Non-inclusion Criteria Research Articles

Prospective Study of the Destabilization Maneuver in Inversion for the Treatment of Acute Ankle Ligament Injury: Case Series

Category: Ankle; Sports Introduction/Purpose: Ankle sprains are highly prevalent injuries in athletes, whether amateurs or professionals. It is estimated that they cause around 5,000 sprains a day in the UK, while American data point to around 23,000 cases daily (1/10,000 individuals). The most current literature has pointed to early diagnosis followed by functional strategies as the approach with the highest success rate for lateral ankle sprains, thus contributing to the prevention of chronic instabilities. offering better quality of life and safety to patients are necessary. Objective: The objective of this work is to present the clinical results obtained from the prospective observation of a series of patients with lateral ankle sprains treated with the destabilization technique in Ankle Inversion added to the conventional treatment. Methods: Design: Comparative prospective study in a single center without a control group Location: The study was carried out at Hospital São Paulo – University Hospital of UNIFESP (HSP-UNIFESP), at the Orthopedics Ambulatory of the Department of Orthopedics and Traumatology (DOT)/EPM-UNIFESP. Inclusion criteria -Over 18 years old of both sexes; -Complaint of ankle sprain within 48 hours -Complete or partial injury to any of the ligaments of the lateral ankle complex; -Isolated or associated ligament injuries; Non-Inclusion Criteria -Past history of surgery on the affected foot or ankle; -Previous complaint in the ankle region; -Any fracture associated with sprains or injuries that influence; -Any condition that is a contraindication to the proposed therapies; -Refusal to participate in the study Sample size: 100 Individuals Results: We conclude that statistically we have a higher percentage of No Re-sprains with 94% against 6% of Re-sprains. This index has a CI (confidence interval) of 4.7%, that is, we have that the Reentorse index was 6.0% ± 4.7% which is the same as saying that the index can vary from 1 .3% to 10.7% with 95% statistical confidence. Conclusion: Based on the findings of the present study, we concluded that in a 12-month follow-up, the ankle inversion destabilization maneuver proved to be effective in preventing new episodes of lateral ankle sprains. and in order to compare the maneuver described in the study with techniques already described in the literature and used by physiotherapists in their clinical practice, should be performed.

The purpose of early maladaptive schemas (EMS) in the relationship dysfunction among people with bipolar disorder in the euthymic phase

ObjectivesAlthough free from characterized manic and depressive episodes, the euthymic period in bipolar disorder (BD) remains characterized by a whole host of difficulties, particularly relational. These difficulties are factors of vulnerabilities and relapses. People's perception of their own relationships has an impact on their symptomatology, their responses to treatment and on relapse rates. Young's early maladaptive schemas (EMS) approach proves to be relevant for understanding the construction of these perceptions and working on them. Nevertheless, to this date, few studies have investigated which EMS are related to relationship dysfunction in this particular population. Determining the link between EMS and relationship difficulties would be relevant to understand psychosocial impairment of people with BD in euthymic states. The present study aims to investigate the associations between the different domains of EMS and relationship dysfunction among patients with bipolar disorder in the euthymic phase. MethodsData are extracted from the FACE-BD cohort, within the BD Expert Center in Versailles. Inclusion criteria were to be aged between 18 and 65 and to be an outpatient with a diagnosis of bipolar disorder (DSM-IV-TR). Patients had to be euthymic at the time of inclusion, according to DSM-IV-TR criteria with a cut-off score of 14 on the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale. Non-inclusion criteria were meeting at the time of the study the criteria for characteristic depressive episode, hypomania or mania according to the DSM-IV-TR. Sociodemographic data, clinical features associated with relationship dysfunction were assessed. EMS and EMS domains were assessed with the YSQ-R short form (Young Schema Questionnaire 3 Short Form) and current relationship dysfunction were assessed with the FAST (Functioning assessment short test subscale). Successive simple linear regression analyses were performed to investigate the association between the severity scores of each EMS and the intensity of relationship dysfunction. Furthermore, successive simple linear regression analyses investigated the association between EMS domain scores and intensity of relationship dysfunction. Multiple linear regression analyses were performed to test the association between EMS scores, then EMS domains, and the intensity of relationship dysfunction after adjusting for age as well as the intensity of residual depressive and manic symptoms. ResultsRelationship dysfunction is partly associated with EMS activation in particular in the separation and rejection domain (P<0.0001), the other-directedness domain (P=0.031) and the over-vigilance and inhibition domain (P=0.005). Having residual depressive symptoms is also among the factors contributing to the relationship dysfunctions of people with bipolar disorder in the euthymic phase. DiscussionThis is the first study demonstrating that the activation of several domains of EMS is a risk factor of relationships difficulties for people in euthymic phase of bipolar disorder. It is necessary to identify which EMS are specifically activated and their domains of belonging in order to prevent and reduce them. EMS are a lever for functional remission. It is therefore relevant to refer people reporting relationship problems to schema therapy consistent with a personalized care. Finally, future studies should focus on the mechanisms underlying the complex relationship between EMS domains and relationship dysfunction in people with bipolar disorder in the euthymic phase. It may also be relevant for future research to control for different types of relationship dysfunction. EMS may be differentially associated with several types of interpersonal problems. The relations between different adaptation styles and EMS should be further investigated to offer more personalized care, with the aim to improve functional remission.

АНАЛИЗ ЭФФЕКТИВНОСТИ ПРОЛОНГИРОВАННОГО ДЕЙСТВИЯ ПРЕПАРАТА «ИНТЕРЛЕЙКИН-1B», НАПРАВЛЕННОГО НА ЛОКАЛЬНОЕ СНИЖЕНИЕ ЦИТОКИНОВОГО КАСКАДА В ТКАНЯХ ПАРОДОНТА У ПАЦИЕНТОВ С БРОНХИАЛЬНОЙ АСТМОЙ

The study involved 63 patients of the pulmonology department with a history of concomitant &#x0D; diseases of bronchial asthma (BA). The patients were divided into the main group 1 (27 patients who under went treatment of periodontal diseases according to the standard treatment protocol) and the main group 2 (36 &#x0D; patients who, in addition to standard therapy for periodontal diseases, were prescribed a course of Interleukin 1b). The control group consisted of 19 conditionally healthy people with no history of somatic pathology. &#x0D; According to the criteria from the national program “Bronchial Asthma”, 27 (27 %) patients were diagnosed &#x0D; with a mild form of BA, 19 (52 %) - with a moderate form, and 9 (20,1 %) – with a severe form of BA. The &#x0D; selection of patients was carried out on the basis of inclusion, non-inclusion and exclusion criteria in the study. &#x0D; The effectiveness of the therapy was assessed by the hygiene index (J.C. Green, J.K. Vermillion (OHI-S)), the &#x0D; papillary-marginal-alveolar index (PMA) in the Parma modification. The level of destructive processes in the &#x0D; bone tissue was assessed using sighting radiographs and orthopantomograms. The quality of the treatment was &#x0D; assessed after 3 weeks, 4 months and then 6 months from the start of treatment.

АНАЛИЗ ЭФФЕКТИВНОСТИ ПРОЛОНГИРОВАННОГО ДЕЙСТВИЯ ПРЕПАРАТА «ИНТЕРЛЕЙКИН-1B» НА ЛОКАЛЬНОЕ СНИЖЕНИЕ ЦИТОКИНОВОГО КАСКАДА В ТКАНЯХ ПАРОДОНТА У ПАЦИЕНТОВ С БРОНХИАЛЬНОЙ АСТМОЙ

The study involved 63 patients of the pulmonology department with a history of concomitant diseases of bronchial asthma (BA). The patients were divided into the main group 1 (27 patients who underwent treatment of periodontal diseases according to the standard treatment protocol) and the main group 2 (36 patients who, in addition to standard therapy for periodontal diseases, were prescribed a course of Interleukin-1b). The control group consisted of 19 conditionally healthy people with no history of somatic pathology. According to the criteria from the national program "Bronchial Asthma", 27 (27%) patients were diagnosed with a mild form of BA, 19 (52%) - with a moderate form, and 9 (20.1%) - with a severe form of BA. The selection of patients was carried out on the basis of inclusion, non-inclusion and exclusion criteria in the study. The effectiveness of the therapy was assessed by the hygiene index (J.C. Green, J.K. Vermillion (OHI-S)), the papillary-marginal-alveolar index (PMA) in the Parma modification. The level of destructive processes in the bone tissue was assessed using sighting radiographs and orthopantomograms. The quality of the treatment was assessed after 3 weeks, 4 months and then 6 months from the start of treatment.

