Background. Blepharospasm (BS) includes non-motor symptoms manifested by psychopathological disorders. The impact of these disorders on patients' quality of life and therapy of motor symptoms with botulinum toxin is poorly understood. Aim. To analyze the correlation of different characterological personality abnormalities (CPA) with the BS severity and the response to botulinum toxin therapy (BT). Materials and methods. Forty-six BS patients (29 females, 17 males) aged 30 to 85 years (6111.5) with BS were examined. The control group included 46 healthy individuals (39 females and 7 males, with a mean age of 56.49.67). Patients were examined before and after BT (after 12 months) using the BS severity scale (BSDI), EQ-5D (EQ-5D-3L) quality of life assessment scales, General Anxiety Disorder (GAD-7) scale, Brief Fear of Negative Evaluation Scale (BFNE-S), and SCID-II-PD structured personality questionnaire. Results. In the BS group of patients, unemployed and non-married were more common (p0.05) than in healthy individuals. In the BS patient group, there was an increase in anxiety (15.525.6 vs 4.283.5 control group by GAD-7 scale) and fear of negative evaluation (42.449.2 in the main group vs 21.347.3 in the control group). Quality of life was lower in BS patients (65.43, median 62 vs 88.2, median 92, p0.05). The prevalence of cluster C CPA (anxiety disorders) in patients with BS and, in particular, the obsessive-compulsive disorder was revealed. Patients with different personality profiles showed no differences in the BS severity before BT. The BT efficacy was higher in patients with cluster C CPA. Conclusion. BS patients often have anxious type CPA; in these patients, BT is more effective than in other CPAs.
Introduction. Presently, percutaneous endoscopic gastrostomy is considered to be the operation of choice when long-term enteral feeding in dysphagia syndrome is required. The technique is characterized by low incidence of early and long-term complications due to low traumatic access and operation time. Aim of the work was to assess the risk predictors of percutaneous endoscopic gastrostomy complications and their significance for the postoperative period. Materials and methods. We searched publications and analyzed literature sources using PubMed and MedLine databases and Cochrane Library and elibrary.ru scientific libraries mainly for the last ten years. The search was performed using a set of key words: percutaneous endoscopic gastrostomy, dysphagia syndrome, postoperative complications, risk factors. Results and discussion. The leading and most studied predictors of early and long-term postoperative period complications after gastrostomy are hypoalbuminemia, uncompensated diabetes mellitus, thrombocytopenia, elevated levels of C-reactive protein, Charlson's comorbidity index (4 points or higher), antiaggregant and anticoagulant therapy, morphoconstitutional features of patients. Conclusion. Data analysis has shown that percutaneous endoscopic gastrostomy at high patient flow and gastropectomy supplementation with gastropexy is practically safe and effective if the selection criteria for the operation are observed taking into account the general condition, risk factors and exclusion of absolute contraindications.
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