Pathology Of Locomotor System Research Articles

“Minimal Brain Dysfunction” (MBD) Influence on the Development of the Feet, Knees, Hips, Pelvis and Spine, Causes, Clinic, Therapy

In pathology of locomotor system, there are many causes but Minimal Brain Dysfunction (MBD) appears very frequently [1-3,6,7,20,24,25,31]. Between patients examined in years 1995 – 2023 this group counted 18 % – 20 % of cases. Mostly children with deformities of feet, knees, hips, pelvis and spine. Important is early therapy - than will be received “healthy status” of movement apparatus in adults.

Syndrome of Contractures and Deformities (SofCD): Dysplasia of Hips, Varus Deformity of Shanks, Wry Neck, So-Called Idiopathic Scoliosis Causes Clinic Prophylaxis Therapy

In the article we present one of two main etiopathological groups of pathology of locomotor system. The health of the adults very often depends on the effectiveness of prophylaxis and proper treatment of disorders in the childhood. The treatment of children often can be easy and give good results, what is important for all years of life of everybody. In our experience, the abnormalities described in article are very frequent, due to various reasons. In the article we present one of the causes of pathology.

Orthopedic morbidity and organization of specialized care for children in Saint Petersburg

Demographic indices, structure and dynamics of orthopaedic morbidity in children and adolescents of St. Petersburg are presented. During 10 years (from 1991) total number and the number of primary visits in connection with osseous-muscular diseases increased 2,5-3 times. In children the rate of orthopaedic pathology among total morbidity increased from 0.7 to 2.1% and in adolescents from 8,2 to 16%o. The problems of organization of specilaized outpatient care as well as hospital and rehabilitation care for the children with loco-motor system pathology were considered.

Стан опорно-рухового апарату у хворих на цукровий діабет

В огляді літератури висвітлено сучасні аспекти патології опорно-рухового апарату у хворих на цукровий діабет 1-го та 2-го типу, а саме патофізіологічні механізми розвитку ушкоджень кісткової тканини під впливом гіперглікемії, оцінено ризики виникнення патологічних переломів у хворих на цукровий діабет за даними світової наукової літератури.

Design and Validation of a Computer Application for Diagnosis of Shoulder Locomotor System Pathology.

ObjectivesTo design and validate a computer application for the diagnosis of shoulder locomotor system pathology.MethodsThe first phase involved the construction of the application using the Delphi method. In the second phase, the application was validated with a sample of 250 patients with shoulder pathology. Validity was measured for each diagnostic group using sensitivity, specificity, and positive and negative likelihood ratio (LR(+) and LR(−)). The correct classification ratio (CCR) for each patient and the factors related to worse classification were calculated using multivariate binary logistic regression (odds ratio, 95% confidence interval).ResultsThe mean time to complete the application was 15 ± 7 minutes. The validity values were the following: LR(+) 7.8 and LR(−) 0.1 for cervical radiculopathy, LR(+) 4.1 and LR(−) 0.4 for glenohumeral arthrosis, LR(+) 15.5 and LR(−) 0.2 for glenohumeral instability, LR(+) 17.2 and LR(−) 0.2 for massive rotator cuff tear, LR(+) 6.2 and LR(−) 0.2 for capsular syndrome, LR(+) 4.0 and LR(−) 0.3 for subacromial impingement/rotator cuff tendinopathy, and LR(+) 2.5 and LR(−) 0.6 for acromioclavicular arthropathy. A total of 70% of the patients had a CCR greater than 85%. Factors that negatively affected accuracy were massive rotator cuff tear, acromioclavicular arthropathy, age over 55 years, and high pain intensity (p < 0.05).ConclusionsThe developed application achieved an acceptable validity for most pathologies. Because the tool had a limited capacity to identify the full clinical picture in the same patient, improvements and new studies applied to other groups of patients are required.

New opportunities to correct equvinus foot deformity in orthopedic-traumatological practice

Aim. To prove the efficiency of using a new variant of leg tutor for correction of locomotor system pathology in treatment of equvinus foot deformity.&#x0D; Materials and methods. A mean age of 23 patients with hemiparesis and equvinus foot deformity was 42.5 years. Tonus and strength of legs was assessed. Angulometric and stabilometric studies were realized.&#x0D; Results. The developed model of leg tutor was used. To eliminate equvinus foot deformity, hyperextension of the knee joint was gradually eliminated using individual choice of the heel form and height, thus strengthening a quadriceps muscle of the thigh. The knee joint stability increased, the intensity of pain syndrome reduced. Arthropathies and deformities of the knee joint were prevented. Innovation of the developed model is the following: a soft glue-based responsive side of textile band “Contact” “Velcro” was stably fixed to the outside surface of posterior third of the plantar part of tutor sleeve. To the responsive side of a textile band, there were fixed removable heel pads (heels from microporous rubber of different height (from 5 to 25 mm) with a responsive hard (with hooks) part of textile band “Contact” “Velcro”). Tutor provided the ability to move and guaranteed stable holding of the extremity segments in the posterior position. There was observed a positive dynamics of changes in the muscular tonus of paralyzed leg.&#x0D; Conclusions. The developed tutor model can be used in orthopedic-traumatological practice to correct equvinus foot deformity; the model efficiency is confirmed by clinical and stabilometric parameters.

