Presence Of Complaints Research Articles

Work-related musculoskeletal complaints of physiotherapists working in intensive care units: Frequency analysis, risk factors, management and prevention strategies.

Intensive care physiotherapists are exposed to situations that may cause physical and mental overload, which can lead to the onset of work-related musculoskeletal complaints. The objective was to analyze these complaints and to identify activities causing greater overload, factors associated with complaints, and management and prevention strategies. Cross-sectional study. Data were collected from 125 physiotherapists in the Intensive Care units (ICU) of a tertiary hospital. The questionnaire used was formulated from questionnaires validated in the literature such as Nordic Questionnaire and Bork Questionnaire. Chi-square test was performed to compare the groups with and without complaints. Logistic regression was used to assess the association effects of the variables on the presence of complaints. Of those interviewed, 76% had a work-related complaint in the last year, with the "lower back" being the most affected region. Eighty percent had complaints for more than one site. "Transfer" was considered the activity causing the greatest overload. Female sex (p = 0.023), lack of physical activity (p = 0.028), inadequate ventilation (p = 0.001) and inadequate furniture (p = 0.006) showed a statistically significant association effect with the presence of complaints. Inadequate ventilation (p = 0.003) and female sex (p = 0.004) influenced the number of affected areas. Physical activity was considered the main strategy for prevention. Musculoskeletal complaints accounted for a high percentage of the analyzed sample, mainly in the lower back. The extent of complaints suggests that strategies should be developed and changes in work dynamics should be carried out.

ОЦЕНКА ОСТРОЙ ТОКСИЧНОСТИ ПРЕПАРАТА 99mTc(CO)3-(HE)3-DARPinG3 У БОЛЬНЫХ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ

Purpose: Study the acute toxicity of the radiopharmaceutical [99mTc]Tc-(HE)3-G3 in breast cancer patients. Material and Methods: The study included 10 breast cancer patients (T1-4N0-2M0) with different HER2/neu expression before systemic/surgical treatment, who were injected with 1000 μg of DARPinG3 protein labeled with technetium-99m ([99mTc]Tc-(HE)3-G3). Throughout the study (48 hours), patients were monitored by medical personnel, during which complaints were assessed, heart rate, blood pressure and body temperature were measured before injection of the radiopharmaceutical, as well as 2, 4, 6, 24 and 48 hours after injection. Additionally, laboratory tests such as general and biochemical blood tests and general urine analysis were performed before injection, 48 hours and 7 days later. Results: The presence of complaints, as well as the detection of adverse reactions in breast cancer patients included in the study at the time of injection of the radiopharmaceutical [99mTc]Tc-(HE)3-G3, as well as 2, 4, 6, 24, 48 hours and 7 days after injection were not detected. The measurement of heart rate, body temperature, and blood pressure also showed no pathological abnormalities. According to general and biochemical blood analysis, general urine analysis and ECG results, no abnormalities were found 2, 4, 6, 24 and 48 hours, as well as 7 days after of the radiopharmaceutical [99mTc]Tc-(HE)3-G3. Conclusion: The performed studies fully demonstrate the safety of the clinical use of the radiopharmaceutical [99mTc]Tc-(HE)3-G3 for radionuclide diagnosis of breast cancer patients. The data obtained were confirmed both by the subjective sensations of the patients directly included in the analysis, and by the data of clinical quantitative parameters before the start, as well as 2, 4, 6, 24 and 48 hours after injection of the radiopharmaceutical [99mTc]Tc-(HE)3-G3.

A retrospective study of the relationship between the presence of complaints and the identified pathological changes in the temporomandibular joint

