Life Activity In Patients Research Articles

Reduction in life activities after hospitalization for COVID-19 in intensive care units

Objective: To verify the factors associated with reduction in life activities in patients 12 months after discharge from the COVID-19 ICU. Methods: This is a cross-sectional, analytical study with a quantitative approach, based on primary data from patients at the Hospital Universitário Regional dos Campos Gerais, Paraná, Brazil. The final sample consisted of 32 patients discharged from the ICU between March 2020 and March 2021. Results: There was statistical evidence of a difference between the means of the groups in the domains Life Activities (p= 0.0001) and Disability (p< 0.0001), confirming that the disabled group has a worse indicator of disability in this domain; as also occurs between the geometric means of the groups. Conclusion: The most prevalent factors associated with reduction in life activities were those involving the physical and psychological domains, directly influencing their recovery. In addition, future research could focus on specific intervention strategies to minimize the impact of these sequelae and improve rehabilitation in COVID-19 patients.

Determination of Pain Severity and Affected Life Activities of Individuals with Chronic Pain during the COVID-19 Pandemic Period

Background/Aims:: The pandemic period can have negative effects on chronic pain. It is possible that these effects may affect life activities together with pain. The study was conducted to determine the change in pain intensity of individuals with chronic pain during the COVID-19 pandemic and the affected activities of daily living. Methods: This descriptive study was conducted with 204 individuals with chronic pain. Data were collected with an Introductory Information Form, a questionnaire about life activities, and a Numerical Rating Scale. Data were analyzed with descriptive statistics, Pearson χ2 and Mann-Whitney-U test. Results: During the pandemic period, it was found that all patients with and without COVID-19 increased the severity of pain. Considering the change in life activities, patients who had COVID 19 during the pandemic period compared to those who did not; It was determined that they had problems in the parenting role, fulfilling their religious beliefs, gaining weight, hygiene activities, dressing-undressing, continuing to work and sexual desires/desires. It was determined that the pandemic period negatively affected the pain intensity of the patients. In addition, it was determined that having COVID 19 damaged many life activities of patients. Conclusions: Considering that the duration of the pandemic is three years, it is thought that this process and being COVID 19 may have long-term effects on the pain levels and life activities of the patients.

Genome-wide CNV analysis uncovers novel pathogenic regions in cohort of five multiplex families with neurodevelopmental disorders

Structural reorganization of chromosomes by genomic duplications and/or deletions are known as copy number variations (CNVs). Pathogenic and disease susceptible CNVs alter gene dosage and its phenotypic expression that often leads to human genetic diseases including Neurological disorders. CNVs affecting same common genes in multiple neurodevelopmental disorders can better explain the shared clinical and genetic aetiology across brain diseases. Our study presents the novel copy number variations in a cohort of five multiplex consanguineous families with intellectual disability, microcephaly, ASD, epilepsy, and neurological syndromic features. Cytoscan HD microarray suite has revealed genome wide deletions, duplications and LOH regions which are co-segregating in the family members for the rare neurodevelopmental syndromic phenotypes. This study identifies 1q21.1 microduplication, 16p11.2 microduplication, Xp11.22 microduplication, 4p12 microdeletion and Xq21.1 microdeletion that significantly contribute to primary disease onset and its progression for the first time in Pakistani families. Our study has potential impact on the understanding of pathogenic genetic predisposition for appearance of complex and heterogeneous neurodevelopmental disorders with otherwise unexplained syndromic features. Identification of altered gene dosage across the genome is helpful in improved diagnosis, better disease management in day-to-day life activities of patients with cognitive impairment and genetic counselling of families where consanguinity is a tradition. Our study will contribute to expand the knowledge of genotype-phenotype expression and future gateways in therapeutics and precision medicine research will be open in Pakistan.

