Diseases Of Musculoskeletal System Research Articles

Appraising the causal role of smoking in multiple diseases: A systematic review and meta-analysis of Mendelian randomization studies.

SummaryBackgroundThe causal association between cigarette smoking and several diseases remains equivocal. The purpose of this study was to appraise the causal role of smoking in a wide range of diseases by summarizing the evidence from Mendelian randomization (MR) studies.MethodsMR studies on genetic liability to smoking initiation or lifetime smoking (composite of smoking initiation, heaviness, duration, and cessation) in relation to circulatory system, digestive system, nervous system, musculoskeletal system, endocrine, metabolic, and eye diseases, and neoplasms published until February 15, 2022, were identified in PubMed. De novo MR analyses were performed using summary statistics data from genome-wide association studies. Meta-analysis was applied to combine study-specific estimates.FindingsMeta-analyses of findings of 29 published MR studies and 123 de novo MR analyses of 57 distinct primary outcomes showed that genetic liability to smoking (smoking initiation or lifetime smoking) was associated with increased risk of 13 circulatory system diseases, several digestive system diseases (including diverticular, gallstone, gastroesophageal reflux, and Crohn's disease, acute pancreatitis, and periodontitis), epilepsy, certain musculoskeletal system diseases (including fracture, osteoarthritis, and rheumatoid arthritis), endocrine (polycystic ovary syndrome), metabolic (type 2 diabetes) and eye diseases (including age-related macular degeneration and senile cataract) as well as cancers of the lung, head and neck, esophagus, pancreas, bladder, kidney, cervix, and ovaries, and myeloid leukemia. Smoking liability was associated with decreased risk of Parkinson's disease and prostate cancer.InterpretationThis study found robust evidence that cigarette smoking causes a wide range of diseases.FundingThis work was supported by research grants from the Swedish Cancer Society (Cancerfonden), the Swedish Heart Lung Foundation (Hjärt-Lungfonden, 20210351), the Swedish Research Council for Health, Working Life and Welfare (Forte, 2018-00123), and the Swedish Research Council (Vetenskapsrådet, 2019-00977). Stephen Burgess is supported by Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (204623/Z/16/Z) and the National Institute for Health Research Cambridge Biomedical Research Centre (BRC-1215-20014). The views expressed are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

ANTİK KAYNAKLARDA KAS İSKELET SİSTEMİ HASTALIKLARINA TEDAVİ YAKLAŞIMI

The works of philosophers who worked and wrote in the field of health and medicine in the Ancient Age are very important in that they convey the development in the diagnosis and treatment of diseases. Skeletal system disorders constitute the most concrete evidences of the diseases that ancient people were exposed to. Information can be attained regarding the lifestyle, nutrition, traumas and social status of ancient societies thanks to the findings revealed by the science of Paleopathology. Since the disease remains of the soft tissues could not reach the present day, the information conveyed by the ancient authors makes up for the deficiency in this field. However, it is understood that chronic diseases such as osteoarthritis, which is common in ancient societies, receive little attention since some of the people treating the diseases are not physicians. However, this disease is a joint disease with a high incidence since prehistoric times. In this study, which uses the information about Musculoskeletal System diseases in written sources and Archaeometry Results of recent years as a source, the purpose is to specifically address Musculoskeletal System diseases that the physicians of Ancient Age frequently encountered and how they struggled with these diseases.

The estimation of quality of life of children with diseases of musculoskeletal system.

The study of life quality was carried out covering 432 children aged 6-17 years with diseases of musculoskeletal system on the basis of the cardio-rheumatological department of the Republican Children Clinical Hospital and children polyclinics of the Republic of North Ossetia-Alania. The Russian version of the SF-36 questionnaire was applied which included 11 questions. The physical and emotional state was studied in 4 age groups: 6-8 years old (8.56%), 9-11 years old (20.14%), 12-14 years old (35.65%), 15-17 years old (35. 65%). The average age of children was 13.06±3.9 years. The significant influence of rheumatic diseases on parameters of life-quality of patients was established: physical and psychological state of children suffers, social adaptation is disturbed. According to the study results, the most problematic age group are children aged 15-17 years, who characterize their condition as mediocre (35.1%). Particular attention should be paid to the fact that there was no improvement in health state during a year among significant proportion of patients (65.3%). The obtained results testify limitation of physical state of health in 78.5% of cases, the most noticeable in age group of 15-17 years. The direct correlation between increase in pain syndrome and age of patient is established. In all age groups, there is decrease in emotional state, which increases with age. The indices of physical component of health in all age groups are significantly lower than the mental one. There are no significant gender differences in respondents assessment of life quality. The indices of life quality of children are generally characterized as low and do not reach 50 points on 100-point scale.The identified problematic age groups require increased attention from pediatric service of the Republic. The anxiety is caused by increase of negative symptoms in older age groups. The study results indicates both low efficiency of specialized rheumatological care of children and need for increased attention to dispensary work with this group of patients at early stages of disease.