Introduction. In the practice of an orthodontist, diseases of the temporomandibular joint (TMJ) are an urgent problem due to their widespread, diverse clinical manifestations.Goal. To study the relationship between the identified anatomical and functional disorders of the TMJ, as risk factors for complications during orthodontic treatment, and the presence of characteristic complaints in the structure of pathological changes in the TMJ.Materials and methods. According to the type of organization and the ratio of data collection time, the scientific study belonged to a longitudinal retrospective study, according to the type of observation: case-control. A retrospective analysis of 102 outpatient medical records of patients who sought medical help from an orthodontist at a dental clinic was carried out. The criterion for inclusion in the study was the presence of a newly diagnosed disease of the temporomandibular joint, mandatory radiological diagnostic methods. Magnetic resonance imaging (MRI) of the TMJ in the patient who sought medical help was used as a radiation diagnosis. As part of the scientific study, the structure of pathological changes in the TMJ was analyzed, the relationship between the presence of complaints and the revealed pathology was studied.Results. The analysis of the data showed that the MR examination of the TMJ reveals pathological changes in patients who sought orthodontic care, both with complaints and with an asymptomatic course of diseases. Data analysis did not show a statistically significant relationship between the presence of complaints and the revealed pathology in the case of degenerative (χ2 = 0.123; p > 0.05), inflammatory changes in the TMJ (χ2 = 0.123; p > 0.05) and pathological disorders of the masticatory muscles (F = 0.704; p > 0.05). The relationship is statistically significant, but weak for ventral dislocation without reposition (p < 0.05; φ = 0.107) and the dorsal arrangement of the disc (p < 0.05; φ = 0.101). In the case of ventral dislocation of the articular disc with the reposition, the relationship is statistically significant, of medium strength (p < 0.05; φ = 0.284).Conclusions. The results of a retrospective analysis of medical documentation confirm the need for instrumental research methods for all patients, regardless of whether they have any complaints at the stage of determining the optimal tactics of orthodontic intervention to obtain diagnostic information on the state of the TMJ in order to prevent the risks of complications during orthodontic treatment.

ЗАБОЛЕВАЕМОСТЬ НАСЕЛЕНИЯ ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ В РЕСПУБЛИКЕ БАШКОРТОСТАН. ЧТО ИЗМЕНИЛОСЬ В ТЕЧЕНИЕ 2019-2022 гг.

Significance. Malignant neoplasms remain widespread, ranking second in the structure of total mortality and topping the structure of primary disability. The share of stage IV cancer remains high. The purpose of the study was to analyze the incidence of malignant neoplasms in population of the Republic of Bashkortostan in 2019-2022 and to assess changes in the level and structure of incidence due to the epidemiological situation caused by Covid-19. Material and methods. The study material was data of the form No. 7 “Information on malignant neoplasms” for 2019, 2020, 2021 and 2022. Data on the number of detected malignant neoplasms among men and women in certain age groups, stages of malignant neoplasms at detection and the number of deaths from cancer within one year after diagnosis were uploaded from the reporting form. Results. In 2020, there was a 21.1% decrease in the incidence of malignant neoplasms compared to 2019. In 2021, the incidence of trachea, bronchi, lung, prostate, colon, and kidney cancer significantly decreased in men, while in women there was a reduction in the incidence of breast cancer, skin melanoma, other neoplasms of the skin, cervix, lymphoid and hematopoietic tissues. The incidence rates in men and women in these years hardly differed. Thus, in 2019, the cancer incidence among men equaled to 358.1 cases per 100,000 people, while among women it was 335.9 cases. Analysis of the incidence rates by year showed that by 2020, it decreased to 281.1 cases among men and to 268.2 cases among women. In 2021, the incidence increased to 296.3 and 292.0 cases, respectively, and in 2022 - to 320.3 and 314.6 cases per 100,000 people. At the same time, in the age groups starting from 25-29 up to 55-59 years, the incidence in women was significantly higher than in men (2.0-2.5 times). Conclusion. The decrease in the incidence of malignant neoplasms in 2020, 2021 and in 2022 compared to 2019 is probably due to the spread of Covid-19. The decrease in the detection of cancer of certain localizations may be associated with a decrease in the coverage with preventive medical examinations and care seeking even in the presence of complaints. In connection with these reasons, the share of IV stage cancer increased. The obtained data indicate a possible reduction in medical care delivery for socially significant diseases in case of epidemiological situations.

