Integrated Treatment Approach Research Articles

Effect of mecobalamin combined with holographic copper acupuncture and scraping technique on tinnitus symptoms in patients with sudden sensorineural hearing loss

Purpose: To examine the effect of methylcobalamin combined with holistic copper acupuncture and scraping technique in ameliorating tinnitus symptoms in patients with sudden sensorineural hearing loss. Methods: 80 patients with sudden sensorineural hearing loss from Department of Otolaryngology, The Hefei First People’s Hospital, Hefei, China were selected as subjects for this study. They were divided into control and study groups, respectively, with 40 patients in each group, based on the different treatment interventions received by the patients. Conventional interventions included the use of Ginkgo biloba extract, Tianmasu injection, dexamethasone pharmacological treatments. The control group received methylphenidate tablets in addition to the conventional treatment, while the study group received further intervention comprising the combination of holistic copper acupuncture and scraping technique on the ear, in addition to the treatment received by the control group. The evaluated outcomes included efficacy, auditory threshold levels, and Pittsburgh Sleep Quality Index (PSQI) score. Results: The overall efficacy of the treatment in the control group was 77.5 %, whereas, it was significantly higher in the study group at 97.5 % (p < 0.05). Prior to treatment, there were no significant differences in pure tone audiometry thresholds between the two groups (p > 0.05). However, post-treatment, the study group exhibited significantly lower pure tone audiometry thresholds compared to the control group (p < 0.05). Before PSQI scores were similar for the two groups (p > 0.05). However, after treatment, the PSQI scores in the study group were significantly lower than those in the control group (p < 0.05). Conclusion: The combined application of methylcobalamin, holistic copper acupuncture, and scraping technique is effective for the treatment of patients with sudden sensorineural hearing loss. This integrated treatment approach significantly alleviates tinnitus and improves sleep-related symptoms in patients with sudden sensorineural hearing loss. Furthermore, it promotes the recovery of pure tone audiometry thresholds and other related parameters.

Sequential high-recovery nanofiltration and electrochemical degradation for the treatment of pharmaceutical wastewater

The presence of antibiotics in aquatic ecosystems poses a significant concern for public health and aquatic life, owing to their contribution to the proliferation of antibiotic-resistant bacteria. Effective wastewater treatment strategies are needed to ensure that discharges from pharmaceutical manufacturing facilities are adequately controlled. Here we propose the sequential use of nanofiltration (NF) for concentrating a real pharmaceutical effluent derived from azithromycin production, followed by electrochemical oxidation for thorough removal of pharmaceutical compounds. The NF membrane demonstrated its capability to concentrate wastewater at a high recovery value of 95% and 99.7 ± 0.2% rejection to azithromycin. The subsequent electrochemical oxidation process completely degraded azithromycin in the concentrate within 30 min and reduced total organic carbon by 95% in 180 min. Such integrated treatment approach minimized the electrochemically-treated volume through a low-energy membrane approach and enhanced mass transfer towards the electrodes, therefore driving the process toward zero-liquid-discharge objectives. Overall, our integrated approach holds promises for cost-effective and sustainable removal of trace pharmaceutical compounds and other organics in pharmaceutical wastewater.

A SYSTEMIC REVIEW ON THE MANAGEMENT OF ATTENTION-DEFICIT/HYPERACTIVITY DISORDER IN CHILDREN

ADHD, a tantalising neurodevelopmental disorder documented in the DSM-5, fascinates with its distinctive characteristics: persistent inattention and hyperactivity. Beyond the surface, it intertwines with cognitive, social, and behavioural domains and affects 5.29% globally. Ayurvedic hints like Mano Vibhrama and Raja-Tama guna alignment illuminate a path, offering tridosha-shaman therapy, Medhya rasayana, and Panchakarma. A fusion of modern understanding and ancient wisdom paves the way for unravelling ADHD's enigma, promising novel solutions. This study aims to systematically review the management of attention deficit hyperactivity disorder in Ayurveda. To conduct this study, Ayurveda research articles were obtained from PubMed, Google Scholar and AYUSH portal. A total of 40 studies were obtained, which underwent further screening processes to achieve the quality of inclusion criteria. A total of 14 articles were selected from different publications of the review. Out of 14 articles obtained, 7 studies (n=14) exclusively focused on shaman chikitsa with different single drugs and various drug formulations, 06 studies (n=14) focused on shaman and Panchakarma therapy, which includes shirodhara, abhyanga, matra basti, kashaya basti and nasya, 1 study (n=14) emphasised the importance of Panchakarma. Out of 14 clinical studies, 6 showed highly significant results, 1 showed comparatively insignificant results, and 7 showed moderately significant results. This study combines Ayurvedic insights with modern ADHD research, providing a promising opportunity for integrative treatment approaches. Further investigation of this intersection could reveal new dimensions in the fight against this complex neurodevelopmental disorder.

