Репозиторий Университета

© 2018, SICOT aisbl. Objective: To investigate the effect of knee arthroscopic synovectomy (AS) on the disease activity, quality-of-life (QoL), and the functional status of patients with rheumatoid arthritis (RA). Materials and methods: A retrospective analysis was conducted on the outcomes of AS performed on 138 RA patients; pre-surgery assessments were done using Disease Activity score (DAS 28) and Routine Assessment of Patient Index Data З (RAPID-3) on а multidimensional health-assessment questionnaire for disease activity, EuroQol-5D (EQ-5D) and the Short-Form Medical Outcomes Study (SF-36) for quality of life, and the Health Assessment Questionnaire (HAQ) for functional status. The pain response to SA was measured by а visual analogue score (VAS) and the Knee Society Score (KSS). Results: All parameters assessed in the study showed significant positive changes: the activity of the disease decreased, and patients’ functional status and QoL improved. Conclusion: AS is effective treatment for recurrent synovitis of the knee in RA patients. This technique improves the functional status of patients and their quality of life and reduces the activity of the disease.

© 2018; Pediatria Ltd. All rights reserved. Chronic pathology of the urinary system (US) among children is widespread. Continuously relapsing course of the disease significantly reduces the quality of life (QOL) of patients and their caregivers. Objective of the research - to analyze the necessity of QOL study of children with US chronic pathology. The article presents modern methods, approaches to the assessment of QOL of children of this group. It explains the need to study the evaluation of QOL in children in pediatric practice. QOL indicators of children with chronic diseases are presented as a criterion for assessing the effectiveness of their treatment and socialization. The revealed flaws of QOL of children of different medical and social groups testify to the need to include this indicator in their survey program to optimize medical care for these patients.

© 2018 John Wiley  &  Sons A/S. Published by John Wiley  &  Sons Ltd Background: The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema. Objectives: The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities. Materials and methods: Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema. Results: Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P =.02), and for depression (median = 4.0) than controls (3.0, P <.001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P =.038, P <.001, and P <.001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68). Discussion: This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.

© 2018, Dynasty Publishing House. All rights resvered. The objective. A comparative study of components of the quality of life of parturient women, whose pregnancy developed both after in vitro fertilisation (with the use of donor or own oocytes) or spontaneously. Patients and methods. We assessed the quality of life of 160 parturient women. In 40 women pregnancy developed after IVF with the use of donor eggs, in 40 women – after IVF with own eggs, 40 patients participated in the programme «Surrogate motherhood», and 40 women had a spontaneous pregnancy. The standard SF-36 questionnaire was used. Results. Surrogate mothers demonstrate a somewhat higher self-assessment of their physical condition, underestimate their limitations on physical activities (daily self-care, walking, climbing stairs, carrying heavy objects, etc.), estimate their health at the moment of the survey higher than respondents of other groups and overestimate their mental health (mood, absence of depression and anxiety, the general index of positive emotions) as compared with respondents of other groups. Conclusion. Preventive psychological diagnostics, psychological follow-up of women during preparation to pregnancy, during carrying a baby and in the postpartum period have favourable effects on the successful outcome of the «Surrogate motherhood» programme.