The choice of coronary revascularization method depending on comorbid pathology

Coronary heart disease plays a leading role in global mortality statistics. Despite the obvious progress in the development of new drug regimens, surgical treatment remains an important component. The high prevalence and complexity of treatment of patients with CHD and comorbid pathology, especially diabetes mellitus and chronic kidney disease, make researchers think about proper approaches to therapy of such patients. The decision to perform revascularization is made in consultation with all Heart Team members, taking into account the results of the invasive study, the presence of complaints in the patient and his "response" to drug therapy. Percutaneous coronary interventions (PCI) are still statistically more likely to result in restenosis and repeat revascularizations than open surgery. Hybrid myocardial revascularization is an alternative method combining the advantages of coronary artery bypass and PCI and reducing the risks of both procedures adverse complications. The choice of the optimal strategy of surgical treatment in patients with comorbid pathology requires special attention.

Irritable bowel syndrome: modern ideas about pathology and the possibility of its correction

Among the defecating disorders with constipation or diarrhea, there is a group of major intestinal disorders defined by the Rome IV Diagnostic Criteria (2016): irritable bowel syndrome, functional constipation, functional diarrhea. The presence of several updates of the Rome criteria is due to the current lack of objective signs of the listed disorders while many options for describing subjective sensation by patients from different countries. It calls for their terminological multilingual standardization. Both constipation and diarrhea can be caused by a variety of exogenous and endogenous factors and have different pathogenetic mechanisms, but they cannot be identified properly using modern clinical and laboratory methods for functional intestinal disorders. However, the high prevalence of these syndromes, characterized by the presence of complaints that reduce patients’ quality of life, necessitates their correction. The drug choice for defecation disorders and abdominal pain is often limited by contradictions from international clinical guidelines and national regulations.Therefore, the Recommendations of the Russian Gastroenterological Association for the treatment of functional intestinal diseases contain many instructions on general therapeutic and dietary measures. The pain syndrome treatment is based on the spasmolytics. Among the laxatives that have long been used in the treatment of chronic constipation, sodium picosulfate has long been successfully used. This drug has high efficacy and safety profiles; the instructions for its medical use allow to prescribe it in patients suffered from irritable bowel syndrome with constipation. The use of sodium picosulfate for IBS is regulated by many clinical recommendations. However, this drug may be ineffective against abdominal pain. It is incorrect to assign the mission of pain relief to a laxative because of multifactorial pathogenesis of IBS pain with constipation or diarrhea and uncertainty of methods for its pharmacological control.

Inflammatory status of the birth canal of pregnant women with cervical insufficiency treated with progesterone therapy, cervical cerclage and obstetric pessary

Preterm birth is a major global health problem. Every year about 15 million babies are born prematurely in the world, of which 1 million newborns die. Spontaneous preterm birth (SPB) accounts for 40–45% of all preterm births. Cervical insufficiency (CI) is a significant risk factor for SPB. The studies have established the influence of the vaginal microbiome on cervical length during pregnancy and the importance of the bacterial composition of the vagina as a factor determining the risk of preterm birth.The objective: to study the vaginal microbiome of pregnant women with CI and various treatment methods (progesterone therapy, cervical suture or obstetric pessary).Materials and methods. During 2020–2023, an observational longitudinal study was conducted in the municipal non-profit enterprise “Perinatal Center of Kyiv”, in which 94 pregnant women participated. Among them 64 women were diagnosed CI (progesterone therapy group – n=22, cervical suture group – n=23 and obstetric pessary group – n=19). The control group included 30 pregnant women without CI.Results. Vaginal progesterone therapy and the use of a cervical suture have less effect on the microbiome than the use of a pessary. Conditionally pathogenic and pathogenic microflora was detected in 27.27% of patients in the progesterone group, 47.82% of patients in the cervical suture group, and 57.89% – in the pessary group.Inflammatory smear grade 3–4 was found in 31.81% of patients in the progesterone group, 47.82% – the cervical suture group, and 57.89% – the pessary group; complaints of discomfort and discharge – in 22.72%, 39.13% and 57.89% of patients, respectively. Compared with the control group, the use of a pessary is associated with an increase in the frequency of identification of opportunistic pathogenic microflora (16.67% vs. 52.63%; p<0.05), unsatisfactory results of bacterioscopic examination (20.00% vs. 57.89%; p<0.05), as well as an increase in complaints of discomfort and significant vaginal discharge (16.67% vs. 57.89%; p<0.05).Conclusions. It has been established that regardless of the type of therapy, inflammatory changes (presence of opportunistic pathogenic and pathogenic microflora, inflammatory type of smear, complaints of discharge and discomfort) of the birth canal are observed in pregnant women with CI.There is a connection between different methods of treatment and unsatisfactory results: bacteriological analysis – the presence of opportunistic pathogenic and pathogenic microflora (p<0.05), bacterioscopic analysis – inflammatory type of smear of the 3-4 grade of purity (p<0.05) and anamnestic analysis – the presence of complaints in female patients (p<0.05).

