Long-term Rehabilitation Of Patients Research Articles

A case of severe pneumonia complicated by sepsis, endocarditis, and prolonged comatose state, with successful rehabilitation

Sepsis with acute organ dysfunction is an urgent problem of modern healthcare. A clinical case of a 38-year-old young woman with communityacquired severe viral-bacterial pneumonia complicated by sepsis, endocarditis, and multiple organ failure is presented. On the 68th day of her stay in the intensive care unit (ICU), the patient was brought out of comatose state and transferred to the pulmonology department for rehabilitation.The purpose of the work was to demonstrate the significance of this clinical case because of the urgent need to increase the effectiveness of treatment and long-term rehabilitation of patients with this severe comorbid pathology.Conclusion. Early diagnosis is extremely important to select effective treatment. The Quick SOFA (Sepsis-related sequential Organ Failure Assessment) score should be used to identify patients with suspected sepsis outside the ICU. This score is based on simple and accessible clinical characteristics that do not require laboratory analysis of homeostatic parameters. The patient was discharged in satisfactory condition to continue rehabilitation in outpatient settings.

Hardware Psychodiagnosis of Resilience Indicators Mental Health

The article reveals the psychohygienic significance of apparatus-psychological objectification of the main indicators of mental health for each person to acquire knowledge about his own individuality and self-regulation of his own mental states. It is noted that self-control of one’s own mental functioning is necessary in the process of treatment of mental disorders and the long-term rehabilitation of patients with chronic mental illnesses, as it allows activating the awareness of the main objective parameters of one’s own mental capabilities in relation to the desired capabilities necessary for a full-fledged life. The functions of the “Hyst” device, manufactured by the Kyiv Telekom-pneumatik plant under the patent of Dr. Sergii Boltivets, are presented as a separate device and a program installed on a computer that processes the received psychodiagnostic data. In accordance with the psychodiagnostic purpose of each of the components of the apparatus complex, its use allows to conduct reactometry, labiliometry and tremormetry of the psychomotor praxis of thinking of children and adults, starting, as a rule, from the age of 5. The device provides the possibility of choosing both a single signal and a series of 10 responses with separate calculation of the reaction of the right and left hand and leg. This provides a psychodiagnostic assessment of interhemispheric interaction and the presence of asymmetry of interhemispheric functioning and its severity. The obtained data are important for identifying the consequences of unconscious but existing craniocerebral injuries and other dysfunctions of psychophysical development. The results of psychological examinations of 2,548 people, including children and adults aged 5 to 82 years, regardless of mental health status, including both self-actualized individuals with high quality indicators of mental health and individuals with chronic mental disorders and various degrees of mental retardation. This made it possible to generalize the main indicators of the instrumental and psychological objectification of the main indicators of the stability of mental health. It was established that the functional indicators of reactometry, labiliometry and tremometry are the basic characteristics of individuality, activity and the ability to self-regulate, which are the main indicators of the stability of a person’s mental health. It was noted that such universal forms and patterns of mental self-organization of a person, which, being transformed during human life, are not lost, have the greatest value.

Epidemiological Aspects of Parasitic Diseases of the Respiratory System Mimicking the Clinical Picture of Respiratory Infections: A Review

Introduction: Acute respiratory infections are one of the most common human diseases and are caused by many pathogens, while helminths receive undeservedly little attention in the structure of respiratory disorders. Meanwhile, the course of helminthiases of the respiratory system is disguised as a disease of nonparasitic etiology, with such manifestations as low-grade fever, dyspnea, cough, pleurisy, bronchitis, being therefore misdiagnosed and inadequate treated with serious consequences. In this review, we point out similar symptoms of bronchopulmonary pathologies associated with respiratory infections and parasitic diseases. Objective: To give a comparative characteristic of the clinical picture of pulmonary helminthiases and acute respiratory infections. Materials and methods: We analyzed literary sources on medical parasitology and helminth biology published in 1900–2021, found in the Web of Science, PubMed, Scopus, Elsevier, Springer and Google Scholar databases. In addition, were reviewed fifteen published case reports of pulmonary parasitoses. Results: We considered the life cycles of flatworms and roundworms belonging to 10 genera including Paragonimus, Taenia, Echinococcus, Ascaris, Toxocara, Ancylostoma, Necator, Strongyloides, Metastrongylus, and Dirofilaria, and summarized data on the respiratory symptoms of parasitic diseases, pathogenesis in the organism of the definitive host, and routes of entry. Conclusion: This review presents a comparative description of helminthiasis with mixed pathogenesis, mimicking the clinical picture of respiratory infections. To avoid inadequate treatment, we recommend supplementing a carefully collected medical history with a differential diagnosis of parasitic diseases for diseases of nonparasitic etiology (allergic and chronic systemic diseases, viral, bacterial infections). It is the early diagnosis of helminthiasis that prevents a life-threatening health condition, severe operations, and further long-term rehabilitation of patients.

