Possibilities of life quality correction of patients with chronic pancreatitis in postoperative hypothyroidis

Aim: to study the quality of life and the emotional state of patients with chronic pancreatitis on the background of postoperative hypothyroidism and the possibility of effective rehabilitation.Materials and methods. 270 patients with chronic pancreatitis were examined, among which 40 patients with primary postoperative hypothyroidism, who made up group 1, group 2 included 30 patients without thyroid pathology. Patients underwent a blood test according to the main biochemical parameters, hormonal blood count, ultrasound of the thyroid gland, hepatobiliary and duodenal zone. The study of quality of life and psychoemotional state by tests.Results In patients with chronic pacreatitis in combination with postoperative hypothyroidism among diseases of the hepatoduodenal zone, chronic non-calculous cholecystitis and non-alcoholic fatty liver disease were identified that are clinically characterized by abdominal pain syndrome according to the GSRS questionnaire. Patients revealed mild depressive state, high levels of personal and situational anxiety. The quality of life of patients was reduced both in physical and in psychological components, due to indicators of role-playing physical and emotional functioning. Against the background of treatment with a combination of succinate-containing drugs, the severity of depression, situational and personal anxiety decreased, and role functioning due to physical and emotional state, social functioning increased.Conclusions: The use of combination therapy with sodium levothyroxine and ethylmethylhydroxypyridine succinate in patients with comorbid pathology during postoperative hypothyroidism improves the clinical picture, psychoemotional balance and quality of life.

Experience in the use of cognitive psychocorrection of the emotional state of women with complicated pregnancy in the third trimester

In the article the data of experimentalpsychological investigation of pregnant women with complicated course of gestation are drawn to determine the peculiarities of their psychological status. One hundred pregnant women in the third trimesterwere examined, 64 of them demonstrated symptoms of late gestosis. The investigation revealed high level of both reactive and personal anxiety in women with complicated course of pregnancy. All the women of this group were subjected to supporting psychotherapy, which was directed to the decreasing psychological troubles. The basic aim of cognitive psychocorrection was to overcome different systemic presuppositions, to help the pregnant women to elaborate an alternative behavioral pattern and to change their attitude to themselves, to form the sense of self-confidence. The results received testify to the expediency of including psychotherapy (supporting and cognitive psychocorrection) into the complex of treatment.

Osteopathic status in patients with new coronavirus infection COVID-19

Introduction. The appearance of COVID-19 has set tasks for healthcare professionals related to the rapid diagnosis and provision of medical care to patients. Currently, intensive study of the clinical and epidemiological features of the disease continues, and of the development of new means of its prevention and treatment. At the same time, it is necessary not only to provide medical care in the acute period of the disease, but also to carry out rehabilitation measures for the consequences of a coronavirus infection. In accordance with the approved clinical recommendations, osteopathic correction in the acute period of an infectious disease is contraindicated. However, there is a potential interest of the possibility of osteopathic correction methods use during the period of convalescence, as well as within the framework of rehabilitation measures after a new coronavirus infection.At the same time, for objective reasons, there is no data on the structure of somatic dysfunctions in this group of patients in the literature. All of the above has predetermined the purpose of the research.The aim of the study is to draw up a map of the most common somatic dysfunctions and analyze their relationship with other subjective and objective manifestations of the disease based on the data of the osteopathic status assessing of patients who have undergone a new coronavirus infection COVID-19.Materials and methods. A cross-sectional study was conducted on the basis of Samara medical and sanitary unit № 2 and on the basis of the Saint-Petersburg «City Mariinsky Hospital» in the period from May 2020 to March 2021. There were 70 patients under observation in the rehabilitation department who had undergone a new coronavirus infection COVID-19. There were assessed the osteopathic status of all patients (by an osteopathic doctor with using personal protective equipment) and the level of anxiety; the data was copied from medical documentation.Results. Somatic dysfunctions of all three levels of manifestation are revealed in patients with the new coronavirus infections during the convalescence period. The global and regional somatic dysfunctions were distributed almost equally (45,7 and 54,3 %, respectively) in the structure of dominant somatic dysfunctions in patients with new coronavirus infections during the convalescence period. Patients with new coronavirus infections during the convalescence period are characterized by medium and high levels of both situational and personal anxiety. In the course of the work, a moderate positive relationship was established between a global rhythmogenic disorder (violation of the production of a thoracic rhythmic pulse) and a large volume of lung tissue damage (CT-2) according to the multispiral computed tomography of the thoracic cavity, as well as between a global psychoviscerosomatic disorder and a high level of situational anxiety.Conclusion. Somatic dysfunctions of all three levels of manifestation are revealed in patients with new coronavirus infections during the convalescence period. In addition, this group of patients is characterized by an average and high level of both situational and personal anxiety.The revealed correlations suggest that the inclusion of osteopathic correction in comprehensive rehabilitation programs for this group of patients may be pathogenetically reasonable.