Musculoskeletal complaints in English law enforcement officers: a cross-sectional study

Objectives. Musculoskeletal (MSK) complaints are prevalent in law enforcement officers (LEOs), but research that examines their risk factors is limited. This study aimed to identify the self-reported MSK complaint prevalence and perceived causes in LEOs. Methods. The Nordic musculoskeletal questionnaire was used to identify the 12-month and 7-day prevalence of MSK ‘trouble’ (ache, pain, discomfort) for nine body sites. The perceived cause, participant characteristics and occupational role were reported. Body fat percentage was measured using bioelectrical impedance. Results. Complete submissions of 186 questionnaires were received (80% male, median age 40.6 years, interquartile range 10.1). Eighty-six per cent of officers reported having an MSK complaint in the last 12 months, where lower back, shoulder and neck complaint prevalence was 59.1, 48.4 and 42.5%, respectively. The occupational role was associated with the site and presence of complaints (p < 0.05), where armed officers presented with more shoulder, lower back and hip/thigh complaints. Age, sex and body fat did not impact complaint prevalence. Participants mainly attributed their complaints to occupation equipment or to sport and exercise. Conclusion. MSK complaints were highly prevalent in this cohort, particularly armed officers. Further research is required to establish the impact of these complaints and how they can be mitigated.

Pelayanan Perizinan Melalui Sistem Online Single Submission Risk Based Approach (OSS-RBA) Pada Dinas Penanaman Modal Pelayanan Terpadu Satu Pintu Dan Tenaga Kerja Kabupaten Kuantan Singingi

It is known that there are still some deficiencies, namely the limited ability or understanding of users in operating electronic service systems, which in this case the OSS-RBA program is known as the digital divide. Some of these deficiencies in the DPMPTSPTK of Kuantan Singingi Regency were the presence of complaints from the public about the difficulty in understanding licensing processing with changes to the permit application process using the system. The licensing process takes quite a long time because it depends on the network of officers working. The limited ability of these business actors makes them continue to visit the Office of Investment and One-Stop Integrated Services (DPMPTSP) of Kuantan Singingi Regency to process account registration and issue business licenses. The large number of business actors who come to the DPMPTSPTK results in the service process taking quite a long time, this is because the internet network at the DPMPTSPTK agency is still joined to the Regent's Office and the IT is always problematic so the internet connection is sometimes slow and the internet connection is lost. This is an obstacle in the data entry process for business actors, which hinders and slows down the assistance services for OSS-RBA operators at the DPMPTSPTK of Kuantan Singingi Regency for business actors. With the need for commitment and willingness from the service provider to be able to help and be open to input given by service recipients in obtaining business licensing. Several licensing service agencies in Indonesia have started to create a joint consensus in the licensing service process which is managed by the public (Adianto et al., 2017). Besides that, there is a lack of training from the DPMPTSPTK service for human resources in implementing the OSS-RBA system. In addition, it is recognized that currently the electronic licensing that has been implemented by the DPMPTSPTK of Kuantan Singingi Regency is not well known or understood by business actors due to the uneven distribution of direct socialization regarding how to use OSS-RBA services online to every region in the Regency. Kuantan Singingi.

Skin irritation in children undergoing orthodontic facemask therapy

Orthodontic facemasks are extraoral orthodontic appliances that influence maxillary and mandibular development in children with skeletal Class III malocclusion. While a facemask is most effective in patients before the growth spurt, skin irritation is common during the treatment. Therefore, this retrospective study aimed to investigate the prevalence and pattern of such skin changes and identify their possible associated risk factors. We included 177 patients with skeletal Class III malocclusion who underwent facemask therapy. Patient age and sex, orthodontic parameters expressing the severity of malocclusion, the presence of complaints in the temporomandibular joint (TMJ) areas, and the level of patient cooperation were evaluated. Additionally, the severity and onset time of skin reactions were further analyzed. The results indicated that 43.5% of patients developed skin changes typical of irritant contact dermatitis. Skin irritation was significantly associated with the presence of TMJ complaints and female sex. Furthermore, skin irritation was more common in younger patients. Clinicians should pay special attention to the skin areas that come into contact with the appliance during each follow-up visit to detect potential problems. Moreover, patients and their parents should be given adequate information about the possibility, prevention, and management of skin problems during facemask therapy.

Epidemiological and Clinical Profile of Newly Diagnosed HIV/AIDS Patients: A Retrospective Analysis of Changing Trends Over 16 Years

To evaluate the epidemiological profile and clinical findings of newly diagnosed HIV-infected patients in terms of changing trends over 16 years. A total of 748 patients (mean±SD age: 34±11.6 years, 88.9% were males) newly diagnosed with HIV/AIDS at a tertiary care hospital located in Istanbul province between 2002 and 2017 were included in this retrospective study. Data on sociodemographic characteristics, potential routes of transmission, the reason for HIV testing, time from diagnosis to treatment onset, and the HIV RNA values and CD4+ T cell count (at diagnosis and treatment onset) were recorded in each patient and compared between the diagnoses made within the 2002-2009 (n=141) vs. 2010-2017 (n=607) periods. When compared to HIV diagnoses within the 2002-2009 period, the diagnoses made within the 2010-2017 period were associated with a significantly higher percentage of males (78.7 vs. 91.3%, p<0.001), 18-29 years age group (23.6% vs. 35.5%, p=0.029), singles (34.0 vs. 49.6%, p=0.004), university graduates (9.9 vs. 23.4%, p<0.001) and students (0.7 vs. 8.2%), p<0.001) along with an increased likelihood of voluntary testing (6.4 vs. 15.2%, p=0.048) and a lower percentage of heterosexual individuals (63.8 vs. 47.0%, p<0.001). Sexual contact (88.0%) was the leading transmission route, and the presence of complaints (44.3%) was the leading reason for HIV testing. Overall, the time from diagnosis to treatment onset was a median 1 month (range, 1 to 97 months), and the median HIV RNA level at the time of diagnosis was 208065 copies/mL with no significant difference between study periods. The diagnoses within the 2010-2017 vs. 2002-2009 period were associated with significantly higher median(min-max) CD4+ T cell counts (378(0-2522) vs. 319(4-1270) cells/mm3, p<0.001) and a lower percentage of patients with CD4+ T cell count <200 cells/mm3 (22.1 vs. 39.0%, p=0.002) at the time of diagnosis. In conclusion, our findings on the epidemiological profile and clinical characteristics of newly diagnosed HIV patients over 16 years (2002-2017) in a tertiary care center in Turkey revealed a considerable increase in the number of new diagnoses, an improved earlier diagnosis and a change in epidemiologic profile over the years with increased likelihood of disease to be more commonly diagnosed among males, 18-29 years age group and MSM.

Frequency and risk of adverse reactions to TB therapy in children and adolescents

