Sensorineural hearing loss is a disorder associated with the damage to the inner ear structures: the cochlea (cortical organ), dysfunctioning of the vestibule-cochlear nerve or the central part of the auditory analyser (brain stem and cortical representation of the cortical temporal lobe). In recent years, there has been a steady increase in ensorineural hearing loss patients; they account for ca. 70% among the total patients with impaired hearing. The disease has numerous causes and a complex pathogenesis. Among the main factors contributing to hearing loss are genetic predisposition, perinatal pathology, including hypoxia at childbirth, exposure to infectious and toxic agents and metabolic disorders, injuries (mechanical, acoustic and altitude trauma). Vascular-rheological disorders in the vertebro-basilar system play an important part because blood is supplied to the inner ear from the anterior inferior cerebellar artery. There are sudden, acute and chronic sensorineural hearing loss. The ensorineural hearing loss isdiagnosed by examinations that allow to verify the diagnosis and to determine the sound analyser damage level. This complex includes audiometric examinations, including the tuning fork examination, speech audiometry, and acoustic impedancemetry. If necessary, ultrasound Doppler imaging of the main blood vessels of the brain, computed tomography of the temporal bones, and MRI of the brain are prescribed. The pattern of comprehensive treatment should include, first of all, the elimination of the disease cause and anti-hypoxic drugs, anti-oxidants and a number of physiotherapy procedures.
According to the literature, about 3% of the world's population suffers from psoriasis; the highest prevalence is observed in the countries of Western Europe and Scandinavia, while this disease is less common among representatives of the Mongoloid and Negroid races. In different countries, the proportion of psoriasis is from 10 to 40% in the total structure of skin diseases. This pathological process has a multifactorial nature; it is based on hyperproliferation of keratinocytes with impaired differentiation, which clinically manifests itself in the form of damage to the skin, nails and joints. Psoriasis is one of the most common dermatoses; men and women suffer from it equally often. The triggering factor for the development of psoriasis can be a psychoemotional stressful situation, as well as the impact of other environmental factors, including hypothermia, trauma, infections, and taking certain medications. As a result of exposure to provoking endogenous and exogenous factors, autoimmune mechanisms, which are based on increased activity of T cells, are triggered. About 70% of psoriasis patients have mild to moderate severity of the disease. Despite the wide range of drugs used to treat psoriasis, they do not demonstrate high efficiency, and the prevalence of this pathology is growing every year. The existing methods of treatment help to cope with exacerbations and relieve inflammation, however, it is impossible to completely cure this disease, and the risk of relapse always remains. One of the tasks of doctors involved in the treatment of psoriasis is not only to reduce the severity of symptoms, but also to teach a patient suffering from psoriasis to live a full life and not depend to a large extent on the manifestations of the disease and the opinions of others.
The article presents the main sources of evidence that are an integral part of modern medical practice, i.e. controlled clinical trials. The concepts of research hypothesis, studied factors, and systematic and random errors are presented. The classification of errors is provided, and the design of their main varieties is described. The issues of the methodological level of planning, conducting, and evaluating the results of the study and their submission to peer-reviewed medical publications are discussed. Particular attention is paid to the problems of external and internal validity of studies and the statistical and clinical significance of their results.
Diabetes mellitus is a chronic disease that develops against the background of insulin deficiency as a result of a decrease in its production or impaired receptor perception by target cells. As a result of impaired glucose metabolism, a state of chronic hyperglycemia develops, which has a detrimental effect on a number of organs and systems. One of such systems that are negatively affected by an increase in glucose concentration against the background of a general violation of all types of metabolism is the nervous system, in particular, its peripheral part. Approximately every second patient with diabetes eventually develops a state of diabetic polyneuropathy (chronic sensorimotor polyneuropathy or distal symmetric polyneuropathy), which is characterized by progressive degeneration of peripheral nerves with the development of pain, motor disorders and loss of sensitivity.
Lately, the problem of drug allergy is becoming more and more urgent, which is a consequence of the wide availability of drugs and the widespread use of counterfeit drugs. According to some authors, the incidence of drug allergy reaches 60%. This pathological reaction is the result of the patient's individual intolerance to one or another medication, and is not inherently its side effect. In some cases, the ingestion of a minimum dose of a drug into the body is sufficient for a severe reaction to develop. Theoretically, any drug can cause an allergy, but there is a group of certain medications, to the ingestion of which an allergic reaction develops most often - these include antibiotics of the penicillin series, sulfonamides, analgesics, some antihypertensive drugs, B vitamins. An allergic reaction can develop with lightning speed, or it can manifest itself within a day. The most common forms of drug allergy include urticaria, Quincke's edema, and itchy rash (toxidermia). The most formidable manifestations of drug allergy are anaphylactic shock and Lyell's syndrome, which manifests itself in the form of total damage to the skin and mucous membranes.
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