Визначення стану базових активностей повсякденного життя у пацієнтів з морбідним ожирінням як аспект ефективності програми фізичної терапії

The main reasons for the restriction of activities of daily life in individuals with morbid obesity are limited mobility due to deterioration in flexibility and strength, deterioration in balance, and concomitant pathology of the musculoskeletal system. The data available in the current literature predominantly highlight disorders of activities of daily life in obese elderly people. At the same time, there are almost no studies highlighting the limitations of activities of daily life in morbid obesity, as well as the gender characteristics of these limitations. The purpose of the study was to determine the nature of daily life activity disturbances in men and women with morbid obesity and the effectiveness of their correction by means of physical therapy against the background of different levels of therapeutic alliance. Materials and methods. 74 adults of the second adult age (39.6 ± 1.4 years) were examined with a morbid obesity established by body mass index (more than 40) (43 women and 21 men). According to the results of determining the therapeutic alliance, they were divided into two groups. The comparison group consisted of individuals with a low level of therapeutic alliance who refused to actively participate in the program of weight loss. The main group consisted of patients with a high level of therapeutic alliance, they underwent a correction program using dietary and lifestyle modifications, therapeutic exercises, massage, acupuncture, psychocorrection lasting one year. The main principle of the program was an individual approach taking into account the physical capabilities, comorbidities, psycho-emotional state of the patient with constant monitoring of body functions against the background of maintaining a high level of therapeutic alliance. The performance of daily life activities was characterized by the dynamics of the Barthel index parameters. Results and discussion. In patients with morbid obesity, a deterioration in the performance of daily life activities (according to the Barthel index) was revealed. The use of kinesitherapy against the background of a decrease in body weight as a part of a physical therapy program allowed the patients to restore their independence when performing activities of daily life (according to the Barthel index). The low level of therapeutic alliance led to poor implementation or non-implementation of the recommendations provided (aimed at reducing body weight, increasing physical activity), which was associated with a lack of improvement in the performance of daily life activities. Conclusion. As a result of one-year implementation of the developed program of physical therapy, a statistically significant (p<0.05) improvement in the studied indicators of daily life activities in patients with morbid obesity and restoration of functional independence in this indicator was determined compared to the initial result

Regional features of the epidemiology of pterygium in the Republic of Bashkortostan

Background. Pterygium is ubiquitous and multifactorial; today, information on the prevalence of pterygium, risk factors, the relationship of its development with concomitant pathology and the type of life activity of patients in various regions of Russia is limited. All of the above led to the conduct of this epidemiological study in the Republic of Bashkortostan.The aim of the study: to study the prevalence of pterygium, as well as to identify the relationship of risk factors for its development with the type of life activity and concomitant diseases in the urban and rural population of the Republic of Bashkortostan.Methods. On the basis of the Ufa Research Institute of Eye Diseases, within the framework of the Ural Eye and Medical Study (UEMS) research project, a population study of people living in urban and rural regions of the Republic of Bashkortostan was carried out. The study involved 5899 people, including men – 43.7 % (2585 people), women – 56.3 % (3314 people), urban residents made 42.3 % (2491 people), rural – 57.7 % (3408 people).Results. As a result of our study, pterygium was diagnosed in 138 people (204 eyes – 2.3 %) (95% CI: 2.0–2.7 %). One-way analysis showed a higher prevalence of pterygium associated (p˂0.10) with a number of systemic and ophthalmic parameters. However, according to the results of multivariate analysis, it was revealed that the prevalence of pterygium was significantly associated with older age (p = 0.006), rural area of residence (p = 0.001) and low educational level (p = 0.03).Conclusion. The prevalence of pterygium in Republic of Bashkortostan according to the UEMS study was 2.3 %, or 23 people per 1000 population among people over 40 years old. The nature of the settlement influences the prevalence of pterygium in the Republic of Bashkortostan. Pterygium was more common among older people among all respondents who took part in the study. In the study, pterygium was not a biomarker of general somatic diseases.

Effects of Orem's Self-Care Model of Nursing on Hand Symptoms and Life Activities in Geriatric Individuals Diagnosed with Rheumatoid Arthritis: A Pilot Study.

According to Orem's self-care deficit theory, when patients cannot meet their care needs, they need nursing systems for maintaining their health. Nursing care for elderly patients with rheumatoid arthritis (RA) should be based on maintaining self-care. This study aims to determine the effects of Orem's self-care model of nursing care given to geriatric patients with RA on hand symptoms, life activities, and hand pain. The study sample comprised a total of 22 patients (intervention group, 11; control group, 11) who met the sample selection criteria at a rheumatology outpatient clinic of a university hospital between June 17, 2019 and September 20, 2019. All interviews with patients in the intervention group were conducted by daily phone calls and a face-to-face interview at the hospital every 4 weeks. Patients continued to receive routine prescription by a physician during the course of application. No difference was observed between the groups in terms of descriptive patient characteristics (p > .05). Hand pain, hand symptoms, and life activities of patients in the intervention group were measured at study initiation, week 4, and week 8. Intragroup comparison revealed that hand pain, hand symptoms, and life activity scores were lowest at week 8 in the intervention group (p < .05). This study indicates that nursing care given according to Orem's self-care model is effective in reducing pain, improving hand functions, and performing life activities.