Assessment of adaptive mechanisms to obturators of the upper jaw according to the data of electronic axiography and cone-beam computer tomography

Was to assess the adaptation of patients to obturator at different periods of adaptation using objective digital methods of analysis: axiography, cone-beam computer tomography, digital facial scans, and intraoral scanning. The study comprised 17 patients with postoperative defects of the upper jaw at different periods of removable obturators usage. In 88.2% of the subjects limited mouth opening and displacement of the mandible to the healthy side was detected. Contracture as a complication can develop in the later stages of rehabilitation. A long-term rehabilitation of patients is recommended using simulators and special gymnastic exercises in order to prevent extra-articular contracture.

Особливості фітотерапії цукрового діабету крізь призму коморбідності й профілактики ускладнень (огляд літератури)

Стаття присвячена огляду літератури з фітотерапії хворих на цукровий діабет (ЦД) крізь приз­му коморбідних процесів і профілактики ускладнень. У статті приділено увагу огляду складових частин рослин, що відповідають за гіпоглікемічну дію, таргетним шляхам їх дії, а також основним принципам і патогенетичним механізмам фармакологічної дії фітопрепаратів при ЦД. Наголошено на комплексності антиглікемічної дії, яка обумовлена взаємодією різних речовин. Автори детальніше зупинились на окремих представниках лікарських рослин, які найчастіше використовуються при лікуванні ЦД, таких як чорниця звичайна, галега лікарська, квасоля звичайна, бузина лікарська, аралія висока, кульбаба лікарська, оман високий, льон звичайний, аралія висока, момордика, гімнема звичайна, гуньба сінна, гінкго дволопатеве. Розглянуто основні комплексні препарати, протидіабетичні рослинні збори, дієтичні добавки, які є на фармацевтичному ринку України. Висвітлені основні підходи до застосування лікарських рослинних препаратів та їх роль у лікуванні та довготривалій реабілітації хворих на ЦД. Наголошено на необхідності проведення наукових пошуків зі створення полікомпозитних ліків рослинного походження багатоцільової дії та вдосконалення лікувально-профілактичних заходів за допомогою фітотерапії.

Современные тенденции в оперативном лечении больных с повреждениями таза и вертлужной впадины (обзор литературы)

Introduction There is evidence in the literature over the past 5 years that pelvic and acetabular fractures are increasing in prevalence with the rise of injuries sustained in road traffic accidents, the growing number and severity of trauma, significant complication rate and unsatisfactory outcomes due to untimely surgical treatment. Objective Review current trends in the selection of surgical approaches and fixation of the pelvis and acetabulum, the postoperative rehabilitation strategies and identify factors for poor outcomes of surgical treatment. Material and methods We performed searches using HAC peer-reviewed and SCOPUS indexed journals, EMBASE, MEDLINE, Сochrane library, еLibrary.ru, Wiley Online Library with search criteria of pelvic fractures, displaced acetabular fractures, open reduction of the pelvis and acetabulum, osteosynthesis, minimally invasive osteosynthesis and primary total hip arthroplasty, approaches and complications of acetabular fracture surgery. Results Indications to surgical treatment of patients with concomitant, multiple and isolated fractures of the pelvis and acetabulum were identified with the use of current strategy and principles of damage control surgery and damage control orthopaedics. Surgical approaches for two-column acetabular fractures have been shown to be extensile and traumatic. Discussion Most authors report use of the active surgical strategy for displaced fractures of the pelvis and acetabulum. Open reduction internal fixation is the standard of care for pelvic and acetabular fractures. Conclusion Postoperative complications and long term rehabilitation of patients with pelvic and acetabular fractures support further research and development of new more effective approaches to address the solution of the challenging issue.

