Psycho-emotional State Of Patients Research Articles

#1396 Anxiety level in kidney transplant recipients with adverse cardiovascular events

Abstract Background and Aims Kidney transplantation is the most cardioprotective method of renal replacement therapy and it has a positive effect on the psycho-emotional state of patients. However, kidney transplant recipients have a higher cardiovascular risk and a higher prevalence of anxiety and depression than people in the general population. The aim of the study was assessment of anxiety levels and the quality of life of kidney transplant recipients preceding adverse cardiovascular events. Method The study included 154 kidney transplant recipients. 54 (35.1%) of them had adverse cardiovascular events (acute coronary syndrome, complicated hypertensive crisis or rhythm disturbance) for three years of observation. The comparison group was 100 (64.9%) recipients without cardiovascular complications during the observation period. The study groups were comparable by age, gender, graft function and traditional cardiovascular risk factors. Results The average level of situational anxiety of kidney transplant recipients was 39 ± 7, the level of personal anxiety—43 ± 8. The structure was dominated by recipients with moderate personal anxiety—55.2% (n = 85) and moderate situational anxiety—66.9% (n = 103). However, the proportion of persons with high personal anxiety was quite high—40.9% (n = 63). The structure of anxiety levels had no significant differences depending on subsequent cardiovascular complications. Nevertheless, kidney transplantation recipients with adverse cardiovascular events had higher previous level of situational anxiety than recipients without cardiovascular events—41 ± 7 versus 38 ± 7, p < 0.05. During the study kidney transplant recipients were asked to rate their quality of life on a scale of 1 to 10. Recipients with subsequent adverse cardiovascular events had a lower subjective quality of life than recipients without cardiovascular complications—7 (6-8) versus 8 (7-8), p < 0.01. Conclusion Based on the study it was found that recipients with adverse cardiovascular events in the late postoperative period are characterized by a higher level of situational anxiety and a lower quality of life before these complications.

Evaluation of Effect of Therapy with Intensive Pulsed Light on Psychoemotional State of Patients with Erythematotelangiectatic Rosacea

Evaluation of Effect of Therapy with Intensive Pulsed Light on Psychoemotional State of Patients with Erythematotelangiectatic Rosacea

Clinical significance of echocardiographic signs of right heart dysfunction in patients with chronic heart failure with preserved left ventricular ejection fraction

Aim: To analyze the features of clinical signs, quality of life and psycho-emotional state in patients with heart failure with preserved left ventricular ejection fraction (HFpEF) and non-obstructive atherosclerosis of the coronary arteries, depending on the presence of echocardiographic criteria for dysfunction of the right heart.Material and Methods. Patients underwent an extended protocol of echocardiography with an assessment of the structure and function of the right heart; ultrasound examination of the lungs with the determination of the number of B-lines; a six-minute walk test, a test for the presence of a symptom of bendopnea with the determination of blood oxygen saturation (SpO2) before and during the test. In addition, quality of life was assessed using the Minnesota questionnaire and the SF-36 questionnaire (The Short Form-36); the psycho-emotional state of patients was analyzed according to the HADS (Hospital Anxiety and Depression Scale), the level of adherence to treatment was analyzed according to the Morisky – Green questionnaire. Patients were divided into two groups depending on signs of right heart dysfunction: Tei index more than 0.54, tricuspid annulus systolic excursion (TAPSE) less than 17 mm, tricuspid annulus systolic velocity (RV S’) less than 9,5 cm/sec.Results. Echocardiographic signs of right heart dysfunction in patients with HFpEF was associated with lower quality of life indicators according to the SF-36 questionnaire, in particular, general health status (p = 0.008) and role limitations due to emotional problems (p = 0.03). During the bendopnea test (p = 0.04), the majority of patients with signs of dysfunction of the right heart (66.7%) had a decrease in SpO2, while in the comparison group the proportion of such patients was 36.7% (p = 0.04). The psycho-emotional state according to the HADS scale and adherence to treatment did not differ in both groups (p > 0.05). The frequency of detection of B-lines according to lung ultrasound was also comparable.