© 2018 by the authors; licensee Modestum Ltd., UK. Objective: High prevalence of ischemic heart disease (IHD) is currently both of medical and social concern, thus requiring treatment with drugs capable of influencing not only the prognosis of the disease but also quality of life of patients. This study was undertaken to investigate the possibilities of antianginal therapy with nicorandil and isosorbide dinitrate in order to improve quality of life of patients with stable angina pectoris. Method: The authors carried out a comprehensive examination of a total of eighty-four 44-to-76-year-old patients suffering from IHD with functional class 2-3 stable angina of effort and followed up in ambulatory settings. The patients were randomized into two groups of treatment to receive either nicorandil or isosorbide dinitrate as antianginal agents added to basic therapy. The groups of patients did not significantly differ by anamnestic and demographic characteristics. The duration of follow up amounted to 24 months. We determined the physical and mental components of health-related quality of life and their dynamics on the background of antianginal therapy with nicorandil and isosorbide dinitrate. The parameters of quality of life were evaluated by the findings of two screening tools: the General Health Questionnaire (GHQ-28) and Seattle Angina Questionnaire (SAQ). Results: The findings obtained within the timeframe of the study demonstrated that patients suffering from FC 2-3 stable angina of effort and taking standard therapy with beta-adrenoblokers, calcium antagonists, and antiplatelet drugs were found to have a decrease in their quality of life. The lowest scores were observed by the scales reflecting the psychological component of health, whereas the scores of physical limitation, angina stability, and angina frequency were considerably better. After 24 weeks of treatment with nicorandil and isosorbide dinitrate, the patients of both groups were found to have significantly improved scores for quality of life assessed by the SAQ on all scales. Initially high scores by the GHQ characterizing the patient’s psychological discomfort were revealed in both groups of patients, with no statistically significant differences between the groups. The highest score was revealed by the scales of somatic symptoms and social dysfunction in both the nicorandil group (11.8 and 13.2 points, respectively) and isosorbide dinitrate group (12.1 and 13.5 points, respectively). The mentioned alterations underline the significance of such disease as IHD in adaptation of the patient to the social environment. Angina attacks, physical limitations lead to deterioration of the emotional state and interfere with daily activity. High scores by the scales of anxiety and depression suggested a low level of mental health of IHD patients with stable angina pectoris. After 24 months of treatment, manifestations of anxiety and depression in patients of both groups significantly decreased (with the results comparable in both groups), with clear advantage in the nicorandil group. Conclusion: Nicorandil turned out to be superior to isosorbide dinitrate in improvement of physical and psychological components of quality of life of patients with stable angina of effort.

© 2018 Media Sphera Publishing Group. All rights reserved. The study demonstrated the results of the comparative analysis of various types of renal replacement therapy effects on the quality of life patients with terminal stage of chronic kidney disease on the basis of standardized questionnaires. It has been shown that the quality of life is significantly improved after a kidney transplantation. At the same time, it has also been found that the introduction of home dialysis, epoetins, active metabolites of Vitamin D, calcimimetics in the clinic care expanded the opportunities for the labor rehabilitation of the dialysis patients and made their quality of life comparable with the same of the kidney transplant recipients.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the quality of life of feeding mothers and toe establish whether the adherence to breastfeeding influences physical and mental health of women. Patients and methods. We conducted a questionnaire survey of 151 mothers who had small infants. Their quality of life was studied with the help of the SF-36 questionnaire. Results. As we have found, the higher is the material wellbeing of the family, the less women adhere to breastfeeding (per capita income of the family of breastfeeding mothers are almost 2 times lower than in nonbreastfeeding women – 22500 ± 3.800 and 43958.33 ± 4.240 rubles, respectively, р < 0.05). Subjective perceptions of physical health (functioning), parameters of life activity (Vitality – VT) and subjective assessment of their health (General Health – GH) were similar in both breastfeeding and nonbreastfeeding mothers (VT 56.48 ± 3.77 and 58.33 ± 2.91; GH 68.52 ± 4.13 and 65.83 ± 1.95, р > 0.05). Irrespective of breastfeeding adherence, women after childbirth did not report of worsening of their health (50.93 ± 4.01 and 44.79 ± 2.61, respectively, р > 0.05). But in breastfeeding mothers parameters of the quality of life were demonstrative of a higher endurance (physical functioning 73.89 ± 1.66 and 85.22 ± 3.19, role functioning 52.78 ± 2.16 and 65.63 ± 3.73, р < 0.05). Breastfeeding mothers more rarely had difficulties in routine activities due to their physical condition and pain (bodily pain 73.89 ± 3.77 and131.35 ± 2.16, р < 0.05), physical and emotional condition did not interfere with communication and social activity (social functioning 67.13 ± 1.93 and 139.8 ± 6.92, р < 0.05, mental health 95.11 ± 7.18 and 58.17 ± 8.11, р < 0.05). They are less prone to depression and have higher values of the positive emotions parameter (role emotional functioning 64.08 ± 3.98 and 215.73 ± 12.67, р < 0.01). Conclusion. The results of the study can be used in programmes aimed at expanding breastfeeding.