Unveiling osteoporosis in type 2 diabetes: A diagnostic and therapeutic challenge

This case report explores the complex relationship between Type 2 Diabetes Mellitus (T2DM) and osteoporosis, highlighting the diagnostic and therapeutic challenges encountered. It presents the journey of P.M, a 55-year-old woman with a 10-year history of T2DM, who was initially screened for osteopenia with MOC DEXA, which failed to accurately diagnose her condition. Subsequent dorsolumbar radiography revealed significant osteoporosis, leading to an integrated treatment approach with denosumab, lifestyle changes, and careful diabetes management. The case highlights the limitations of traditional diagnostic methods in diabetic patients and underscores the need for personalized, comprehensive care strategies to address both diabetes and osteoporosis, illustrating the potential for improved outcomes through targeted therapies and ongoing patient monitoring. This report contributes to a broader understanding of the management of complex comorbid conditions and underscores the need for continued innovation in clinical practice.

Clinical manifestations and outcomes of otitis media with effusion in adult patients following Omicron infection in China.

This study investigates the clinical features and therapeutic outcomes of otitis media with effusion (OME) in adults following infection with the Omicron variant of coronavirus disease 2019 (COVID-19), in the context of China ending its "Zero-COVID-19" policy. Conducted as a multicenter, retrospective analysis at two medical institutions in Eastern China from December 2022 to February 2023, the study included patients with confirmed Omicron infection who were diagnosed with OME within two months, adhering to guidelines from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF). Data on demographics, time from infection to OME manifestation, associated symptoms, and treatment outcomes were collected. Among 68 patients (73 affected ears) with OME post-Omicron infection, common symptoms included cough and nasal obstruction (69.1%). All reported ear fullness, with 86.8% experiencing hearing loss. Tympanic bullae were observed in 72.6% during otoscopy, and most tympanometry results showed a B-type tympanogram (80.0%). An integrated treatment strategy led to an 83.6% cure rate, although 8.2% experienced relapse within 2-3 months. Our findings highlight OME as a prevalent ear complication associated with COVID-19 during the Omicron pandemic, underscoring the necessity for further investigation into its complexities. While the integrated treatment approach proved effective, the 8.2% post-treatment recurrence rate underscores the importance of ongoing monitoring and signals an urgent need for more comprehensive research.

Expert consensus-based clinical recommendation for an integrative anthroposophic treatment approach to acute tonsillitis in childhood

BackgroundMedical guidelines are an important basis for qualitative and cost-effective patient care. However, there is a lack of clinical recommendations in anthroposophic medicine (AM), an integrative medicine approach frequently practised in Europe. Acute tonsillitis, which includes tonsillopharyngitis, is a common childhood disease. that is mostly caused by a viral infection. Symptomatic treatment is therefore of high importance, and AM can offer several therapy options. Methods53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprises five survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel. ResultsResponse rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75–90%). ConclusionThe clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.