Experience with interleukin-23 inhibitor guselkumab using in patients with severe psoriasis and the impact of the disease on the psycho-emotional background

Psoriasis is a chronic immune-mediated disease that leads not only to damage to the skin and its appendages, but is also associated with concomitant systemic diseases, including damage to the musculoskeletal system, cardiovascular pathologies, kidney disease, metabolic syndrome and changes in the nervous system. Not long ago, a term was introduced to unite psoriasis and concomitant comorbid diseases – psoriatic disease. Recently, special attention has been paid to assessing the psychoemotional state and quality of life of patients with psoriasis who bear the burden of a chronic disease. It is no secret that any skin disease significantly worsens the quality and standard of life of the patient and can lead to social and professional stigma and discrimination, and a number of restrictions. Psoriatic disease is recognized as a multisystem inflammatory disease and a holistic approach to treatment is recommended, focusing on comorbidities, including mental health, psychosocial well-being and quality of life. The Dermatological Life Quality Index (DLQI) is one of the most convenient indices that allows you to assess the severity of the burden of chronic skin diseases, including psoriasis, on a person’s daily activities; a correlation was found between the severity of psoriasis, the presence of concomitant diseases, especially psoriatic arthritis and the DLQI level. DLQI is higher in patients with moderate to severe psoriasis, in patients with mild psoriasis (low PASI index), but with damage to socially significant areas of the skin (face, hands and feet, scalp, genitals, nail plates), in patients with active manifestations of psoriatic disease in the form of concomitant diseases, which complicates the choice of drug for treatment. The availability, effectiveness, and treatment regimens of modern drugs play an important role in the psycho-emotional state of patients. Today the biological drugs have been actively used in the treatment of psoriasis, which have a number of advantages compared to drugs of basic anti-inflammatory therapy and phototherapy, and, accordingly, are more effective and are of value for patients who experience emotional discomfort from a chronic skin disease in everyday life. The purpose of this article was to study the prevalence and nature of mental and psychiatric pathologies in patients with psoriasis, the possible improvement of DLQI in patients with psoriasis using a biological drug from the group of interleukin-23 inhibitors guselkumab.

Method and organization for expert evaluating of rehabilitation services for lower limb prosthetics: problems and solutions

Relevance. Prosthetics of the lower limb after amputation restores the patient's ability to move and self-care. Preparation and prosthetics in the early stages after amputation, in the absence of contraindications, improves the physical, psycho-emotional state of patients, reduces the risk of complications due to forced exercise and exacerbation of concomitant somatic pathology, as well as increases exercise tolerance, restores mobility, functioning after amputation.The aim of the work is to improve the quality of life of patients with mobility disabilities.Materials and methods. The information base of the study was the normative legal acts of the Russian Federation, standards, clinical recommendations defining the existing system of providing rehabilitation services for prosthetics of the lower limb.Conclusion. Unsatisfactory prosthetics of the limb after amputation negatively affects the quality of life of the patient. For this reason, the assessment of the rehabilitation service of prosthetics of the lower limb, including using the tools of the International Classification of Functioning, Disability and Health, is both relevant and necessary.

Evaluation of the treatment strategy for complicated allergic rhinitis.

Aim: To carry out a comprehensive evaluation of treatment modification for patients with seasonal allergic rhinitis (SAR) complicated by anxiety-neurotic disorders. Materials and Methods: Patients with SAR in the acute stage on the background of anxiety disorders were studied. Immunological studies were carried out, an assessment of the dynamics of indicators of the quality of life of patients, the level of anxiety / depression was assessed. In the clinical group, a variant of therapy modification was proposed. Results: Significant changes in the subpopulation ratio of lymphocytes, an increase in the immunoregulatory index, which indicated the severity of the immunological process, were revealed in SAR patients in the acute stage against the background of anxiety disorders. At the same time, a significant activation of the humoral link of immunity was observed: an increase and a significant increase in IgE in the blood serum and an increase in the content of sIgA in the nasal secretion. In most patients, eosinophilia was found in the peripheral blood and in the rhinocytogram before treatment. In the study of the quality of life of patients, changes in many parameters were found. Conclusions: The combination of "Nazafort Allergy Protection" and Atarax seems to be the most successful, which significantly improved the physical and psycho-emotional state of patients with SAR, complicated by anxiety and neurotic disorders. This combination led to an increase in the stress resistance of patients.