Frequency of somatic pathology occurrence in workers of the main professions of coal pits in the South of Kuzbass

The problem of incidence rate among workers of the main professions of the coal mining industry is traditionally considered from the perspective of occupational pathologies. At the same time, the issues of the spread of production-related somatic diseases among this category of the employable population are undeservedly left without due attention. The objective of the study was assessing the frequency of somatic pathology occurrence in workers of coal pits in the South of Kuzbass. 489 workers of the main professions of coal pits in the South of the Kemerovo region were examined (men aged 22 to 55 years, who were randomized into 2 groups according to the level of exposure to a complex of unfavorable factors of the production environment). The first group with a higher level of exposure to harmful and hazardous production factors of class 3.3 and 3.4 included 196 people: machinists of mining and technological equipment, machinists of drilling rigs, explosives; the second group with the level of danger and harmfulness of class 3.1 and 3.2 consisted of 293 workers, namely, drivers of technological motor vehicles. The study of the frequency of somatic pathology was carried out depending on the length of work experience and the age of the subjects. Each group was divided into subgroups: by the age and work experience. In group 1, somatic pathologies were detected in 52.0% of the cases, in group 2 - in 44.4% (χ2=2.772, p=0.096). In the structure of somatic diseases in the group with a higher class of danger and harmfulness, diseases of the circulatory system (38.24%), diseases of the musculoskeletal system and connective tissue (12.75%) and diseases of the nervous system (8.82%) prevailed; in the group with a lower hazard class there were also diseases of the circulatory system (33.85%), diseases of the musculoskeletal system and connective tissue (14.62%), diseases of the nervous system (12.31%). The frequency of somatic diseases is recorded in a direct linear relationship with the work experience and age of coal pit workers. Limitations. This study is limited to a sample of workers in the main professions of coal pits undergoing periodic medical examinations at the Research Institute for Complex Problems of Hygiene and Occupational Diseases. Conclusion. In the structure of somatic diseases of workers of the main professions of coal pits in the South of Kuzbass, three nosological forms occupy a leading position: diseases of the circulatory system, diseases of the musculoskeletal system and connective tissue, and the nervous system. Among the surveyed workers employed in coal pits with a higher level of exposure to harmful and hazardous production factors, a 100% incidence of somatic diseases was revealed among the respondents aged more than 41 years and with work experience over 21 years. These data should be taken into account when carrying out periodic medical examinations, preventive medical examinations, for the development and implementation of therapeutic and prophylactic measures and post-shift rehabilitation programs. Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Association "Ethical Principles for Conducting Human Scientific Medical Research" as amended in 2013 and the "Rules of Clinical Practice in the Russian Federation", approved by the Order of the Ministry of Health of the Russian Federation No. 266 of 19.06.2003. All subjects signed an informed consent to participate in the study.

Examining Characteristics and Service Utilization of South Korean Home Health Care Patients: Secondary Analysis of 10-Year Data From a Tertiary Hospital

This study aimed to identify the characteristics of home health care (HHC) patients, main diagnoses, service type, home visit patterns, and primary caregiver type from a major tertiary hospital in South Korea to provide basic data for tailored nursing care. We used Electronic Health Records (EHRs) data of 1776 patients, from 2011 to 2020, from a premier tertiary hospital in South Korea and conducted secondary data analysis using descriptive statistics, a chi-squared test, and an independent samples t-test. Patients’ mean age (i.e., 50.9% men and 49.1% women) was 74.50 ± 15.48 years. Further, admission to HHC via the outpatient and inpatient department comprised 1047 (59.0%) and 729 patients (41.0%), respectively. Based on the Korean Standard Classification of Diseases, neoplasms (49.9%) were identified as the most common main diagnosis, followed by diseases of the nervous system (10.3%) and musculoskeletal system and connective tissue disease (6.2%). An average of 2.2 homecare nursing services were provided per visit, with lab sampling (43.9%), other intravenous injections (31.0%), and ventilator care (23.0%) being the most frequent services. The total HHC service period for patients via the outpatient department was 76.88 days longer (292.24 vs 215.36 days) than those from the inpatient department. Younger patients were cared for by parents and siblings and older patients by spouses, offspring, and formal caregivers. It is pivotal to identify general characteristics of HHC patients through long-term monitoring and retrospective analysis to provide high-quality and tailored interventions to them.

