Functional Rehabilitation Of Patients Research Articles

Effects of a Modified Long-Acting Cocktail on Analgesia and Enhanced Recovery After Total Hip Arthroplasty: A Double-Blinded Randomized Clinical Trial

BackgroundWe compared the efficacy and safety of a modified cocktail for postoperative analgesia and early functional rehabilitation in patients undergoing total hip arthroplasty (THA). MethodsA prospective, double-blind randomized controlled trial was conducted with 200 patients who underwent unilateral primary THA at our hospital. Magnesium sulfate and sodium bicarbonate were added to a traditional cocktail of ropivacaine, epinephrine, and dexamethasone. Primary outcome measures were visual analogue scale (VAS) pain scores at various intervals after surgery; morphine consumption for rescue analgesia after surgery; and time to first rescue analgesia. Secondary outcomes were hip function after surgery, daily walking distance, and quadriceps muscle strength. The third index was the incidence of postoperative adverse reactions. ResultsMorphine consumption was significantly lower in the modified cocktail group than in the control group in the first 24 hours after surgery (6.2 ± 6.0 versus 14.2 ± 6.4 mg, P < 0.001), as was total morphine consumption (10.0 ± 8.6 versus 19.2 ± 10.1 mg, P < 0.001). The duration of the first rescue analgesia was significantly prolonged (23.7 ± 10.3 versus 11.9 ± 5.8 mg, P < 0.001). Morphine consumption was also significantly reduced in the magnesium sulfate and sodium bicarbonate groups over a 24-hour period compared with that in the control group (9.4 ± 6.5 versus 14.2 ± 6.4 mg, P < 0.001, 9.6 ± 6.4 versus 14.2 ± 6.4 mg, P < 0.001). The modified cocktail group had significantly lower resting VAS pain scores than the control group at 6, 12, and 24 hours after surgery (P = 0.036, P = 0.010, and P = 0.017, respectively). The VAS pain scores during movement at 6 and 12 hours after surgery were also significantly lower than those in the control group (P = 0.045, P < 0.001, respectively). The modified cocktail, magnesium sulfate, and sodium bicarbonate groups showed better hip range of motion (P < 0.001, P = 0.013, P = 0.046, respectively) and longer walking distance (P < 0.001, P = 0.014, P = 0.019, respectively) on the first postoperative day, and levels of inflammatory markers were significantly reduced. The incidence of postoperative adverse reactions was similar among the four groups. ConclusionThe modified cocktail with a new adjuvant can prolong the duration of postoperative analgesia, reduce the dosage of rescue analgesics, and accelerate early postoperative functional recovery in patients undergoing THA.

Clinical features of three-layer’s impairment of capillary plexuses’ perfusion at follow-up in patients with Purcher retinopathy and Purcher-like retinopathy

In Purcher retinopathy and Purcher-like retinopathy, ischemic lesions occur at the level of all three retina capillary plexuses. Recognition of characteristic ischemic patterns by optical coherence tomography helps to predict the degree of visual functions’ recovery. The aim of this study is to present clinical cases of patients with Purcher retinopathy and Purcher-like retinopathy and to observe the dynamics of visual rehabilitation of patients with retinal vascular conditions. Two patients with complaints of central vision loss and skotomata in the visual field were examined. The complex of multimodal visualization included fundus photoregistration with fundus camera, optical coherence tomography and optical coherence tomography-angiography, and microperimetry. Paracentral acute middle maculopathy and acute macular neuroretinopathy are the manifestations of the same ischemic process on different levels of retinal vascular plexuses. The “diffuse” pattern damages in paracentral acute middle maculopathy lead to more permanent structural and functional impairments opposed to the “skip” pattern. The optical coherence tomography allows to predict the possibilities of visual and functional rehabilitation in patients with ischemic damage of retinal vessels.

Neuroimaging of neuropsychological disturbances following ischaemic stroke (CONNECT): a prospective cohort study protocol

IntroductionNeuropsychiatric distubance is a common clinical manifestation in acute ischemic stroke. However, it is frequently overlooked by clinicians. This study aimed to explore the possible aetiology and pathogenesis of neuropsychiatric...