Effects of Photobiomodulation Using Low-Level Laser Therapy on Alveolar Bone Repair

Alveolar bone repair is a complex and extremely important process, so that functions such as the mastication, occlusion and osseointegration of implants can be properly reestablished. Therefore, in order to optimize this process, many procedures have been used, such as grafting with biomaterials and the application of platelet-rich fibrin (PRF). Another method that has been studied is the use of photobiomodulation (PBM) with the use of low-level laser therapy (LLLT), which, through the absorption of photons by the tissue, triggers photochemical mechanisms in the cells so that they start to act in the search for homeostasis of the affected region. Therefore, the objective of this review was to analyze the use of LLLT as a possible auxiliary tool in the alveolar bone repair process. A search was carried out in scientific databases (PubMed/MEDLINE, Web of Science, Scopus and Cochrane) regarding the following descriptors: “low-level laser therapy AND alveolar bone repair” and “photobiomodulation AND alveolar bone repair”. Eighteen studies were selected for detailed analysis, after excluding duplicates and articles that did not meet predetermined inclusion or non-inclusion criteria. According to the studies, it has been seen that LLLT promotes the acceleration of alveolar repair due to the stimulation of ATP production, activation of transcription and growth factors, attenuation of the inflammatory process and induction of angiogenesis. These factors depend on the laser application protocol, and the Gallium Aluminum Arsenide—GaAlAs laser, with a wavelength of 830 nm, was the most used and, when applications of different energy densities were compared, the highest dosages showed themselves to be more efficient. Thus, it was possible to conclude that PBM with LLLT has beneficial effects on the alveolar bone repair process due to its ability to reduce pain, the inflammatory process, induce vascular sprouting and, consequently, accelerate the formation of a new bone matrix, favoring the maintenance or increase in height and/or thickness of the alveolar bone ridge.

ASSESSING THE STATE OF THE ALVEILAR MORPHOTYPE IN PLANNING AND CARRYING OUT ORTHODONTIC TREATMENT OF PATIENT WITH INFLAMMATORY PERIODONTAL DISEAS ES

Aim: to assess the state of periodontal tissues when planning and performing controlled orthodontic movement of crowns and roots of teeth using the overlay of computed tomography on 3-D visualization of the process of movement of dentition in patients with inflammatory periodontal diseases.&#x0D; Methods: Based on the inclusion and non-inclusion criteria, the study involved 80 patients aged 25-35 years, who were divided into 2 groups - control (with clinically healthy periodontium) and main (with chronic generalized periodontitis) for orthodontic treatment of dentoalveolar anomalies. Orthodontic equipment for the comparison groups was identical (aligners, vestibular and lingual braces with passive self-ligation). Prior to the start of the orthodontic program, the alveolar morphotype was determined by CT of patients superimposed on the program for digital modeling of the future result; the optical density of the alveolar bone was estimated in Hounsfield units (HU). Clinical indicators for assessing the condition of periodontal tissues and after completion of the orthodontic program in the comparison groups.&#x0D; Results: After the completion of orthodontic treatment, patients of group 1 had a lower number of periodontal complications - 42% versus 54% in group 2, with initially normal periodontium with a thin alveolar morphotype; 18% and 23% - with a thick alveolar morphotype. The best results were noted in the aligners subgroup - 16% and 18% for groups 1 and 2, respectively; the worst - in the subgroup with lingually fixed braces - 50% and 55%, respectively. The most common periodontal complication was tissue recession. Thanks to the predictive planning of the assessment of patients' computed tomograms superimposed on the program of digital modeling of the final result after the displacement of teeth, a positive result of orthodontic treatment was obtained and the risk of negative impact of the orthodontic program on both intact periodontal tissues and damaged periodontium was minimized.&#x0D; Conclusions: The new ability to control the state of the alveolar ridge bone using 3-D visualization of tooth movement with CT overlay increases the efficiency of orthodontic treatment planning by 40%, ensuring a minimum of side effects and complications.

Epidemiological and Etiological Aspects of Ocular Trauma at the Fana Reference Health Center

Ocular trauma plays an important role in ophthalmological emergencies and poses a real public health problem due to its frequency, severity and impact on visual function [2]. These can include bruises, wounds, foreign bodies and burns [1]. The aim was to study the clinical and epidemiological aspects of ocular trauma at the Fana referral health centre. Materials and methods: This was a prospective study of 157 cases of ocular trauma out of 2539 patients seen in consultation at the FANA CSRéf from 1er November 2021 to 30 April 2022. Inclusion criteria: All cases of ocular trauma seen and followed up at the centre. Secondary ophthalmology centre (CSO) in Fana during the study period and having given their consent. Non-inclusion criteria: All patients who consulted for reasons other than ocular trauma and cases of ocular trauma who did not give their consent. Results: The study involved 157 cases of ocular trauma out of a total of 2,539 consultants, representing a frequency of 6.18%, with males the most affected at 68.2%. It occurred mainly in young, active people aged between 15 and 44 (54.77%); farmers were the most affected (38.2%). Contusions were the most frequent type of trauma, accounting for 49%; wounds of the globe accounted for 13.4% of cases; the aetiological agents were very diverse, but the preponderance of attacks of plant origin was noted, with a frequency of 39.5%. The delay in treatment was long; in our study, 40.8% of patients were consulted more than a week after the trauma. Discussion: Farmers and stockbreeders were the most exposed to accidents in a rural context, with long delays in treatment leading to complications and irreversible after-effects.