Sexual Dysfunction in Depressed Patients Presenting to Psychiatry Ward/Opd

Background: Depression is a pervasive mental health issue that significantly affects individuals' quality of life, often accompanied by sexual dysfunction. Previous research has highlighted the complex relationship between depression and sexual dysfunction, but there remains a need for further investigation into their co-occurrence and the impact of treatment modalities on these conditions. Objective: This study aims to explore the prevalence and severity of sexual dysfunction among depressed patients, examine the correlation between the severity of depression and sexual dysfunction, and assess the effects of different medication regimens on sexual health. Methods: A descriptive study design was employed, examining 250 depressed patients seeking treatment at the Psychiatry Ward and Outpatient Department of Khyber Teaching Hospital, Peshawar, from September 2022 to August 2023. Participants were selected through purposive sampling, with inclusion criteria being individuals aged 18 years and above, diagnosed with depression according to DSM-5 criteria. The Arizona Sexual Experiences Scale (ASEX) and the Patient Health Questionnaire-9 (PHQ-9) were administered to evaluate sexual dysfunction and depression severity, respectively. Data analysis was conducted using SPSS version 25, employing descriptive statistics and Pearson correlation coefficients to analyze the data. Results: The study found that 48% of participants experienced significant sexual dysfunction in the domain of desire, with 68% of participants having moderate to severe depression. A strong correlation was observed between the severity of depression and sexual dysfunction, with Pearson correlation coefficients of 0.65 for desire, 0.72 for arousal, and 0.68 for satisfaction (p<0.001 for all). Medication analysis revealed that 45% of patients on antidepressants, 60% on antipsychotics, and 50% on combination therapy reported sexual dysfunction. Conclusion: The findings confirm the high prevalence of sexual dysfunction among depressed individuals and its strong association with the severity of depression. The study underscores the necessity of adopting an integrated treatment approach that addresses both depression and sexual dysfunction, highlighting the importance of considering the side effects of psychiatric medications on sexual health.

Pharmaceutically active micropollutants: origin, hazards and removal.

Pharmaceuticals, recognized for their life-saving potential, have emerged as a concerning class of micropollutants in the environment. Even at minute concentrations, chronic exposure poses a significant threat to ecosystems. Various pharmaceutically active micropollutants (PhAMP), including antibiotics, analgesics, and hormones, have been detected in underground waters, surface waters, seawater, sewage treatment plants, soils, and activated sludges due to the absence of standardized regulations on pharmaceutical discharge. Prolonged exposureof hospital waste and sewage treatment facilities is linked to the presence of antibiotic-resistant bacteria. Conventional water treatment methods prove ineffective, prompting the use of alternative techniques like photolysis, reverse osmosis, UV-degradation, bio-degradation, and nano-filtration. However, commercial implementation faces challenges such as incomplete removal, toxic sludge generation, high costs, and the need for skilled personnel. Research gaps include the need to comprehensively identify and understand various types of pharmaceutically active micropollutants, investigate their long-term ecological impact, develop more sensitive monitoring techniques, and explore integrated treatment approaches. Additionally, there is a gap in understanding the socio-economic implications of pharmaceutical pollution and the efficacy of public awareness campaigns. Future research should delve into alternative strategies like phagotherapy, vaccines, and natural substance substitutes to address the escalating threat of pharmaceutical pollution.

Depression and fatigue six months post-COVID-19 disease are associated with overlapping symptom constellations: A prospective, multi-center, population-based cohort study

BackgroundDepression and fatigue are commonly observed sequelae following viral diseases such as COVID-19. Identifying symptom constellations that differentially classify post-COVID depression and fatigue may be helpful to individualize treatment strategies. Here, we investigated whether self-reported post-COVID depression and post-COVID fatigue are associated with the same or different symptom constellations. MethodsTo address this question, we used data from COVIDOM, a population-based cohort study conducted as part of the NAPKON-POP platform. Data were collected in three different German regions (Kiel, Berlin, Würzburg). We analyzed data from >2000 individuals at least six months past a PCR-confirmed COVID-19 disease, using elastic net regression and cluster analysis. The regression model was developed in the Kiel data set, and externally validated using data sets from Berlin and Würzburg. ResultsOur results revealed that post-COVID depression and fatigue are associated with overlapping symptom constellations consisting of difficulties with daily activities, perceived health-related quality of life, chronic exhaustion, unrestful sleep, and impaired concentration. Confirming the overlap in symptom constellations, a follow-up cluster analysis could categorize individuals as scoring high or low on depression and fatigue but could not differentiate between both dimensions. LimitationsThe data presented are cross-sectional, consisting primarily of self-reported questionnaire or medical records rather than biometric data. ConclusionsIn summary, our results suggest a strong link between post-COVID depression and fatigue, highlighting the need for integrative treatment approaches.

