Aim of the study is to develop the diagnostic checklist based on the incidence and significance analysis of the external features of the dysplasia of the connective tissue (DCT) for its screening and assessment of its prevalence in the adolescents' population. Materials and methods.110 adolescents (aged from 10 to 14 years) were examined, 81 of them had the dysplasia of the connective tissue (the first group). The second group was presented by 29 adolescents without DCT. The presence and degree of manifestation of DCT were established according to the criterions of Kadurina T. I., Gorbunova V.N. (2009), Т. Milkovska-Dimitrova (1987). There were the physical, laboratory and instrumental examination. Statistical processing of the results was carried out using Statistica 6.0 program and IBM SPSS
Development of the undifferentiated connective tissue dysplasia (UCTD) is influenced by various adverse factors to the fetus during intrauterine growth. There is not a clear linkage to the contribution of the separate factors to the development of the UCTD.Aims of the studyare to determine the risk factors associated with the development of the UCTD of the adolescents and to appreciate the predictive value of the examined factors related to UCTD to form the dispensary groups of the children with UCTD.Materials and methods. During the first stage of the study there was an examination of 110 adolescents at the age of 10–14 years old, the UCTD presence was established according to the scale proposed by T.I. Kadurina and V.N. Gorbunova (2009). During the second stage the data of the prenatal casework and maternity hospital records attached to the out-patient medical records were examined to detect the specialties of the antenatal life course. During the third stage 2 groups were formed: with the presence of UCTD (n = 81) and without UCTD (n = 29). The mother groups were formed accordingly with the adolescents groups.Results. The pregnancy of the mothers of the adolescents with UCTD proceeded against the anemia, threatening miscarriage, chronic fetal hypoxia, chronic fetoplacental insufficiency, toxicosis, gestosis, and concomitant chronic conditions (thyroid, kidneys, digestive apparatus, aspiration pathology) more common than the pregnancy of the mothers of the adolescents without UCTD. The binary logistic regression method allowed the predictors of the UCTD’s formation to be determined, there were: toxicosis during the gestation course (OR = 10.9; CI 95% 2.94–40.49), anemia of pregnancy (OR = 8.6; CI 95%: 2.42–30.81), gestosis (OR = 6.53; CI 95%: 1.27–33.71), chronic fetal hypoxia (OR = 4.4; CI 95%: 1.09–17.83) and pre-existing chronic conditions of the mothers (OR = 3.6; CI 95%: 0.86–15.48). Different factor combination enhances the likelihood of the delivery of a child with UCTD more than 6.5-fold: chronic conditions of the mothers and chronic fetal hypoxia (OR = 6.8; CI 95%: 1.95–48.57); anemia of pregnancy and chronic fetal hypoxia (OR = 7.2; CI 95%: 1.01–50.99), and toxicosis (OR = 10.4; CI 95%: 1.48–72.82).Conclusion. The risk factors associated to the development of UCTD in adolescents are: toxicosis during the gestation course, anemia of pregnancy, gestosis, chronic fetal hypoxia and pre-existing chronic conditions of the mothers. The use of the equation of the binary logistic regression allows the prediction of the possibility of the development of UCTD in adolescents at the level of 80.9% and to form the dispensary groups of children in order to prevent the development of dysplastic-dependent pathology
Early detection of the connective tissue dysplasia (CTD) is hampered as the used diagnostic criteria are complex and subjective. The aim of the study is to examine the incidence and clinical profile of the adolescent CTD by means of the screening checklist. Methods. The study included the pupils at the age of 10-14 years. The questionnaire designed to reveal the 7 CTD's signs (thin skin, skin hyperelasticity, keloid cicatrix, blue sclera, soft auricles, arachnodactylia, joints hypermobility), containing 12 illustrated questions with explanation for the parents, was performed as a screening method. The conditionally healthy group (the absence of CTD) consisted of the adolescents with below 12 points total and CTD group was presented by the adolescents with 13 and more points. The physical development was appreciated according to the centile tables, Quetelet index and Vargui index. The health status analysis was based on the outpatient medical records. Results. 1560 pupils were the participants of the study: 752 boys (48.2%) and 808 girls (51.8%). CTD signs were observed in 965 (61.9%) children. The adolescents with CTD's signs demonstrated the following characters more often than the adolescents without CTD's signs: soft auricles-788 (81.7%) against 277 (46.6%), skin hyperelasticity-685 (71%) against 93 (15.6%), joints hypermobility-665 (68.9%) against 203 (34.1%), blue sclera-665 (68.9%) against 184 (30.9%), arachnodactylia-534 (55.3%) against 57 (9.6%). The disharmonious physical development because of the underweight body took place in 430 (52.3%) adolescents with CTD. Compared to the conditionally healthy group the most of the adolescents with CTD had the pathology of the musculoskeletal system (scoliosis, flatfoot), myopia, vegetative-vascular dystonia, digestive apparatus diseases. The CTD is associated with greater probability of the development of above mentioned pathologies, that can be indicative of the contribution of the anomalies of the connective tissue development into the etiopathogenesis of the these diseases. Conclusion. It is established that there is the high prevalence of the CTD signs among the adolescents (pupils) at the age of 10-14 years.
Background. Amputation of a limb leads to significant changes in a person's life, since mobility restrictions affect the ability to perform daily tasks and professional duties. Aim. To identify factors that negatively affect the results of motor rehabilitation of elderly disabled people with lower limb loss. Material and methods. Data on patients with postamputation lower limb defects, who were divided into two groups, were analyzed. The first group (comparison group) included patients aged 60 years and younger 171 people, including 141 men and 30 women; the second group (main group) consisted of patients over 60 years of age 260 people, including 207 men and 53 women. Patients of the second group with a satisfactory result of rehabilitation were included in subgroup 2A, with an unsatisfactory result in subgroup 2B. The influence of gender, age, level of mobility, cognitive abilities, daily activity, level of amputation, presence of concomitant diseases, body mass index, duration of the post-amputation period on the result of rehabilitation in the second group were assessed. Statistical analysis used the 2 test, the MannWhitney U test for independent groups, and binary logistic regression. Results. The indicators of mobility before prosthetics in elderly people with disabilities did not differ significantly from those in people under the age of 60, however, by the end of the rehabilitation course, the optimal level of mobility in the room (without using a wheelchair) was reached by 75.4% of the comparison group and only by 52.7% of the main group (ꭓ2=22.59, р 0.001). Further analysis showed that at the age of over 66.5 years, the risk of obtaining an unsatisfactory result of motor rehabilitation is 2.3 times higher (p=0.006) than at the age of 6066.5 years. In older women, this risk is 2.7 times higher than in men of the same age (p=0.014). With a body mass index of more than 28.5 kg/m2, the risk increases by 3.2 times (p=0.001), and with a duration of the post-amputation period at the time of primary prosthetics of more than 1 year, it increases by 2.6 times (p=0.008) compared with lower values of these indicators in elderly people with disabilities. Conclusion. The factors associated with the unsatisfactory result of motor rehabilitation of elderly disabled people with lower limb loss are: age over 66.5 years, female sex, body mass index over 28.5 kg/m2, duration of the post-amputation period at the time of primary prosthesis over 1 year.