Effectiveness Of Conservative Treatment Research Articles

TREATMENT EXPERIENCE OF ECTOPIC PREGNANCY

The article presents the results of treatment of ectopic tubal pregnancy. Multiparous with episodes of artificial, involuntary termination of previous pregnancies, ectopic pregnancy in the previous history, inflammatory diseases of the upper portion of the reproductive tract, infertility, diagnostic- therapeutic invasions into the uterine cavity because of benign tumors or underlying processes in the endometrium, relapsing infections of the lower portion of the reproductive tract, and experienced laparotomy/laparoscopy because of surgical pathology are found to be in a high risk group concerning development of ectopic pregnancy. The majority of them (76,5 %) had a lack of pre-gravid training. Expectant tactics of patient management took place in 14,7 % of observations. The majority of cases of ectopic pregnancy (67,7 %) resulted in surgery. Practically in a half of them (43,5 %) organ- preserving surgery of the fallopian tube were performed. According to our studies, effective conservative treatment of ectopic pregnancy with Methotrexate was 50 %. Positive experience with Methotrexate administration was obtained with interpretation of certain symptoms occurring after its use in patients being under our observation.

Elastic Venous Compression Devices for Pregnant and Post-Partum Women: Effects on Chronic Venous Disease Signs and Symptoms and Compliance

Pregnant women are at risk to develop Chronic Venous Disease (CVD) signs and symptoms. Compression therapy is one of the most effective conservative treatments for alleviating symptoms of CVD, particularly in pregnant women.

Значение видео-уродинамического исследования в выборе метода лечения детей с нейрогенными дисфункциями мочевого пузыря

Video urodynamics is the standard for assessment of the lower urinary tract in children with neurogenic urinary disorders aiming to provide more information about the condition of the lower urinary tract v. retrograde urethrocystography. Video urodynamics parameters are used as possible indicators for choosing various surgical treatment options, however, all work is focused on adult patients, and data for the pediatric cohort were not available as yet. The purpose of this research was the evaluation of the role of video urodynamics and retrograde urethrocystography in the selection of effective conservative and surgical treatment of neurogenic urinary disorders in children. Materials and methods used: 112 patients aged 1,8 to 18 y/o with neurogenic urinary disorders were included in the study, of whom 101 were those who had been proven effectively treated with conservative M-cholinoblockers or had successfully undergone minimally invasive surgery as follows: intradetrusor injection of botulinum toxin (n=21), transurethral correction of VUR (n=17), simultaneous execution of two of these interventions (n=22). Based on the results of video urodynamic and cystographic examination of these patients with the CHAID technique, the classification trees were built in order to evaluate the effective treatment (conservative/surgical). Results: the median age of patients was 9,0 years [7,8-12,0]. The first classification tree containing the parameter “presence of VUR according to the results of retrograde cystography.” The sensitivity of the obtained model for the effectiveness of surgical treatment was 83,3% v. 73,2% for conservative treatment. The accuracy was 79,2%. The ROC-AUC value was 0,783. The second classification tree contained the maximum Pves value according to the results of the video urodynamics, presence of hyperactivity, presence of VUR. The sensitivity of the obtained model for the effectiveness of surgical treatment was 93,3% v. 97,6% for conservative treatment. The accuracy was 95,0%. The ROC-AUC value was 0,972. Comparison of ROC-AUC values by the Delong test revealed statistically significant differences between these binary classification metrics (p<0.001). Conclusion: the parameters of video urodynamics have greater diagnostic accuracy in effective prediction of both conservative and surgical treatment methods compared to the retrograde urethrocystography.

Effectiveness of McKenzie exercises plus stabilization exercises versus McKenzie exercises alone on disability, pain, and range of motion in patients with nonspecific chronic neck pain: A randomized clinical trial.

