Disability In Adult Population Research Articles

The Importance of Having a Single, Dedicated Medical Team to Treat Congenital Talipes Equinovarus Using the Ponseti Method: A Retrospective Analysis of Treatment Outcomes After 3 Years of Follow-up.

Congenital talipes equinovarus (CTEV) is a relatively common pediatric orthopaedic disorder and a frequent cause of disability in adult populations. The Ponseti method has emerged as the generally preferred for treating children with CTEV. Strict adherence to this technique's basic principles is critical to achieving favorable outcomes. In 2013, our institution decided that every case of pediatric CTEV would be treated by a single dedicated medical team. The present study aimed to compare the treatment outcomes of children with CTEV treated using the Ponseti method in period I (multiple surgeons) versus those in period II (single dedicated team). We included respectively the children with CTEV treated using the Ponseti method in Geneva University Hospitals' pediatric units from 2007 to 2018. Data on patient demographics, clinical characteristics, and the treatment outcomes were collected. The primary outcome was the number of relapsed feet (treatment failure) after 3 years of follow-up. The 2 periods' outcomes were compared using χ 2 and independent Student t -tests. Run charts were used to report yearly rates of complications, minor and major recurrences, treatment failure, brace noncompliance, and feet that underwent tenotomy. A total of 48 feet (32 patients) and 42 feet (29 patients) in periods I and II were included. The periods showed similar rates for participants' characteristics. The run charts illustrated the overall improvements in treatment outcomes in period II. A total of 8 relapsed feet (5 patients) were reported, all during period I. Since all the pediatric CTEV patients at our institution began to be treated by a single dedicated medical team, we have observed a decrease in all recurrences and complications and an absence of treatment failure. These results highlight the importance of the continuity of care and strict adherence to the Ponseti method. Level-III Retrospective comparative study.

The present-day medical demographic situation in the Republic of Karelia

The analysis of basic medical and demographic indicators (primary morbidity and disability of adult population, mortality, age structure and life expectancy) and provision of medical care in the Republic of Karelia in 2011-2020 was carried out. It established consistently high level of primary morbidity of population with respiratory diseases; injuries, poisoning and other consequences of external causes; diseases of genitourinary system. Diseases of cardiovascular system and malignant neoplasms occupy leading positions in the structure of causes of disability and mortality of population during period under review. The levels of primary morbidity, disability and mortality of the Republic population are higher than at national level. The age structure of population has regressive type, there is long-term process of demographic aging, life expectancy is gradually increasing. Since 2011, the number of out-patient clinics increased up to 3 times and their capacity increased too. The degree of provision of population with medical personnel remained stable for a decade. The number of secondary medical personnel is decreasing, while both indicators are higher than the national indocators.

English

BACKGROUND Visual disability is one of the most significant global health concerns. One of the studies conducted in northern part of Saudi Arabia showed that the prevalence of visual disability in adult population of 23.5 %. Very few studies have been conducted in Saudi Arabia to determine the prevalence of visual disability in the younger population. We wanted to determine the prevalence of visual disability in students studying at Qassim University. We also wanted to study and compare the utilization of compensatory rehabilitation by the students of urban and rural areas and the subjective response of beneficiaries. METHODS This study was done from September 2011 to May 2012, in the Department of Optometry in Qassim University, Buraidah, Kingdom of Saudi Arabia. A crosssectional retrospective review from the records of 642 male students referred by the deanship of student’s affairs to the optometry clinic were studied. RESULTS The prevalence of visual disability in this study was found to be 2 %. Out of the total 642 students, a significant number of students [541 (84 %)] benefited from the scheme and 101 (16 %) were declared normal. Those who were declared visually disabled (2 %) were getting compensation on monthly basis and the remaining 82 % with mild to moderate visual problems benefitted with spectacles. More number of urban students were suffering from visual abnormalities (87.6 %) as compared to rural students (45.1 %). CONCLUSIONS Though visual disability among young population at Qassim University was found to be low as compared to adult population is Saudi Arabia, it is recommended to conduct regular check-ups for visual acuity and plan to reduce the magnitude of the problem. A significant number of students utilized the compensation and rehabilitation program provided by the department of optometry. KEY WORDS Refractive Error, Blindness, Student Compensation, Qassim University, Saudi Arabia

Prevalence and risk factors of hypertension among civil servants in Sidama Zone, south Ethiopia.