Comparison of Activity-Based Home Program and Cawthorne-Cooksey Exercises in Patients With Chronic Unilateral Peripheral Vestibular Disorders

ObjectiveThis study aimed to investigate the effects of an activity-based home program and an exercise-based home program on dizziness severity, balance, and independent level of daily life activities in patients with dizziness due to chronic unilateral peripheral vestibular disorders. DesignA single-blind randomized controlled trial. SettingUniversity dizziness management clinics. ParticipantsIndividuals (N=75) between 18 and 65 years of age who had chronic unilateral peripheric vestibular disorders and vestibular rehabilitation indication. InterventionParticipants were randomly divided into 3 groups: an activity-based home program (group 1/activity group), an exercise-based home program (group 2/exercise group), and a control group (group 3). After an initial assessment, all groups participated in the patient education program. In addition, the activity-based home program was administered to the first group, while the Cawthorne-Cooksey home exercise program was administered to the second group. Main Outcome MeasuresVisual analog scale (VAS), Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography before and immediately after the treatment program. ResultsA statistically significant improvement was found in the activity and exercise groups in terms of VAS, VADL, Sensory Organization Test (SOT) 5, SOT 6, and SOT (composite) scores compared with the control group (P<.05). A statistically significant improvement was found in the activity group in terms of the instrumental subscale of VADL, SOT 5, SOT 6, and SOT (composite) scores compared with the exercise group. ConclusionsThe activity-based home program was more effective in improving the home management task, the occupational task, and balance than the exercise-based home treatment program in patients with chronic peripheral vestibular disorders.

Daily life activities in patients with Alzheimer’s disease or semantic dementia: Multitasking assessment

The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.

Randomized Controlled Trial of Multi-Component Cognitive Stimulation Therapy (SADEM) in Community-Dwelling Demented Adults.

Dementia is a persistent, progressive state of cognitive decline against which pharmacological intervention has a modest efficacy, reducing behavioral but not cognitive symptoms. Therefore, different non-pharmacological therapies have been developed; the most scientifically recognized are cognitive therapies that have improved cognitive function and daily life activities. To evaluate the effectiveness of a multicomponent cognitive stimulation therapy (SADEM) on cognitive and behavioral function and daily life activities in patients with mild stage dementia. Controlled clinical trial with pre- and post-intervention (12 months) and follow-up (24 months after) evaluations. Participants (67) diagnosed with mild dementia were randomly assigned to intervention group (n = 39) or control group (n = 28). The intervention took place throughout one year and consisted of two weekly 90-minute sessions and one more a year after a monthly follow-up. Instruments were used to evaluate outcomes in cognitive, behavioral, and affective domains. The results showed statistically significant differences, with improvement in the cognitive outcomes and the Dementia Index post-intervention (p = 0.01). No progression of the disease was observed at the end of the study. The multicomponent intervention tested had positive effects on cognitive and behavioral functions and daily life activities in people with mild stage dementia, delaying progression for at least two years.

The effect of peripheral neuropathy on daily life activities in patients receiving chemotherapy

Objective: The aim of this study is to determine the relationship between pain and pain related factors associated with peripheral neuropathy and daily life activities in patients receiving chemotherapy.Methods: The study used a descriptive and cross-sectional design to examine 80 patients who came to the outpatient chemotherapy unit of two university hospitals to receive chemotherapy drugs such as taxane, platinum analogs and vinca alkaloids. The data were collected by using face-to-face interview method through “General Information Form”, “S-LANSS Pain Scale” that is a bedside test for distinctive diagnosis of neuropathic pain and “Health Assessment Questionnaire (HAQ)” which is a scale prepared by the researcher and measures daily activities to evaluate physical disability.Results: In the group with neuropathic pain, HAQ scores (p = .003; p &lt; .01) and S-LANSS scores (p = .005; p &lt; .01) of the patients who did not have hand-foot complaints prior to the treatment but experienced hand-foot discomfort with the beginning of chemotherapy treatment, were found to be statistically significantly higher. There was a statistically significant positive relation between HAQ score and S-LANSS pain score at the level of 61.2% (r = 0.612; p = .001; p &lt; .01).Conclusions: It was concluded that the symptoms of Chemotherapy-Induced Peripheral Neuropathy (CIPN) and related pain and pain-related factors negatively affect the level of doing daily life activities.