Chronic nonspecific neck pain is a common disorder that causes disability and reduced quality of life. Effective conservative treatment options are needed to manage this condition. This randomized trial compared the efficacy of McKenzie exercises alone versus McKenzie plus cervical and scapulothoracic stabilization training for patients with chronic nonspecific neck pain. A randomized controlled trial was conducted in an outpatient physical therapy clinic. 76 patients with chronic (> 3 months) neck pain were randomized to 6 weeks of either McKenzie exercises alone (n= 38) or McKenzie plus stabilization exercise (n= 38). The McKenzie protocol included posture correction, range of motion exercises, and lateral neck stretches. The stabilization program added targeted exercises for the neck and scapula. The combination of McKenzie plus stabilization exercises resulted in significantly greater reduction in current neck pain intensity compared to McKenzie alone at 6 weeks (mean difference: -1.2 points on 0-10 scale, 95% CI -1.8 to -0.6; p< 0.001). Neck disability improved in both groups. Cervical range of motion also improved more with the addition of stabilization, except for extension. Adding specific cervical and scapulothoracic stabilization exercises to a standard McKenzie protocol led to clinically meaningful reductions in neck pain compared to McKenzie therapy alone in patients with chronic nonspecific neck pain. This combined approach can improve outcomes.

Efficacy of shock wave therapy and ultrasound therapy in non-insertional Achilles tendinopathy: a randomised clinical trial.

Physiotherapists and physicians continue to seek effective conservative treatments for Achilles tendinopathy. This study aimed to subjectively and objectively determine the therapeutic efficacy of radial shock wave therapy (RSWT) and ultrasound therapy in non-insertional Achilles tendinopathy. Thirty-nine patients with non-insertional Achilles tendinopathy were randomly assigned to three experimental groups, i.e., RSWT (group A), ultrasound therapy (group B), and placebo ultrasound (group C) groups. Before the intervention and at weeks 1 and 6 after the treatment, the patients were assessed using the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire and posturographic measurements of step initiation performed on the force platforms under two different conditions (non-perturbed transit and perturbed transit). Six weeks after therapy, all groups exhibited significantly increased VISA-A scores against the measurement at week 1 after therapy. The post-therapy percentage changes in VISA-A scores were significantly greater in group A compared to group B. The three-way ANOVA demonstrated that treatment type affected sway range in the frontal plane and mean velocity of the centre of foot pressure displacements in the sagittal and frontal planes during quiet standing before step initiation. The Bonferroni post-hoc test showed that the means of all those variables were significantly smaller for group A than for group B patients. The three-way ANOVA revealed an effect of the platform arrangement on transit time and double-support period. The Bonferroni post-hoc test revealed statistically longer transit time for the perturbed vs. non-perturbed trials; a reverse relationship was observed for the double-support period. The VISA-A showed that RSWT was significantly more effective than sonotherapy for alleviation of pain intensity as well as function and activity improvement in patients with non-insertional Achilles tendinopathy. Therefore, RSWT therapy can be used in clinical practice by physiotherapists to alleviate the symptoms of non-insertional Achilles tendinopathy. Objective data registered by force platforms during quiet standing before and after step initiation did not prove useful for monitoring the progress of treatment applied to patients with non-insertional Achilles tendinopathy between consecutive therapy interventions.Clinical trial registration:https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000860369, identifier (ACTRN12617000860369).

Chemical neurolysis for the conservative treatment of hip fractures.

Aim: Hip fracture management is challenging when surgical risks outweigh benefits. Inadequate analgesia from conservative treatments prompted new procedures targeting hip capsule denervation. This study evaluates the efficacy and safety of single injection chemical hip neurolysis in the pericapsular nerve group plane.Materials & methods: In eligible patients, an ultrasound-guided diagnostic block was performed using 5ml of 2% lidocaine in the pericapsular nerve group plane. If positive, 6ml of 99.9% alcohol was administered.Results: From May 2022 to May 2023, five patients underwent hip neurolysis. None reported pain at day 5 or during follow-up. There were no adverse effects.Conclusion: Chemical neurolysis seems to provide effective and safe conservative treatment for hip fractures, offering reliable analgesia for nonsurgical candidates.