Experience of using benzoyl peroxide and clindamycin gel in the treatment of mild and moderate acne

BACKGROUND: Acne is an actual problem for both patients and doctors of different specialties, especially dermatovenerologists and cosmetologists. Up to 85% of young people are affected by the disease. Skin lesions on the face and lack of effect of previously administered therapy are often accompanied by severe psychosocial maladjustment even in mild forms of dermatosis. In addition, recently there has been a tendency towards increased resistance of Cutibacterium acnes to antibacterial agents, which requires the development of drugs, including those to prevent antibiotic resistance.
 AIM: Clinical and morphofunctional assessment of the effectiveness and tolerability of the Zerkalin Intensive gel (benzoyl peroxide and clindamycin) in patients with mild to moderate acne.
 MATERIALS AND METHODS: the study involved 30 patients with acne (28 women and 2 men) aged 18 to 34 years, 4 of them had mild severity, 26 had moderate severity. All patients applied benzoyl peroxide and clindamycin gel once a day in the evening, the observation period was 12 weeks. Dermatological examination was carried out visually with a simple count of inflammatory lesions (papules, pustules). In order to assess the morphofunctional parameters of facial skin, all patients underwent a non-invasive digital study using the Capricorn AI Intelligent Imager Bitmoji device, based on 3D visualization. To study the impact of the disease on various aspects of the patient's life and as an effectiveness criterion, the Dermatology life Quality Index (DLQI) was used.
 RESULTS: in all patients using the benzoyl peroxide and clindamycin gel there was a regression of inflammatory and non-inflammatory elements and a decrease in post-acne phenomenon, while an improvement in the condition of the skin process was registered within the first 2–4 weeks. As a result of the treatment, complete cleansing of the skin was achieved in 8 patients, significant improvement in 17, and improvement in 5. At the end of the entire observation period, according to the questionnaire, the subjects observed a decrease in DLQI compared with the baseline (18.4±3.03 versus 3.03±0.15; p 0.05), which indicates an improvement of the quality of life and psychoemotional state of patients and the effectiveness of therapy.
 CONCLUSION: Benzoyl peroxide and clindamycin gel for the treatment of mild to moderate acne is an effective remedy, especially with a predominance of pustular elements, which is confirmed based on the results of a visual examination and the positive dynamics of indicators of superficial and deep analysis of facial skin (sebumetry, corneometry, pigmentation, reactivity and level colonization by C. acnes). The gel was well tolerated by patients and did not cause any adverse events or allergic reactions.

Substantiation for inclusion of psychocorrective methods in comprehensive program of medical rehabilitation of patients who have suffered COVID‑19 in conditions of sanatorium-resort organization

The new coronavirus infection COVID‑19 both by itself and restrictive measures related to the pandemic (prolonged isolation, compliance with sanitary and epidemiological restrictions, etc.) have a pronounced negative impact on the psycho-emotional state of patients. The article presents the results of a study of the initial psychological state of patients who have undergone a new coronavirus infection COVID‑19, justifies the use of various psychocorrective methods in the conditions of patients’ stay in a sanatorium-resort organization.

Experience with the interleukin 6 inhibitor (Olokizumab) in patients with rheumatoid arthritis in real clinical practice: Influence on inflammatory activity and disease outcomes

