Non-steroidal anti-inflammatory drugs (NSAIDs) are most popular medications for the treatment of pain in common musculoskeletal diseases such as osteoarthritis (OA) and non-specific low back pain (LBP). However, the factors affecting the effectiveness of these drugs have not been determined fully. Aim: to identify factors affecting the effectiveness of NSAIDs in patients with OA and LBP. Materials and methods. An observational study was conducted to evaluate the effectiveness of a 2-week course of NSAIDs in OA and LBP in real clinical practice. The study group consisted of 3604 patients with OA and LBP (60.6% women and 39.4% men, mean age 55.0±13.4 years). According to the study design, aceclofenac (Airtal) and other NSAIDs used in the ratio 1:1. The main criterion of effectiveness was the frequency of complete pain relief after 2 weeks of therapy. In addition, the decrease of pain and general health were determined on a 10-point numerical rating scale (NRS). We compared the frequency of complete pain relief in patients who had and did not have the studied factors. The value of the studied factors was determined using OR (95% CI). Results and discussion. Most patients received aceclofenac (54.9%), as well as diclofenac (2.0%), ketoprofen (1.9%), lornoxicam (2.2%), meloxicam (13.7%), naproxen (2.1%), nimesulide (5.8%), celecoxib (5.9%), ethicoxib (7.1%) and other NSAIDs (4.4%); 56.2% of patients received muscle relaxants, mainly tolperisone (74.7%), vitamin B (10.4%), and proton pump inhibitors (42.8%). Complete pain relief was achieved in 54.8% of patients. The pain decrease and general health improvement were (for NRS) 63.9±13.4% and 61.7±14.8%, respectively. The efficacy of aceclofenac was slightly higher than in the whole group: complete pain relief was in 59.9% of patients. Adverse events in aceclofenac use were observed in 2.3% of patients, other NSAIDs-from 2.4 to 14.1%. The frequency of complete pain relief was higher in men: OR 1,239 (95% CI 1.08-1.418; p=0.002), who had the first episode of pain - OR 3.341 (95% CI 2.873-3.875; p=0.000), a good" response " to NSAIDs in history - OR 1.656 (95% CI 1.385-1.980; p=0.000) and received NSAIDs in combination with muscle relaxants - OR 1.218 (95% CI 1.067-1.390; p=0.004). The effect of therapy is lower in patients 65 years and older-OR 0,378 (95% CI 0.324-0.442; p=0,000), with body mass index >30 kg/m² - OR 0.619 (95% CI 0.529-0.723; p=0.000), with severe pain (≥7 points NRS) - OR 0.662 (95% CI 0.580-0.756; p=0.002), with pain at rest, - OR 0.515 (95% CI 0.450-0,589; p=0.000), pain at night - OR 0.581 (95% CI 0.501-0.672; p=0.000) and the presence of stiffness - OR 0.501 (95% CI 0.438-0,573; p=0.000). Treatment results are significantly worse in the cases of combination of LBP and joint pain, as well as pain in the trochanter major and pes anserinus area (p
The study of endobronchial microcirculation in 30 patients with polycythemia vera (PV) was carried out. Group I included 18 patients with PV in the stage-IIA, group II included 12 patients in the stage IIB. All were performed diagnostic bronchoscopy and endobronchial laser Doppler flowmetry. 12 patients underwent biopsy of the mucous membrane of the right upper lobe bronchus. Based on the study the following conclusion was made patients with PV in the stage of expressed clinical and hematological manifestations have the disturbance of endobronchial microcirculation. More significant changes of microcirculatory blood flow are diagnosed in patients with IIB stage. Leading role in the disturbance of microcirculation in PV belongs to the sludge syndrome that develops as a result of erythrocytosis and thrombocytosis, leading to the formation of red blood cell and platelet stasis. With normalization of hemoglobin and red blood cells in the peripheral blood, hematocrit, endobronchial microcirculation indicators are improving, but not completely that can be explained by polyethiologic the disturbance of microcirculatory ben funection. Revealed changes contribute to the development of tissue hypoxia and exchange acidosis, atrophic changes of bronchial mucosa and the accession of intercurrent respiratory infections.
In the seventies of the past century ballistocardiography had been thought to be obsolete in cardiology for impossibility of objective calibration. In the present work the quantitative ballistocardiography (Q-BCG) for measurement of systolic force (F) and minute cardiac force (MF) in sitting subject was described. The new principle of piezoelectric transducer enabled to register the force caused by the heart and blood movement, which was not measured before. The calibration proved that the action of the force on the transducer was expressed quantitatively without the amplitude-, time-, and phase deformation. The close relationship of skeletal muscle force and F was proved. The F and MF changed under different physiological conditions (age, partial pressure of oxygen, body weight, skeletal muscle force). It was shown that the systolic force (F) and minute cardiac force (MF) are the physiological parameters neurohumorally regulated similarly as the heart rate or systolic volume.
Уральский НИИ фтизиопульмонологии-филиал ФГБУ «НМИЦ ФПИ» МЗ РФ, г. Екатеринбург, РФ 2 Уральский федеральный университет, г. Екатеринбург, РФ Цель исследования: повышение на основе технологий 3D-навигационного моделирования эффективности интервенционных миниинвазивных вмешательств при диагностике ограниченных диссеминированных и очагово-фокусных поражений легких. Материалы и методы. Проведено сравнение информативности трансбронхиальной биопсии легких (ТББЛ) с 3D-навигацией и традиционной ТББЛ у 50 пациентов в двух группах. Группа 1-20 пациентов с саркоидозом I и II стадий, у которых с помощью 3D-моделирования выстраивалась виртуальная навигационная карта для сопровождения трансбронхиальной биопсии легкого. Группа 2-30 пациентов с саркоидозом I и II стадий, которым ТББЛ проводилась по стандартной методике. Информативность ТББЛ оценивали по результатам гистологического исследования биоптатов. Тестирование разработанной программы позиционирования торакопортов осуществлено у 30 пациентов двух групп, которым предполагалось выполнение биопсии легкого при торакоскопическом миниинвазивном вмешательстве по поводу диссеминированного процесса в легких разного генеза. Основная группа (ОГ)-10 пациентов, у которых использована разработанная программа для определения точек расположения торакопортов. Контрольная группа (КГ)-20 пациентов, у которых диагностическое хирургическое вмешательство проводилось по стандартной методике. Результаты исследования. Реализация технологии позволяет при диссеминированном поражении легких повысить частоту наличия диагностически значимых структур в полученном образце для гистологического исследования при ТББЛ (с 56,3 до 90,0%) и сократить продолжительность диагностических торакоскопических миниинвазивных вмешательств в (с 39,75 до 33,50 мин).
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