Gait temporospatial parameters: Assessment tools for post-surgical recovery in patient with different anatomo-topographic types of lumbar disc herniation

The development in technology and informatics in the last decades enables integrated analysis of biomechanical and clinical data and facilitates the understanding of relations between human gait characteristic and different medical conditions of a patient. The aim of the study was to demonstrate the importance of gait temporospatial parameters analysis [opposite foot off, opposite foot contact, foot off, cadence, step length, walking speed, step time, step width, stride length, stride time] to quantify the response to surgical treatment for patients with lumbar disc herniation related to the anatomotopographic type of disc herniation. The study was prospective, with consecutive selection of subjects according to eligibility criteria, using a control group. The number of subjects was 64: 41 patients [61% with extensive lumbar disc hernia, 22% with paracentral lumbar disc hernia and 17% with intraforaminal lumbar disc herniation] and 23 healthy subjects. The flowchart had 2 visits: presurgical evaluation and postsurgical evaluation. The patients were evaluated clinically, imagistically and biomechanically. The biomechanical evaluation was performed with VICON MX optical motion capture system. Data of interest were temporospatial parameters of gait: opposite foot off, opposite foot contact, foot off, cadence, step length, walking speed, step time, step width, stride length, stride time. Specific statistic techniques were used in order to confirm the results. The most consistent response in terms of normalization of gait temprospatial parameters are to be observed in patients with intraforaminal herniation, followed by patients with paracentral disc herniation. The gait temprospatial parameters of patients with extensive lumbar disc herniation responded the least in terms of normalization.&nbsp

Вирусные гепатиты В, С и D в Республике Молдова: достижения и проблемы

Agenția Națională pentru Sănătate Publică, IP Universitatea de Stat de Medicină și Farmacie Nicolae Testemițanu, IMSP Centrul Republican de Diagnosticare MedicalăRealizarea primelor trei Programe Naționale de combatere a hepatitelor virale B, C și D în Republica Moldova, începând cu anul 1997, au condus la reducerea semnificativă a morbidității prin hepatitele virale B, C și D acute, dar pe fundalul incidenței sporite a hepatitelor virale cronice, unde indicatorii îi depășesc vădit pe cei din țările Comunității Europene. Studiile realizate demonstrează că contingentele de populație cu risc sporit de infectare continuă să prezinte un potențial înalt ca sursă reală de infectare cu virusurile hepatice nominalizate pentru alte categorii de populație. Ca urmare a utilizării tehnicilor de biologie moleculară, au fost evidențiate genotipurile și subgenotipurile virusurilor hepatitelor B, C și D în special la contingentele de populație cu risc sporit de infectare, demonstrând că unele posedă un potențial înalt de cronicizare, cu evoluție spre ciroză și cancer hepatocelular. Utilizarea produselor antivirale de ultimă generație recomandate de OMS pentru tratamentul hepatitelor virale B și C a demonstrat o eficacitate înaltă nu numai terapeutică, ci și profi lactică, manifestată prin reducerea numărului de bolnavi purtători de virusuri și a noilor focare. Este important de menționat că prejudiciul economic prevenit ca urmare a realizării Programelor Naționale de combatere a hepatitelor virale în perioada 1997-2015 a constituit 822.453 mii lei, pe când cheltuielile din bugetul de stat pentru realizarea acestor programe au alcătuit 84.618,5 mii lei. Realizarea integrală a prezentului Program de combatere a hepatitelor virale B, C și D în contextul Planului Strategic al OMS de eliminare a hepatitelor virale parenterale până în anul 2030 va avea un beneficiu socioeconomic extrem de important pentru Republica Moldova.The implementation of the first three National Programs against viral hepatitis B, C and D in the Republic of Moldova since 1997 has allowed to significantly reduce morbidity of acute viral hepatitis B, C and D, but on the increased background of incidence of chronic viral hepatitis the indicators clearly outweigh those in the European Community. Studies have shown that the contingent of population at high risk of infection continues to show a high potential as a real source of infection with viral hepatitis viruses for other population categories. As a result of the use of molecular biology techniques, the genotypes and subgenotypes of hepatitis B, C and D viruses have been highlighted, particularly in contingent of population at high risk of infection, demonstrating that some have a high potential for chronicization with progression to cirrhosis and hepatocellular cancer. Using of next-generation antiviral drugs in the treatment of viral hepatitis B and C recommended by the WHO has shown a high, not only therapeutic but also prophylactic efficacy manifested by reducing the number of virus-bearing patients, and new outbreaks. It is important to note that the economic prejudice prevented by the implementation of the National Programs against viral hepatitis during the period 1997-2015 amounted to 822.453 thousand lei, while the spending from the State Budget for the implementation of the nominated programs amounted to 84.618.5 thousand lei. The full implementation of the current Program for combating viral hepatitis B, C and D in the context of the WHO Strategic Plan for the elimination of parenteral viral hepatitis by 2030 will have a very important socio-economic benefit for the Republic of Moldova.Реализация первых трех Национальных программ по борьбе с вирусными гепатитами B, C и D в Республике Молдова с 1997 года позволила значительно снизить заболеваемость острыми вирусными гепатитами B, C и D, но на фоне высокого уровня заболеваемости хроническими вирусными гепатитами, показатели явно перевешивают показатели стран Европейского Cоюза. Исследования показали, что среди групп населения с высоким риском инфицирования все еще присутствует высокий потенциал в качестве реального источника заражения вирусами гепатитов для других категорий населения. В результате использования методов молекулярной биологии были выделены генотипы и субгенотипы вирусов гепатитов B, C и D, особенно среди групп с высоким риском инфицирования, демонстрируя, что некоторые имеют высокий потенциал к хронизации и прогрессированию к циррозу и гепатоцеллюлярного рака. Использование противовирусных препаратов последнего поколения для лечения вирусных гепатитов В, C и D, рекомендованных ВОЗ, продемонстрировало не только высокую терапевтическую, но и профилактическую эффективность за счет сокращения числа вирусоносителей и новых очагов инфекции. Важно отметить, что предотвращённый экономический ущерб в результате реализации Национальных программ по борьбе с вирусными гепатитами в период 1997–2015 годов составил 822.453 тысяч леев, а расходы государственного бюд-жета на реализацию указанных программ составили 84.618,5 тысяч леев. Полная реализация текущей Программы по борьбе с вирусными гепатитами B, C и D в контексте Стратегического плана ВОЗ по элиминации парентеральных вирусных гепатитов к 2030 году будет иметь важное социально-экономическое значение для Республики Молдова