From Surviving to Thriving: Older Adults Adapting and Coping after Hematopoietic Cell Transplant

Topic Significance & Study Purpose/Background/Rationale Due to advances in treatment regimens and supportive care, there are a growing number of older adults with hematologic malignancies undergoing hematopoietic cell transplant (HCT). While these advances have improved overall survival for this population, patients continue to experience rapid decline in physical, emotional, social, and role functioning post-HCT. Nursing interventions can assist with returning to life activities, an important goal for older patients. Current literature on adaptation and coping post-HCT has focused on younger survivors. The purpose of this qualitative descriptive study is to describe the experience of returning to life activities in patients 60 years of age and older who were more than three months post-HCT. Of particular interest was how coping resources and strategies help older patients adapt and cope to limitations in physical, psychological, and cognitive limitations. Methods, Intervention, & Analysis Twenty English speaking adults 60 years and older with hematological malignancy 3 to 12 months post-HCT completed semi-structured interviews. Open-ended questions and probes were guided by the Transactional Model of Stress and Coping to explore adaptive functioning, coping resources, and coping strategies. An integrated grounded theory approach was used to code the textual data to identify themes. Saturation was reached when the interview generated no new substantial information. Findings & Interpretation Eight allogeneic and twelve autologous HCT recipients participated in the interviews. Three main themes emerged from the interviews. Adaptive functioning: all participants described adapting to physical and psychological changes. Coping resources: family (95%) and the healthcare team (80%) helped participants overcome physical, psychological, and cognitive limitations. Coping strategies: participants reported using emotion-focused, problem-focused, and meaning-based coping strategies. Overall, engaging in life activities and social support were significant in the recovery of physical, psychological and cognitive function. Discussion & Implications Older HCT recipients are an understudied population at high risk for functional decline. Patient-centered information on how HCT treatment influences cognitive function, functional outcomes, and quality of life will have broad implications for patient education and development of interventions for HCT patients. The next phase of this study will use these findings to guide development of health promoting interventions that nurses and the healthcare team can implement to help HCT recipients return to life activities.

Therapeutic effect of acupoint injection and rehabilitation training program on upper limb function and daily life activities of patients with shoulder-hand syndrome after cerebral hemorrhage

Objective To investigate the effect of acupuncture point injection and rehabilitation on the functional recovery of upper limbs and daily living ability of shoulder-hard syndrom (SHS) after cerebral hemorrhage. Methods A total of 96 patients SHS after cerebral hemorrhage were divided into the observation group (n=56) and the control group (n=40). Both groups recieved the routine treatment for cerebral hemorrhage and rehabilitation technique training. Besides, the control group was treated with intermediate frequency physiotherapy, and the observation group was treated with electroacupuncture and acupoint injection of Salvia miltiorrhiza and ligustrazine. After 1 months of treatment, the the upper limb movement function, daily living ability (ADL), shoulder joint pain, joint activity degree, and the degree of joint swelling were evaluated and compared. Results After treatment, the FMA (60.1 ± 6.4 vs. 41.8 ± 18.7, t=6.799), MBI (65.2 ± 3.5 vs. 50.6 ± 2.1, t=23.512) scores of the observation group were significantly higher than those of the control group. The VAS (2.7 ± 1.4 vs. 4.9 ± 1.3, t=7.817), edema volume (2.1 ± 2.1 cm3vs. 2.1 ± 2.1 cm3, t=7.316) of the observation group were significantly lower than those of the control group ( P<0.01). The anterior flexion (163.1 ± 6.7°vs. 56 ± 10.9°, t=59.516), extension (39.6 ± 5.8°vs. 23.2 ± 6.7°, t=12.799), abduction (168.1 ± 9.6°vs. 52.1 ± 8.9°, t=60.148), adduction (52.1 ± 3.6° vs. 29.8 ± 4.3°, t=27.580), external rotation (49.8 ± 7.6°vs. 23.2 ± 5.2°, t=19.151), internal rotation (107.0 ± 8.5°vs. 60.2 ± 6.1°, t=29.758) of the observation group were significantly higher than those of the control group (P<0.01). The total effective rate of the observation group was 91.1% (52/56) and the control group was 70% (28/40), and the difference between the 2 groups was statistically significant (χ2=7.209, P<0.01). Conclusions Acupuncture combined with acupoint injection and rehabilitation technology can relieve pain, eliminate edema and improve motor function and daily living ability of SHS patients after intracerebral hemorrhage. Key words: Cerebral Hemorrhage; Shoulder-hard syndrome; Electroacupuncture; Injections,acupoint; Activities of daily living