POS1126 CLINICAL EFFICACY AND SAFETY OF MONOCLONAL ANTIBODY AGAINST NERVE GROWTH FACTOR AND FIBROBLAST GROWTH FACTOR-18 THERAPY OF OSTEOARTHRITIS

BackgroundOsteoarthritis (OA) is the most common chronic progressive musculoskeletal system disease affecting more than 500 million people globally, which represents the formidable public health challenge. Currently osteoarthritis treatment includes acetaminophen, NSAIDs and/or opioids, intra-articular corticosteroid injections. Some guidelines also recommended chondroitin and glucosamine sulfate, suggested that they may be effective and reduce functional impairment. However, despite of the huge amount of data on the problem of OA, there is still no effective treatment that slows down the progression of the disease. Recently appeared monoclonal antibodies against nerve growth factor (NGF) as well as fibroblast growth factor (FGF)-18 may be the promising tool for clinical improvement of OAObjectivesTo evaluate the safety and efficacy of anti-NGF and FGF-18 on patients with osteoarthritis by a systematic review.MethodsIn the current study the search process was conducted in PubMed using the following strategy: “FGF-18” or “anti-NGF” and “OA”, “monoclonal antibody” + “osteoarthritis”. All articles published in the format of Case Reports, Clinical Study, Clinical Trial Protocol, Clinical Trial, Multicenter Study were reviewed. Clinical outcomes were assessed using clinical scores, included the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Pain and Physical Function score, Patient’s Global Assessment of OA (PGA-OA), adverse events (AEs); cartilage repair and total femorotibial joint cartilage thickness were assessed using magnetic resonance imaging.ResultsBased on our search 23 publication were included in the study after omitting repetitions. Among 23 studies, 16 used anti-NGF monoclonal antibodies (Tanezumab, Fasinumab, Fulranumab), and 7 used recombinant human FGF-18 (Sprifermin). The total of 6679 patients were analysed in these articles.In the pooled analysis NGF inhibitors demonstrated statistically significant improvements compared with placebo in WOMAC Pain and Physical Function score (all studies revealed significantly better clinical outcomes in the anti-NGF group). After treatment with FGF-18 (Sprifermin) there was also improvement in WOMAC scores though not statistically significant. However, FGF-18 therapy was associated with the reductions in loss of total and lateral femorotibial cartilage thickness. Moreover, it does not only significantly reduce cartilage loss but also increase cartilage thickness. In terms of cartilage repair, 5 of 7 studies reported improvement in total femorotibial joint cartilage thickness.The AEs of FGF-18 or anti-NGF therapies were not serious, however they may affect the compliance and satisfaction of patients and clinicians. The proportion of patients with adverse events in anti-NGF treatment group was higher than that in FGF-18. The following conditions were reported in anti-NGF: abnormal peripheral sensation such as hypoesthesia (7.43%), paraesthesia (9.15%), hyperesthesia (0.36%), peripheral neuropathy and sensory disturbance (0.35%); arthralgia (15%), back pain (15.06%), pain in extremity (10%), headache (9.11%), upper respiratory tract infection (10.65%), diarrhoea (11.95%), sinusitis or nasopharyngitis (10.13%). The difference in AEs between sprifermin and placebo groups was found insignificant, most frequently reported event was arthralgia.ConclusionIn recent years significant progress has been achieved in search for pathogenetic therapy of OA. Based on the results of current research findings, NGF inhibitors relieved pain and enhance joint function and may be considered as the most effective for functional improvement. FGF-18 decrease the cartilage loss and may improve cartilage thickness. However, further clinical longitudinal studies characterised the risk-benefit are needed to establish their safety and efficacy.Disclosure of InterestsNone declared

Clinical features and ultrasound findings of a rare musculoskeletal system disease–neuromuscular choristoma