Individual approach to metastatic colorectal cancer treatment (clinical cases)

Two patients with metastatic colorectal cancer underwent R0 large bowel resection followed by surgery liver and lungs metastases, retroperitoneal lymph nodes and post-op chemotherapy. The total follow-up period of the first patient was currently 12 years, the recurrence-free period was 5 years. In the second patient, stabilization of the disease was observed for 12 years, and the total follow-up period – 18.5 years. An integrated treatment approach to metastatic CRC with active surgery for removable distant metastases or perioperative use of the most effective drug therapy for potentially resectable metastases can control the disease even with an aggressive course.

Emotionally unstable personality disorder and anorexia nervosa – a dietetic approach and therapeutic progress

Objectives. This study aimed to comprehensively evaluate the impact of a multifaceted treatment approach, combining nutritional intervention, antipsychotic medication and psychotherapy, to the recovery of a female patient diagnosed with an eating disorder. The objective was to delineate how these integrated modalities contribute to improvements in both physical health and psychological well-being. Materials and method. A mixed-methods research design was employed. Quantitative data were gathered through weekly monitoring the patient’s body weight and weekly assessments of vital blood parameters, to objectively measure physical health progress. Qualitative data were collected using semi-structured interviews with the patient and her multidisciplinary healthcare team, including dietitians, psychologists and medical staff, providing insights into the psychological impact and patient’s experience of the treatment. Advanced data processing and visualization techniques were used, employing Microsoft Excel for the creation of comprehensive charts and graphs to analyze and present the data. Results. The results indicated a notable improvement in the patient’s overall health status, with significant gains in body weight and the stabilization of blood parameters. Psychologically, the patient demonstrated enhanced coping mechanisms and emotional well-being, as evidenced by her responses to RO-DBT and EMDR therapies. The nutritional intervention, tailored to her specific needs, along with the judicious use of antipsychotic medication played a key role in supporting her recovery. Conclusions. The study underscores the efficacy of an integrated treatment approach in managing eating disorders. The synergy between nutritional intervention, antipsychotic treatment and psychotherapy emerged as a crucial factor in addressing the complex interplay of physical and psychological aspects of the disorder. These findings contribute with valuable insights into the holistic management of eating disorders, highlighting the importance of personalized and comprehensive treatment strategies. This research adds to the existing body of knowledge, suggesting directions for future studies and clinical practices in the field of eating disorder treatment.

Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors

BackgroundVietnam conducted the national Noncommunicable Disease Risk-Factor Surveillance (STEPs) surveys in the years 2010, 2015, and 2021. This study aims to use STEPs data to assess the burden of comorbidity between diabetes and hypertension, analyze trends over time, and identify factors associated with this comorbidity.MethodsThe study extracted data for the population aged 25–64 years old from three STEPs surveys. Survey weight was used for all estimations of prevalence and 95% CI. Correlated factors with comorbidity were examined by a multivariate logistics model.ResultsThe prevalence of comorbidity in 2021 was about 3.92% among Vietnamese people aged 25–64. In the last 10 years, this prevalence has increased more than 8 times (from 0.44% to 3.92%). Sub-populations demonstrating the most significant changes included the male population, people living in urban areas, and older people. Significant factors correlated with comorbidity included demographic factors, body mass index (BMI), and clustering of 4 noncommunicable diseases (NCDs) behavioral risk factors (OR = 3.48, p < 0.05).ConclusionThe high comorbidity between hypertension and diabetes underscores the imperative for integrated treatment and management approaches in Vietnam. Coordinated care is essential for addressing the complex interplay between these two prevalent conditions.

Factors influencing TCM syndrome types of acute cerebral infarction: A binomial logistic regression analysis.