Aesthetic and functional rehabilitation of patients after upper jaw resection

The article presents the orthopedic stages of treatment of patients with defects of the hard palate and part of the alveolar process, carried out in the period from 2020 to 2022. During this period, orthopedic treatment was performed on 5 patients: 3 men and 2 women aged 58 to 70 years. The features of clinical and laboratory stages with digital visualization of the clinical situation by scanning the Medit i700 are described. The structural features of the obturator prosthesis are highlighted.&#x0D; The conclusion is made about the prospects of using the proposed technique in the orthopedic treatment of patients after resection of the upper jaw.

Evaluation of the effectiveness of functional rehabilitation in patients with multiple sclerosis

Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. May have individual and dynamic course, with symptoms of varying severity. It takes 4 forms: relapsing-remitting, primary progressive, secondary progressive and relapsing-chronic.&#x0D; Aim of the research: Evaluation of the effectiveness of functional rehabilitation in patients suffering from multiple sclerosis.&#x0D; Material and methods: The research group consisted of 94 people (67 women and 27 men) aged 24-70 years, diagnosed with multiple sclerosis. Study participants went through a four-week process rehabilitation based on functional exercise. In research the survey method was used and the research technique was used proprietary questionnaire.&#x0D; Results: The research confirmed the improvement of physical fitness of patients suffering from multiple sclerosis due to the rehabilitation process. In total, 78.72% of the respondents described their physical condition as better or much better than before rehabilitation. Only a few – 3,19% – considered that rehabilitation did not improve the quality of life. The vast majority of respondents - 70.21% as a result of rehabilitation indicated an improvement in independence in everyday functioning. In 93,62% it influenced a better well-being.&#x0D; Conclusions: A correlation has been demonstrated between the performance of kinesiotherapeutic rehabilitation in patients with multiple sclerosis and the improvement of their physical fitness. A significant difference was found in the degree of satisfaction with one’s own functional state before and after the rehabilitation process.

PJM and Cryotherapy in a New Approach for Spasticity Management: An Experimental Trial

Background: Spasticity has been proven to affect the quality of life and functional rehabilitation in patients post-stroke. Several studies aimed to investigate ways to reduce muscle tonicity in this population. Peripheral joint mobilization (PJM) as well as cryotherapy can be used effectively to reduce spasticity and enhance the range of motion. Objectives: This study aimed to investigate the direct effect of cryotherapy, and that of peripheral joint mobilization, on spasticity as a primary outcome and range of motion as a secondary outcome in stroke patients. Methods: Eighteen participants met the inclusion criteria. Patients with ankle plantarflexor spasticity (n=14), patients with biceps brachii spasticity (n=13), and patients with triceps brachii spasticity (n=10) underwent our interventions on two distinct visits. On the first session, Kaltenborn’s PJM was performed, while on the second session ice-massaging technique was applied on the biceps brachii, triceps brachii, and gastrocnemius muscles over the duration of five continuous minutes. The assessment tools used were Modified ashworth scale (MAS) to assess spasticity level and goniometer to evaluate the range of motion (ROM). Statistical tests were performed using SPSS software, Version 23.0. Results: Cryotherapy and peripheral joint mobilization showed a significant reduction in spasticity of the biceps brachii and triceps brachii muscles (p &lt; 0.05), while only cryotherapy had a significant change on gastrocnemius muscle. For ROM, only PJM showed a significant positive change on both active and passive ranges. Conclusion: Both modalities showed effectiveness in direct reduction of spasticity, hence contributing to a more manageable and practical functional rehabilitation of stroke patients

Efficacy of soft palatal augmentation prosthesis for oral functional rehabilitation in patients with dysarthria and dysphagia: a protocol for a randomised controlled trial

IntroductionPalatal augmentation prosthesis (PAP) is used in patients with articulation and swallowing disorders caused by postoperative loss of tongue tissue due to tongue cancer, cerebrovascular disease sequelae and age-related hypofunction....

Dynamic interaction nursing intervention on functional rehabilitation and self-care ability of patients after aneurysm surgery.