BackgroundNeuromuscular choristomas (NMCs), are extremely rare developmental lesions that, have been previously established associated with recurrent fibromatosis after surgery, leading to several operations or even amputation. However, reports on the ultrasound imaging features and clinical conditions of NMCs are rare. The purpose of this study is to describe the ultrasound features and clinical analysis of NMCs to provide suggestions to identify the optimal management strategy.MethodsFrom September 2020 to September 2021, 7 patients with a confirmed diagnosis of NMC who underwent ultrasound examination in our department were enrolled in our study. Physical examinations were performed to detect motor deficits, sensory deficits, neuropathic pain, limb undergrowth, muscular atrophy, cavus foot and bone dysplasia. Ultrasound imaging was performed and investigated both in affected nerves and neuromuscular choristomas associated desmoid-type fibromatosis (NMC-DTF). All patients had a definite history and regular follow-up. The clinical course, physical examinations, ultrasound features and pathologic results of NMC patients were analyzed.ResultsSeven patients with an average age of 7.0 ± 7.2 years (range: 2–22 years) were enrolled in our study. The affected nerves included the sciatic nerve (6 cases) and the brachial plexus (1 case). Six patients (85.7%) presented with limb undergrowth, 6 (85.7%) with muscular atrophy, and 5 (71.4%) with cavus foot deformity. Based on ultrasound findings, all the visibly affected nerve segments presented with hypoechoic and fusiform enlargement with intraneural skeletal muscle elements. Five patients (71.4%) had NMC-DTFs at the site of the affected nerve. All NMC-DTFs were shown as hypoechoic solid lesions adjacent to the nerve and were well circumscribed. In the subset of the surgery group, all 5 patients presented with progression to NMC-DTFs at the site of the NMCs. No fibromatosis was detected in the other two nonsurgical patients.ConclusionsUnderstanding the typical ultrasound features and clinically associated conditions would support the early diagnosis of this rare disease. When a potential diagnosis is determined, an invasive procedure such as biopsy or resection might not be a good choice given the frequent occurrence of complications such as aggressive recurrence.

Factors of choising the timing of the patella luxation surgical treatment in dogs

Musculoskeletal system diseases are in the first place in the structure of dogs’ admission to veterinary clinics. Lameness in dogs are diagnosed in about 70% of the cases in the hind limb, whereof about 50% are attributed to the knee joint. One of the most frequently diagnosed pathologies of the knee joint is the patella luxation (PL). The aim of our study is to determine a relation between the development of comorbid pathologies of the knee joint (such as patella luxation, cranial cruciate ligament disease, osteoarthritis) with the degree of dislocation, age, general condition of the animal, changes in hematological and biochemical parameters of blood, and based on this to justify the need for PL surgical treatment at an earlier age. The study was conducted at the facilities of St. Petersburg State University of Veterinary Medicine and VEGA veterinary clinic chain in the city of St. Petersburg, Russia. The study was carried out on 48 dogs with different breeds, gender and age, with varying PL grade, which had not previously undergone knee joint surgical treatment. The animals were allocated into two groups depending on the knee joint concurrent pathologies: 20 dogs with PL only — in group 1, 28 dogs with knee joint polypathologies (PL, cranial cruciate ligament disease, and osteoarthritis) — in group 2. According to the results of statistical analysis using the Mann-Whitney U-test, the average age (3.4 years and 6.9 years, respectively) and the degree of lameness (2.0 and 3.0, respectively) are statistically significantly different in dogs of the 1st and 2nd groups. There are also statistically significant differences in the levels of segmented neutrophils (5.8 and 9.6×10^3/mkl in dogs of the 1st and 2nd groups, respectively) and lymphocytes (7.2 and 9.6×10^3/ mkl, respectively). A statistically significant increase of the serum concentration of bilirubin, ALT, alkaline phosphatase, GGT and triglycerides was detected.The obtained results allow to recommend surgical treatment of PL at an earlier age, since in the absence of timely treatment, comorbid knee joint arthropathies, such as PL, cranial cruciate ligament disease, osteoarthritis, develop, which requires more serious surgical interventions against the background of a more severe general condition of animals.

Infrared Thermography as a Non-Invasive Tool in Musculoskeletal Disease Rehabilitation—The Control Variables in Applicability—A Systematic Review

In recent years, the usefulness of infrared thermography (IRT) as a valuable supplementary imaging method in medical diagnostics, as well as for assessing the effects of the treatment of musculoskeletal injuries, has been increasingly confirmed. At the same time, great importance is attached to the standards of thermographic research, the fulfillment of which determines the correct methodology and interpretation of the results. This article discusses the medical applications of infrared thermography in musculoskeletal system diseases, with particular emphasis on its usefulness in assessing the therapeutic effects of physical treatments used in rehabilitation. The literature from the last decade that is available in the Medline and Web of Science databases has been reviewed. Among the physiotherapeutic methods used, the following were selected that directly affect the musculoskeletal system: cryotherapy, laser therapy, electrotherapy, diathermy, and massage. The article summarizes all the guidelines and recommendations for IR imaging in medicine and rehabilitation.

