Assessment of the impact of the rehabilitation procedure on functional and clinical condition of patients with coxarthrosis

Objectives: Coxarthosis is one of the most frequent reasons for disability of people at the age of 50 and more. The chronic and progressive nature of this disease makes it a common reason for impairment of the patient’s functional and clinical condition. The aim of the study is to assess the impact of the rehabilitation procedure on functional and clinical condition of patients with coxarthrosis measured with the WOMAC and Lequesne Indexes. Material and methods: The study included 85 patients, among whom 50 patients were treated non-invasively (35 women and 15 men) and 35 were treated surgically (21 women and 14 men). All patients were provided with the physiotherapeutic treatments (point laser therapy power 100 mW dose 8 J, time 12 minutes), kinesitherapy (the patients did non-weight bearing exercises hip joint exercises, isometric exercises for muscles of the hip), and classical massage. All patients were provided with physiotherapeutic treatments for 10 days, excluding Saturdays and Sundays. The assessment of functional and clinical condition of patients with coxarthrosis was conducted using the WOMAC Questionnaire and the Lequesne Pain Index for the hip joint. The assessment of functional and clinical condition was carried out on the first and the last treatment day. Results: The rehabilitation procedure significantly improved functional and clinical condition of all patients. The greatest improvements were observed with surgically treated male patients who had been ill for less than 10 years. Conclusions: The proposed rehabilitation procedure significantly improves functional and clinical condition of patients with coxarthrosis. Disease duration, female sex and non-invasive treatment are factors influencing on the efficiency of rehabilitation for patients with coxarthrosis. The results suggest the necessity of using rehabilitation procedures in patients with coxarthrosis

Balneoterapia w leczeniu reumatoidalnego zapalenia stawów i choroby zwyrodnieniowej stawów

  Choroby reumatyczne są to autoimmunologiczne schorzenia o charakterze zapalnym, o postępującym i przewlekłym przebiegu. Celem pracy było omówienie znaczenia metod balneofizykoterapeutycznych w terapii reumatoidalnego zapalenia stawów i choroby zwyrodnieniowej stawów. Z przedstawionego przeglądu literatury wynika, że zabiegi te stosowane u pacjentów z reumatoidalnego zapalenia stawów lub chorobą zwyrodnieniową stawów pozwalają na uzyskanie efektu przeciwbólowego, przeciwzapalnego. Poprawa jakości życia, zmniejszenie liczby leków przeciwbólowych oraz przedłużenie okresu remisji umożliwia pacjentom prowadzenie „prawie normalnego życia”.

Review paper Raynaud’s phenomenon: new aspects of pathogenesis and the role of nailfold videocapillaroscopy

Raynaud’s phenomenon (RP) refers to paroxysmal pallor or cyanosis of the digits of the hands or feet and, infrequently, the tips of the nose or ears (acral parts) owing to cold-induced vasoconstriction of the digital arteries, precapillary arterioles, and cutaneous arteriovenous shunts. Raynaud’s phenomenon reflects an exaggeration of normal central and local vasomotor responses to cold or emotion. Raynaud’s phenomenon has been classified as primary or secondary, depending on whether it occurs as an isolated condition or is associated mainly with a connective tissue disease. Dysregulation of autonomic and sensitive nerve fibers, functional and structural vessel changes, and intravascular alterations can be observed in the pathogenesis of RP. Nailfold videocapillaroscopy (NVC) is the best non-invasive and repetitive diagnostic technique for detecting morpho-functional changes in the microcirculation. Nailfold videocapillaroscopy is accepted in early diagnosis and monitoring of primary and secondary RP

Visual assessment of voice disorders in patients with occupational dysphonia

[b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI) system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG) and digital stroboscopy (DS) with a high resolution module. [b]material and methods[/b]. The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany). Vocal folds vibrations were registered at the rate of 4,000 frames per second. [b]results[/b]. HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. [b]conclusions[/b]. HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia) and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment

Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy

Microvascular abnormalities are one of the most important causes of persistent diabetic complications. The aim of this study was to compare microvascular changes examined by nailfold capillaroscopy with serum concentrations of soluble E-selectin (sE-selectin) and IL-18 in type 1 diabetic patients with and without microangiopathy. Serum levels of sE-selectin and IL-18 were determined by an enzyme-linked immunosorbent assay in 106 patients with type 1 diabetes and in 40 healthy controls. All diabetic patients were evaluated by extensive clinical, laboratory and capillaroscopic studies. Morphological changes were observed by nailfold capillaroscopy in 86 out of 106 (81%) diabetic patients. Severe capillaroscopic changes were seen in 32 out of 54 (59%) patients with microangiopathy, but in only seven out of 52 (13%) patients without microangiopathy. Higher serum levels of sE-selectin (p < 0.001) and IL-18 (p < 0.05) were demonstrated in diabetic patients compared to controls. Significant differences of sE-selectin (p < 0.001) and IL-18 (p < 0.01) serum concentrations were observed between diabetic patients with microangiopathy and controls. Moreover, comparison between patients with and without microangiopathic complications showed a significantly higher capillaroscopic score and sE-selectin serum concentration in the group with microangiopathy (p < 0.001). Furthermore, diabetic patients with severe microvascular changes in capillaroscopy showed significantly higher IL-18 (p < 0.001) and sE-selectin (p < 0.05) serum levels than subgroups without changes or with mild abnormalities. Our findings suggest that abnormalities in nailfold capillaroscopy may reflect the extent of microvascular involvement and are associated with higher sE-selectin and IL-18 serum levels, as well as with microangiopathic complications in diabetic patients. <i>(Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 1, pp. 104–110

Usefulness of high-speed digital imaging (HSDI) in the diagnosis of oedematous – hypertrophic changes of the larynx in people using voice occupationally

Introduction. The aim of the study is the evaluation of the usefulness of High-Speed Digital Imaging (HSDI) in the diagnosis of organic dysphonia in a form of oedematous-hypertrophic changes of vocal fold mucosa, morphologically confirmed by Transmission Electron Microscopy (TEM) method in patients working with voice occupationally. Material and methods. The group consisted of 30 patients working with voice occupationally with oedematous-hypertrophic changes of vocal fold mucosa. Parameters of vocal folds vibrations were evaluated using HSDI technique with a digital HS camera, HRES Endocam Richard Wolf GmbH. The image of vocal folds was recorded with a rate of 4000 frames per second. Postoperative material of the larynx was prepared in a routine way and observed in transmission electron microscope OPTON 900–PC. Results. HSDI technique allows to assess the real vibrations of vocal folds and determine many parameters. The results of TEM in the postoperative material showed destruction of epithelial cells with severe vacuolar degeneration, the enlargement of intercellular spaces and a large number of blood vessels in the stroma, which indicates the presence of oedematous-hypertrophic changes of the larynx. Discussion. The ultrastructural assessment confirm the particular usefulness of HSDI method in the diagnosis of organic dysphonia in a form of oedematous-hypertrophic changes. Key words: High-Speed Digital Imaging, oedematous-hypertrophic changes, vocal fold mucosa, laryn

Przydatność techniki szybkiego filmu High-Speed Digital Imaging (HSDI) w zmianach obrzękowo-przerostowych krtani u osób zawodowo pracujących głosem

Wstęp: Celem pracy jest ocena przydatności metody szybkiego filmu w sekwencji cyfrowej – High-Speed Digital Imaging (HSDI) w diagnostyce dysfonii organicznych w postaci zmian obrzękowo-przerostowych błony śluzowej fałdów głosowych potwierdzonych ultramorfologicznie metodą mikroskopii elektronowej transmisyjnej – Transmission Electron Microscopy (TEM) u pacjentów zawodowo pracujących głosem. Materiał i metody: Badaniem objęto grupę 30 chorych zawodowo pracujących głosem ze zmianami obrzękowo-przerostowymi błony śluzowej fałdów głosowych. Parametry drgań fałdów głosowych oceniano z zastosowaniem techniki szybkiego filmu w sekwencji cyfrowej z wykorzystaniem cyfrowej kamery HS, HRES Endocam Richard Wolf GmbH. Rejestrowano obraz fałdów głosowych z szybkością 4000 klatek na sekundę. Materiał pooperacyjny krtani był przygotowany w rutynowy sposób i oglądano go pod mikroskopem elektronowym transmisyjnym OPTON 900 – PC. Wyniki: Technika szybkiego filmu – HSDI pozwala na ocenę rzeczywistej wibracji fałdów głosowych i określenie wielu parametrów. Wyniki uzyskane techniką TEM w materiale pooperacyjnym wykazały destrukcję komórek nabłonka, z nasilonym zwyrodnieniem wodniczkowym i poszerzeniem przestrzeni międzykomórkowych oraz dużą liczbę naczyń krwionośnych w podścielisku, co przemawiało za obecnością zmian obrzękowo-przerostowych błony śluzowej fałdów głosowych. Dyskusja: Uzyskane wyniki oceny ultrastrukturalnej potwierdzają szczególną przydatność metody szybkiego filmu w sekwencji cyfrowej (HSDI) w diagnostyce dysfonii organicznej w postaci zmian obrzękowo-przerostowych