage to the date of radiosurgery. There were 97 bleeds over 174.4 patient-years during the observation period, with an annual hemorrhage rate of 55.7%. If the first bleed is excluded, the annual hemorrhage rate was 8.6%. Only three patients demonstrated re-bleeding, which occurred at 3, 12 and 79 months after radiosurgery. Over a total follow up time of 344 patient-years the annual re-bleeding rate was therefore 0.87%, indicating that the risk of BSCM hemorrhage was significantly decreased by radiosurgery. GKRS was a safe and effective treatment for symptomatic low volume BSCMs when a low marginal dose is used. A randomized controlled trial is needed that compares GKRS to observation if we want to establish the true efficacy of this treatment.

Cephalometric analysis for functional occlusion

BackgroundVarious elements contributing to good functional occlusion have not been clearly assessed with cephalometrics for the diagnosis of functional problems and their application in clinical practice. The aim of this study, therefore, was to analyze different components of functional occlusion to formulate concise functional cephalometric analysis.Materials and MethodsEighty-two cases (38 males and 44 females), with class I occlusion and balanced facial profile, were examined based on the selection criteria, and cephalograms were taken in natural head position. All the radiographs were then analyzed using various functional parameters.ResultsThe mean values of condylar path angle and incisal path angle were 55.83° and 65.67°, respectively, with large deviations. However, both showed positive correlation. The value of the angle of long axis of mandibular incisor with respect to the line joining center of condyle and lower incisor tip was 88.04°. Moreover, the angle between the occlusal plane and horizontal plane was 12.88°. In vertical plane, lower face height (LFH) was found to be slightly less than the upper face height. Maxilla contributed around 45% of the LFH while mandible formed about 60%. Furthermore, upper alveolar component (maxillary alveolar height) formed more than half of the maxilla (53.79%) whereas lower alveolar component (mandibular alveolar height) was 74.8% of the mandible.ConclusionThis study has analyzed various components of functional occlusion and formulated a concise functional cephalometric analysis for diagnosis, treatment planning, and assessment of treatment results.

Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?

Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and α-adrenergic drugs have been proposed as medical treatments for PPI. Most studies were small and used different criteria for quantifying incontinence and assessing treatment results. Thus, there is not enough evidence to recommend the use of these medications as standard treatment of PPI. To determine whether medical therapy is a viable option in the treatment of PPI, randomized, placebo-controlled studies are needed that also assess side effects in the elderly population.

Применение метода оптической когерентной томографии в комплексной сравнительной оценке результатов терапии послеоперационного транзиторного роговично-конъюнктивального ксероза

The aim of this study was to conduct a comprehensive comparative assessment of treatment results of postoperative transient corneal conjunctival xerosis with the use of Derinat, Emoksipin and Stillavit based on the data of optical coherent tomography of the cornea and the functional status of the eyes. The survey, medication with dynamic observation of 20 patients (40 eyes) with corneal conjunctival xerosis. Groups were randomized according to duration of disease, gender. As a comparison group, were examined in 10 healthy volunteers . According to the study design the subjects were divided into groups depending on the applied therapy: group 1 (10 patients, 20eyes) receiving standard therapy; group 2 (10 patients, 20 eyes) receiving Derinat, Emoksipin and Stillavit in complex standard therapy in the recommended dose. The efficacy of treatment was evaluated according to the OCT, recorded in 1 month after therapy. According to the obtained results OCT of the cornea, tear produktion effect from the combined use Derinat, Emoksipin and Stillavit was more significant in comparison with the results of standard therapy. The combined use of Derinat, Emoksipin and Stillavit can be recommended in complex therapy of postoperative transient corneal conjunctival xerosis. The method of optical coherence tomography is a highly informative when non-invasive studies of the cornea in patients suffering from postoperative transient corneal conjunctival xerosis.

Evaluation of the efficiency of 2 types of periodontal probing

Background: The periodontal probing has an important role in clinical examination of the periodontal status; different types of periodontal probes have been described. The aim of this investigation was to evaluate comparatively the efficiency of periodontal probing with conventional periodontal probe and electronic periodontal probe. Material and Methods: We examined 57 patients, each patient being subjected to conventional and electronic probing. We assessed the tolerance degree for each probing type and also the time consumed by probing and periodontal charting. Results: The periodontal probing with the electronic probe revealed superior results regarding the accuracy of the measurements, the tolerance level and the time consumed. Conclusions: The electronic periodontal probing is an exceptionally accurate method in establishing diagnosis and assessing treatment results. The electronic periodontal probe represents an efficient and useful tool for measurements of the gingival sulcus and periodontal pockets, and also for determination of the periodontal risk.

Hereditarily predisposed diseases of joints. A structure of the tactics for their understanding

The article describes a model of the diagnostic cognitive process; more precisely, this is tactics as a method and a technique for achieving the goal, a stage on the way from the special methodology of realization of the theory to directly diagnosing hereditarily predisposed diseases of joints. The role and features of the criterion of multifactoriality are elucidated. Peculiarities in the assessment of different hereditarily predisposed syndromes at stages of their clinical realization are described. The authors built a system of sense assessment of treatment results.