Standards for providing emergency care at the prehospital and early hospital stages for patients with mechanical jaundice

Mechanical jaundice is a condition characterized by obstructive disorders in the biliary system, posing a diagnostic challenge that requires advanced visualization techniques and laboratory tests for accurate diagnosis. This article explores the role of biochemical markers, presents an analysis of the algorithm for laboratory diagnosis and visualization techniques in order to stratify patients with jaundice syndrome, and conduct timely and effective conservative treatment with further surgical interventions. A comprehensive diagnostic and therapeutic algorithm has been developed whose use by emergency physicians at the prehospital and early hospital stages will lead to a rapid and qualitative elimination of biliary obstruction, a reduction in the level of complications, and the achievement of optimal treatment outcomes for patients.

Daflon 500mg is used for the treatment of all grades of hemorrhoids

Background: Hemorrhoidal diseases are very common diseases found in surgical outpatient clinics, affecting populations all over the world. Treatments for the different grades of hemorrhoids include lifestyle changes, conservative medical therapy, and operative interventions. Objective: To assess the conservative treatment response of all grades of hemorrhoidal disease (grades 1-4) to a venotonic agent (Daflon 500mg). Patients and Methods: This is a prospective observational study of 196 patients with hemorrhoids, conducted during the period from January 2015 to January 2020, All treated with the standard dose of a venotonic agent (Daflon 500mg). An observation of the reduction and disappearance of the signs and symptoms of the different grades of the disease was done at 1, 3, and 6 months. Results: The mean age of the patients was 46.6 (range 14–85) years. The majority (41.84%) were diagnosed with grade III hemorrhoidal disease and 30.1% with grade II disease; Grade I and Grade IV constitute 9.69% and 18.37%, respectively. excellent improvement observed in about 72.45%, temporary response seen in 15.82% of cases. Conclusion: Daflon 500 mg is an effective first-line conservative treatment for all four grades of hemorrhoidal diseases, including grade 4, which has a 44.74% permanent response rate. This medical treatment, in turn, reduces the chance of surgical intervention and its complications.

The transdifferentiation of human dedifferentiated fat cells into fibroblasts: An in vitro experimental pilot study.

Skin grafting is a common method of treating damaged skin; however, surgical complications may arise in patients with poor health. Currently, no effective conservative treatment is available for extensive skin loss. Mature adipocytes, which constitute a substantial portion of adipose tissue, have recently emerged as a potential source of stemness. When de-lipidated, these cells exhibit fibroblast-like characteristics and the ability to redifferentiate, offering homogeneity and research utility as "dedifferentiated fat cells." We conducted an in vitro study to induce fibroblast-like traits in the adipose tissue by transdifferentiating mature adipocytes for skin regeneration. Human subcutaneous fat tissues were isolated and purified from mature adipocytes that underwent a transformation process over 14 days of cultivation. Microscopic analysis revealed lipid degradation over time, ultimately transforming cells into fibroblast-like forms. Flow cytometry was used to verify their characteristics, highlighting markers such as CD90 and CD105 (mesenchymal stem cell markers) and CD56 and CD106 (for detecting fibroblast characteristics). Administering dedifferentiated fat cells with transforming growth factor-β at the identified optimal differentiation concentration of 5 ng/mL for a span of 14 days led to heightened expression of alpha smooth muscle actin and fibronectin, as evidenced by RNA and protein analysis. Meanwhile, functional validation through cell sorting demonstrated limited fibroblast marker expression in both treated and untreated cells after transdifferentiation by transforming growth factor-β. Although challenges remain in achieving more effective transformation and definitive fibroblast differentiation, our trial could pave the way for a novel skin regeneration treatment strategy.

Analyze, design, develop, implement, and evaluate approach to develop a pelvic floor muscle training guidebook to treat stress urinary incontinence in women.

Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.