The aim of the study was to evaluate in real clinical practice the effectiveness of therapy with an interleukin-6 inhibitor (olokizumab) in patients with rheumatoid arthritis (RA) in terms of clinical and laboratory activity of the disease, as well as patient-reported outcomes (PROs). Material and methods. 10 patients with a reliable diagnosis of RA were examined: the average age of the patients was 45.70±17.9 years, the duration of the disease was 9.0 (3.0; 12.0) years. Patients were with moderate or high disease activity: DAS28-ESR – 5.13 (4.34; 5.80) points; CDAI – 30.00 (24.00; 35.00); SDAI – 31.86 (24.36; 38,59). All patients were prescribed treatment with olokizumab (OKZ) at a dose of 64 mg subcutaneously every 4 weeks against the background of therapy with methotrexate, leflunomide, non-steroidal anti-inflammatory drugs and glucocorticoids (GC) (up to 10 mg/day in terms of prednisolone). Three patients had previously received tocilizumab (intravenously once a month at a dose of 8 mg/kg), the administration of which was discontinued for administrative reasons 6–12 months before the appointment of OKZ. The results of treatment were assessed by the dynamics of clinical, laboratory parameters (DAS28-ESR, SDAI, СDAI, CRP, ESR, IgM RF, ACCP) and outcomes assessed by the patients themselves (PROs): HAQ-DI index, general assessment of the health status of patients (OSZB) according to VAS, pain according to VAS; scales FACIT, SF-36. As psychometric methods, the questionnaire “Type of attitude towards the disease (TOBOL)”, the Hospital Anxiety and Depression Scale (HADS), and the Toronto Alexithymic Scale (TAS-26) were used. Observation was carried out before treatment, after 3 and 6 months of therapy. Results. Against the background of OKZ therapy, after 3 and 6 months, compared with the baseline, there was a significant decrease in the clinical indices of RA activity: DAS28-ESR – 5.13 (4.34; 5.80), 3.53 (2.83; 4.26) and 3.48 (2.8; 4.10) points respectively; CDAI – 30.00 (24.00; 35.00), 11.00 (6.0; 16.00) and 10.0 (5.0; 15.0) points respectively; SDAI – 31.86 (24.36; 38.59), 11.05 (6.07; 16.07) and 10.17 (7.02; 15.02) points respectively; CRP – 14.30 (7.00; 24.70), 0.70 (0.40; 0.90) and 0.65 (0.20; 3.0) mg/l respectively. No significant dynamics of ESR, RF IgM and ACCP was noted. After 3 and 6 months of treatment with OKZ, there was a significant decrease in OSZB and pain severity according to the VAS scale, and an improvement in the functional state of patients was observed according to the HAQ-DI questionnaire of fatigue indicators (FACIT-F) (p<0.05). The physical component of the SF-36 scale increased significantly only by the 6th month of therapy (p<0.01), while the mental component did not undergo significant changes (p>0.05). In the process of treatment of OKZ, the attitude of patients to the disease changed from the ergopathic, neurasthenic and sensitive components in the TOBOL profile, before it began, then by its end, the dominant ones were harmonious, ergopathic and sensitive profiles. In addition, starting from the 3rd month of treatment in patients with RA, an adaptive response to the disease prevailed. A decrease in the level of anxiety was revealed, compared with the baseline, after 3 and 6 months of observation, depression indicators did not change significantly. Conclusion. In general, the results of this study indicate the effectiveness of ICD in RA, not only in terms of reducing the clinical and laboratory activity of the disease, but also in terms of outcomes reported by the patient himself, characterizing the quality of life and the psycho-emotional state of patients.

Anxiety in subjects with cardiovascular disease: Current diagnostic strategies and therapeutic options. A review

Anxiety and anxiety disorders are important modifiable risk factors for cardiovascular and other common chronic non-communicable diseases and complications. Anxiety disorders significantly reduce the motivation and adherence of patients to lifestyle changes and drug therapy, significantly worsen the quality of life, and increase the risk of disability and the costs of the health care system. The issues of diagnosis and therapy of anxiety are relevant for the practice of physicians and cardiologists due to the high incidence of anxiety disorders in patients with cardiovascular diseases, a decrease in the quality of life and an increase in adverse outcomes, and also due to the insufficient awareness of the risks associated with the psycho-emotional state of patients. Therapy of anxiety disorders includes both drug and non-drug methods. The first-line drugs in treating most anxiety disorders are selective serotonin reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors. The risk of possible side effects of these agents in patients with cardiovascular diseases should be considered. Sedative and anti-anxiety drugs, including non-benzodiazepine tranquilizers, are more commonly used. The most studied drug from this class in therapeutic and cardiological practice is fabomotizole. The efficacy and safety of fabomotizole, including long-term use, have been studied in numerous studies in patients with cardiovascular diseases and a wide range of anxiety disorders.

Исследование психометрических свойств «Госпитальной шкалы тревоги и депрессии» (HADS), рекомендованной для врачей общесоматической практики, на выборке пациентов с нарушением двигательных функций