Acute cerebral infarction, characterized by a rapid onset and high fatality rate, presents a significant global challenge in terms of timely and effective treatment. In recent years, research focusing on the combined approach of traditional Chinese medicine (TCM) and Western medicine has demonstrated promising results in improving therapeutic outcomes in patients with acute cerebral infarction. This study adhered to the latest edition of Internal Medicine of Traditional Chinese Medicine, published by the China Press of Traditional Chinese Medicine, as a reference. It selects eight commonly encountered TCM syndrome differentiations for accurate diagnosis. This study included 151 patients admitted to the hospital between 2019 and 2022 with acute cerebral infarction. Data on various diagnostic indicators were meticulously collected and subjected to single-factor analysis. Among the multiple factors analyzed, those exhibiting a significance level of P < 0.05 included blood pressure, uric acid, glucose level, triglyceride level, total cholesterol level, homocysteine level, duration of disease, and cerebral infarction site. Subsequently, a binary logistic regression analysis was performed to assess the impact of these factors on different TCM syndrome types. The findings of this study indicate that Wind Phlegm Obstruction syndrome, triglyceride levels, location of cerebral infarction, uric acid levels, and disease duration significantly influence the development and progression of acute cerebral infarction. Additionally, blood pressure and cerebral infarction site were found to have a statistically significant impact on the Wind Yang Disturbance syndrome. Uric acid level and blood pressure were also identified as statistically significant factors. Moreover, total cholesterol and homocysteine levels were found to significantly affect phlegm stasis-blocking collateral syndrome. The insights gained from this study will contribute to the advancement of integrated treatment approaches, combining traditional Chinese and Western medicine, for acute cerebral infarction. Furthermore, these findings can serve as a valuable reference for the general population in terms of preventive measures against this condition.

Electron-ion-plasma surface modification of hypereutectic silumin

In this study, an integrated treatment approach was employed to modify hypereutectic silumin. This method involved electroexplosive alloying of the surface layer with yttrium oxide powder, followed by irradiation with a pulsed electron beam. The experimental data obtained demonstrate that this integrated treatment results in the formation of a submicron-nanocrystalline structure characterized by high-speed cellular crystallization of aluminum within the surface layer. This structure is composed of crystallization cells enriched with aluminum atoms, indicating the creation of a solid solution based on aluminum. The nanocrystalline layers, formed by silicon particles and yttrium oxide, are positioned at the cell boundaries. The study reveals that, as a consequence of integrated treatment with an electron beam energy density of 25 J/cm2 , the wear parameter of the modified samples increases by 7.9±0.6-fold, and the friction coefficient decreases by 1.7±0.15-fold compared to the initial state. Additionally, the microhardness of the modified silumin surface layer increases by 1.5±0.12-fold compared to the initial state. When the electron beam energy density is elevated to 35 J/cm2, the wear parameter of silumin is enhanced by 2.1±0.21-fold, while the friction coefficient increases by 1.13±0.1-fold. However, the microhardness decreases by 1.3±0.13-fold, while still surpassing the specified characteristics of untreated silumin. This investigation postulates that the substantial increase in the wear parameter during integrated treatment may be attributed to the presence of silicon inclusions in the surface layer that did not dissolve during the modification process. These inclusions are surrounded by the high-speed cellular crystallization structure mentioned earlier.

Behavioral psychology combined with Morita therapy for the treatment of anxiety disorder in library administrators

BackgroundAnxiety disorders are a common mental health problem, especially in highly stressful work environments, such as librarians, who need to cope with large amounts of information and the population. Librarians are important players responsible for organizing and managing library resources, and they face many challenges, including handling complex tasks, meeting user needs, and interacting with different individuals. Because of these professional characteristics, librarians may face persistent stress and anxiety.Subjects and MethodsLibrarians who met the study criteria were recruited from different libraries as study participants, and participants were randomized into the experimental group and the control group. The experimental group received behavioral psychology and Morita treatment intervention, while the control group received conventional treatment or waiting treatment. Finally, the effects of behavioral psychology and Morita treatment on anxiety levels were analyzed using the SPSS 23.0 software.ResultsThe analysis found that the incidence of anxiety disorders decreased by 45.87% after receiving the behavioral psychology intervention and Morita therapy intervention. 73.23% of the patients showed significant disease improvement. In the control group, only 22.36% of participants with anxiety disorders improved. It was 20.87% lower than the experimental group.ConclusionsDuring the treatment, the therapist works with the librarian to develop an individualized treatment plan and provide support and guidance. This integrated treatment approach can help librarians establish healthier mental states and coping mechanisms. Through cognitive reconstruction, exposure exercises, behavioral experiments and other methods, they can gradually face and deal with anxiety triggers and develop more positive and adaptive coping strategies.

Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.

Comorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18-35 years) residential substance use treatment service. A single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes. The study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.

An integrated treatment approach in patient with metastatic colorectal cancer and concomitant late cardiovascular complications of chemoradiotherapy for Hodgkin’s lymphoma. Clinical case

The high efficacy of the currently used combined chemoradiotherapy for Hodgkin’s lymphoma not only significantly increased overall survival, but also made it possible for most patients to achieve the same quality of life as in a healthy population. at the same time, the problem of identifying late treatment complications, in particular cardiovascular the high efficacy of the currently used combined chemoradiotherapy for Hodgkin’s lymphoma not only significantly increased overall survival, but also made it possible for most patients to achieve the same quality of life as in a healthy population. at the same time, the problem of identifying late treatment complications, in particular cardiovascular diseases, remains an urgent problem, the timely diagnosis of which is an important task. the development of a second malignant neoplasm and the appointment of drug antitumor therapy with cardiotoxic agents necessitate a multidisciplinary approach. In the presented clinical observation, such tactics of patient management made it possible not only to timely identify late cardiovascular complications of Hodgkin’s lymphoma chemoradiotherapy, but also to conduct treatment for the second malignant disease with cardiotoxic agents with a positive antitumor effect.

An integrated treatment approach including an obligatory component of psychological support to patients with tuberculosis in the anti-tuberculosis medical organizations of the Samara region

Aim to implement a comprehensive approach to treatment of patients with tuberculosis in anti-tuberculosis medical organizations.&#x0D; Material and methods. Fifty-two patients and fourteen employees took part in the study. For psychodiagnostics, we used the "TOBOL" questionnaire, the diagnostics of professional "burnout" by K. Maslach, S. Jackson, the Wheel of Life concept by Paul J. Meyer. The data was analyzed using Mann Whitney U-test, Wilcoxon signed rank test.&#x0D; Results. The older patients had a tendency for excessive vigilance and aggressiveness in their attitude to the disease. The harmonious and anosognostic types of attitude to the disease were prevalent in patients with permanent employment. The medical workers demonstrated a high level of emotional burnout. The training aimed at prevention of burnout was the part of the study. After the training, the registered values of emotional exhaustion were reduced by 7 points, the depersonalization score shifted from high to average, the reduction of personal achievements score raised by 5 points.&#x0D; Conclusion. The age and social status can influence the type of attitude towards tuberculosis. Patients under 40 years of age with permanent employment have a more favorable prognosis of adherence to treatment and persistent clinical cure of tuberculosis. The introduction of an integrated approach to the provision of medical care with the mandatory presence of psychological support is relevant and necessary. This study substantiates the expediency of creating a psychological assistance office in a medical organization.

Integrative therapy of postpartum endometritis in first-calf heifers in the conditions of a biogeochemical province

The research was carried out at the Sarafanovo farm, in Chebarkul district, Chelyabinsk region. We established that postpartum endometritis in first-calf heifers is widespread in biogeochemical provinces that contain an excess of nickel and iron. This pathology demonstrates distinct violations of organism’s functional state, accompanied by changes of blood values, a decrease in nonspecific defenses and an increase in peroxidation processes. The on-farm treatment routine makes a certain therapeutic effect, but does not fully ensure the restoration of the body systems, especially the regulation of mineral metabolism. It has been shown that the additional inclusion of Phosprenyl, Gabivit-Sе and Vitartil, which stimulate organism’s defenses, into the on-farm treatment routine contributes to faster restoration of metabolic processes and leads to recovery of animals. Normalization of indicators of nonspecific defenses was detected both on the 7th and 14th days of treatment. An integrated treatment approach due to introducing of the studied medications into the traditional routine helps to reduce the time of treatment of endometritis in first-calf heifers (by 3-4 days), and their milk production increases. The daily milk yield in the experimental group of cows was 18,6±0,29 kg, in the control group – 15,3±0,33. Therefore, the Phosprenyl, Gabivit-Sе and Vitartil should be included in the basic routine of on-farm treatment of endometritis.

Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature.

Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10-24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed.