Vol 26, No 1 (2020)

Background. Current approaches to the rehabilitation of stroke patients are based on the early start of rehabilitation measures, a certain sequence, duration, and, of course, the active participation of the patient and their environment. Recently, the scientific medical community has engaged in a serious discussion on the organization of rehabilitation from the perspective of a multidisciplinary approach.

Aim. To assess the impact of the multidisciplinary approach to the outpatient rehabilitation phase on the main health components in stroke patients.

Materials and methods. An experimental, longitudinal, open study included 60 patients with stroke in the late residual period. The studied patients were classified into groups using stratification randomization: Group 1 – 30 (50%) patients with high rehabilitation potential, as well as a high degree of personal interest in undergoing the outpatient phase of medical rehabilitation; Group 2 – 30 (50%) patients who had rehabilitation potential but were, for several reasons, forced to refrain from undergoing the outpatient phase of medical rehabilitation. The duration of the outpatient rehabilitation phase was 14 days: the course of rehabilitation treatment included 10 visits to the rehabilitation department, which operates on the principles of lean manufacturing and a quality management system; 2 days of medical leave; and 2 days of independent work by patients. The multidisciplinary team included a neurologist, physiotherapy physiologist, physical therapy instructor, speech therapist, psychologist, occupational therapist, and a social worker who received special training in medical rehabilitation. As the criteria for assessing the effectiveness of rehabilitation measures during the course of this study, we identified 11 key indicators that allowed us to assess the recovery of neurological deficit, motor functions, possible risk of patients falling, psycho-emotional state, cognitive functions, level of disability, frequency of repeated strokes, number of visits to the clinic place of residence, level of independence, and quality of life of the patient.

Results. When we compared these groups in response to the course of rehabilitation treatment, the patients who passed the outpatient stage achieved a positive result of 91% (a positive response to 10/11 criteria for evaluating effectiveness), while the percentage of response to treatment in the second group was 18% (positive answer for 2/11 criteria for evaluating effectiveness).

Conclusion. To achieve the rehabilitation goals and objectives set for the patient in the late recovery period, it is advisable to conduct the outpatient phase of medical rehabilitation.

Aim. The aim of the study is to evaluate the effectiveness of using a Chenot corset in the treatment of idiopathic scoliosis in children and adolescents.

Materials and methods. Thirty-five patients aged 7 to 17 years, suffering from idiopathic scoliosis degree II-III, under our supervision, were included. The distribution according to gender was 8 boys and 27 girls. The range of the angle of scoliotic deformation before the appointment of the corset was from 21 to 47 degrees according to Cobb on the anterior-posterior x-ray of the spine performed standing. The average angle of deformation was 32 degrees.

Results. Evaluation of the effectiveness of corset therapy was carried out after the patient had adapted to the orthosis (3 months after the appointment of the corset) and reached a wearing time of 18–21 h per day on an x-ray of the spine performed in a standing corset. The average correction was 37.5%, and the average angle of deformation was reduced from 32 to 20 degrees.

The introduction of cone beam computed tomography (CBCT) methods allow to most accurately visualize the bone structures of the maxillofacial region, which enables the specialist to obtain a detailed 3D model of the jaws and teeth with a fairly high resolution.

This article provides the use of computed beam tomography method in orthodontic practice to analyze the initial thickness of bone tissue at various levels of the root length of the frontal group of teeth during their retrusion and protrusion. The calculation results allow us to draw conclusions about the volume of bone tissue and the possibility of orthodontic manipulations. The results of the study significantly improve the diagnosis and planning of orthodontic treatment for pathology in the frontal jaw.

This paper presents a comprehensive assessment of safety monitoring of the use of botulinum toxin type A (BTA) drugs in the WHO databases (VigiBase) and automated information system (AIS) “Roszdravnadzor-Pharmacovigilance”, as well as a comparison of the dynamics of receipt of messages.

The authors present a post-marketing study of domestic experience in the use of BTA drugs (Dysport, Botox, and Xeomin) based on a retrospective clinical and pharmacological analysis of 169 medical records of children with cerebral palsy in whom these drugs were used to treat spasticity syndrome.

Analysis of the spectrum of adverse events, which were mentioned in 10 (5.9%) medical records, showed that their nature corresponded to the data set out in the instructions for medical use. Serious adverse reactions according to the criteria of severity “death” and “threat to life”, with a high degree of reliability of cause-and-effect relationship were not revealed during the study, which confirms a sufficiently high safety profile of these drugs.

This paper focuses on improving the methodology for assessing the effectiveness and safety of BTA drugs for the treatment of spasticity syndrome in children and the need to identify and report all adverse drug reactions.

This article analyzes the frequency and features of cardiac amyloidosis in the elderly. The morphology and pathogenesis of amyloid cardiomyopathy are presented. The features of the clinical picture of the heart and aortic lesions in systemic and local variants of amyloidosis are analyzed. Polymorbidity in older people, which complicates the diagnosis of cardiac amyloidosis and leads to a delay in treatment, is reviewed. The diagnostic methods of various types of cardiac amyloidosis are evaluated. Modern trends in the treatment of amyloidosis are presented.