<p style="text-align: justify;">The aim of the study is to investigate the psychometric characteristics of the Hospital Anxiety and Depression Scale (HADS) on a sample of patients with impaired motor functions. HADS was used to examine the current psychoemotional state of 73 women and 27 men aged 62.1±13.7 years who were in the hospital for inpatient rehabilitation for motor function disorders arising from a stroke (n=50) or developing against the background of chronic musculoskeletal disorders (n=50). Independent of the psychologist, a psychiatrist examined the same patients, filling out Hamilton Anxiety and Depression scales. A comparison of the findings led to the conclusion of overdiagnosis with the HADS subscales. At the same time, it is shown that the questionnaire items have satisfactory indices of discriminativeness and internal reliability. The combination of low content and convergent validity of some items of the questionnaire allowed modifying subscales, reducing the number of items without prejudice to psychometric characteristics. By comparing the data obtained with an objective external criterion for the Anxiety (HADS-A) and Depression (HADS-D) subscales, new cutoffs (9 points) were determined for diagnosing the presence or absence of anxiety and depression, which allows to use this version of the test more effectively for screening the current psychoemotional state in patients with impaired motor functions who enter the second stage of medical rehabilitation.</p>

Treatment and rehabilitation of patients with temporomandibular joints pathology

Relevance. According to statistical observations, the pathology of the temporomandibular joints (TMJ) is often found in dental practice, and is accompanied not only by a pronounced pain syndrome, but also by the occurrence of internal disorders in the structure of the joints themselves. The article discusses the causes of diseases of the temporomandibular joints, gives a physiological justification for the principles of treatment of this pathological condition, indicating further principles of rehabilitation. The aim of the study is to develop principles for the treatment and rehabilitation of patients with TMJ. Materials and Methods. The condition of patients was determined on the basis of a comprehensive examination, including functional diagnostic tests, collection of anamnestic data, study of models of biomechanical occlusions, axonography, psycho-emotional state of patients using the SCL-90-R scale, quality of life. Results and Discussion. The pathology of the temporomandibular joint is considered as a disorder of its functioning, both in the absence of morphological changes and in their presence. In the absence of changes, the psychosomatic factor plays a decisive role against the background of stressful conditions (20-27 %). In the presence of pathological changes in the elements of the joint, the violation of occlusion comes first, which leads to a decrease in the elasticity of the articular surfaces, due to a change in the state of the synovial fluid. Conclusion. To prescribe therapeutic measures for the pathology of the temporomandibular joint, a specific triad of clinical manifestations is necessary: severe pain syndrome, limitation of movements of the lower jaw, internal disorders of the joint (detected using MRI). Rehabilitation of patients with TMJ diseases, according to our research, should be carried out in a complex of gnathological, conservative and surgical treatment. As a surgical treatment, we recommend: prosthetic synovial fluid, arthrocentesis, arthrolavage and prosthetics of the head and articular cavity of the condylar process.

Stabilotraining in Motor Rehabilitation of Patients after Stroke: a Prospective Randomized Study

INTRODUCTION. Proprioceptive deficits are one of the common sensory impairments after stroke and have a negative impact on motor activity. AIM. Evaluation of the effect of stabilization training on the dynamics of clinical and functional indices and the efficiency of motor rehabilitation in patients after stroke. MATERIAL AND METHODS. The dynamics of motor (motor functions, activity) and non-motor (cognitive and emotional volitional) consequences of stroke, as well as the quality of life under the influence of complex application of stabilization training with the use of scales (National Institutes of Health Stroke Scale, Medical Research Council Scale, Modified Ashworth Scale of muscle spasticity, «Memory for images» and «10 words», Schulte-Platonov Table, Lusher Color Test, The Hospital Anxiety and Depression Scale), International Classification of Functioning (ICF), EQ-5D questionnaire and stabilography method. The effectiveness of motor rehabilitation was evaluated by the dynamics of the integral index of health level. RESULTS AND DISCUSSION. After complex rehabilitation in stroke patients the regression of neurological disorders was detected (almost half of patients after rehabilitation showed mild degree of impairment, in 6 % of cases full recovery of paretic leg muscle strength was achieved, the share of patients with severe and moderate paresis decreased, hypertonicity of paretic muscles decreased). Complementing the complex of motor rehabilitation with stable exercise led to a decrease in the degree of functional limitations (in 48.5 % of patients after rehabilitation the Hauser walking index indicated a mild degree of walking disorder, patients became able to walk around the room without using aids, reduced dependence on others in everyday life), improved quality of balance function and quality of life, a positive impact on the psychoemotional state of patients and increased effectiveness of rehabilitation measures. CONCLUSION. Stabilotraining application in the complex of motor rehabilitation of patients allowed to improve walking and balance functions, psycho-emotional state of patients, to increase their quality of life and, accordingly, to increase the effectiveness of rehabilitation measures after stroke.

Improvement of the psycho-emotional state and cytokine profile of patients with rheumatoid ­arthritis and hepatic steatosis after therapy with thioctic (lipoic) acid and methotrexate

Background. The social significance of such inflammatory diseases as rheumatoid arthritis is growing all over the world, which determines the need to find new ways to optimize the ongoing standard therapy.
 Aim. Evaluation of the effect of combined use of thioctic (lipoic) acid with methotrexate in comparison with methotrexate and meloxicam therapy on the psycho-emotional state of patients with rheumatoid arthritis and hepatic steatosis.
 Material and methods. The study included 60 women diagnosed with rheumatoid arthritis and hepatic steatosis. By the beginning of the observation, patients divided into two groups were comparable according to all criteria for inclusion in the study. The first group took methotrexate and thioctic (lipoic) acid, the second group methotrexate and meloxicam daily for a month. The psycho-emotional state of the patients according to the Spielberger tests modified by Yu.L. Khanin and depression according to Beck were assessed. Determination of pro-inflammatory cytokines was carried out by enzyme immunoassay. The research results were subjected to statistical processing.
 Results. An intergroup analysis showed that the use of thioctic acid and methotrexate led to a significant decrease in the level of anxiety in patients, in contrast to women taking methotrexate and meloxicam (the level of reactive anxiety decreased by 2.7 times compared with baseline data; p=0.03). It is also important to note the revealed correlation between the degree of decrease in the level of tumor necrosis factor and the severity of anxiety 1 month after taking the cytostatic and the hepatoprotector (Kendal's Tay-b correlation coefficient, r=0.732, p=0.046).
 Conclusion. The inclusion of thioctic (lipoic) acid in the basic therapy with methotrexate in patients with rheumatoid arthritis and hepatic steatosis improves their psycho-emotional state in the form of a decrease in anxiety-depressive spectrum disorders, practically normalizing the level of pro-inflammatory tumor necrosis factor , the degree of reduction of which correlates with the degree of reduction in the level of anxiety.

ИСПОЛЬЗОВАНИЕ ОПРОСНИКОВ ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКИ ДЕПРЕССИВНЫХ СОСТОЯНИЙ, ОПРЕДЕЛЕНИЯ СТРЕССОУСТОЙЧИВОСТИ И СОЦИАЛЬНОЙ АДАПТАЦИИ В СОСТАВЕ КОМПЛЕКСНОГО ПОДХОДА К ЛЕЧЕНИЮ И РЕАБИЛИТАЦИИ СОТРУДНИКОВ ОРГАНОВ ВНУТРЕННИХ ДЕЛ, ПЕРЕНЕСШИХ НОВУЮ КОРОНАВИРУСНУЮ ИНФЕКЦИЮ COVID-19

Introduction. Psychoemotional disorders arising against the background of general somatic diseases, and often being their root cause, undoubtedly affect not only the prognosis and dynamics of somatic pathology, but also the quality of life of the individual as a whole. Aim. The aim of the work was to assess the extent of stress load, identify premorbid deviations of the psycho-emotional state, as well as the presence of signs of borderline mental disorders in order to use the results in the planning and implementation of psychocorrective (psychotherapeutic) interventions. Material and methods. A study of the psycho-emotional state of 98 employees of internal affairs bodies who were admitted for treatment to the therapeutic department of the hospital of Federal Medical Unit of the Ministry of Internal Affairs of Russia in the Amur region was carried out. 46 of those examined tested positive for COVID-19. Results and discussion. A comparative analysis of the frequency of occurrence of deviations in the psycho-emotional state in patients who underwent COVID-19 and patients who did not have a new coronavirus infection did not reveal statistically significant differences. Conclusion. It was concluded that the approach of continuous psychological testing of patients entering hospitalization helps to quickly identify a contingent with signs of comorbid pathology (simultaneous coexistence of somatic diseases and psycho-emotional disorders), which in turn makes it possible to plan and implement psycho- correctional measures in a timely manner.