The effect of obesity on functional capacity, anxiety and daily life activities in patients with coronary artery disease and phase II cardiac rehabilitation

Objective. The aim of our study was to investigate the effect of cardiac rehabilitation (CR) program on obese and non-obese patients with coronary artery disease. Methods. The records of 60 coronary artery disease patients aged between 18-75 years, who were included in CR were evaluated. Of the study subjects, 20 had undergone coronary artery bypass grafting (CABG) and 40 had undergone percutaneous coronary intervention (PCI). The patients were divided into two groups by body mass index (BMI), with Group I being non-obese (BMI < 30 kg/m 2 ) and Group 2 being obese (BMI ≥ 30 kg/m 2 ). The effect of 30 session CR on the two groups were evaluated with 6-min walk test (6MWT), Short Form-36 (SF-36) and Beck Anxiety Inventory (BAI). Results. Baseline characteristics of the group 1 (39 patients) and group 2 (21 patients) were similar. Statistically significant improvement was detected in group 1 and group 2 patients by CR program in 6MWT, BAI and SF-36 parameters ( p < 0.05). 6MWT, BAI and SF-36 parameters changes by cardiac rehabilitation were compared between the two groups. According to the comparison 6MWT (group 1; 60 (20-183) vs group 2; 34 (15-180), p = 0.012) and MET (group 1; 1.44 ± 0.56 vs group 2; 1.09 ± 0.41, p = 0.015 changes were significantly higher in group 1 than in group 2. However, the changes of BAI and SF-36 parameters were similar in two groups ( p > 0.05). Conclusion. CR was found to be effective and safe in terms of functional capacity, daily life activities and anxiety in both obese and non-obese patients. Functional capacity gain in the obese group was less than non-obese patients.

МЕДСЕСТРИНСЬКА ОЦІНКА ЯКОСТІ ЖИТТЯ ХВОРИХ НА БРОНХІАЛЬНУ ОБСТРУКЦІЮ РІЗНОГО ГЕНЕЗУ

Хронічне обструктивне захворювання легень (ХОЗЛ) належить до прогресуючих захворювань суспільства і є провідною причиною смертності населення у багатьох економічно розвинених країнах світу, що становить значиму медичну і соціальну проблему, не обминає стороною жоден прошарок суспільства. Сучасні методи діагностики ХОЗЛ та арсенал лікарських засобів не завжди досягають стійких ремісій, що погіршує якість життя хворих, тому пошук доступних, дешевих методів реабілітації пацієнтів є актуальним.Мета дослідження – медсестринське дослідження та оцінка якості життя хворих на бронхіальну обструкцію різного генезу до та після навчальних програм, а також розробка рекомендацій щодо удосконалення догляду і профілактики хвороби при даній патології в умовах Тернопільського обласного протитуберкульозного диспансеру (ТОПТД) та навчання хворих правилам якісного життя.Матеріали і методи. Дослідження складалося з 3 етапів. Перший етап – аналіз історій хвороб пацієнтів із ХОЗЛ та туберкульозом легень (ТБЛ), які мали бронхообструктивний синдром (БОС) та їх анкетування. Другий етап – на основі отриманих даних адаптування та застосування уже відомих навчальних програм до специфіки ТОПТД для пацієнтів із специфічними та неспецифічними ураженнями легень. Третій етап – оцінка якості життя у хворих до та після навчально-реабілітаційного процесу. Ретроспективно проведено аналіз 60-ти історій хвороб пацієнтів із легеневою бронхообструкцією в період за 2015– 2016 рр., з них – 30 хворі на ХОЗЛ, інші 30 – на ТБЛ.Результати досліджень та їх обговорення. У процесі комплексного лікування, навчання і реабілітації хворих із БОС різного генезу, поряд з оцінкою тяжкості клінічного перебігу захворювання, дослідженням вентиляційної функції легень варто визначати рівень якості життя пацієнтів. У пацієнтів із бронхообструкцією відзначається значне погіршення якості життя, яке виявляється у зниженні повсякденної життєвої активності пацієнтів і зумовлене впливом симптомів захворювання на фізичну, психічну й емоційну сфери пацієнтів. При ранньому включенні у комплексне лікування індивідуальних програм тривалої фізичної реабілітації і психокорекції можна досягти тривалого поліпшення якості життя хворих та істотно змінити психоемоційний статус пацієнтів, зменшуючи рівень депресії і тривоги.Висновки. Оптимальною формою реабілітації стаціонарних хворих на ХОЗЛ та ТБЛ, поліпшення якості життя пацієнтів є активна навчальна робота з пацієнтами, яка повинна включати програми групового й індивідуального навчання їх, боротьбу з тютюнокурінням, корекцію порушень психологічного стану та фізичні реабілітаційні заходи, а також підвищення толерантності до фізичного навантаження у хворих із БОС.