SOCIOLOGICAL STUDY OF THE HEALTH STATUS OF DENTISTS OF THE DENTAL PROFILE

Resume. Today, dental care is one of the most popular types of medical care. In terms of the number of appeals, it ranks second after the number of appeals to physicians. In the age group of the population over 35 years of age, problems related to dental and oral diseases come to the fore and the need for orthopedic treatment reaches 60-100%. The dental health of the population of Ukraine has a steady tendency to deteriorate. Dentists are considered to be specialists with a high level of morbidity, as their work requires physical strength and endurance in the face of various harmful professional factors. Dentists are one of the most numerous categories of health professionals, who rank third in terms of occupational disease.
 Purpose and objectives. Conduct a health analysis among dentists.
 Materials and methods of research. As part of the study, a sociological survey of 167 dentists was conducted, a questionnaire was developed and an anonymous questionnaire method was applied.
 Results of the research. All doctors who took part in the survey said they were satisfied with the choice of profession, despite the fact that 70% rate the level of psycho-emotional stress as high, 30% medium, 10 low. 40% of the surveyed doctors indicated that they experience maximum psycho-emotional stress during dental reception in the presence of a large flow of patients, 20% indicated that they experience increased stress during a conversation with a patient, 20% during manipulations in the mouth. The structure of occupational pathology of dentists is dominated by diseases of the musculoskeletal system, gastrointestinal tract, respiratory system, nervous system and skin diseases. At the same time, chronic forms predominate among these diseases (73.4%), which directly indicates late treatment in medical institutions. The most harmful factor for health in the profession 52.4% of respondents believe that psycho-emotional stress, 19.6% believe that such a factor is physical activity, 26.4% consider contact with infectious patients the most dangerous factor, 1.6% find it difficult to answer this question.
 Among the listed diseases in the questionnaire, dentists noted that they are most afraid of contracting HIV (41%), hepatitis (30%), tuberculosis (27%), are not afraid of infection and 1% are afraid of infection. However, 40% of respondents said that if a patient has a history of contagious diseases, the tactics of treatment and personal protection will change.
 The analysis of the incidence of the upper respiratory tract and lungs among dentists of different age groups revealed an increase in incidence with age. However, there was a decrease in morbidity in the group of 51 years and older, which is probably associated with a decrease in the reactivity of the organism and a decrease in response to the influence of external pathogens in this age group.
 According to the survey, 83% of dentists reported a feeling of tension during the working day, by the end of the working day 70% of dentists noted a feeling of fatigue and 87% fatigue of the visual organs.
 Conclusion. The most pronounced and common for dentists of various dental specialties is the intensity of the labor process, which is expressed by high psycho-emotional stress. The leading factor in the development of musculoskeletal disorders among dentists is the length of intervals during which the doctor takes an awkward fixed posture.

Expert opinion on clinical application of Baimai Ointment

Baimai Ointment, derived from Tibetan classics, is indicated for Baimai diseases(nervous system diseases) with the effects of relaxing tendons and activating collaterals. It is included in the National Basic Medical Insurance Drugs Catalogue and is widely used for neurological rehabilitation and musculoskeletal system diseases, showing efficacy and safety. Nevertheless, the description of indications, usage, and dosage in the instructions of Baimai Ointment is unclear. There has been no standard for the application of Baimai Ointment. To give full play to its effect and to guide and standardize the clinical medication, this research group organized 23 experts specializing in Tibetan medicine, traditional Chinese medicine, western medicine, evidence-based medicine, methodology, pharmacy, and bibliography from 14 organizations jointly developed this Expert opinion on clinical application of Baimai Ointment. Due to the lack of clinical evidence, this expert consensus is innovatively combined with massive ancient classics, abundant experts' experience, and comprehensive clinical evidence. After discussion and in-depth interview, the consensus on the indications, usage, dosage, duration, frequency, course, and combination protocol of Baimai Ointment has been achieved. Safety and contraindications have been clearly stated. This expert opinion can provide guidance and references for clinicians at all levels to use Baimai Ointment in a reasonable and standardized way.