© 2018 Voprosy Sovremennoi Pediatrii - Current Pediatrics. All rights reserved. Abstarct:-Background. An important goal of treating patients with juvenile idiopathic arthritis (JIA) is to achieve the best quality of life associated with health. Objective. Our aim was to assess the impact of methotrexate plus etanercept therapy on the quality of life of patients with early and late JIA. Methods. The prospective study included patients with early and late JIA without systemic manifestations. The patients' quality of life was assessed with the help of questionnaires for children and parents: the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale, the Pediatric Quality of Life Inventory (PedsQL) Rheumatology Module, and the Health Utilities Index Mark 3 (HUI3). The quality of life was assessed prior to the therapy and after one, six, and 12 months of treatment. Results. 150 children with JIA aged 5.1 (2.0; 17.7) years; 50 children aged 4.0 (2.3-11.4) years in the group of etanercept monotherapy, 50 children aged 5.0 (3.2-9.0) years in the group of methotrexate monotherapy, and 50 children aged 9.9 (6.4-13.0) years in the group of methotrexate plus etanercept combination therapy. All groups showed low scores on all questionnaires before treatment, compared to healthy children. In the course of therapy, there was a tendency for score increase to almost 1.0 according to the HUI3 questionnaire in all groups. After one year of etanercept therapy, the parameters of the quality of life of children with early JIA did not differ from healthy children; the score increased from 56 to 90 p = 0.942 according to the physical functioning scale and from 60 to 85 p = 0.889 according to the emotional functioning scale. In the 2nd group, there was a tendency for score increase, but a statistically significant difference was found across all scales of the questionnaire. After 12 months of etanercept plus methotrexate combination therapy in patients with late JIA, the questionnaire analysis showed that the responses of healthy children and children with JIA differed with probability p = 0.001 for the physical functioning scale, p = 0.001 for the social functioning scale, p = 0.001 for role functioning, and p = 0.001 for the total score. The score increase from 60 to 85 p = 0.789 was noted for emotional functioning scales. Conclusion. The use of questionnaires to assess the quality of life in children with severe chronic diseases can significantly improve the efficacy of treatment and ensure its control.

© The European Society of Cardiology 2017. Aims: To evaluate safety and efficacy of moderate intensity interval exercise training early after heart failure decompensation on exercise tolerance and health-related quality of life (HRQoL). Methods and results: This is a prospective randomized controlled study. We screened 234 consecutive patients admitted with decompensated heart failure; 46 patients (42 men/4 women; 61±12 years of age) were randomized to a moderate intensity aerobic interval training (n = 24) or to a control group (n = 22). Patients underwent cardiopulmonary exercise testing, echocardiography and Minnesota Living with Heart Failure questionnaire (MLHFQ) at baseline, after three weeks and after three months. After three weeks, peak-VO2 increased by 17% in the training group (p = 0.003) with further increase by 10% after three months (p < 0.001) but did not change significantly in controls. MLHFQ score improved after three weeks, with better results in the training group (from 64.6±15.6 to 30.8±12.9, p < 0.001). After three months, MLHFQ further improved in the exercise training group, but not in controls. Left ventricular ejection fraction was not significantly different between the two groups at baseline and after three months. No serious adverse events related to exercise testing or training wssere observed. Conclusions: Interval exercise training early after an episode of heart failure decompensation is safe and effective in improving exercise tolerance and health-related quality of life in selected patients after achievement of clinical stability. Positive effects remained sustained after three months. Further studies are needed to define role and indications for interval exercise training early after heart failure decompensation.

© 2018, Indian Journal of Public Health Research and Development. All rights reserved. Study design: randomized controlled before-and-after and in follow-up trial. Forty-six CAD patients volunteered to take part in the study: a group of 27 patients undertook an Intermittent Hypoxia (O2 at 10%) - Hyperoxia (O2 at 30%) Training (IHHT), while a control group (CTRL) of 19 patients was allocated to sham IHHT treatment (breathing via face mask by room air, O2 at 21%). Exercise performance, blood and metabolic profile, quality of life (MOS SF-36, Seattle Angina Questionnaire, SAQ) were measured before and after IHHT/sham IHHT in both groups; the intervention group was also assessed one month after completing the IHHT. The IHHT intervention group showed improved exercise capacity (+1,8 ml O2/min/kg, p=0,02), reduced resting systolic and diastolic blood pressures (151/85 before vs 130/73 after p<0,01), enhanced Left Ventricle Ejection Fraction (62,6±5,5% vs 58±6,2%, p<0,01), glycemia was significantly reduced only at 1-month follow-up (6,18±1,7 after vs 7,10±2,34 mmol/l at baseline, p=0,037). Frequency of angina as reason to stop exercising was significantly reduced after treatment and at 1-month follow-up. In CAD patients an Intermittent Hypoxia-Hyperoxia Training program is associated with improved exercise tolerance, risks factors profile and quality of life (SF-36, SAQ). IHHT has proved to be safe, well tolerable and easily applicable in cardiac patients.