The effectiveness of cervical rehabilitation interventions for pain in adults with myogenic temporomandibular disorders: A systematic review and meta-analysis.

Little evidence exists for the most effective conservative treatment approach for adults with myogenic temporomandibular disorders (MTMD). We aim to assess the effectiveness of cervical rehabilitation interventions on pain intensity and sensitivity in adults with MTMD compared to comparison intervention such as placebo, sham treatment, education or no intervention. For this systematic review and meta-analysis, we searched PubMed, EMBASE, Medline, PEDro databases, forward and backward citations and grey literature studies through PROSPERO, clinical trials and data registries without language or date restrictions between inception and 1 December 2021. We selected randomised controlled trials (RCTs) based on adult populations with MTMD who had a cervical rehabilitation intervention which was defined as any conservative intervention targeting the anatomical structures of the cervical spine. The primary outcome measures for pain were self-reported pain intensity and pain sensitivity through the pressure pain threshold (PPT) of the masseter and temporalis muscles. Secondary outcome measures of maximal mouth opening (on MMO) were included. Included studies were assessed for bias with the Cochrane risk of bias tool for randomised trials. Evidence from RCTs was synthesised to determine treatment effect size as differences between standardised mean difference (SMD) for changes in pain intensity, PPT and MMO comparing adults with MTMD who were treated with cervical rehabilitation interventions compared to a control group. This study is registered on Prospero, number CRD 42021289299. Our general search yielded 2647 studies where seven RCTs met eligibility criteria with low to some concerns in their risk of bias. Pain intensity (five studies, n = 223, SMD -0.98, 95% CI -1.67 to -0.28, I2 = 79%), PPT of the masseter muscle (six studies, n = 395, SMD 0.64, 95% CI 0.43 to 0.86, I2 = 90%) and the temporalis muscles (five studies, n = 295, SMD 0.76, 95% CI 0.07 to 1.45, I2 = 84%) showed large treatment effect estimates favouring cervical rehabilitation interventions compared to no treatment, sham cervical treatment, patient education or non-cervical neuromuscular techniques. Compared to control interventions, one type of cervical rehabilitation intervention, cervical manual therapy alone or in combination with a neck exercise program was associated with statistically significant, large treatment effect estimates on pain intensity (four studies, n = 203, SMD -1.52, 95% CI -2.50 to -0.55). This review found that in the short-term, cervical rehabilitation interventions especially upper cervical MT alone or in combination with a neck exercise program are effective in improving multiple pain outcomes in adults with MTMD. However, further research is needed to measure the long-term effects of this type of intervention.

Comparing the effectiveness of pulsed radiofrequency treatment to lumbar dorsal root ganglion according to application times in patients with lumbar radicular pain: protocol for a randomised controlled trial

IntroductionLumbar radicular pain (LRP) is a common symptom characterised by a sharp, shooting or lancinating sensation localised to one or more dermatomes of the lumbar spine. Despite its high prevalence...

Prognostic value of cancer markers in ovarian endometriosis in women of reproductive age

The article contains fragments of a scientific study aimed at developing prognostic criteria for uterine leiomyoma, the authors studied cancer markers in women of reproductive age. Early diagnosis of uterine leiomyoma contributes to effective conservative and organ-preserving treatment of this disease.

Stress Urinary Incontinence in Young Female Athletes- From Prevalence to Treatment- A Review

Urinary incontinence is a prevalent issue among females aged 15-65, with prevalence rates ranging from 10% to 55%. Stress Urinary Incontinence (SUI) is the most common form in young athletes, with rates ranging from 0% (golf) to 80% (trampolinists). Activities like jumping, landing, and running can cause leakage due to an increase in intraabdominal pressure. This study aimed to identify management strategies and the prevalence of SUI in teenage female athletes. A literature search was conducted on studies conducted between 1990 and the present, excluding abstracted and non-open access studies. The research found that the chance of urinary stress incontinence in young and nulliparous female athletes in sports ranges from 0% (golf) to 80% (trampolinists). These activities, including gymnastics, long jumps, track and field, and ball activities, significantly impact their standard of existence, psychological situation, and athletic performance. Effective conservative treatment options for SUI include behavioral and lifestyle modifications, pelvic floor exercises, and core strengthening exercises. Female athletes require significantly stronger pelvic floor muscles than inactive females, and contraction of these muscles should occur as the inner core muscles are engaged. Future studies, instruction, and focused therapies are needed for female athletes with SUI.