Эпидемиология инвалидности трудоспособного населения города Твери на примере пациентов хирургического профиля

The health of the nation is the main marker of the successful development of the state. Maintaining and improving the health of citizens are the main tasks of social policy in every country. Morbidity and disability are among the main indicators of the state of public health. They reflect the demographic situation and the level of socio-economic development of the country. Every year the number of persons with disabilities increases, which makes the problem of disability of the able-bodied population extremely relevant. Monitoring of disability, as one of the medical and demographic indicators, is the basis for ensuring the protection of the health of citizens. Research on the epidemiology of disability is the key to preventing an increase in the number of disabled citizens. In addition, it plays an important role in the distribution of the state budget to improve the quality of life of people with an assigned disability group and to carry out preventive measures aimed at reducing the impact of risk factors for disability. Purpose. Assessing the degree, structure and dynamics of disability among residents of the city of Tver using the example of surgical patients observed in the “City Clinical Hospital No. 7”, and detection the main number of diseases that caused the setting of a disability group. Methods. An analysis was carried out regarding the data on the official reports of the surgical department polyclinic No. 1 of the state budgetary healthcare institution “City Clinical Hospital No. 7” in Tver for the period from 2010 to 2020. The dynamics of the frequency of registration of persons with disabilities was studied among surgical patients, the main groups of diseases that caused disability were identified, the structure of disability by groups was analyzed. The degree of reliability of the obtained data was assessed. Results. The growth of citizens with disabilities in the outpatient surgical department increased 3,3 times from 2010 to 2020. The dynamics was wave-like. There was a sharp rise in the number of people who received a disability group for the first time from the beginning of 2010 to the end of 2013. The indicators did not change much from 2014 to 2020. However, the dynamics of the percentage of the working population among persons with disabilities developed in inverse proportion. Those who received a disability group for the first time mainly had pathologies of the musculoskeletal system and vascular diseases. Conclusion. Based on the data of the surgical department of the polyclinic in the city of Tver, the number of persons with disabilities tends to increase. It requires constant monitoring. The number of persons with disabilities tends to increase. It was illustrated through an example of a study in Tver. All that leads to a decrease in the able-bodied population and an increase in social inequality. It is an urgent problem in the region.

The role of working conditions in the formation of occupational morbidity of workers in metallurgical production

Introduction. The working population health is the basis of human capital, which is a factor in the country’s sustainable economic development. The conditions of occupational activity rank first in the structure of health factors of a working person. Materials and methods. The working conditions and the structure of the newly identified occupational morbidity at a metallurgical enterprise located in the territory of the Republic of Bashkortostan are analyzed based on statistical reporting documents on newly established occupational diseases for the period 2011-2019 and the hygienic characteristics of labour assessment presented by Rospotrebnadzor specialists with suspicion of an occupational aetiology of the diseases. Results. Over the past number of years, workers in manufacturing industries of the Republic of Bashkortostan (RB) have been diagnosed annually from 2.16 to 6.76 cases of occupational diseases per 10 thousand workers, which makes it possible to attribute these industries to a high level of occupational risk. Over the past decade, 117 cases (11 to 26 cases per year) of occupational diseases were detected at the enterprise for the first time. In the structure of nosological forms, musculoskeletal system diseases and connective tissue rank first. Limitations of the study. The limitation of this study is the lack of complete information about working conditions in the presented sanitary and hygienic characteristics. In recent years, there has been a decrease in registered occupational morbidity against the background of minor changes in working conditions. The identification of occupational diseases is often associated with the level of competence of employees of medical institutions who examine the relationship of the disease with the occupation and certain attitudes of the employee and employer. Conclusion. The working conditions of metallurgical workers are characterized by the impact of a complex of occupational factors, the leading of which is the intensity of the work process. The working conditions of this process are considered to be harmful Class 3 (3.3). Between 2011 and 2019, the link between the disease and occupational activity was established in 117 cases, mainly in workers (wire drawers, wire winders, repairmen, metal sorters) experiencing significant physical dynamic loads.