BACKGROUNDNursing practices based on the dynamic interaction model have been shown to be superior to generic nursing practices. However, whether this model is effective in patients recovering from intracranial aneurysm surgery is not well studied.AIMTo investigate the effect of nursing based on a dynamic interaction model on functional rehabilitation of patients after aneurysm surgery. METHODSA total of 86 cases in our hospital with intracranial aneurysm from April 2019 to April 2021, were selected and divided into the study group and the control group, with 43 patients in each group. The control group received routine nursing, and the research group received nursing intervention based on a dynamic interaction model. The daily living ability (activities of daily living, ADL), cognitive function (Simple Intelligent Mental State Scale, MMSE), quality of life (Generic Quality of Life Inventory-74, GQOL-74), self-care ability (Exercise of Self-Care Agency scale), incidence of complications, and nursing satisfaction were recorded before and after intervention.RESULTSBefore intervention, ADL (52.09 ± 6.44), MMSE (18.03 ± 4.11), and GQOL-74 (53.68 ± 4.34) scores in the study group were not significantly different from those in the control group (ADL: 50.97 ± 7.32, MMSE: 17.59 ± 3.82, GQOL-74: 55.06 ± 3.98) (P > 0.05). After intervention, ADL (86.12 ± 5.07), MMSE (26.64 ± 2.66), and GQOL-74 (83.13 ± 5.67) scores in the study group were higher than those in the control group (ADL: 79.81 ± 6.35, MMSE: 24.51 ± 3.00, and GQOL-74: 77.96 ± 6.27) (P < 0.05). Before intervention, self-concept (17.46 ± 4.44), self-care skills (25.22 ± 4.20), self-care knowledge (22.35 ± 4.74), and self-care responsibility (15.06 ± 3.29) scores in the study group was similar to those in the control group (self-concept: 16.89 ± 5.53, self-care skills: 24.59 ± 4.46, self-care knowledge: 21.80 ± 3.61, and self-care responsibility: 14.83 ± 3.11) (P > 0.05). After the intervention, self-concept (26.01 ± 3.18), self-care skills (37.68 ± 6.05), self-care knowledge (45.56 ± 5.83), and self-care responsibility (22.01 ± 3.77) scores in the study group were higher than those in the control group (self-concept: 22.97 ± 3.46, self-care skills: 33.02 ± 5.65, self-care skills knowledge: 36.81 ± 5.54, and self-care responsibility: 17.97 ± 3.56 points) (P < 0.05). The incidence of complications in the study group (4.65%) was lower than that in the control group (18.60%) (P < 0.05). Nursing satisfaction in the study group (95.35%) was higher than that in the control group (81.40%) (P < 0.05).CONCLUSIONNursing intervention based on a dynamic interaction model can improve postoperative cognitive function, daily living ability, self-care ability, quality of life, and patient satisfaction, while reducing the risk of complications.

Combination of fixed and removable prosthesis for full mouth rehabilitation of a severely worn out dentition in a male patient

Dental problems in old age mostly arises from age related factors such as occlusal wear due to attrition and abrasion, loss of teeth due to loss of periodontal support and endodontic involvement of teeth etc. Prosthetic dentistry has created new dimensions in providing esthetic and functional rehabilitation of patients with severely worn-out dentition. This clinical case report demonstrates successful multidisciplinary approach to a full mouth rehabilitation of a patient whose dentition has been esthetically and functionally restored with combination of both fixed and removable prosthesis.

PERIODONTAL STATUS IN PATIENTS WITH MANDIBULAR FRACTURES

Purpose: The aim of the present study was to assess the gingival and periodontal status of patients with maxillofacial trauma and to determine the need for periodontal treatment after removal of the intramaxillary fixation. Material and methods: The study included 36 patients with a fracture of the lower jaw. After the clinical and radiological examination of the patients, treatment was performed on a case-by-case basis. 30 days after fixation and removal of the wire ligatures of the patients, the oral-hygienic and periodontal status was assessed using the following indices: simplified oral hygiene index, gingival bleeding index, community periodontal index of treatment needs and evaluation of oral malodour. Results: The most common cause of fractures is a traffic accident, followed by domestic injuries. The level of oral hygiene immediately after removal of the wire ligatures and intermaxillary fixation varied between relatively good and poor, with a greater number of patients having poor hygiene (OHI-S ≥5). The periodontal status of the patients, measured by CPITN, also showed a statistically significant level of clinically established periodontal destruction. Halitosis was detected in all patients. Conclusions: The course of the healing process in the alveolar bone and the functional rehabilitation of patients with mandibular fractures depends not only on the type of surgical treatment for immobilization of the fragments but also on the maintenance of optimal oral hygiene.