MONITORING ASSESSMENT OF THE EFFECT OF TRANSCRANIAL ELECTRICAL STIMULATION ON THE PSYCHO-EMOTIONAL STATE IN THE WOUND PROCESS AFTER SURGICAL INTERVENTIONS IN THE ORAL CAVITY

The Goal is evaluation of the analgesic effect and psychoemotional state of patients against the background of the use of TES therapy in the wound process after dental interventions in patients.
 Materials and methods We selected two representative clinical groups by age, medical and social status, and the nature of the pathology. The first group (main) included 105 patients, where after primary radical operations; treatment of the wound process was carried out comprehensively with the use of transcranial electrical stimulation (TES). Group II (comparison) consisted of 128 patients who received traditional therapy according to the clinical protocol. In all patients with open wounds, pain syndrome, psychoemotional state, and clinical course of the wound process were evaluated by generally accepted methods.
 Research results It has been established that long-term pathological processes in stomatological pathology increase both depression and contribute to the development of psychological dysfunction (Table 2). The assessment of the pain syndrome in a comparative aspect was carried out in the main and comparison groups starting from the second day, since the residual effect of painkillers can be observed on the first day. The results are shown in Table 3
 It follows from our data that a significant decrease in pain syndrome was observed in patients on the background of TES therapy already on the 2nd day after surgical interventions (p < 0.001). And starting from the 3rd day, the pain syndrome had a pronounced tendency to decrease, and on the 5th day in the II and III main groups it was (2.78 ± 0.32 and 1.13 ± 0.08) points. and on the 8th day (1.62 ± 0.08 and 0.80 ± 0.02) points, respectively, which is significantly higher than the comparison group (р < 0.05).
 The analysis of the psychological state indicates that against the background of TES-therapy, there is a more significant decrease in the level of reactive anxiety, as well as situational and personal anxiety compared to the comparison group, which has a positive effect, as evidenced by clinical observations, on the course of the wound process and wound healing.
 From the data in Table 4, on the background of TES therapy, there is only a significant decrease in the level of reactive anxiety both in patients of the 1st group, and in the 2nd and 3rd groups compared to patients on the background of traditional treatment.
 In addition, in the II and III groups, compared to the comparison group, the level of situational anxiety decreased to (31.4 ± 2.3 and 35.0 ± 2.4) points, which almost corresponds to the level of the control group
 (p > 0.05). Personal anxiety in these groups was at the level of (37.5 ± 4.3 and 39.6 ± 4.1) points, which is significantly higher than the control group (p < 0.05). In the comparison groups, both situational and personal anxiety even on the 5th day of postoperative intervention was significantly higher than the control group (p < 0.05).
 Conclusions:
 
 Timely assessment of pain syndrome and psycho-emotional state before and after dental intervention allows for their timely correction, which has a positive effect on wound healing.
 The use of TES therapy in the wound process in the complex treatment of the wound process is more effective than traditional therapy in terms of correcting the pain syndrome and psycho-emotional state of patients.
 High efficiency, lack of negative impact on the human body makes it possible to recommend the TES-therapy method in dental practice.

Peculiarities of Diabetes Mellitus Impact on the Effectiveness of Cardiac Rehabilitation of Patients with Coronary Heart Disease After Myocardial Revascularization

Aim: To investigate the impact of diabetes mellitus on the course of the disease, the quality of rehabilitation measures and the psycho-emotional state of patients. Materials and Methods: The study involved 134 patients, who were divided into four groups depending on the method of revascularization and the presence or absence of diabetes mellitus. The patients underwent a 21-day rehabilitation programme, at the beginning and at the end of which they were assessed for left ventricular ejection fraction, exercise tolerance, maximum oxygen consumption, and treatment adherence. Throughout the study, the patients were under the supervision of a psychologist. Results: The study found that patients with diabetes showed a signif i cant improvement in the measured indicators, but to a lesser extent than patients without diabetes. Conclusions: The mechanisms of poorer outcomes in patients with diabetes are mostly related to psycho-emotional factors as a result of the diagnosed disease, but they require further study.