Introduction.In the treatment of tuberculosis in children, the proportion of adverse events to therapy can be as high as 55 %, especially at the initial stages of treatment. Timely detection and monitoring of their development can improve the effectiveness of tuberculosis treatment.The aim of the workwas to study the peculiarities of adverse reactions in children and adolescents during antituberculosis therapy for their prediction and timely detection.Materials and methodsA retrospective cohort study including 243 patients aged 0 to 17 years who received treatment in two major institutions of Kemerovo Oblast – Kuzbass during 2018–2021 was conducted. Statistical processing of the material assessed risk factors for the development of adverse events in the groups with dyspeptic, toxic and allergic reactions.ResultsIn the course of chemotherapy 88 patients (36.2 %) developed adverse reactions: dyspeptic – in 55 patients (62.5 %), allergic – in 29 (32.9 %) and toxic – in 28 patients (31.8 %). Adverse reactions developed more often in children and adolescents with concomitant diseases of the gastrointestinal tract, in the presence of complaints before treatment for tuberculosis, during treatment on IV, V chemotherapy regimens with the presence of Pto, Pas, Lfx and Cm in the scheme, as well as when taking broad spectrum antibiotics and anti-tuberculosis drugs.DiscussionDespite the involvement in the process of identifying and monitoring the development of adverse reactions in TB treatment in children, the main risk factors for their development have not yet been identified. The study demonstrates the contribution to the development of adverse reactions of such factors as treatment on IV, V chemotherapy regimens, comorbid GI diseases, presence of complaints during hospitalization in a TB hospital and taking antibiotics together with antituberculosis drugs.ConclusionUndesirable phenomena were mostly observed at the start of antituberculosis therapy. Allergic, toxic and dyspeptic reactions occurred most frequently in the study group. The risk factors for their development were: IV, V chemotherapy regimens (OR = 2.5), presence of Pto (OR = 2.7), Pas (OR = 3.0), Lfx (OR = 2.3) and Cm in the CT regimen (OR = 3.8), comorbid GI diseases (OR = 3.5), complaints during hospitalization in the TB hospital (OR = 1.8) and taking antibiotics together with antituberculosis drugs (OR = 2.5).

Impact of surgically assisted rapid mandibular expansion on the temporomandibular joint - A retrospective study

This study evaluates the impact of tooth-borne Surgically Assisted Rapid Mandibular Expansion (SARME) on the temporomandibular joint (TMJ) function and condylar morphology.Medical records of patients who received a SARME between 2014 and 2018 are retrospectively reviewed concerning functional problems. Morphological changes of the condyles are analyzed by means of surface registration of 3D reconstructed CBCT scans preoperatively and one-year postoperatively, and correlated to functional outcome.In 68 patients data are complete. The risk of TMJ dysfunction is slightly increased from 18 to 25% at a mean of 14 months after SARME. This is attributed to an increase in the number of minor problems (75–82%). The presence of complaints before SARME is the only identifiable risk factor for also having complaints after the intervention (p = 0.0019). In one patient with pre-existent TMJ dysfunction complaints deteriorated after SARME. After SARME no cases of extended condylar resorption are described. There is no correlation between morphological condylar changes and the prevalence of TMJ dysfunction (p = 0.7121 for appositional and p = 0.3038 for resorptive changes). However, appositional and resorptive changes at the condylar head appear to correlate with growth potential, based on age, gender and skeletal deformity (p < 0.0001 and p = 0.0154 respectively).Within the limitations of the study it seems that SARME does not have a negative impact on TMJ function or condylar integrity and, therefore, the choice for or against this approach can be made without considering consequences for TMJ a major issue for the decision.

Differential diagnosis and treatment of neck pain

Neck pain is widespread in the population and reaches 60%. Women in the age group under 60 are more likely to be affected than men. Acute pain is typical for young people, chronic – for patients of the older age group. Neck pain can be nonspecific, neural or mixed, depending on the involvement of various anatomical structures in the pathological process.Nonspecific (nociceptive, musculoskeletal) pain accounts for about 80–90% of all cases. The clinical picture may also include limited range of motion in the cervical spine (CS), changes in muscle tone in the region. With damage to the cervical spinal roots, neural symptoms join, which is observed in 11.9–43% of cases.The key to making the correct diagnosis is a deep study of complaints, anamnesis, and a thorough physical examination. Paraclinical research methods play a secondary role in the diagnosis, they are prescribed only if their results can affect the formulation of the diagnosis and further treatment. The need for differential diagnosis between nonspecific and neuropathic pain arises in the presence of complaints and clinical manifestations characteristic of both options. Standard schemes of drug therapy for nonspecific and neuropathic pain have certain differences, while they do not depend on the localization of the process and the involvement of certain structures in the process. In both cases, the main therapeutic tasks are to provide effective pain relief and influence on the inflammatory process. With these tasks, NSAIDs are most fully coping. The original diclofenac has a pronounced analgesic and anti-inflammatory effect with a high safety profile, which, together with a variety of dosage forms, makes it attractive for the treatment of various types of neck pain. An additional local effect on pathologically altered structures by the topical diclofenac forms significantly increases the effectiveness of the treatment. In the above clinical cases, two variants of neck pain are considered, which have similar symptoms, while being different forms of pathology.

Реабілітація хворих на COVID-19 з використанням комплексу амінокислот, вітамінів та мікроелементів

Abstract. The aim of the study: to analyse the effectiveness of using “ІmmunоАctive” dietary supplement in patients with post-COVID-19 syndrome. Materials and methods. Three groups were formed for the study: control group — apparently healthy people with negative history of COVID-19; group 1 — patients who survived COVID-19 and did not take “ІmmunоАctive” during their rehabilitation period; group 2 — patients who survived COVID-19 and took “ІmmunоАctive” during their rehabilitation period. The research protocol included: screening of the patients according to criteria of their eligibility and non-eligibility; performance of general clinical and immunologic studies at the moment of the disease onset (by visit to a doctor and the positive test for COVID-19); in 12 weeks after their disease the patients underwent post-COVID-19 rehabilitation during 1 month, which included certain physical exertion and diet therapy; repeated general clinical and immunologic studies after rehabilitation. In addition to their physical exertion and rational nutrition, patients from group 2 took “ІmmunоАctive” dietary supplement by 1 capsule once a day during meal. The study involved 37 patients, who survived COVID-19 and had a moderate course by data of their clinical and laboratory examinations. The criteria of eligibility were as follows: outpatient treatment during the acute period without complications, only taking of antipyretic drugs during the acute period, the age from 40 to 55, and the presence of complaints about asthenia and loss of capacity to work later than 12 weeks after the disease. Conclusions. By data of haematologic analysis it was revealed that even a mild course of the disease was accompanied with anaemization of the organism. Immune status indices demonstrated development of the state of immunodeficiency in conditions of coronavirus infection. The use of “ІmmunоАctive” dietary supplement first of all normalized indices of “red blood” and produced favourable immunomodulatory effects on the humoral and cellular components of immunity. Key words: Post-COVID rehabilitation, haematologic studies, immunologic studies, “ІmmunоАctive” dietary supplement.

Clinical manifestations of gastrointestinal tract changes in children with juvenile idiopathic arthritis

Summary. Juvenile idiopathic arthritis remains one of the most common chronic inflammatory rheumatic diseases of childhood. A significant proportion of patients experience nausea, vomiting, abdominal pain and loss of appetite with methotrexate therapy, which can significantly complicate the course of the disease. The aim was to study the clinical and anamnestic signs of liver disorders in children, depending on the manifestations of juvenile idiopathic arthritis. Materials and methods of research. The presence of gastrointestinal complaints, namely abdominal pain, loss of appetite, nausea and vomiting in 104 children with juvenile idiopathic arthritis who were treated at the State Institution "Institute of Child and Adolescent Health of the National Academy of Medical Sciences of Ukraine" was analyzed. Results. According to the results of the study, children with juvenile idiopathic arthritis had gastrointestinal complaints in 47.12%. We find out that the majority of children had gastrointestinal complains at the age of 10–13 years (55.36%, p ˂ 0.001), and at the onset of the disease after 15 years (100%, p ˂ 0.01). Young children often complained of abdominal pain and vomiting, older children complained of loss of appetite and persistent nausea, regardless of the variant, activity, duration of arthritis and the presence of methotrexate in complex therapy. It was also found that appearance of gastrointestinal complaints were observed more often at a dose of methotrexate less than 10 mg / m2 / body surface (p ˂ 0.05). Conclusions. 1. We find out that in 47.12% children with juvenile idiopathic arthritis had gastrointestinal complaints, aged 10–13 years (55.36%; p ˂ 0.001). The most amounts of complaints were common for patients older than 15 years old (p ˂ 0.01). 2. The nature of the complaints varied and depended mainly on the age of the patients. Younger children had abdominal pain and vomiting simultaneously older children had decreased appetite and nausea. The presence of complaints did not depend on the variant, activity and duration of the juvenile idiopathic arthritis. 3. According to our study complaints were not due to the presence of methotrexate in combination therapy. Children complained much more often if methotrexate dose was less than 10 mg / m2 than in the case of higher doses (p ˂ 0.05).