Single-stent strategy for left coronary artery bifurcation lesions in patients with chronic ischemic heart disease: protocol of a randomized trial

Aim. This study aims to compare the intraoperative, immediate postoperative and long-term postoperative results of stenting followed by final kissing balloon angioplasty (FKB) and without FKB for left coronary artery (LCA) bifurcation lesions in patients with chronic ischemic heart disease.Material and methods. We plan to perform an open-label, prospective, randomized, single-center, cohort trial that will include 40 patients with left main coronary artery bifurcation lesion, who will undergo stenting procedure followed by FKB or without FKB, using the second-generation drug-eluting stents. Randomization into two groups will be done after performing coronary angiography, confirming the inclusion criteria and the absence of non-inclusion criteria and signing a written consent in 2 copies. Group 1 — stenting followed by FKB. Group 2 — stenting without FKB. The total follow-up period is 24 weeks. It is planned to contact by phone on 30th and 180th day (±7 days) of postoperative period to obtain the information about patient condition, general survival rate, the events of combined controlled points and drug therapy. During 2d phone contact, on 180th day (±7 days), a patient will be invited to undergo multispiral computed tomography of the coronary arteries.The primary combined end-point: cardiac death, nonfatal myocardial infarction, acute cerebrovascular accident and the repeat target vessel revascularization. The secondary combined end-point: thrombosis and stent restenosis.Conclusion. Our study will optimize the approach to the choice of stenting strategy (with or without FRB) for left main coronary artery bifurcation lesions in patients with chronic ischemic heart disease.

Acute Appendicitis at the Markala’s Reference Health Center about One Hundred and Three Cases

The aim is to study acute appendicitis in the surgery department of the Markala Reference Health Center. Patients and Methods: We conducted a retrospective study in the general surgery department of the reference health center which took place over a period of 35 months from October 1, 2019 to October 30, 2021. The retrospective period was from the month of October 2019 in October 2020 then follows the prospective period until October 2021. Inclusion criteria: Were included in our study; all patients with appendicitis or its complicated forms in the general surgery department of the Csréf in Markala. Non-inclusion criteria: Were not included in our study; cases of appendicitis outside the general surgery department of the Csréf. -Appendicitis accounted for 58.2% of hospitalizations or 31% of emergency surgeries performed during the study period. 85.4% of the patients were without medical-surgical ATCD, on the other hand the oldest of our patients was 61 years old; the average age was 29 years old and the youngest was 13 years old. Furthermore, we note that there was no age of onset of appendicitis. The treatment received by all of our patients was appendectomy (93 cases were operated on urgently and the 10 cases were first cooled and then operated on 3 months after the medical treatment). No major complication was noted in our patients, apart from three cases of infection of the surgical site related to the fact that it was an appendicular abscess. Conclusion: Acute appendicitis is one of the most common surgical emergencies in digestive surgery. Its diagnosis is essentially clinical, sometimes made difficult by the absence of anatomo-clinical parallelism linked to the polymorphism of the lesions and the variations in the position of the organ in the abdominal cavity. Untreated, it can progress to serious complications (generalized peritonitis). It is a condition with low morbidity and mortality subject to early diagnosis and surgical treatment.

Low back pain in pregnant women: A necessary or an avoidable evil?

The aim of this study was to determine the prevalence, the main features and the potential risk factors of LBP in pregnant women. This cross-sectional study included 173 pregnant women in the third trimester. Non-inclusion criteria were severe mental disability and known previous history of musculoskeletal diseases. The participants were categorised into two groups: women with pregnancy-related LBP and pain-free women. Demographic, socio-professional, clinical and obstetrical data were compared between the two groups using the appropriate statistical tests. The mean age was 32.2±5.4years [17-45]. Among them, 108 (62.4%) reported one or more episodes of LBP during at least 7days, mostly in the third semester (n=71). The presence of LBP was significantly associated with history of LBP in previous pregnancies and jobs requiring prolonged standing. Active jobs and the presence of gestational complications were significantly more common in pain-free women. In the multivariate analysis, LBP was independently predicted by the history of LBP in previous pregnancies and the absence of gestational complications. The association of LBP with gestational complications as a protective factor has not yet been reported in previous studies. These complications are a common cause of hospitalisation, which represents a period of relative rest during pregnancy. Our results revealed that history of LBP in previous pregnancies, sedentary lifestyle prior to pregnancy and prolonged standing are the main risk factors of LBP. In contrast, rest and avoidance of physical overstrain during pregnancy may be protective factors.

