18 research outputs found
Epidemiological assessment of the prevalence of coxarthrosis according to reports from medical organizations
Background. Coxarthrosis prevalence rates are necessary to assess the socio-economic significance of this pathology and to calculate the need for endoprosthetics. Information about the provision of medical care to patients with coxarthrosis is presented in the reports of various medical organizations, but in state statistical reports at the regional level this nosological form is not taken into account as a separate line.The aim. To estimate the prevalence of coxarthrosis based on the combined use of medical records from various sources in a region with a specialized clinic for prosthetics of large joints.Materials and methods. A retrospective descriptive epidemiological study based on materials from the Irkutsk region for 10 years (2008–2017) was carried out. Three main sources of data on patients with coxarthrosis were used: continuous and randomized samples based on population visits to polyclinics (n = 24 029), information from the bureau of medical and social expertise on disability (n = 19 081) and information from a specialized clinic on total hip arthroplasty (THAP) (n = 6227). The dynamics of indicators by years, the distribution of patients by sex, age and groups of disabilities have been analyzed. Regional indicators of incidence and prevalence of coxarthrosis were calculated based on extrapolation of sample data.Results. The following average annual regional indicators for patients with coxarthrosis were calculated: primary visits to polyclinics (incidence) – 73.8 (71.9–75.7) with a frequency of visits 1.9 times a year, the frequency of THAP operations – 3,3 (3,0÷3,6), disability – 10.1 (10.0÷10.3). The median age of patients at the initial visit was 61 years (Q1 = 46; Q3 = 76). The proportion of men among different groups of patients ranged from 41 to 44%, the proportion of disabled people among patients of the polyclinic and surgical hospital – from 45.2 to 47.1%. The estimated prevalence of coxarthrosis among the adult population was 413.5 (410,6÷416,4) / 10000.Conclusions. The epidemiological analysis algorithm described in the article is proposed as the first stage in assessing the social and economic significance of coxarthrosis and the regional need for arthroplasty of large joints
Assessing socio-economic damage caused by coxarthrosis in the population
Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis. The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation. Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per 1 conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices. Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2 % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners. Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age
COMPLEX CHARACTERISTICS OF PATIENTS WITH COXARTHROSIS IN IRKUTSK REGION
Coxarthorosis is a degenerative-dystrophic disorder affecting all layers of population with increasing sickness rate among adult people. Coxarthoris is characterized by steadily progressive course leading patients to disability without ability of self-service. Closer attention of all kinds of medical workers is necessary in diagnostics and. rendering of all kinds of assistance available for this category of patients: not only qualified, medical attention, but also help in social rehabilitation
PREVALENCE AND STRUCTURAL CHARACTERISTIC OF COXARTHROSIS IN THE UST-ORDYNSK BURYAT DISTRICT
The prevalence of coxarthrosis in Ust-Ordynsk Buryat Region was defined as 19,8 ‰0 This article gives complex characteristics of coxarthrosis in the named region
TO THE PROBLEM OF PATHOMORPHOLOGY OF FEMORAL HEAD AT THE III-IV STAGES OF COXARTHROSIS
The article presents the results of research of femoral head morphology at the III-IV stage of coxarthrosis. Tissue reorganization in femoral head is shown
Клініко-рентгенологічна і гематологічна оцінка застосування кераміки, легованої кремнієм, за осколкових переломів кісток у собак
None of the methods of osteosynthesis provides the consolidation of bone fragments which have lost contact with soft tissues. It makes extremely difficult treating of this type fractures. Bone defect between the fragments and absence of a primary biological matrix complicates revascularization, causes long-term life of the connective tissue and cells of cartilaginous phenotype in the fracture zone. It is leads to a long-term consolidation of the fracture. Composites of hydroxyapatite and calcium phosphates are considered as bioactive and therefore the most promising for bone defects replacing. The aim of this investigation was clinical, radiological and hematological evaluation using of silicon-doped ceramics for fragmented bone fractures in dogs. For study was chosen dogs with accidental fragmented fractures of tubular bones which treated by extracortical osteosynthesis method. Animal was divided into two groups. A bone defects were filled with ceramics (GTlKg-3) for experimental animal group (n = 7), while no filling of bone defects in control animal group(n = 7) was performed. Protocol of anesthesia included medetomidine, butorphanol tartrate and epidural anesthesia with 2 % lidocaine solution. Animals of the control group began to lean on the injured limb from the 12–15th day after surgery, while the animal of research group from the 8-9th day. Complete limb repair in dogs of the control group occurred on the 38–42th day, but such period for experimental group animals was shorter – 25–27th day after the osteosynthesis. X-ray investigation (60th day) of experimental group dogs showed new formed bone tissue with osteosclerotic zones without