Arthroscopic Treatment of Focal Osteochondral Lesions of the First Metatarsophalangeal Joint

Background:This study aimed to assess the arthroscopic treatment, one of the surgical treatment options, for early grade focal osteochondral lesions of the first MTP joint, and to determine the impact of the arthroscopic microdrill hole surgery on foot function and daily life in a patient group with failed conservative treatment.Materials-Methods:This prospective study reviewed 27 patients having hallux rigidus with osteochondral injury of the first MTP joint who were operated with first MTP joint arthroscopy. Six patients had Coughlin-Shurnas grade 4 hallux rigidus and were excluded from the study; 5 patients were excluded due to having an arthroscopic kissing lesion, and 3 patients were excluded for not having attended regular follow-up after third month. After excluding the above patients, the study was completed with 14 patientsResults:The mean hallux vagus angle was 13.29⁰ (±1.93 SD) and the mean intermetatarsal angle was 9.14⁰ (±0.86 SD). Apart from joint arthroscopy, no soft tissue procedure and/or any procedure requiring osteotomy was intended in any patient. The median operative duration was 27.8 (19-56) minutes.The patients had mean preoperative VPS and AOFAS-Hallux scores of 8.14±0.86 SD and 48.64±4.27, respectively; the corresponding postoperative values of both scores were 1.86±0.66 SD and 87.00±3.70. Both VPS and AOFAS-Hallux scores changed significantly (p<0.01)Discussion:In this prospective study we explored the impact of arthroscopic microdrill hole surgery on foot functions and daily life activities in patients with focal osteochondral lesions of the first MTP joint. Our results indicated significant improvements in VAS and AOFAS scores with this treatment. The micro drill technique we applied in this study is based on the principle of opening 4-6-mm long tunnels to enable stem cells to migrate to the defected area and achieve cure by differentiation in full-thickness chondral injuries with exposed subchondral bone.In conclusion, arthroscopic microhole drill technique can be applied with impressive functional scores and without any complication in persons who failed conservative therapy for hallux rigidus with focal chordal injury, a common foot problem. There is a need for comparative studies with long follow-up period in this field.

Implementation of mobile diary app into clinical practice of gestational diabetes treatment

Introduction. The key element of successful treatment of gestational diabetes mellitus (GDM) is a well-organized diet and physical activity plan for the patient. In order to better monitor everyday life activity of patients and get more well-formed information on the process of treatment, a mobile application with electronic diary was given to patients at Almazov Federal North-West Medical Research Centre.The aim of the study is to assess the beneficial action of mHealth app diary usage in clinical practice of gestational diabetes treatment.Materials and methods. Android application diaCompanion was developed and given to a group of patients with detected GDM, who used it to keep records of food intake, blood glucose measurements, insulin injections, physical activity, sleep and ketones. These records were formed into unified electronic diaries and sent remotely to attending physicians. The developed diary app contained necessary functionality for disease management, including embedded food database with micronutrient and macronutrient parameters for more than 2000 local food items, record analysis and editing, database management, automated data retrieval and forwarding to attending physician.Results. By the end of May 2016, 85 patients were included in the study with 39 of them already ended the course. A total of 11020 measurements of blood glucose, and 11747 meals recorded by patients into the application were analyzed. The average number of recorded days per patient was 49 (a minimum of 2 and a maximum of 128 days). The average glucose levels were 4.9 + 0.7 mmol/L at fasting state, 6.3 ± 1.1 mmol/L-1 hours after breakfast, 6.2 ± 0.8 mmol/L after lunch, and 6.2 ± 0.9 mmol/L after dinner. In the analysis of food diaries the average daily energy intake was 1125 ± 405 kcal and the daily consumptions of carbs, proteins and fats were 104±42 g, 66±25 g and 60±22 g respectively. These figures are well below the recommended dietary allowance for pregnant women, may be due to underreporting by patients.Conclusion. Although the study is being in progress, the general impact of app usage revealed a high convenience of this practice from the physician’s perspective. Current approach made it possible to preserve and organize the data, which might otherwise be lost or not collected. This data may be used in medical studies, carried out on patients with GDM.