Results of the osteopathic treatment of the temporomandibular joint dysfunction (meta-analysis)

Introduction. Dysfunction of the temporomandibular joint (TMJ), and especially such a symptom as facial pain, is one of the most common diseases in the modern world. Among the publications devoted to this problem, works about osteopathy as a method of TMJ treating have become increasingly common, and it allows us to summarize these works within the framework of a systematic review with using a meta-analysis.Aim: to study according to the literature the results of the osteopathic correction using for patients with TMJ dysfunctions, and to conduct a meta-analysis.Materials and methods. The selection of scientific papers from the available databases was carried out according to the following criteria. Inclusion criteria: availability of the article full text in Russian or English; patients aged from 18 to 65 years examined by a dentist and diagnosed with TMJ dysfunction; division of patients into 2 groups: receiving standard treatment in one group, and osteopathic and standard treatment in another group; the results of dental examination are described; the duration of observations from 3 to 6 months. Non-inclusion criteria: description of a single clinical case; the sample under study was less than 20 patients; studies on healthy volunteers; the presence of surgical and traumatological pathology in patients (the consequences of improperly fused fractures, orthognathic surgery, resorption of the condyles of the mandible). There was used R-studio program, including meta package, to perform meta-analysis. There was also used the Newcastle–Ottawa scale to assess the risk of systematic errors in the cohort studies.Results. The final analysis by the indicator of pain reduction in the head area according to the 10-point visualanalog scale (VAS) included 3 articles. The Newcastle scale′s results showed a low risk of systematic errors. The performed calculations support generally the assumption of the advantage of osteopathic correction inclusion in the therapy in terms of reducing the severity of pain syndrome, estimated in points according to VAS. When assessing the osteopathic status in all studies, the somatic dysfunctions of the head, neck region and local somatic TMJ dysfunctions were mainly detected in patients with TMJ dysfunctions.Conclusion. Based on the studied literature and the results of this meta-analysis, it can be concluded the advantage of osteopathic correction inclusion in the treatment of TMJ dysfunctions.

Predictors of steroid dependence and resistance in patients with ulcerative colitis

AIM: detection of steroid dependence and steroid resistance predictors in patients with ulcerative colitis (UC).PATIENTS AND METHODS: a retrospective study was conducted. The medical documentation of 1105 patients, who underwent inpatient treatment in Ryzhikh National Medical Research Center of Coloproctology from 2018 to 2021, were analyzed. 69% of patients (n=762) received systemic steroid therapy for UC. In accordance with inclusion and non-inclusion criteria, the medical documentation of 170 patients was selected for statistical analysis. Depending on the steroid status of patients, three groups were identified: group 1 (n=56) with steroid dependence, group 2 (n=56) with steroid resistance and group 3 - control (n=58), who were prescribed systemic GCS without the further development of steroid dependence and resistance.RESULTS: the incidence of steroid dependence was 23.4% (n=259), and steroid resistance was 15.2% (n=168). We identified the following predictors and risk factors of steroid dependence: age of the disease onset &lt;30 y.o. (AOR=0,960, 95%CI= 0,928-0,993, p=0,019), start dose of prednisolone &lt;60 mg (AOR=2,369, 95%ДИ= 1,030-5,441, p=0,042), prescription of systemic GCS ≥2 courses per year (AOR=2,988, 95%ДИ= 1,349-6,619, p=0,007), Mayo Index Score &lt;10 (AOR=0,631, 95%ДИ=0,492-0,809, p&lt;0,001). The risk of steroid resistance statistically significant when Mayo Index Score ≥10 (AOR=2,573, 95%ДИ=1,094-6,050, p=0,030), albumin level &lt;37,1 g/l (AOR=4,571, 95%ДИ=1,567-13,330, p=0,005), CRP ≥47,1 mg/l (AOR=2,641, 95%ДИ=1,102-6,328, p=0,029).CONCLUSION: it is rational to predict an individual response to GCS in patients with UC. With a high risk of developing steroid dependence and steroid resistance, it is advisable to consider early appointment of biological and target therapy, avoiding represcription of GCS.

Telemedicine Management: Approaches and Perspectives-A Review of the Scientific Literature of the Last 10 Years.

This research paper describes the approaches and perspectives of telemedicine worldwide. The objective of this literature review was to analyze the theoretical and empirical studies that address telemedicine management in the last 10 years based on the scientific literature obtained from the Scopus, Scielo, Ebsco, ProQuest, Dialnet, and Redalyc databases, from which 50 articles were selected. The inclusion criteria were the last 10 years, scientific articles, language, variables, and open access. The non-inclusion criteria were repeated articles, not addressing the variable, and not open access. The results show a tendency to manage telemedicine through various approaches and scenarios. These can be grouped into humanistic, socioeconomic, ethical, contingency in the Armed Forces-NASA, and application in the field of medicine with teaching to the entire chain of users, as well as controls and monitoring of patients. In this sense, it is concluded that telemedicine management worldwide faces challenges that must be overcome to reduce still-existing barriers and achieve better access to health systems worldwide.