a periosteal reaction, bone tissue, with a normal view of the epiphyseal areas and the bone marrow cavity. This is evidence of localized reparative osteogenesis (within bone trauma only), and completed fracture consolidation. At the same time in cases of the control group we found lower X-ray density of new bone, periosteum was thickened with excessive proliferation of the endosteum, especially below the site of bone injury. Thus, in case the absence of hydroxyapatite matrix in bone defects there were compensatory increasing proliferation of periosteum and endoosteum. Fragmented fractures of tubular bones in dogs have occurred by erythrocytopenia, that quickly disappear due to the reparative osteogenesis in dog of experimental group. These animals have had leukocytosis increasing due to the first three days after osteosynthesis as a reaction to the implantation of a calcium-phosphorus composite material. Dogs of control group have had second wave of leukocytosis increasing on forty-second day associated with elongated remodeling process. Areparative osteogenesis can be accelerated in 1.5 times in case of replacement of bone defects with silicon doped hydroxyapatite ceramics. It is possibility realized thru moderate reduction of active phase of inflammation and acceleration of proliferative phase, mainly from endosteum side with early mineralization of bone regenerate. The dynamics of hematology parameters is a typical for the tubular bone consolidation that indicates about moderate inflammation and demonstrate biological tolerance of silicon-doped hydroxyapatite ceramics.Ні один зі способів остеосинтезу не забезпечує консолідації осколкових фрагментів кістки, які втратили зв’язок з м’якими тканинами, що надзвичайно ускладнює лікування переломів такого типу. Внаслідок кісткового дефекту між уламками відсутність первинної біологічної матриці ускладнює реваскуляризацію, зумовлює тривале функціонування в зоні перелому сполучнотканинного і хрящового фенотипу клітин, що призводить до тривалої в часі консолідації перелому. Композити гідроксиапатиту і фосфатів кальцію, вважаються біоактивними, а тому найбільш перспективними для заміщення кісткових дефектів. Мета дослідження – клініко-рентгенологічна і гематологічна оцінка застосування кераміки, легованої кремнієм, за осколкових переломів кісток у собак. Сформували дослідну (n = 7) і контрольну (n = 7) групу собак із випадковими осколковими переломами довгих трубчастих кісток, у яких виконували екстракортикальний остеосинтез, а в дослідній кісткові дефекти заповнювали керамікою (ГТлКг-3). Анестезіологічне забезпечення включало внутрішньом’язове введення медитомідину, буторфанолу тартрат та епідуральну анестезію 2 % розчином лідокаїну. Тварини контрольної групи починали опиратись на травмовану кінцівку із 12–15-ї доби, а дослідної – вже з 8–9-ї доби. Повне відновлення функції кінцівки в контрольній групі відбувалося на 38–42-у, а в дослідній – на 25–27-у добу після проведення остеосинтезу. На 60-ту добу в собак дослідної групи рентгенологічно досить чітко в ділянці кісткової травми візуалізувалася кісткова тканина з остеосклеротичними зонами без періостальної реакції з нормальною рентгенологічною картиною епіфізарних ділянок і кістковомозкової порожнини. Це було свідченням повної консолідації перелому та перебігом репаративного остеогенезу в межах лише кісткової травми. Натомість у контрольній групі на 60-у добу кістковий регенерат мав меншу рентгенологічну щільність, періост був потовщеним з надмірною проліферацією ендоосту, особливо нижче ділянки кісткової травми. Тобто за відсутності заміщення кісткових дефектів композитними імплантами відбувається компенсаторне посилення проліферації пері-та ендоосту. За осколкових переломів довгих трубчастих кісток у собак має місце помірна еритроцитопенія, яка досить швидко усувається в динаміці репаративного остеогенезу за використання в якості імплантів у кістковий дефект гідроксиапатитної кераміки, легованої кремнієм. У дослідних тварин в перші три доби після остеосинтезу лейкоцитоз посилюється як реакція на імплантацію кальцій-фосфорного композитного матеріалу, а в контрольних його посилення на 42-у добу пов’язане з процесами ремоделювання. У випадку заміщення кісткових дефектів за осколкових переломів довгих трубчастих кісток у собак керамікою на основі гідроксиапатиту і β-трикальційфосфату, легованої кремнієм, репаративний остеогенез прискорюється в 1,5 разу за рахунок скорочення його запально-резорбтивної стадії та прискорення проліферативної, головним чином з боку ендоосту з ранньою мінералізацією кісткового регенерату. Динаміка гематологічних показників є типовою для консолідації довгих трубчастих кісток у собак, що свідчить про відсутність вираженої реакції організму на імплантацію гідроксиапатитної кераміки, легованої кремнієм
Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial
Trial registration
ClinicalTrials.gov Identifier: NCT01765387Background
Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue.
Methods
A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction.
Results
The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session.
Conclusions
Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise
INFLUENCE OF WAVE RADIATION OF ROAD ASPHALT PAVEMENT ON LEVEL AND FREQUENCY OF SPECTRUM NOISE OF AUTOMOBILE TYRE
Experimental researches on indication of noise of an automobile tire, spectral characteristics of tyres noise and asphalt coverings at vehicle’s traction are carried out. It has been revealed that wave radiations of the road asphalt pavement do not influence on the level and frequency of the noise spectrum of an automobile tyre. The technique of the experimental researches has been carried out and presented