Clinical and neurophysiological correlations in post-Covid‑19 patients and rationale for pathogenetic therapy

Clinical and neurological, neurophysiological, and neuropsychological examination of 50 patients aged 50–65 y. o. with an experience of COVID‑19 infection within the last 3 to 6 months, revealed pathological changes in the central nervous system in the form of cerebrastenic and autonomic disorders, motor disorders, vestibulopathy symptoms, which occurred in various combinations, with astheno-vegetative syndrome as obligate. Cognitive impairments were detected in 26% of patients; the mental fatigability index was 1.055 ± 0.124; a high level of situational anxiety was noted in 35% of patients, and a high level of personal anxiety in 50 % of patients with the experience of COVID‑19. The study of brain biopotentials revealed moderate diffuse changes (18%) and irritative disorders on the part of hypothalamic (69 %) and diencephalic structures (20%). All of the above may indicate that, regardless of the form of coronavirus infection occurred in humans, i. e., latent, mild, moderate or severe, one of the targets of the pathological impact of COVID‑19 virus is the median structures of the brain responsible for autonomic and cognitive functions. Nevertheless, in our opinion, these disorders are associated not with a direct pathological effect, but are mediated mainly by circulatory disorders in the microcirculatory bed due to endothelial damage and are rather functional disorders on the part of the central nervous system. This provides the grounds for the selection of pathogenetic therapy aimed at stabilizing the functional state of neurons, and one of the drugs of choice may be citicoline (Noocyl), the action of which is associated with reinforcing the cell membrane of the neuron and normalizing bioelectric processes.

Influence of Clinical Anamnestic and Psychological Factors on Adherence to Treatment of Patients with Chronic Obstructive Pulmonary Disease

The purpose of the study was to determine the influence of various factors on the level of adherence to treatment in patients with chronic obstructive pulmonary disease. Materials and methods. We examined 75 people with chronic obstructive pulmonary disease aged 45 to 65 years. In the study we used clinical examination of patients, laboratory, instrumental research methods, analysis of medical records, statistical-analytical, as well as clinical-psychopathological and psychodiagnostic methods (Morisky Medication Adherence Scale, determination of the level of subjective control, anxiety with Spielberger-Khanin method, the level of depression in the Beck questionnaire). Results and discussion. According to the results of the testing, three groups of patients were identified: 24% of patients with high, 32% of medium and 44% of low adherence to the treatment. Comparing our results with the literature, we can confirm data on a relatively low level of adherence to treatment among patients with chronic diseases, in particular chronic obstructive pulmonary disease. According to anamnestic data, patients with a high level of adherence to treatment were mostly married (61.11%) and had higher education (50%). Clinically, they belonged to group C (50%) with severe III airway obstruction (50%). These patients expressed high satisfaction with the inhaler (61.11%) and regularly communicated with the doctor (72.22%) (p <0.05). Regular communication of the patient with the doctor and satisfaction with their inhaler has an extremely significant impact on the level of adherence to treatment. According to a psychological study, these patients had an external type of subjective control (66.67%), a high level of personal anxiety (50%) and a pronounced level of depression (38.89%) (p <0.05). Numerous scientific studies on the impact of patients' commitment to the treatment of psychological factors, especially the level of personal anxiety and depression, contain a wide variety of data, which may indicate the extremely complex nature of each individual. Patients with a low level of adherence to treatment had difficulty using an inhaler (60.61%) and insufficient communication with a physician (69.70%) (p <0.05). In addition, according to psychological research, they had an internal type of subjective control (57.58%), low levels of personal anxiety (42.42%), severe (45.46%) and moderate levels of depression (42.42%) (р <0.05). Conclusion. Thus, the level of adherence to treatment in the examined patients with chronic obstructive pulmonary disease is low. This is influenced by a large number of socio-demographic, clinical-anamnestic and psychological factors