New Infiltration Technique in the Treatment of the Plantar Fascia Syndrome Based on Platelet-Rich Plasma.

Pain in the attachment of the plantar fascia in the calcaneus represents 10% of all sports injuries, affects 10% of foot runners, and will affect around 20% of the world population. There is no effective conservative treatment for it. This paper justifies a new definition and name for this pathology, Plantar Fascia Syndrome (PFS), presents a methodology for its diagnosis, and presents the clinical and functional effectiveness of a new conservative treatment based on platelet-rich plasma (PRP). In total, 25 patients (from an initial sample of 260) diagnosed with recalcitrant PFS lasting for more than 12 months were treated with a single infiltration of 2 mL of PRP, according to a new technic proposed. The study was approved by the ethical committee for clinical research of the reference hospital. The patients were controlled after 15, 30, 90, and 180 days, reviewing on each occasion pain, thickness of the plantar fascia, and active extension of the ankle joint. A total of 15 days after infiltration, 85% of patients had no clinical signs requiring treatment. After 90 days of infiltration, no patients showed clinical signs. This improvement in the patients' condition lasted for 180 days. All patients after treatment can fully resume normal activity with no pain.

Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life.

The treatment paradigm in older patients with malignant hemopathies is the choice between an effective conservative treatment that preserves quality of life and an intensive, potentially curative treatment with more toxicities. For each patient, it is important to determine the risk/benefit ratio. The patient should be involved in the discussion, sufficiently informed and able to express himself and his expectations in terms of quality of life. However, this informed consent is conditioned by the ability of the patient to understand the risks and benefits of the treatment. Decline in quality of life is an important parameter for older patients with cancer and many prospective trials have now confirmed the impact of different side effects of treatment, such as recurrent hospitalization, loss of autonomy in daily activities, loss of contact with grandchildren and loss of cognitive functions. Interventions oriented to vulnerabilities detected in the older patients (by comprehensive geriatric assessment) and an optimal approach, including preventive measures to reduce treatment-related toxicity and mortality, are directly correlated to improvement in quality of life.

Conservative treatment of cholelithiasis: the effectiveness of the use of ursodeoxycholic acid

Relevance. Conservative treatment of cholelithiasis is most effective in the early stages of the disease. The use of ursodeoxycholic acid preparations is most justified, taking into account the pathogenesis of the disease. Effective conservative treatment can prevent the development of postcholecystectomy syndrome, the most common complication of surgical treatment. This is a socially significant task.Goal. Conducting conservative treatment with ursodeoxycholic acid to a patient with GI with dynamic monitoring and evaluation of the effectiveness of the therapy. Identification of early signs of the development of cholelithiasis and prevention of factors of the development of concretions in the gallbladder.Materials and methods. A patient with newly diagnosed cholelithiasis was prescribed ursodeoxycholic acid preparation under the control of laboratory and instrumental research methods. Dynamic observation of the patient was carried out during 1 year of treatment, and the previous results of ultrasound examination were also analyzed, which made it possible to identify predisposing factors of stone formation. The appointment of the drug ursodeoxycholic acid made it possible to achieve the goal – to «dissolve» gallstones. Regular ultrasound examination, even in the absence of clinical manifestations, is one of the methods for detecting cholelithiasis at an early stage – biliary sludge in the gallbladder.