Catamnesis of pediatric thoracic and abdominal cancer survivours

Background. Malignancies of thoracic and abdominal localization are the second in pediatric oncopathology, after hemoblastoses. A progress in treatment of this heterogeneous tumors had been achieved by surgery approaches, chemotherapy, supportive care and irradiation role definition in multimodal therapy. Inspite of high survival rate, health condition of pediatric thoracic and abdominal cancer survivours in 5 years and more time in our country are unknown. Aim. To analyze health condition of pediatric thoracic and abdominal cancer survivours and kids, who were born in survivours families. Materials and methods. 324 patients, survived from thoracic and abdominal malignancies were enrolled the study from 1979 to 2015. Patients were subdided into 2 groups: 1st - 126 (38.9%) patients, treated from 1979 to 1996 and 2nd - 198 (61.1%) patients - from 1997 to 2015. Such approach aligned with historical treatment modification - upward 1996 modern anticancer treatment protocols are using and indications for irradiation are limited. Results. By improving therapy of nephroblastoma, decreased number of skeletal disorders from 11.5% in 1st group to 3.9% in 2nd, but increased concomitant renal complications from 5.3% to 21.5% and endocrinopathy from 2.4% to 6.7% in 1st and 2nd groups respectively. In hepar tumours survivours, chronic gastroduodenitis and pancreatoduodenopathy were registrated in 25% and 16% in 1st and 2nd groups respectively. In neuroblastoma survivours, locomotor system pathology (including osteoporosis) was found in 12.1%. Second malignant tumours in period from 8 months to 25 years after end of treatment were in 0,9%, benign - 1,6% of pediatric thoracic and abdominal cancer survivours. Kids, who were born in survivours families, had health condition as their equals in age without oncological family anamnesis. Conclusions. Catamnesis of pediatric thoracic and abdominal cancer survivours can predict possible complications, develop individual rehabilitation and personalized follow up programs. Besides, afterhistory data can help in development of complex treatment approaches for this heterogenous tumours.

Probable molecular genetic predictors for development of the locomotor system pathology in the extreme physical exertion

The article presents the basic results of the theoretical analysis of currently available data on modern and future using of molecular genetic markers to determine predisposition to musculoskeletal system diseases in athletes and subsequent regenerative capacity of the organism. The basic genetic markers associated with athletes resistance to injuries are described. It has been shown that one of the most important factors is genetic predisposition to osteoporosis.

Spatiotemporal Changes Posttreatment in Peripheral Arterial Disease.

Accumulating evidence suggests revascularization of peripheral arterial disease (PAD) limbs results in limited improvement in functional gait parameters, suggesting underlying locomotor system pathology. Spatial and temporal (ST) gait parameters are well studied in patients with PAD at baseline and are abnormal when compared to controls. The purpose of this study was to systematically review and critically analyze the available data on ST gait parameters before and after interventions. A full review of literature was conducted and articles were included which examined ST gait parameters before and after intervention (revascularization and exercise). Thirty-three intervention articles were identified based on 154 articles that evaluated ST gait parameters in PAD. Four articles fully assessed ST gait parameters before and after intervention and were included in our analysis. The systematic review of the literature revealed a limited number of studies assessing ST gait parameters. Of those found, results demonstrated the absence of improvement in gait parameters due to either exercise or surgical intervention. Our study demonstrates significant lack of research examining the effectiveness of treatments on ST gait parameters in patients with PAD. Based on the four published articles, ST gait parameters failed to significantly improve in patients with PAD following intervention.

Vladislav Vladimirovich Povoroznyuk

The article is dedicated to the 60th anniversary of the honored Ukrainian scientist, the head of the department of clinical physiology and pathology of locomotor system of the SI «Institute of Gerontology named D. F. Chebotarev NAMS Ukraine», MD, Professor V. V. Povoroznyuk.

Modern Tendencies of Synovial Fluid Substituting Drugs Based on Bound Hyaluronic Acid Use in Treatment of Patients with Loco-Motor System Pathology and Injuries

Analysis of literature on hyaluronic acid role and properties as well as on the use of synovial fluid substituting drugs based on bound hyaluronic acid (HA) shows the significance of this type of therapy for the arrest of articular and periarticular pain syndrome, and high efficacy in complex treatment of osteoarthritis. Recent data enabled to understand better the mechanisms of HA metabolism and to determine the advantages HA drugs use depending on the production technology, molecular weight and other pharmacodynamics properties.