Correction of persistent cloaca in children: experience and analysis of treatment results

Introduction. Cloaca is one of the most difficult to be corrected varieties of the pathology of the anorectal zone, occurring with a frequency of 1 case per 40 000–25 000 live births. Purpose: аnalysis of diagnostic methods and surgical correction, treatment outcomes of children with cloacal malformations. Materials and methods . The article analyzed 16 cases of surgical treatment of cloacal anomalies based on the Irkutsk Municipal Pediatric Clinical Hospital in Irkutsk for the period from 2008 to the present. Gender composition: girls – 14 (87,5%), genotype (46XX – 13; 46XX, del (6) – 1), boys – 2 (12,5%). Results. The most common cloacal anomaly was a persistent cloaca – 11 (68,8%), the extrophy of the cloaca was 4 – 25 (25%) and the posterior cloaca – 1 (6,25%) was much less common. Aggravated obstetric history was found in reliable data on the presence of teratogenic factors is associated with a lack of information on obstetric history. In 93,8% of cases, cloacal anomalies were combined with other congenital malformations. In 100% (11) of cases the posterior-sagittal anorectovaginourethroplasty was performed in its various modifications, including LAPassisted – 3 (27,3%). When evaluating long-term results, it was revealed that 3 (27,3%) patients developed chronic recurrent pyelonephritis, 2 (18,2%) had urinary incontinence and first-degree anal incontinence, 1 (9,1%) had sphincter-detrusor insufficiency and anal incontinence of 3 degrees. Conclusion. According to the authors, the issues of surgical strategy for the correction of cloacal anomalies remain unresolved. The morphology of blemish, the spectrum of concomitant pathology are important in the choice. The results of treatment in favorable cases should be considered quite satisfactory. However, in severe forms, poor functional results occur, which often requires repeated reconstructive interventions and long-term rehabilitation of patients.

Prognostic meaning of stress in a long-term rehabilitation of patients having obesity

Prognostic meaning of stress in a long-term rehabilitation of patients having obesity

Simultaneous bilateral trochanteric fractures—a report of four cases

Simultaneous bilateral intertrochanteric fractures are very rare. There is a paucity of data in current literature documenting patients with such kind of hip fractures. It is severe and potentially life-threatening, associated with a high morbidity. The major determinants of successful outcome are high vigilance, early single stage stabilization and mobilization as well as management of associated comorbid conditions that may influence the long term rehabilitation of patients. Here we reported 4 cases of concurrent bilateral trochanteric fractures along with review of the literature. Our study aimed to discover its frequency, identify the injury mechanisms as well as factors present in the pathogenesis of these fractures, and outline the available treatment modalities.

Comprehensive geriatric assessment of effects of hospitalization and long-term rehabilitation of patients following lower extremity arthroplasty.

[Purpose] This study was performed to examine the effects of subacute physical therapy (PT) on activities of daily living (ADL), quality of life, and geriatric aspects of patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA). [Subjects] The subjects were TKA (n=56) and THA (n=39) patients who received PT on the first day of independent ADL (up to 2 weeks) and just prior to discharge (4 weeks). [Methods] The functional independence measure (FIM), grip strength, knee extension strength (KES), timed up and go (TUG) test, mini-mental state examination (MMSE), geriatric depression scale short form (GDS-15), fall efficacy scale (FES), and medical outcome study 8-item short-form health survey (SF-8) were used as outcome measure, and comorbidity involvement was also investigated. [Results] Improvements in FIM, KES, TUG, GDS-15, FES, and SF-8 scores were seen in both groups (effect size, 0.31–0.87). Poor PT effects were found for THA patients aged ≥65 years, for TKA and THA patients with an MMSE score ≤28, and for THA patients with two or more comorbidities. [Conclusion] Positive effects were seen in patients who received PT at 2–4 weeks after surgery. Thus, additional PT for approximately 2 weeks after the beginning of independent ADL may be beneficial.