Psychological Peculiarities of Physical Rehabilitation of Patients with Ischemic Stroke

the purpose of the research is: to study the characteristics of disorders of psychomotor function and psycho-emotional state of patients with ischemic stroke according to the initial examination; to develop a method of physical re-habilitation of patients with ischemic stroke at the inpatient stage of rehabilita-tion, depending on the severity of psychomotor functions and features of the psycho-emotional state; to outline psychological essence of biomechanical laws which direct the disorders of the psychomotor function of a personality.research methods. There were used the following psychological and peda-gogical research methods: the analysis of literature sources, the method of psy-chological and pedagogical observation, psychological and pedagogical experi-ment.the results of the research. The methods of functional biomanagement with external feedback are proved to be fundamentally new and promising in physical rehabilitation, having been used with the aim of training physiological or retraining pathologically impaired functions. The empirical data is shown to be obtained corresponding to the goals and tasks of the movement restoration system in the case of various diseases and brain injuries. The strongest stimula-tor of movement is proved to be so called kinesthetic sense, to reproduce con-sciously performed movements. Kinesthetic sense is a mean that is a necessary prerequisite for the rehabilitation of patients with ischemic stroke. conclusions. The psychological essence of biomechanical laws is defined in relation to the disorders of the psychomotor function of a person: 1) the rule of redistribution of functions of the affected limb; 2) the rule of functional copying of another person’s movements; 3) the rule of ensuring the optimum in psycho-motor activity.

Determination of pain intensity, pain-related disability, anxiety, depression, and perceived stress in Polish adults with temporomandibular disorders: A prospective cohort study.

There is a need to assess a relationship between the psychoemotional state of patients and the occurrence and the intensity of pain and temporomandibular disorders (TMD) in relation to a Polish population. There are no such precision data in the literature relating to the population of big Eastern European country. The study conducted by the authors refer to a large group of male and female adult patients of the Polish population in a different age profile. As a result, this study provides a picture of the situation that also takes into account population characteristics that may affect the clinical situation of patients. The aim of the study was to assess the pain intensity, pain-related disability, anxiety, depression, and perceived stress among Polish adults with TMD as well as the association between psychosocial impairment and TMD. This prospective cohort study included 219 adult patients from the Outpatient Clinic for Temporomandibular Disorders at the Academic Dental Polyclinic in Wroclaw. The patients completed validated questionnaires, and received a TMD diagnosis based on a standardized examination (Diagnostic Criteria for Temporomandibular Disorders) performed by a qualified dentist. A statistical analysis was carried out on the collected data. Myalgia was the most commonly diagnosed condition among the TMD patients. Furthermore, the prevalence of perceived stress, anxiety, and depression was high in the studied sample. Females showed more depression symptoms than males, while the level of anxiety and stress was similar in both groups. The most statistically significant correlation was observed between the group of masticatory muscle disorders and the level of depression, stress, pain intensity, and pain-related disability. Due to the high prevalence of increased levels of anxiety, depression, and perceived stress, it is essential to screen the psychosocial status of Polish TMD adult patients. Psychosocial status may have an impact on a studied patient's response to treatment and pain intensity, and pain-related disability. Therefore, Polish TMD adult patients should be provided with management based on an interdisciplinary approach. [https://clinicaltrials.gov/], identifier [NCT05183503].

Psychoemotional state of patients with cancer of the oral cavity and oropharynx

Annotation. The work is devoted to the study of the psychoemotional state of patients with tumors of the oral cavity. The aim of the study was to find out the manifestations of physical problems, such as pain and difficulty swallowing, as influencing factors on psycho-emotional stress and as a result of reducing the quality of life in patients with oncology of the oral cavity and oropharynx in the pre- and postoperative period. An analysis of the psycho-emotional state (according to the Hospital Anxiety Depression Scale (HADS)), pain syndrome (using a visual analogue scale (VASH, Visual Analogue Scale, VAS)), and the presence of dysphagia (according to the classification developed and tested by us) of 34 patients with oncopathology of the oral cavity before and after treatment was carried out. In the postoperative period, patients are divided into two groups depending on the type of analgesia. Statistical processing of the obtained data was carried out using Excel software from the Microsoft Office 2003 package, STATISTICA 5.5 (belongs to the Central Scientific Research Institute of National Pirogov Memorial Medical University, Vinnytsya, license number AXXR910A374605FA) according to the Student’s criterion at p<0.05. The obtained results of the study indicate that long-term postoperative analgesia has a positive effect on the reduction of pain syndrome, restoration of swallowing and correction of the psycho-emotional state. Thus, the detection of a malignant tumor in the oral cavity and oropharynx in itself leads to severe psychological stress. Moreover, psychological health deteriorates sharply if the development of a tumor is accompanied by pain, impaired swallowing, and sleep. Therefore, high-quality analgesia leads to the elimination of pain syndrome and improvement of swallowing, which in turn has a positive effect on the psycho-emotional state of the patient in the postoperative period.