EXPERIENCE OF PHARMACOGENETIC TESTING IN THE TREATMENT OF ANTIPSYCHOTICS

IntroductionOne of the promising methods for optimizing treatment in order to achieve high-quality remissions is a personalized approach to prescribing therapy in the form of pharmacogenetic testing, the feasibility of which has already been substantiated and proven in a number of clinical guidelines. By the beginning of 2022, several influential regulatory and expert organizations recommend considering the results of genetic testing when prescribing therapy. Thus, personalization of antipsychotic therapy is being introduced in the world practice.ObjectivesTo establish the significance of pharmacogenetic markers that determine the efficacy and safety of antipsychotic therapy in patients with schizophrenia in clinical practice.MethodsThe study included 264 patients (141 men, 123 women; 27.3 ± 4.5 years) from among the first hospitalized in a psychiatric hospital in the period 2018-2020, meeting the inclusion criteria (psychosis within the schizophrenia spectrum disorders; consent to participate in research). Non-inclusion criteria - signs of organic brain damage; alcohol or substance abuse; somatic pathology in the stage of decompensation). The examination took place in three stages - in the first days of hospitalization at the peak of the acute condition and during the formation of remission - after 6 and 12 months. Genetic analysis was performed using high-density biochips from Illumina CoreExome Bead (Illumina Inc, USA). During the follow-up observation, some patients dropped out due to refusal to undergo examination, change of diagnosis or change of place of residence. After 6 and 12 months, it was possible to trace the dynamics of the state of 91 patients (50 men, 41 women; 24.9 ± 4.6 years).ResultsBased on the follow-up results, two types of schizophrenia dynamics were identified - with a relatively favorable and unfavorable course. The formation of a relatively stable remission corresponding to the criteria proposed by the working group was noted in 47 patients (51.6%), carriers of gene polymorphisms: DRD2 rs1799732 (del); COMT rs4680(GG); BDNF rs6265 (CC); ANKK1 rs1800497 (GG); MC4R rs489693 (AA); ABCB1 rs1045642 and ABCC1 rs212090 (GG). An unfavorable course with the ineffectiveness of antipsychotics was found in 48.4% of cases in patients with DRD2 rs1799732 (G/del) carriers; COMT rs4680(AA); BDNF rs6265 (TT); ANKK1 rs1800497 (AA); MC4R rs489693 (GG); ABCB1 rs1045642 and ABCC1 rs212090 (AA).ConclusionsAfter analyzing the results of genetic testing and clinical and dynamic characteristics of the course of schizophrenia, we can talk about the relationship between the establishment of high-quality remission in the presence of polymorphisms in the genotype, whose role has been proven in terms of the effectiveness and safety of antipsychotics.Disclosure of InterestNone Declared

Spot Drug Stimulation: а Randomized Study of 90 Patients with Lumbosacral Dorsopathies

AIM. A randomized placebo-controlled study was conducted to evaluate the therapeutic efficacy of Vishnevsky anesthetic blockade and chondroprotective drug pharmacopuncture in dorsopathies. MATERIALS AND METHODS. 90 patients aged 29–65 years with acute lumbosacral dorsopathy were under observation. Clinical condition dynamics, thermography, tetrapolar rheovasography and results of psychological testing by the methods of «Multilateral personality study» and «Self-activity-mood» were assessed. After determining compliance with the inclusion and noninclusion criteria, the patients were divided into 3 randomized groups (each of 30 patients)differing in treatment methods. In the 1st (control) group, the patients received basic standard treatment, and in the other two groups we additionally performed local medication on the lumbar region and lower extremities on reflexotherapy points. Methodically, anesthetic was injected into the lumbar points according to the Vishnevsky method, and a chondroprotective drug (Group 2) or physiological solution (Group 3, placebo) was differentially injected into the distal points. A course of 10 procedures was carried out in the order of three times a week. Statistica for Windows v.7 program was used for statistical analysis. RESULTS. It was found that upon completion of the treatment there were significant differences in the regression of neurological manifestations, thermographic data and rheographic markers of lower extremity blood flow between the two resultant groups and the control group, in which no significant shifts in the analyzed indices were detected. Both variants of local stimulation, characterized by a pronounced reflex effect, were reliably superior to the basic therapy in terms of efficacy. However, despite the comparable rates of algia reduction in the 2nd and 3rd groups, the level of pain sensations by the end of the treatment course was significantly lower in the patients of the 2nd group that received not only anesthetic blockade in the lumbar region, but also chondroprotector pharmacopuncture. In the same group, more significant shifts were obtained according to the results of psychological testing. The noted phenomenon can be explained by the points of medication application: achieving rapid pain relief due to anesthetic blockade and the overall maximum performance provided by chondroprotector pharmacopuncture. The follow-up data obtained testify to the stability of the achieved positive results under the influence of the reflexotherapy techniques to a greater degree in the patients of the 2-nd group. CONCLUSION. The combined method including anesthetic blockade by Vishnevsky’s method and chondroprotective pharmacopuncture in the region of the lower extremities was highly effective in treating patients with lumbar dorsopathy. In this group, there were notably more significant positive shifts compared to the group that received only anesthetic injections on the lumbar region, according to the severity of the pain syndrome, the results of psychological testing and follow-up data.