Замещение дефектов конъюнктивы: возможности и ограничения

Background: conjunctival disorders are associated with multiple anatomical functional impairments of the eye and ocular adnexa. Rehabilitation of these patients implies the recovery of both macroanatomy and functions of damaged tissues and structures. Aim: to analyze the outcomes of surgical repair of conjunctival defects from the viewpoint of the recovery of ocular anatomy and functions and ocular adnexa. Patients and Methods: a retrospective analysis of the outcomes of surgical repair of conjunctival defects using full-thickness and/or split- thickness autografts of the labial or cheek mucosa in 27 patients. The mean age of participants was 36.86±19.46 years. Follow-up was 1.5 to 6.5 years. The patients were divided into two groups. Group 1 included 21 patients with local symblepharon. Group 2 included patients with subtotal or total conjunctival adhesions of a healthy eye (group 2A, n=3) or in anophthalmia (group 2B, n=4). Results: surgical repair of conjunctival defects provided a complete anatomical functional rehabilitation of patients with local symblepharon and esthetical rehabilitation of patients with subtotal conjunctival adhesions or ankyloblepharon in anophthalmia, whereby allowing keratoprosthesis in a patient with one potentially seeing eye. Meanwhile, we failed to achieve a complete functional rehabilitation and recovery of vision in patients with a potentially seeing eye due to the loss of the palisades of Vogt and/or tear-producing conjunctival structures. Conclusions: surgical repair of conjunctival defects using the technique proposed completely recovers the macroanatomy of the conjunctival fornices and sac and, therefore, improves eyeball and eyelid mobility. However, impossibility of recovering histology in virtually complete loss of native conjunctiva does not allow complete rehabilitation of patients with symblepharon or ankyloblepharon of a potentially seeing eye. Keywords: symblepharon, anlyloblepharon, limbal deficiency, tear production, corneal leucoma, mucosal autograft. For citation: Gushсhina M.B., Tereshchenko A.V., Gushchin A.V., Afanasyeva D.S. Surgical repair of conjunctival defects: perspectives and limitations. Russian Journal of Clinical Ophthalmology. 2022;22(2):137–144 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-137-144

A Clinical Case of Two-Stage Visual-Functional Rehabilitation of a Patient with Postinfectious Central Corneal Opacity in Combination with Mixed Astigmatism Using Laser Keratorefractive Surgery

Introduction: to evaluate the clinical and functional results of two-stage treatment in a patient with post-infectious Central corneal opacity combined with mixed astigmatism.Patient and methods. Patient N., 19 years old with postinfectious (postherpetic) Central corneal opacity, mixed astigmatism was examined and operated using two-stage corneal laser treatment. To determine the possibility of surgical treatment of the patient, a complex of General ophthalmology was performed (checking visual acuity near and far in natural conditions and in conditions of drug-induced mydriasis, IOP measurement, autorefractometry, examination of visual fields, A- and Bscanning, ophthalmoscopy with examination of the Central and peripheral areas of the fundus), as well as special (keratopography and Scheimpflug camera examination, optical coherence tomography (OCT) of the anterior segment of the eye with analysis of the epithelial map, quantitative assessment (Schirmer test-1) and qualitative (tear film rupture time) lachrymal products, assessment of the epithelium state when stained with vital dyes and infrared meibography) research methods. To determine the activity of herpetic infection, PCR diagnostics were performed. The follow-up period was 2 years.Results and discussion. To achieve high visual-functional rehabilitation while preserving the native lens, a two-stage treatment algorithm was developed using technologies of laser corneal refractive surgery. At the first stage, in order to regularize the ocular surface and eliminate Central corneal opacity, an inverted topographically oriented PRK was performed; at the second stage, residual refractive errors were corrected using topographically oriented FemtoLASIK technology.Conclusion. According to the results of a literature search and analysis of Internet resources, there were no previously recorded and published works using a similar two-stage method. Therefore, the described clinical case justifies the relevance and novelty of the goal and has an evidence-based Foundation for the use of a two-stage laser keratorefractive treatment system in the ophthalmological practice of visual and functional rehabilitation of patients with Central corneal opacity in combination with mixed astigmatism or hypermetropic refraction. The two-year postoperative follow-up period showed stable and high visual-functional results with no recurrence of the inflammatory process.