Hypertension is the leading cause of death and disability in adult populations globally. Its prevalence is increasing rapidly in Ethiopia. Studies conducted to date address different population categories. However, there is lack of data on the prevalence and risk factors of hypertension among civil servants working in various sectors and levels. To assess the prevalence and risk factors of hypertension among civil servants in Sidama Zone, south Ethiopia. An institution-based cross-sectional study was conducted from March 1-30, 2019 on a sample of 546 civil servants selected randomly from different departments of Sidama Zone Administration. Data were collected using structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered using Epi Data 3.1 and analyzed using SPSS version 20. Multivariable logistic regression analysis was used to identify factors associated with hypertension. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were computed to assess the presence and strength of associations. A total of 546 civil servants responded resulting in a response rate of 94.9%. The prevalence of hypertension was 24.5% [95% CI: 23.3% - 25.6%]. The identified risk factors of hypertension were male sex (AOR 4.31[95% CI: 1.84-10.09]), moderate current alcohol consumption (AOR: 4.85; [95% CI: 1.73-13.61]), current khat chewing (AOR 2.97[95% CI: 1.38-6.40]), old age (AOR: 4.41[95% CI: 1.19-16.26]), being obese (AOR 5.94 [95% CI: 1.26-27.86]) and central obesity (AOR 3.57 [95% CI: 1.80-7.07]). One in four civil servants are hypertensive. Different demographic, behavioral and metabolic factors increase the odds of hypertension among civil servants. Prevention and control of hypertension shall involve promotion of healthy lifestyles such as weight management, regular physical activity and quitting or cutting down on harmful use of substances such as alcohol and khat.

Outcome of fractures of dorso lumbar spine treated by short segment posterior stabilization with intermediate pedicle screws

<p class="abstract"><strong>Background:</strong> Spine fractures are common in today’s world due to high frequency of motor vehicle accidents and work place injuries. These are major cause of disability in adult population. The mortality rate following spinal injuries is 7%. The aim of the study was to study the functional and radiological outcome of fractures of dorso lumbar spine treated by short segment posterior stabilization with intermediate pedicle screws.</p><p class="abstract"><strong>Methods:</strong> Dorso-lumbar fractures with intact pedicle on the fractured segment, Load sharing classification score of equal or less than 6, Neurologic involvement caused by the fracture, loss of vertebral body height by more than 50% and kyphosis angle more than 20° are included. Patients with multiple level fractures and pathological fractures were excluded from the study. Denis classification and AO classification were used. Load sharing score is used to decision making for intermediate screw fixation.<strong></strong></p><p class="abstract"><strong>Results:</strong> L1 is more frequently fractured followed by D12. Distraction type (AO) and burst (Denis) are most common types. 4 of our patients had complete neurological deficit. 15 had incomplete deficit and 11 patients doesn’t have any neurological involvement. Frankel A grade cases remained in the same grade. Mean Kyphotic correction is 6.7°. Mean AVBCP in the postoperative cases 26. None of the cases developed kyphosis or loss of correction in the follow up. Outcome using Roland Morris disability questionnaire is excellent in 64.3%, good in 21.6% and poor in 14.3% cases.</p><p class="abstract"><strong>Conclusions:</strong> To conclude that short segment posterior stabilisation with intermediate screws provides better biomechanical stability when compared with conventional short segment fixation.</p>

The Medical Social Aspects of Repeated Disability of Adult Population Due to Malignant Neoplasms in the Russian Federation

The article presents the results of the analysis of the level and severity of repeated disability of the adult population due to malignant neoplasms in the Russian Federation. This pathology is associated with high prevalence and mortality, which makes it classify as socially significant. An effective solution to the problem of preventing the debilitating complications of malignant tumors requires the formation of a statistical database to evaluate the results of diagnostic and treatment-and-prophylactic measures and the development of optimal approaches to the medical and social rehabilitation of patients. The authors present the results of the study, which indicate that there is an age-related differentiation of adult disability due to malignant neoplasms -- elderly people predominate. In middle age, the level of recurrent disability due to this class of diseases decreases during the analyzed period (2008-2017). Among the population of young age, the tendency to change the level of recurrent disability is less stable, however, since 2014, there has been a trend for the growth rate. The structure of recurrent disability by severity is characterized by the predominance of persons with disabilities II (43.6%) and III (42.1%) disability groups with a lower proportion of persons with disabilities with I first disability group against the background of a uniform trend of increasing disability level of all three groups. The results of the ranking of subjects of the country by the level of re-disability due to malignant neoplasms among the adult population are presented. The selected subjects of the Russian Federation with a negative situation, which makes it possible to substantiate the need to strengthen measures for the prevention of primary disability and optimize the medical and social rehabilitation of patients suffering from this disabling pathology, taking into account regional features.