Adecuación de la prescripción de antiinflamatorios no esteroideos y gastroprotección en atención primaria

To assess whether prescribing non-steroidal anti-inflammatory drugs (NSAIDs) is adequate for gastrointestinal protection associated with NSAID use. Cross-sectional descriptive study. Primary Care Centre in La Mina, Barcelona, Spain. A random sample of 500 patients, stratified by doctor was selected from a total of 4504 patients with an NSAID prescription. The dependent variables were the adequacy of NSAID prescription and gastrointestinal protection. The independent variables were: age, sex, concomitant treatments, type and number of NSAIDs. The variables were collected from the clinical history. The 476 patients included with an NSAID prescription had a mean age of 47.9 (18.1) years, and 63.4% were women. The NSAIDs most prescribed were, ibuprofen (60.3%), diclofenac (23.1%), and naproxen (4.0%). The most common reason for prescribing the NSAID was locomotor system pathology; 45.4%. The prescription was adequate in 44.7% (95% CI, 40.2-49.3), and inadequate in 23.5% (95% CI, 19.8-27.6). It was inadequate in 49.5% of patients over 65 years, while in under 65 year-olds 16.5% were inadequate. Gastrointestinal protection was inadequate in 28.2% (95% CI, 22.7-35.7); 12.8% excessive and 16% insufficient. In the multivariate analysis, the inadequacy probability of NSAIDs is 5.45 times greater in patients of 65 or more years than in younger patients. NSAID prescribing and gastrointestinal protection can be considered to be inadequate in 25% of patients. Advanced age is a major risk factor in inadequate prescribing.

NO role in pathology of locomotor system (part 1)

NO role in pathology of locomotor system (part 1)

Evaluation of Analgetic Effect of Dexalginum 25 (Dexketoprofen) in Traumatology and Orthopaedics

Clinical testing of analgetic effect and safety of nonsteroid anti-inflammatory drug dexalginum 25 was conducted in 45 patients with injuries and pathology of loco-motor system. Control group (49 patients with similar pathology and manifestation of pain syndrome) was treated by opium analgetic tramadol retard. It was shown that dexalgin 25 in therapeutic doses possessed analgetic effect in acute and chronic pains of various severity. The highest efficacy of the drug was noted in acute pains of medium and moderate severity. In patients with very severe pains dexalgin 25 allowed to decrease narcotic analgetics dose by 2 times. Dexalgimun 25 provided chronic pain relief only within the period of its use. Side effect were noted 2.7 times rarely in comparison to tramadol retard and such effect were less marked. Rate «favor-risk* of unsteroid anti-inflammatory drug dexalginum 25 was better than in opium analgetic tramadol retard.

Specialized Rehabilitation Center for Pediatric Orthopedics and Traumatology

Issues of the organization of the work on the rehabilitation of children with loco-motor pathology are reviewed on the example of St. Petersburg Rehabilitation Center Ogonyok. The tasks of such centres include the conservative treatment of children with loco-motor system pathology with simultaneous provision of education process. The structure, list of members of staff as well as characteristics of the material and technical basis including therapeutic and diagnostic units are presented. The advantages of the rehabilitation centers over specialized health centers are shown.

Treatment of vertebrogenic-dependent tachycardias and extrasystoles in children

Treatment results of 39 children with sinus tachycardia and extrasystolia are presented. All children simultaneously had various types of locomotor system pathology, mainly in the cervical and thoracic spine. In the majority of patients the orthopaedic correction by the authors technique allowed to restore the cardiac rhythm without the use of antiarhythmic drugs.

Modern Principles of Chemoprophylaxis of Postoperative Complications in Trauma and Orthopaedic Patients

The basic preconditions and rational schemes of intraoperative chemoprophylaxis of purulent complications are considered. The leading role of Staphylococcus in the infection pathology of loco-motor system (in 77% of patients, aged after 18, with osteomyelitis and infection of soft tissue) is taken into account. The comparative analysis of the results of the 1st (cefazolin) and 2nd (zinacef) generation cephalosporins application is performed at reconstructive operations in the comparable groups of patients. With due regard for the significant rate of Staphylococcus resistence to cefazolin in vitro (up to 25- 42% of isolates in patients with different diseases) and considerably lower resistence to zinacef (under 10%) the authors consider the later to be more preferable for the prevention of suppurative complications in traumatology and orthopaedics.

Evolution of coxarthrosis in the light of working ability expertise

Among the patients who for the first time called on MLEC for the evaluation of disablement group due to locomotor system pathology the patients with coxarthrosis were 35%. The results of clinical, X-ray, radionuclide examination as well as dynamics of medical social rehabilitation (by the data of capacity for work expertise) were analyzed in 200 patients with posttraumatic, idiopathic and dysplastic coxarthrosis. It was shown that existent methods of conservative and operative treatment gave efficient medical rehabilitation only in low percentage of cases, but the absense of clear medical social rehabilitation programme for those patients aggravated the matter. The best results were noted in patients operated for aseptic necrosis of the femur head. In all three forms of coxarthrosis the most efficient method of surgery was total replacement.