Effect of electroacupuncture combined with caudal epidural injection on functional rehabilitation of patients with lumbar hernia

To observe the effect of electroacupuncture (EA) combined with caudal epidural injection on subjective pain, walking capability, lumbar flexibility and muscle strength in patients with lumbar disc hernia (LDH). Sixty LDH patients were randomly allocated to the control group and the research group. The patients of the control group received ultrasound guided caudal epidural injection, and those of the research group received EA combined with ultrasound guided caudal epidural injection. Bilateral Jiaji (EX-B2) and adjunct points Guanyuanshu (BL26), Shenshu (BL23), Chengfu (BL36), Huantiao (GB30), Zhibian (BL54), etc. on the affected side were stimulated with EA (2 Hz/16 Hz, 5-8 mA) for 30 min each time, once every other day for 4 weeks, with 2 days' rest between every two weeks. The patients' pain was evaluated by using visual analogue scale (VAS), walking capability assessed by timed-up and go (TUG) test (time of walking back and forth in 3 m distance), lumbar flexibility (range of motion, ROM) detected by using an inclinometer and the strength of the lumbar flexor and extensor determined by using a push-pull dynamometer. After the treatment, self-comparison showed that the VAS score and TUG-measured time in both groups were significantly decreased (P<0.01, P<0.05), and the post-bucking ROM and extension ROM in the research group, and the lumbar flexor and extensor muscle strength in both groups were obviously increased compared with their own pre-treatment (P<0.05). Comparison between two groups showed that the VAS score and TUG-measured time of the research group were significantly lower than those of the control group (P<0.01), while the lumbar flexor's ROM as well as the extensor's strength were significantly higher in the research group than in the control group (P<0.05). For patients with LDH, EA combined with caudal epidural injection can alleviate pain, improve the walking capability, lumbar flexibility and strength of the lumbar extensor, and the therapeutic effect of the combined treatment is significantly better than that of simple caudal epidural injection.

High-density surface electromyography maps after computer-aided training in individual with congenital transverse deficiency: a case study

BackgroundThe aim of this study was to determine whether computer-aided training (CAT) of motor tasks would increase muscle activity and change its spatial distribution in a patient with a bilateral upper-limb congenital transverse deficiency. We believe that our study makes a significant contribution to the literature because it demonstrates the usefulness of CAT in promoting the neuromuscular adaptation in people with congenital limb deficiencies and altered body image.Case presentationThe patient with bilateral upper-limb congenital transverse deficiency and the healthy control subject performed 12 weeks of the CAT. The subject’s task was to imagine reaching and grasping a book with the hand. Subjects were provided a visual animation of that movement and sensory feedback to facilitate the mental engagement to accomplish the task. High-density electromyography (HD-EMG; 64-electrode) were collected from the trapezius muscle during a shrug isometric contraction before and after 4, 8, 12 weeks of the training. After training, we observed in our patient changes in the spatial distribution of the activation, and the increased average intensity of the EMG maps and maximal force.ConclusionsThese results, although from only one patient, suggest that mental training supported by computer-generated visual and sensory stimuli leads to beneficial changes in muscle strength and activity. The increased muscle activation and changed spatial distribution of the EMG activity after mental training may indicate the training-induced functional plasticity of the motor activation strategy within the trapezius muscle in individual with bilateral upper-limb congenital transverse deficiency. Marked changes in spatial distribution during the submaximal contraction in the patient after training could be associated with changes of the neural drive to the muscle, which corresponds with specific (unfamiliar for patient) motor task.These findings are relevant to neuromuscular functional rehabilitation in patients with a bilateral upper-limb congenital transverse deficiency especially before and after upper limb transplantation and to development of the EMG based prostheses.

Factors associated with discharge destination following inpatient functional rehabilitation in patients with traumatic spinal cord injury.