Anxious-depressive Disorders in Patients with Syndrome Chronic Venous Cerebral Dysfunction and Various Levels of Blood Pressu

Introduction. The syndrome of chronic venous cerebral dysfunction (SCVCD) - widely studied at present nosology. In the presence of anxiety-depressed disorders, this disease is complicated. Specific clinical manifestations of SCVCD, as pronounced practical experience, are found in people of different age and social groups, usually in conditions of comorbidity, in particular, with different arterial pressure (AP) and accompanying anxiety-depressive disorders, which is reflected in the general intellectual potential of society. In our opinion, it is an interesting and relevant issue that contributes to changes in the emotional-volitional sphere of a person carries out a SCVCD in combination with different indicators of arterial pressure (AP). The aim of the study. To conduct a comparative analysis of the interconnections of the indicators of the emotional-volitional sphere (anxiety and depression), estimated using the scales of the anxiety Ch. D. Spieberger - Yu. L. Hanin and depressions A. T. Beck, in patients with chronic cerebral venous dysfunction syndrome and without it and various indicators of arterial pressure. Materials and methods. 153 patients tested on a series of reactive and personal anxiety and depression. The main group amounted to 125 people who were elected by clinical signs of the existence of the SCVCD and various indicators of AP, and they were distributed to three clinical groups: 33 people - people with increased indicators of AP (157.20 ± 12.20 / 98.30 ± 4.20 mm Hg - hypertonics; 21 person with reduced blood pressure (100.32 ± 7.23 / 65.45 ± 6.40 mm Hg) - hypotonic; 24 people with labile AP with predominantly normal average digits of AP (125.23 ± 12.20 / 82.22 ± 4.14 mm Hg) - "conditional" normotonics. For comparison of indicators, 28 patients of the control group were involved - people without clinical signs of SCVCD and various indices of AP, distributed on the same principle: hypertension - eight people, hypotonics - five people, "conditional" normotonics - 15 people. The statistical elaboration of the results was carried out using the Medstat application package. Since the law of distribution of indicators differed from normal, for the presentation of data calculated median value and the inter-quatering interval (QI-QIII), for comparison used nonparametric criteria for U. Kruskala A. Wallis, criteria for J. Dannah and Chi-square. Results. The level of personal and reactive anxiety (among persons with chronic cerebral venous dysfunction) in hypertonics was statistically significantly higher than hypotonics. The level of depression (among persons with chronic cerebral venous dysfunction) in hypotonics was statistically significant than in hypertension and "conditional" normotonics. In patients in the control group, there is no statistically significant connection between the numbers of personal and reactive anxiety and the level of depression with the digits of arterial pressure. Anxiety is most often an essential part of depression. Transformation of hypotension in hypertension (and vice versa) in persons with chronic cerebral venous dysfunction syndrome may be accompanied by a transition of anxiety in depression or depression in anxiety. Conclusions. The assessment of personal and reactive anxiety on the scale of anxiety and depression revealed statistically significant bonds with arterial pressure in persons with chronic cerebral venous dysfunction syndrome. The figures of personal and reactive anxiety were statistically significant in hypertension compared to normotonics (p less than 0.001) an hypotonic (p less than 0.001). The figures of depression were statistically significant in hypotonics compared with hypertonics and normotonics (p less than 0.001). In persons from the control group, the level of reactive anxiety and blood pressure in hypertonics (p = 0.003) in comparison with hypotonic and normotonics is statistically significant. In hypеrtonics with chronic venous dysfunction syndrome, it was statistically significantly higher (p less than 0.001) level of personal anxiety compared with hypertonic control group, and among the hypotonics of the main group noted statistically significant (p less than 0.001) higher level of depression. Key words: Syndrome of chronic cerebral venous dysfunction, reactive anxiety, personal anxiety, arterial pressure, depression.