The Effectiveness of Rheumatic Exercise With Citronella Oil on Decreasing Pain Intensity in Pre-Elderly Experiencing Rheumatism

Rheumatic disease has a significant impact on individuals and society. This disease also affects the economy of the individual, society and country. The highest prevalence of joint disease in Indonesia based on diagnosis by health professionals or symptoms has been identified in East Nusa Tenggara (33%), followed by West Sumatra (33%), West Java (32%), and Bali (30%). The prevalence of joint disease in Bandung City has been reported as 27%. Musculoskeletal system diseases and connective tissue problems (including rheumatism) are the second most common condition in women (69%), after vascular system disease. A rheumatic exercise is a form of physical exercise that has a good effect on increasing the ability of joint muscles, which can improve fitness and increase endurance. If the muscles are frequently trained, the synovial fluid will increase, which can reduce the risk of injury and prevent knee pain in patients with knee rheumatism. Rheumatic exercises have a direct psychological impact, namely helping to give a relaxed feeling, reduce tension, and increase feelings of pleasure because during exercise the pituitary gland increases beta-endorphin levels. Increased concentrations of beta-endorphins in the blood and parasympathetic nerves reduce heart rate and pulse, causing the pain that causes joint stiffness to decrease. The purpose of this study was to determine the effectiveness of rhematic exercise with a modified combination of citronella oil to reduce pain intensity in the pre-elderly with rheumatism in Puskesmas Garuda Kota Bandung. This was a quasi-experimental study with a two group pre- and post-test design with a control. The average pain scale value before the intervention was 5.7 and the average pain scale after the intervention in the treatment group was 1.45. The rheumatic exercise intervention with a topical combination of citronella oil was more effective in reducing the intensity of rheumatic pain in the pre-elderly who had rheumatism in Garuda City Health Center, Bandung. The results may be useful for health workers to improve their performance in helping the community.
 Keywords: Rheumatic exercise, pain intensity, pre-elderly

Ефективність комбінованої терапії з використанням мелоксикаму (Локсидолу) і Кокарніту в лікуванні пацієнтів із хронічними захворюваннями опорно-рухового апарату в період загострення

Стаття присвячена питанням лікування хронічних захворювань опорно-рухового апарату в період загострення. Приділено увагу вибору препарату групи нестероїдних протизапальних засобів та препарату метаболічної дії. Наведені дані дослідження ефективності та безпеки комплексного призначення мелоксикаму (Локсидолу) та Кокарніту.

Нейропатичний компонент болю при захворюваннях кістково-м’язової системи: огляд літератури та результати власних досліджень. Частина I

Лікування хронічного больового синдрому залишається складним завданням, особливо в людей літнього віку. Дослідження альтернативних механізмів виникнення болю дозволить покращити ефективність лікування та якість життя таких пацієнтів. У статті наведені дані огляду літератури, які стосуються нейропатичного болю при найпоширеніших захворюваннях кістково-м’язової системи. У першій частині розглядаються загальні питання термінології, епідеміології, патофізіології та діагностики нейропатичного болю.

Эффективность неденатурированного и гидролизованного коллагена II типа в терапии болевого синдрома

Collagens play an important structural role and contribute to the mechanical properties, organization and shape of tissues. In musculoskeletal system diseases (MSD), the amount of type II collagen in the cartilage extracellular matrix significantly decreases. Degradation and reduction of type II collagen are associated with osteoarthritis (OA). At present, SYSADOA (Symptomatic Slow Acting Drugs for Osteoarthritis) are widely used in the treatment of OA for oral and parenteral use. Besides, increased attention has been paid to the new treatment methods for OA based on a new promising type II collagen molecule: undenatured (UC-II) and hydrolyzed (HC-II) collagen. UC-II is a native collagen (fibrillar protein with a molecular weight of 300 kDa), whereas HC-II is a polypeptide (molecular weight of 2–9 kDa). The article describes the molecular mechanisms of action of UC-II and HC-II, and identifies the main differences between them. The diverse mechanism of action of the described collagen types determines their clinical use: UC-II is prescribed mainly in MSD, in particular OA, and HC-II is mainly used in cosmetology, as well as in MSD. The article also presents the study results demonstrating the safety and efficacy of drugs and dietary supplements containing UC-II and HC-II in relieving pain syndrome during OA. KEYWORDS: undenatured type II collagen native collagen, hydrolyzed collagen, collagen peptides, SYSADOA, pain syndrome, osteoarthritis. FOR CITATION: Shavlovskaya O.A., Bokova I.A., Romanov I.D., Shavlovsky N.I. Efficacy of undenatured and hydrolyzed type II collagen in the treatment of pain syndrome. Russian Medical Inquiry. 2022;6(10):571–575 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-571-575.

The assessment of risk factors associated with difficult intubation as endocrine, musculoskeletal diseases and intraoral cavity mass: A nested case control study.

The predictive factors of difficult airway have been studied to reduce especially the incidence of unanticipating difficult intubation, provide patient safety, and avoid wasting resources. In this study, it was aimed to investigate whether endocrine, musculoskeletal diseases, presence of intraoral mass, and demographic factors have predictive values in the evaluation of difficult air-way as well as frequently used airway assessment tests. This study was designed a nested-case control study. After eligibility criterions, totally 1012 patient data were collected, 92 of them were difficult intubation, 920 of them were non-difficult intubation patients (1: 10 ratio). Demographic characteristics of the patients (age, gender), body mass index (BMI), Mallampati, Cormack-Lehane Score (CLS), sternomental distance (SMD), inter incisor gap (IIG), type of surgery, endocrine, musculoskeletal and cardio-pulmonary diseases, and the presence of intraoral mass were compared between groups. Age >52 years, male gender, ASA 3-4, higher BMI, CLS 3-4, Mallampati 3-4, IIG <4 cm, and SMD <10 cm were found statistically significant in terms of difficult intubation. Besides, a statistically significant relationship was found when the groups were compared in the presence of intraoral mass (17.57 times higher, p<0.05), endocrine diseases (3.51 times more common, p<0.05) and musculoskeletal system diseases (4.5 times higher, p<0.05). In this study, it was demonstrated that endocrine disorders such as diabetes mellitus and thyroid disorders, musculoskeletal system diseases, and the presence of intraoral cavity mass should be used as predictors for difficult intubation with commonly used airway assessment tests.

ASSESSMENT OF FUNCTIONAL ACTIVITY REDUCTION - AS A CRITERION FOR DETERMINING DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS.

The aim: To analyze the assessment of the decrease in working capacity degree in patients with rheumatoid arthritis in accordance with modern diagnostic disease criteria and social approaches to disability definition in the world (the decline degree of vital activity). Materials and methods: We analyzed the dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020. We analyzed the data of medical and social cases of 433 patients with RA (referral for medical and social examination, Form 088/o). We studied the degree of reduction of their efficiency. Statistical processing was performed using descriptive and variational statistics methods. The results were calculated on a personal computer using the licensed programs STATISTICA 6.1 (StatoftInc., Serial № AGAR909E415822FA). Results: It is shown that in Ukraine in 2016-2020 the primary disability had a tendency to increase. The article defines the approaches to medical and social examination of patients with rheumatoid arthritis to determine the ability to work and signs of disability. The article emphasizes the importance of a thorough study of medical data, data on the functional state of the affected joints using functional tests, determining the state of the patient's social activity according to the assessments of questionnaires based on the principles of evidence-based medicine. Conclusions: The problem of RA is a relevant in the world and in Ukraine. The dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020 shows a growth trend: from 5.8 to 7.1 per 10 thousand population. Carrying out medical and social examination of RA patients to determine the state of working capacity and signs of disability requires careful study of medical data, data on the functional state of the affected joints with functional tests and determining the state of social activity of the patient according to questionnaires. In patients with RA, the most important data for determining violations of vital signs and the presence of functional disability are: disease activity, its course, the presence of lesions of internal organs and the completeness and quality of treatment methods recommended from the standpoint of evidence-based medicine.

Health conditions among Navy divers at end of service: a retrospective cohort study

Purpose: To identify the most prevalent health conditions among divers during their last year of Navy service. Methods: For this retrospective descriptive study we used data from the Dive Jump Reporting System to identify 4,623 active-duty divers who separated between 2008 and 2018. Medical records, dive histories, and personnel files were merged, linked and analyzed at the individual level. Results: On average, 420 divers separated each year. Among the separating divers, 99% were male, 26% were aged 25 to 29 years old with a mean age of 35 (SD = 9, range 18 to 65). The major medical categories with the highest numbers of divers affected were: musculoskeletal system diseases (prevalence rate (PR) = 515.2 per 1,000 divers/year); nervous system (PR = 411.9); injury and poisonings (PR = 249.8); and mental disorders (PR = 237.3). Of the 50 specific conditions that affected the most divers the top four were joint disorders (PR = 34.5), disorders of refraction and accommodation (PR = 30.1), back disorders (PR = 26.8) and organic sleep disorders (PR = 21.6). Compared to divers with fewer than 29 dives, divers with 49-plus dives were about twice as likely to have diagnoses related to symptoms involving head and neck. Conclusions: The study found high rates of conditions such as musculoskeletal disorders, joint and back disorders, and some mental health related disorders. Special warfare divers have high rates of hearing loss, and other disorders of ear. The results show the need and to develop and implement group-specific mitigation programs.