Periods till psoriatic arthritis onset and diagnosis in Russian patients with moderate to severe psoriasis (according to psoriasis patient registry)

Background. Early detection of psoriatic arthritis in patients with psoriasis remains an unmet medical need. Early diagnosis and treatment initiation in patients with psoriatic arthritis decreases the risk of adverse patient outcomes and improves patients quality of life.&#x0D; Aims. To describe a period between psoriasis and psoriatic arthritis onset and a period between psoriatic arthritis onset and diagnosis in Russian patients with moderate to severe psoriasis.&#x0D; Materials and methods. Analysis of data from the psoriasis patient registry. Patients aged 18 years and older with an established diagnosis of psoriasis and psoriatic arthritis were included in the analysis. Noninclusion criteria: no data on psoriasis and/or psoriatic arthritis onset (for the period between psoriasis and psoriatic arthritis onset description); no data on psoriatic arthritis onset and/or diagnosis (for the period between psoriatic arthritis onset and diagnosis description).&#x0D; Results. Sample size for the descriptive characteristic of period between psoriasis and psoriatic arthritis onset was 891 patients; sample size for the descriptive characteristic of period between psoriatic arthritis onset and diagnosis was 849 patients.&#x0D; Psoriatic arthritis onset preceeded cutaneous manifestation of psoriasis in 2.5% of patients. Concurrent onset of cutaneous psoriasis and psoriatic arthritis (within one year) had 10.7% of patients. In 86.8% of patients, cutaneous manifestation of psoriasis preceded manifestation of psoriatic arthritis.&#x0D; Exclusively of patients with psoriatic arthritis developed before or concurrently with cutaneous manifestation of psoriasis, the mean duration of period between psoriasis and psoriatic arthritis onset was 13.7 10.3 years, the median [IQR] 12 [619] years.&#x0D; In 24% of patients psoriatic arthritis was diagnosed 1 year and more after its onset. The mean (SD) period from signs and|or symptoms onset till psoriatic arthritis diagnosis was 3.9 5.0 years; median [IQR] was 2 [14.5] years.&#x0D; Conclusions. A diagnostic delay in 24% Russian patients with psoriatic arthritis is one year or more. In this subgroup of patients the mean delay in diagnosis of psoriatic arthritis is about 4 years.

Prevalence and Contributing Factors of Orthostatic Hypotension in the Cardiology Department of the CHU Ignace Deen in Conakry

Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension; describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.

Visual Outcome of Adult Cataract Small Incision Cataract Surgery in Northern Benin

Introduction: Cataract remains a public health problem in Africa. Its treatment remain essentially surgical. Several management techniques are available and the most adapted to a context with poor resources like lack of material and financial resources is small incision cataract surgery (SICS). Method: This was an exhaustive recruitment of the study population meeting the inclusion and non-inclusion criteria. Carried out from January 1st to May 30th of 2022 at Hôpital Saint André de Tinré (HOSAT) located in the Northern part of Benin. It involved patients aged 40 and above who underwent cataract surgery during the period of this study. Visual acuity was assessed before and after the surgeries at day 1 and day 30. Results: We included 213 eyes. The average age was 65.2 ± 9.1 years with a mean age of 65.2 ± 9.1 years. Comorbidities were dominated by arterial hypertension in 57.5% of cases. Preoperatively, all patients had at least in one eye a visual acuity of less than 1/20. The main intraoperative complication was posterior capsular tear with vitreous loss, found in 6% of cases. The average power of the implant was 21.4 ±1.7 diopters. The standard implant was used in 64.7% of patients. After one month, the visual acuity without postoperative correction was good in 32.1%; borderline visual acuity was 41.4% and poor visual acuity was 26.5%. Conclusion: Cataract remains the main cause of blindness in developing countries, particularly in rural areas. It is important to sensitize patients for early screening in order to improve theirs qualities of life.