The Effect of Karkatibeejadi Churna by Internal Administration in Mutraghata with special reference to Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia is a non-malignant enlargement of the prostate gland caused by excessive growth of prostatic tissue. The main symptoms of BPH include hesitancy, frequency, urgency, weak stream urination, straining and nocturia. These together termed as LUTS. We cannot see a single disease in Ayurveda which shows all the features of benign prostatic hyperplasia. Mutragranthi is one among the 12 types of Mutraghatas which can be compared with benign prostatic hyperplasia due to its similarities in morphological, anatomical, and clinical features. Lower urinary symptoms in patients are very troublesome which affects their daily routine and sleep pattern and a negative impact on their quality of life. Embarrassment and the treatment cost prevent them to take timely treatment. In modern system of medicines, the treatment of BPH is done by conservative and surgical therapies. These methods have significant complications and are too expensive. Karkatibeejadi churna is mentioned in Bhaishajyaratnavali in Mutraghata prakarana. The ingredients of this Choorna are easily available and easy to prepare and consume. This case study was done in a participant of age 67 years with symptoms of benign prostatic hyperplasia which was confirmed by USG in search of an effective, cost effective conservative treatment. The Choorna was given for 60 days and assessments were done on 0th, 16th 31st, 46th and 61st days and the result showed significant reduction in symptoms, prostate volume and post void residual urine of benign prostatic hyperplasia.

Pelvic Health Content in Canadian Entry-To-Practice Physiotherapy Programs: An Online Survey.

Pelvic health physiotherapy is an emerging and sensitive area of practice that offers effective conservative treatment for pelvic health conditions. Canadian entry-to-practice curriculum guidelines accord programs considerable flexibility regarding incorporating pelvic health content, which may lead to differences between programs and diverse levels of competence among new graduates. The purpose of this study was to determine the nature and extent to which pelvic health content is incorporated in entry-to-practice physiotherapy programs in Canada. We conducted a descriptive cross-sectional e-survey of representatives from Canadian entry-to-practice physiotherapy programs. Ten out of 15 Canadian programs participated. Programs incorporated pelvic health content throughout the required curriculum (n = 9) and in optional courses (n = 6). All participating programs covered musculoskeletal-related conditions, urinary incontinence, and pelvic pain conditions, and included anatomy and physiology, clinical reasoning, subjective assessment and pelvic floor muscle training topics. Three programs trained students in internal pelvic floor techniques in elective courses. All programs covered cisgender women populations, however, transgender populations were seldom covered. This study provides an understanding of pelvic health curricular content that can serve as a first step towards standardizing and improving entry-level pelvic health training in Canada.

A global assessment of forest integrity within Key Biodiversity Areas

Forest ecosystems cover one third of the terrestrial land surface, with those that are still functioning and largely intact being critically important for the conservation of threatened and endemic biodiversity. Key Biodiversity Areas (KBAs) are sites contributing significantly to the global persistence of biodiversity; >16,000 KBAs have been identified to date, almost half of which are of importance to forest species, including one-fifth that are important for one or more globally threatened species. It is important to track changes in forest integrity within KBAs to determine which important areas are under the greatest threat (so as to identify the actions needed), and also to track the overall effectiveness of conservation interventions. We utilised the Forest Landscape Integrity Index (FLII), which has been mapped globally at a 300 m resolution, to measure trends in forest integrity across 6844 KBAs of importance for forest biodiversity. In total 54 % (3.9 million km2) of these KBAs was forested, of which 44 % (1.7 million km2) is considered still to be of high integrity. South America, Africa and Asia were regions with the largest areas of high integrity forest within KBAs, while Oceania and Australasia had proportionally the highest amount of high forest integrity within their KBAs. We found that forest integrity was proportionally higher in larger KBAs, KBAs with larger proportions of forest, KBAs located close to other forested KBAs, and in protected KBAs. Unprotected and partially protected high-integrity forested KBA areas (making up 26 % of the current forested KBA estate) are among the highest priorities for assessing required conservation actions, including restoration to increase connectivity and reduce fragmentation and edge effects, and/or efforts to expand protected areas or other effective area-based conservation measures' (OECMs).