Spinal Cord Independence Measure (SCIM-III). Preparation of the Russian-language version

There was accomplished the procedure of linguistic and cultural adaptation of a questionnaire Spinal Cord Independence Measure (SCIM-III) specifically designed for the assessment of disorders of life activity in patients with traumatic disease of the spinal cord. In the work there are presented: the Russian-language version of the questionnaire, instructions on features of the filling and evaluation of results.

Increased C-Reactive Protein and Weight Loss are Associated with The Inability to Switch from Tube Feeding to Oral Intake in Patients with Cerebrovascular Disease

Background: Appropriate nutrition management is required for elderly patients with cerebrovascular disease. These patients can present with no oral intake at admission, although several patients subsequently switch to oral intake during hospitalization. Therefore, we aimed to investigate the factors associated with patients who require the continuation of tube feeding. Methods: We retrospectively examined clinical factors at admission and discharge of two groups of patients with cerebrovascular disease who attended a convalescent rehabilitation ward: the switching group (n=17), who switched from no oral intake at admission to oral intake at discharge, and the continuation group (n=47), who continued tube feeding until discharge. This study design is retrospective cohort study. Results: A comparison of the two groups revealed that continuation of tube feeding was associated with a greater loss of body weight between admission and discharge (−3.8±4.0 kg in the continuation group vs. −1.5±2.0 kg in the switching group), and an increase in the C-reactive protein level, compared with a decrease in the switching group (2.2±6.9 mg/dL in the continuation group vs. −2.2±4.3 mg/dL in the switching group). These results suggest that to maintain and improve physical function, cognitive function, and daily life activities in patients with cerebrovascular disease with no oral intake, weight loss and inflammatory disease onset should be assessed. Conclusion: We believe that a comprehensive approach to oral intake should be used for patients with cerebrovascular disease.

Daily life activity in patients with left ventricular assist devices.

Exercise capacity is usually evaluated by peak oxygen consumption (peak-VO2). However, assessment of peak-VO2 in patients with a left ventricular assist device (LVAD) might not be the best method to provide insight into their daily life activity. The aim of this study was to assess the postoperative activity of LVAD patients using actigraphy and to compare these patients to a healthy and a heart-transplanted (HTx) population. Activity was continuously monitored using wrist-accelerometers in LVAD patients after implantation, during 4 weeks of rehabilitation following hospital discharge, and at 2 follow-up assessments. Peak-VO2 values measured during rehabilitation were correlated with activity. Additionally, actigraphy data from LVAD recipients were compared with data measured in healthy and HTx subjects. After hospital discharge a significant increase in physical activity of LVAD recipients was observed (55 ± 28 vs. 102 ± 23 Activity Scores, n = 11, p = 0.002). During rehabilitation as well as at the follow-ups (140 ± 43 and 253 ± 33 days post-implantation) no significant increase in activity was observed. Peak-VO2 values correlated to daily activity both in LVAD and HTx patients (r &gt; 0.5). Average daily activity was significantly lower in LVAD and HTx patients than in the healthy population (130 ± 30 and 148 ± 60 vs. 245 ± 63 Activity Score; n = 18 in each group, p &lt; 0.001). Activity in LVAD recipients increased substantially after hospital discharge with no further significant improvement observed during a period of 8.5 months. Similarly to the peak-VO2, also the daily activity of LVAD recipients was 53% compared to healthy subjects. These results highlight the need for an optimized physical therapy in this patient cohort.

Diastolic dysfunction reduces stroke volume during daily's life activities in patients with severe aortic stenosis

aortic flow, pulsed Doppler of LV outflow tract and brachial blood pressure were recorded; mean aortic gradient, SVi and aortic valve area by continuous equation were obtained both at rest and during Valsalva maneuver. SVi percent changes (Delta SVi %) were calculated in each patient. Differences between baseline and Valsalva maneuver were tested by paired t-test, whereas differences in patients with and without dyspnea were determined by t-test for unpaired data.