Retrospective review of data from a prospective database of a Level 1 trauma center. This project aims to identify factors collected during the acute and rehabilitative care following a traumatic spinal cord injury (TSCI) associated with success and failure to return home after inpatient intensive functional rehabilitation (IFR). Level 1 trauma center specialized in TSCI care in Montreal, Canada. All eligible patients from our prospective database were separated into two groups according to discharge destination following IFR. Clinical variables collected during the acute and rehabilitative care as well as demographic variables were compared between patients who managed to return home (Group 1) and those who were discharged elsewhere (Group 2). Multivariable regression analyses were conducted with variables that were significant at the univariate level. Out of the 193 patients included, 22 (11%) failed to return home following IFR. Six variables were associated with failure to return home at the univariate level: longer acute length of stay (LOS), longer rehabilitation LOS, living alone, higher neurological level of injury, having comorbidities, and having a pressure injury (PI) during acute care. Three variables remained significant at the multivariate level: living alone, increasing acute LOS and presenting a high cervical (C1-C4) neurological level of injury. It is important that acute care clinicians recognize the aforementioned factors early after TSCI in order to optimize patients for community reintegration.

Post stroke depression and its effects on functional rehabilitation of patients: socio-cultural disability communities

Background: Stroke is considered to be the third, most frequent cause of death and the leading cause of disability in Western societies. Apart from physical problems, stroke can cause psychological and social problems, too as post Stroke Depression (PSD) which is the most common emotional disorder that usually occurs in the first months, in about 1/3 of patients surviving after stroke.Aim: To describe the frequency of post stroke depression (PSD) and its effects on functional recovery of patients.Method: A systematic review was conducted on databases MEDLINE, PUBMED, CINAHL, and the web using Google Scholar.Results: Thirty articles were retrieved, from 2000 and onwards which met the selection criteria. According to the results, PSD is a common and serious complication after stroke. Approximately 1/3 of the patients have a type of depression in the first year after stroke, with the risk increasing, the first months of the onset of stroke. The researchers suggest that there is a collaborative relationship between stroke and depression, which leads to inability to perform activities of daily living and slows the rehabilitation of patients.Conclusion: Early detection of PSD and the implementation of appropriate therapeutic interventions in rehabilitation units help to speed up the recovery process and reintegration of patients into society.

Functional rehabilitation of patients after endovitreal surgery of rhegmatogenous retinal detachment with complete retinal attachment

To increase the functional effectiveness of endovitreal surgery in patients with RRD by including Cytoflavin in the system of postoperative rehabilitation. The study involved 68 patients with RRD aged 37 to 65 years. Patients underwent vitrectomy using the 25 Gauge technology with endolaser coagulation of rupture zones and silicone oil tamponade in the vitreous cavity. Three months after the surgery, silicone oil was removed from the vitreous cavity. Patients were divided into 2 groups: the main - 34 people who received Cytoflavin in addition to standard therapy, and the control - 34 people receiving only standard postoperative treatment. The time course of the treatment's functional effectiveness was analyzed using best corrected visual acuity (BCVA) and macular photosensitivity. Laser Doppler flowmetry (LDF) was used to register the microcirculation and microcirculation efficiency indices. Morphological signs of macular ischemia were registered by optical coherence tomography angiography (OCT-A). Patients of the main group showed higher level of restoration of macular function compared with the control group. The increase in functional activity of the macular area correlated with postoperative dynamics of restoration of central retinal thickness. Analysis of LDF and OCT-A indices showed that improvement of visual functions in patients treated with Cytoflavin is directly related to restoration of chorioretinal blood flow. The use of Cytoflavin in patients after endovitreal surgery of RRD led to improvement of BCVA by an average of 2.6 times and photosensitivity of the macula by 2 times. The visual functions of patients improved after using Cytoflavin due to its positive effect on chorioretinal microcirculation and the density of macular capillary plexuses.

An innovative technique for the fabrication of fixed removable guide flange prosthesis for lateral mandibular resection

Rehabilitation of patients with a severe mandibular defect is challenging to prosthodontists. The esthetic and functional rehabilitation of patients with lateral mandibular resection is difficult due to the lack of supporting tissues for the prosthesis. The mandibular deviation furthermore results in facial asymmetry and unstable occlusion. This case report describes an innovative technique to rehabilitate a patient with lateral mandibular resection using customized access post attachment system to retain guide flange prosthesis for reducing mandibular deviation.

CLINICAL ASSESSMENT OF THE EFFECTIVENESS APPLICATION "BIOCERULIN" IN THE COMPLEX TREATMENT OF THE PATIENTS WITH ONTOGENIC FLAGMONS OF THE MAXILLOFACIAL AREA

Treatment of odontogenic phlegmon of the maxillofacial region remains an urgent problem of surgical dentistry due to the steady increase in their frequency, tendency to generalize the process and adverse effects. In this regard, there is a constant search for ways to improve the effectiveness of treatment of patients with odontogenic phlegmons of maxillofacial region. New technologies of drug treatment of this pathology are developed and put into practice.&#x0D; In recent years the attention of researchers in various conditions accompanied by the development of oxidative stress began to attract drugs that have antioxidant action, as it became known that the excess of reactive oxygen species in the regenerating wounds in the hearth of purulent inflammation affects the course of the course, wound healing. Interest in the treatment of various pathological conditions of the body is caused by the domestic antioxidant multifunctional enzyme "Bioceruline" which is composed of copper.&#x0D; In this regard, the purpose of our study was to evaluate the effectiveness of the use of "Biocerulin" in the complex treatment of patients with odontogenic phlegmon of maxillofacial region.&#x0D; The object of the clinical study was 45 patients with odontogenic phlegmons of the maxillofacial region from 18 to 55 years old, who were treated in the maxillofacial department of PU "Poltava M.V. Sklifosovskyi regional clinical hospital PRC». All patients were without somatic pathology in compensated clinical condition. Immediately after hospitalization, patients underwent an emergency opening of purulent lesion, revision and adequate drainage of the affected cellular spaces, removal of the "causal" tooth. The extent of surgery and the choice of optimal access depended on the location and prevalence of phlegmon. Depending on the treatment, patients were divided into comparison groups (22 patients) and the main group (23 patients). The traditional therapy was used in the comparison group. "Biocerulin"was prescribed for the patients of the main group in addition to the traditional therapy.&#x0D; Analysis of obtained data in the treatment of patients with phlegmon revealed that both groups of patients had clear differences in the clinical course of purulent-inflammatory process. On the 2nd day after the opening of the phlegmon theweakness, headache, and sleep disorders were noted in the most of the patients of the comparison group who received traditional therapy. Pain with varying degrees of intensity was present in all patients. Improvement of the general condition of patients of this group was noted not earlier than 3-5 days after surgery. The improvement of the general condition and reduction of pain, normalization or decrease in body temperature, the beginning of restoration of function of the jaw apparatuswere notedin patients of the main group on the background of the introduction of "Bioceruline" already on the 2-3rd day after surgery.&#x0D; Thus, on the basis of the conducted researches it is possible to conclude that the basic (traditional) conservative therapeutic measures used for patients of the comparison group are not effective enough for the relief of the local and general inflammatory process, which caused the prolonged nature of organ-specific and functional rehabilitation of patients as a whole. The use of "Bioceruline" in complex therapy of patients with odontogenicphlegmons of the maxillofacial regionprovides rapid and intensive recovery of the general condition of patients and accelerates reparative processes in the wound and shortens the treatment time via 1.4 bed-days.

Effects of health education based on behavior change wheel theory on functional exercise compliance of stroke patients

Objective To explore the effects of health education based on behavioral change wheel theory on functional exercise compliance of stroke patients. Methods Using convenience sampling method, we selected 70 stroke patients hospitalized in Beijing Shijitan Hospital from June 2018 to April 2019 as the research object, and divided them into control group and observation group according to the odd and even number of hospitalization, with 35 cases in each. Finally, 30 cases were included in the control group and 32 cases in the observation group. The control group was given routine health education and routine follow-up after discharge. The observation group was given health education based on the theory of behavioral change wheel. Three months after discharge, exercise compliance and satisfaction with nursing were compared between the two groups. Results Before intervention, there was no significant difference in the scores of each dimension and total score of functional exercise compliance between the two groups (P>0.05) .After intervention, the scores of each dimension and total score of functional exercise compliance in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05) . There were 8 very satisfied cases, 18 satisfied cases and 4 unsatisfied cases in the control group, and the satisfied rate was 86.7%. There were 22 very satisfied cases and10 satisfied cases in the observation group, and the satisfied rate was100%. The difference was statistically significant (P<0.05) . Conclusions Health education based on behavioral change wheel theory can improve functional exercise compliance and nursing satisfaction of stroke patients, and is conducive to functional rehabilitation of patients, which is worthy of clinical promotion. Key words: Stroke; Functional exercise; Compliance; Behavior change wheel