Analysis of incidence and disability of adult population due to malignant neoplasms in the Republic of Bashkortostan

Aim. To study the state of the primary incidence and disability due to malignant neoplasms in the Republic of Bashkortostan and their structures.Methods. The comparative analysis of the primary incidence and disability rates due to malignant neoplasms among the adult population of the Republic of Bashkortostan for the period 2010-2014 was performed. The state of the primary incidence taking into account gender and place of residence was studied. The structure of primary disability of adult population taking into account age and degree of disability was analyzed.Results. Over the period 2010-2014 in the Republic of Bashkortostan a statistically significant reduction of primary incidence among the population and increase in the primary incidence due to malignant neoplasms by 14.6% was observed. The incidence is higher among urban residents than among rural population, in men it is higher than that in women. On average, one in four, who is recognized as disabled, suffers from malignancy. In the structure of disability of people suffering from malignant neoplasms, II degree of disability prevails. The reliable increase in the level of primary III degree disability due to malignant neoplasms is registered over time. The rate of disability caused by malignancy among people of retirement age is higher than among working-age people.Conclusion. The given data are indicative of the need to strengthen the strategy of primary prevention of malignant neoplasms.

The effectiveness of manual therapy for neck pain: a systematic review of the literature

A systematic review of randomised, controlled trials was undertaken to determine the effectiveness of manual therapy for mechanical neck disorders in reducing pain and disability in adult populations. Neck pain is a common ailment that can result in pain, disability and considerable cost. Manual therapy is a treatment modality commonly sought by patients to manage neck pain.A literature search of MEDLINE, CENTRAL, CINHAL, SPORTdiscus, PEDro and MANTIS was conducted. Articles were included if manual therapy was performed on one group within the trial, on participants with mechanical neck pain, including neck disorders with associated headache. Studies were excluded if the cause of neck pain was serious pathology, systemic disease, or trauma, or if neck pain was associated with radicular findings, or the headache was the primary disorder.Five trials involving 995 participants were included; four of the trials were of high methodological quality according to the validated Jadad criteria. Due to the heterogeneity of the data from the included trials, the studies could not be pooled for meta-analysis and a qualitative analysis was performed instead. Strong evidence demonstrated that manual therapy was not significantly superior to other interventions (exercise, physical therapy, medication, short wave diathermy) for relief of neck pain. Patients who received manual therapy reported being significantly more satisfied with their care than patients who received any other single therapy. A trend across three of the studies showed that manual therapy combined with exercise returned moderately larger improvements, although not statistically significant, improvements in pain, disability and patient-perceived recovery than manual therapy alone. Results in favour of combined therapies suggest multinodal care, including manual therapy and exercise, may be a potentially useful intervention in the treatment of mechanical neck disorders.

Connexins: New genes in atherosclerosis

Atherosclerosis, the main cause of death and disability in adult populations of industrialized societies, is a multifactorial progressive process involving a variety of pathogenic mechanisms. Our current view on the pathogenesis of the disease implies complex patterns of interactions between a dysfunctional endothelium, leukocytes, and activated smooth muscle cells in which cytokines and growth factors are known to play a crucial role. Apart from paracrine cell‐to‐cell signalling, a role for gap junction‐mediated intercellular communication in the development of the disease has been recently suggested. Gap junction channels result from the docking of two hemichannels or connexons, formed by the hexameric assembly of connexins, and directly connect the cytoplasm of adjacent cells. In this review, we summarize existing evidence implicating connexins in atherosclerosis. Indeed, the expression pattern of vascular connexins is altered during atherosclerotic plaque formation. In addition, changes in connexin expression or gap junctional communication have been observed in vascular cells in vitro by disturbances in blood flow, cholesterol, inflammatory cytokines, and growth factors. Furthermore, genetically modifying connexin expression affects the course of the atherosclerotic process in mouse models of the disease. Finally, the involvement of connexins in treatment of atherosclerotic disease will be discussed.