Prospective Study of the Inversion Destabilization Maneuver in the Treatment of Acute Ankle Ligament Injury: Case Series

Category: Ankle; Sports; Trauma Introduction/Purpose: Ankle sprains are highly prevalent injuries in athletes whether they are amateurs or professionals. It is estimated that around 5,000 sprains occur a day in the UK, while American data point to around 23,000 cases daily (1/10,000 individuals). The world literature has pointed out that about 7 - 10% of orthopedic visits in an emergency service are due to ankle sprains, corresponding to about 25% of all musculoskeletal injuries. The objective of this paper is to present the clinical results obtained from the prospective observation of a series of patients with lateral ankle sprains treated by the destabilization technique in Inversion of the ankle added to the conventional treatment. Methods: Design Case series, prospective, single center location. The study will be carried out at Hospital São Paulo - University Hospital of UNIFESP (HSP-UNIFESP), at the Orthopedics Outpatient Clinic of the Department of Orthopedics and Traumatology (DOT)/EPM-UNIFESP. Inclusion criteria - Over 18 years of age of both sexes; - Complaint of ankle sprain up to 48 hours - Complete or partial injury to any of the ligaments of the lateral ankle complex; - Isolated or associated ligament injuries; Non-Inclusion Criteria - Past history of surgery on the affected foot or ankle; - Previous complaint in the ankle region; - Any fracture associated with the sprain or influencing injuries; - Any condition that is a contraindication to the proposed therapies; - Refusal to participate in the study Results: We observed in our series of 100 individuals with lateral ankle sprains 6 new episodes of sprain in a follow-up of 12 month. we did not observe the occurrence of spontaneous ankle sprains in the 6 cases, external causal factors were pointed out by the patients. In 1 case the patient stepped on a squash ball, 1 case the patient had his ankle stepped on during a soccer match, in another case the patient suffered a fall while walking with high heel shoes. We also observed a fall from the stairs, a fall on another player's foot during a volleyball game and in the last case the patient suffered a fall after stepping on a hole in the sidewalk during street racing. Conclusion: Based on the findings of the present study, we concluded that in a 12-month follow-up, the ankle inversion destabilization maneuver proved to be efficient in preventing new episodes of lateral ankle sprain, however, new studies with a longer follow-up time, as well as and in order to compare the maneuver described in the study with techniques already described in the literature and used by physical therapists in their clinical practice should be performed.

Substantiation of the economic efficiency of the author′s manual repositioning method of the shoulder joint

Introduction. Shoulder joint′s dislocation stands first among all dislocations. Assistance to patients with dislocation of the shoulder carries out both outpatient and inpatient. The cost of inpatient treatment is many times higher than that of outpatient care.The aim of the study is to substantiate the economic efficiency of the author′s manual technique for shoulder dislocation repositioning.Materials and methods. The study is longitudinal from 2013 to 2020 inclusive, the sample is continuous, the place of the study is the trauma center of the City Hospital № 1 N. I. Pirogov. Criteria for inclusion of patients in the study — primary dislocation of the shoulder. Diagnosis closed traumatic dislocation of the shoulder in total — 1 968 people. Non-inclusion criteria — secondary dislocation. Successful repositioning of shoulder dislocation on an outpatient basis was performed in 1 159 (58,9 %) patients; after unsuccessful repositioning, 809 (41,1 %) patients were hospitalized with shoulder dislocation. Outpatient patients were randomly divided into 2 groups: group 1 — patients (n=1 552) underwent reduction of the dislocation using traditional methods using local anesthesia, in group 2 patients (n=416) the author′s manual technique was used without local anesthesia. There were no statistically significant differences in gender, age, and type of dislocation in both groups. The effectiveness of using traditional methods with the use of local anesthesia was 52% (dislocation was repositioned in 807 patients), the rest of the patients were treated in an inpatient setting. The use of manual techniques was effective in 84,6 % of cases (352 people), 64 people were hospitalized (15,4 %).Results. Comparison of the cost of treatment was carried out on the basis of the Tariff Agreement in the compulsory medical insurance system of the Sevastopol city dated December 20, 2021: the cost of treating one patient with shoulder dislocation in the traumatology department (13 582,49 rubles) is 13,3 times more than in the trauma center (1 019,5 rub). The effectiveness of the author′s manual technique is 1,63 times higher than the use of standard reduction methods using local anesthesia.Conclusion. The use of the author′s manual technique in patients with shoulder dislocation on an outpatient basis has a higher efficiency compared to traditional methods due to the fact that more patients receive assistance on an outpatient basis, the cost of this service is much cheaper than inpatient treatment. In addition, this type of treatment is carried out without anesthesia, which also reduces the cost of treating of this category of patients.