Treatment of mixed anxiety and depressive disorder: results from a observational study of the efficacy and tolerability of agomelatine

Objective: to study the efficacy, safety and tolerability of agomelatine in mixed anxiety and depressive disorder.Patients and methods. Agomelatine was administered to 30 patients diagnosed with mixed anxiety and depressive disorder for 3 months. The patients' condition was assessed using a battery of psychometric methods – the Hamilton Depression Scale, the Hamilton Anxiety Scale, and a short form of the SF-12v2 quality of life questionnaire.Results and discussion. It was shown that agomelatine effectively reduces both symptoms of depression and anxiety, begins to have a therapeutic effect a week after the start of administration, however, the drug shows the best clinical effect when administered for a period of three months or more. The predictors of complete remission on agomelatine therapy in this sample were: the presence of sleep disorders (early and medium, but not late insomnia), a greater severity of somatized anxiety, the presence of complaints of decreased workplace performance and activity.Conclusion. Our study has shown that agomelatine is an effective, safe and well-tolerated drug in the treatment of mixed anxiety and depressive disorder.

Cue the complaint: the visual cues of Facebook business pages and their influence on consumer complaint behaviour

ABSTRACT The visual cues of websites have been found to affect consumer attitudes and behaviours. Facebook business pages (FBPs) also exhibit visual cues, several of which are pertinent to consumers considering whether to make a complaint on a FBP. Drawing on social cognitive theory (SCT), we explore the role of these visual cues in consumers’ social learning and reveal their influence on consumers’ likelihood to complain and attitude towards the firm. Four experiments examine the influence of three visual cues: the presence of complaints by other consumers, firm responsiveness, and evidence of redress. Results indicate that consumers are more likely to complain when complaints of others are present on a FBP, and any form of redress has a greater positive effect than firm responsiveness. Moreover, a consumer’s perceived likelihood of a successful complaint was found to explain the impact of visual cues on their likelihood to complain and attitude towards the firm.

КОММУНИКАТИВНЫЕ ОСОБЕННОСТИ ВЗАИМОДЕЙСТВИЯ ВРАЧЕЙ-ГИНЕКОЛОГОВ С КЛИЕНТАМИ

This article discusses the problems of social and medical counseling. Within the framework of medicine, most clients remain satisfied with the quality of medical staff counseling, but there are certain specific areas of counseling where the individual and personal characteristics of the clients play an important role. An example of this service is the gynecological service. Clients of gynecologists are mostly pregnant women who have manifestations of emotional instability and anxiety. As a result, the standard counseling services for them do not fully meet their social and medical needs. In our survey, we found that in 100% of cases, the interviewed gynecologists indicated the presence of complaints from clients about their professional activities. The most frequent complaints were about inattention and emotional coldness of the gynecologist. Complaints are based on a purely subjective perception of clients and do not reflect the professional qualities of the doctor. This trend creates a need to develop an updated program of gynecological counseling to fully meet the needs of its clients.

Meteopathies and arterial hypertension: causes, manifestations

At present, the question of the influence of climatogeographic and meteorological factors on human health continues to be relevant and causes discussions among scientists and clinicians around the world. The aim is to study the manifestations and causes of pathological meteosensitivity in patients with arterial hypertension permanently residing in the Far North. For the period from June 2017 to March 2018, 138 patients with a confirmed diagnosis of arterial hypertension (AH) were included in the study based on generally accepted criteria (ESH/ESC, 2018), permanently living in the Far North. Men – 42 people (30.4 %), women – 96 people (69.56 %). The age of the study participants ranged from 18 to 65 years, averaging 45 ± 5.6 years. 32 people smoked (23.19 %). The condition for inclusion in the study was the presence of complaints about meteosensitivity, the manifestation of meteopathies against the background of changes in meteorological conditions, the short duration and relativity of these disorders in the same patient in the same weather conditions. The main meteorological elements that can be considered predictors of meteopathies have been determined, and the main manifestations of pathological meteosensitivity in patients with AH permanently residing in the Far North have been identified. The presence of pathological meteosensitivity should probably be considered as an additional risk factor for the development of cardiovascular events. At present, details such as the manifestation of the metabolic syndrome in patients with hypertension, the degree of hypertension and the duration of the underlying disease, changes in biochemical parameters, and their associations with meteopathies require detail.