Effect of early care intervention on the long-term rehabilitation of patients with stroke

Objective To explore the effect of early nursing intervention on the long-term rehabilitation of patients with stroke.Methods Totals of 62 stroke patients were admitted between June 2010 and December 2011,and were randomly divided into control group and treatment group,with 31 cases in each group.Control group received conventional rehabilitation care plan implementation,while the treatment group received the early intervention rehabilitation plan of care.Before and after the intervention,the recovery of exercise capacity was assessed by using Fugl-Meyer scale,and the quality of life by the SF-36 summary rating scale.Results Before the intervention,no significant difference was found in the score of SF-36 and Fugl-Meyer between control group and treatment group (P ＞ 0.05).After the intervention,SF-36 score of treatment group in the 12 months and 24 months,respectively,were higher than that in the control group [(89.92 ± 13.12) vs (78.16 ± 12.35),(91.26 ± 13.67) vs (82.14 ± 12.95)],with significant difference (t =2.968,3.125 ; P ＜ 0.05),as well as the Fugl-Meyer score [(67.27 ± 13.25) vs(53.18 ± 11.36),(88.12 ± 12.15) vs(69.29 ± 12.65),(91.24 ± 12.65)vs (73.25 ± 11.15)]in the 3,12,24 months,and the difference was statistically significant (t =2.376,2.176,2.315;P ＜ 0.05).And the improvement of exercise capacity in the treatment group was significantly better than that in the control group (P ＜ 0.05).Conclusions Early intervention rehabilitation care have an important effect on the long-term effect of rehabilitation of stroke patients,which can significantly improve patients' rehabilitation exercise capacity and quality of life. Key words: Stroke ; Early nursing; Long-term rehabilitation

Hemorojinių mazgų chirurginio gydymo rezultatų palyginimas

Valery Larionovich Denisenko 2nd Vitebsk regional clinical hospital, Nekrasova 10, Vitebsk 211000, BelarusEl. paštas: boln_priem@vitebsk.by Tikslas: Palyginti prieširdžių pertvaros defekto chirurginio ir perkateterinio gydymo metodų ankstyvuosius rezultatus ir komplikacijas. Comparative analysis of chronic hemorrhoids surgical treatment Valery Larionovich Denisenko 2nd Vitebsk regional clinical hospital, Nekrasova 10, Vitebsk 211000, BelarusE-mail: boln_priem@vitebsk.by Abstract. The problem of hemorrhoids treatment has been important for more then two thousand years. After the standard closed hemmorroidectomy in the postoperative period pain syndrome long-term rehabilitation of patients, a large number of relapses, can be observed. Implementation method of rubber band ligation, as well as the trans anal doppler-guided hemorrhoidal artery ligation, are an alternative to hemorrhoidectomy in patients with hemorrhoids stage III. The analysis of treatment result was in 75 patients with chronic hemorrhoids treated at proctologic ward in the station Vitebsk (since 2008 II Vitebsk Regional Clinical Hospital) from 2002 to 2009. Accordiny to method of treatment for chronic hemorrhoids three groups of patients. Application were distinguished of trans-anal disarterization of internal hemorrhoids under doppler control with mucopexy and lifting and rubber band ligation gives positive results. In reduction of patients disability from 18,4 ± 0,5 days to 1,3 ± 0,3 days (p < 0,05) rehabilitation of the patients on faster than rehabilitation after using traditional techniques. Key words: hemorrhoids, Doppler, lifting, mucopexy.

Incidence of skin breakdown and higher amputation after transmetatarsal amputation: Implications for rehabilitation

The purpose of this study of patients with transmetatarsal amputation (TMA) is to describe multiple patient characteristics, including the incidence of subsequent skin breakdown and higher amputation, that may influence rehabilitation treatment and outcomes. Data were gathered on all patients having a TMA at this facility between April 1989 and September 1993. One hundred twenty TMAs were performed on 107 patients with a mean age of 62.4 ± 13.8 years. There were 55 men and 52 women. Thirteen patients (12%) had a bilateral TMA. Twenty-nine patients (27%) developed skin breakdown. Of these, 48% occurred within the first 3 months after surgery. Thirty patients (28%) required a higher amputation. Of these, 60% occurred in the first month after TMA. In addition, this group of patients had a high incidence of diabetes mellitus (77%), hypertension (54%), electrocardiogram (EKG) abnormalities (60%), congestive heart failure (22%), and prior ipsilateral vascular surgery (51%). These results indicate that patients with TMA often present with a complicated medical condition and that they are at high risk of skin breakdown or higher amputation, especially in the first 3 months after surgery. The investigators conclude that patients with TMA may benefit from a rehabilitation program emphasizing protection of the residuum during their return to functional activities. Additional research is needed to determine optimal acute and long-term rehabilitation of patients with TMA.