© 2018 Russian Transplant Society. All rights reserved. The article offers analysis of the problem status as well as World and Russian experience of donor organ recipients participation in sports and physical training. The connection of physical activity with the quality of life of patients after transplantation is reflected. The problems associated with organ donation in Russia and other countries and the importance of sports activities in promoting this problem are described. The analysis of foreign experience in the organization of sports games for people with transplanted organs, which indicates: the importance of research methods in admission to physical education and sports among recipients, the need for dosing and selection of physical activity, the involvement of a transplant doctor for individualization of rehabilitation programs. The personal experience of foreign athletes with transplanted organs, including the experience of the Russian recipient’s participation in the 21st world games 2017 is presented. Experience of carrying out sports activities for people with transplanted organs in Russia is also given.

© 2018 Ima-Press Publishing House. All Rights Reserved. What factors negatively influence the accuracy of topical diagnosis of spinal nerve root lesion during neurological examination has not been solved until now. Objective: to identify the nature of the relationship between the accuracy of topical diagnosis of spinal nerve lesion from neurological symptoms in patients with cervical disk herniation and the peculiarities of their emotional status and quality of life. Patients and methods: Forty-eight patients with cervical disc herniation were examined. At first, the level of spinal nerve root lesion established during neurological examination was compared with the results of magnetic resonance imaging or computed tomography and surgical intervention. Thereafter, the importance of emotional factors in determining the accuracy of topical diagnosis is studied in these patients. Results and discussion: If there was a divergence between preliminary neurological and final diagnoses, personality traits, such as hysteria, psychasthenia, alexithymia, and trait anxiety were most significant. The most substantial differences were found in the index of alexithymia. The accuracy of topical diagnosis was influenced not only by the psychological profile of patients with cervical disc herniation, but also by their quality-of-life indicators. These are persons who are anxious and suspicious and are characterized by anxiety, fearfulness, indecision, and constant doubt. They use the symptoms of a somatic disease as a means to avoid responsibility. These patients solve all their problems, by escaping into disease, which causes social maladjustment. Conclusion: The features of an individual's psychological profile as increased anxiety, hysteria, and psychasthenia reduce the accuracy of topical diagnosis of the lesion by 25.6%. Patients with cervical disk herniation, low quality-of-life indicators, and high scale scores for hypochondria, depression, psychasthenia, and trait anxiety need their emotional status to be corrected.

© Ima-Press Publishing House. All rights reserved. Objective: to investigate the influence of the aesthetic component of dental health on the anxiety level and quality of life of socially active elderly patients. Patients and methods. A total of 32 patients aged 60 to 67 years who had a poor aesthetic appearance of the hard tissues of the front teeth were followed up. All the patients underwent determination of anxiety levels by the Spielberger-Hanin procedure and assessment of quality of life using an abbreviated 26-item version of the World Health Organization Quality of Life (WHOQOL-BREF-26) questionnaire; the updated Oral Health Impact Profile (OHIP-14) was also used. Aesthetic rehabilitation of vital front teeth was carried out using photo composite materials made in Russian and foreign countries. Results. Before treatment, the state anxiety scores were 54±1.4 scores; the trait anxiety ones were 41±1.2 scores; at 1 week after treatment, these were 42±0.5 and 39±0.6, respectively (p ≤ 0.05 for both indicators), and at 6 months, these were 44±0.5 and 43±0.7, respectively. Conclusion. The aesthetic component of dental health in socially active elderly patients is directly proportional to quality of life and inversely proportional to the level of trait or state anxiety. Russian and foreign photo composite restorative materials showed equal sustained performance.

© Ima-Press Publishing House. All rights reserved. Botulinum toxin injection therapy is the mainstay for managing patients with motor manifestations of dystonia. It is important to identify possible cognitive and mental disorders, sleep and perceptual disorders (non-motor disorders) in these patients. Correction of these disorders will be able to optimize treatment and to improve quality of life of patients.