Assessment of correction effectivenes of psychoemitional state in pregnant women after application of assisted reproductive technologies

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups.

Quality of life of patients with non-alcoholic fatty liver disease with different thyroid status

The aim. To study the quality of life and psychoemotional state of patients with non-alcoholic fatty liver disease against the background of primary hypothyroidism during the use of ethylmethylhydroxypyridine succinate.Materials and methods. 111 patients with non-alcoholic fatty liver were examined, among them 35 were without thyroid dysfunction, 55 with compensated primary hypothyroidism, 21 with decompensated hypothyroidism. The patients underwent general clinical, biochemical, enzyme-linked immunosorbent assays of blood, instrumental studies, testing according to psychological questionnaires.Results. With decompensation of hypothyroidism, a statistically significant increase in indicators of depression, situational and personal anxiety was revealed in comparison with patients without hypothyroidism. The examined patients showed an increase in the level of situational and personal anxiety. The presence of hypothyroidism in the examined patients significantly worsens these indicators, leading to an increase in the degree of anxiety, aggravated by decompensation of hypothyroidism. A positive dynamic was revealed in the correction of the psychoemotional status of patients in the observation group during the complex treatment with ethylmethylhydroxypyridine succinate: the severity of depression, situational and personal anxiety, manifestations of dyspeptic and reflux syndromes decreased.Conclusion. Hypothyroidism affects the quality of life and psycho-emotional state of patients with non-alcoholic fatty liver disease: it worsens the degree of depression, situational and personal anxiety. The addition of ethylmethylhydroxypyridine succinate to standard therapy with sodium levothyroxine in patients with non-alcoholic fatty liver disease in the setting of hypothyroidism improves the quality of life and psycho-emotional state.

Laura Bowler and Cordelia Lynn, Houses Slide. London Sinfonietta, Aszodi, Edwards, Mitchell. Royal Festival Hall.

At its beginning Houses Slide is raised from complete darkness by 16 cyclists. Their pedalling powers the show; its constant woosh is the pedal point against which Laura Bowler's music is played. Both impressive and absurd, pedalling fast but getting nowhere, these cyclists are an apt symbol for the questions that Houses Slide raises. This London Sinfonietta commission explores the consciousness of the ecologically conscious. At the heart of the piece lies a paradox that has become part of our collective and personal anxiety. We are repeatedly told two contradictory things: that our actions are utterly disastrous (for example, heating the world, killing the whales) and, at the same time, that they are too insignificant to create positive change. How can we be simultaneously so dangerous and so ineffective? And what can we (guilty yet useless creatures as we are) do? These are the questions that come to mind as we listen to the recorded text that accompanies the piece throughout. This text is a verbatim record of personal testimonies gathered through the artists' call out to the public to submit answers to questions about how they've experienced the climate changing and what it makes them feel. Some speak of the disappearance of moths and hedgehogs, others of unseasonal snow or floods, and one voice candidly says that they haven't experienced any change at all, but they believe the scientists who tell them that change, the crisis, is happening.

Computer electroacupuncture: rationale for the use in the treatment of painful form of irritable bowel syndrome

In a prospective clinical trial, we have compared the effectiveness of the computerized electroacupuncture (CEAP) added to thestandard pharmacological therapy of the patients with painful form of irritable bowel syndrome (IBS)in the main group against its isolated pharmacological therapy in the control group. The study involved 80 volunteerswhich were previously randomly divided to the 2 equal groups due to the type of treatment. Patients in the main group received three courses of CEAP. Each CEAP course contained the five everyday sessions, the interruption period between courses was one month. The inclusion of CEAP to the complex therapy of the painful IBS was accompanied with decreasingof the pain severity to 42%, byVisual Pain Scale. The patients' subjective condition indicators were significantly improved: the levels of depression (according to the Zung test), actual and personal anxiety (according to the Spiberger-Khanin questionnaire) were decreased, the parameters assessed using the SAN questionnaire were increased. Key words: acupuncture, computer electroacupuncture, irritable bowel syndrome, pain treatment, reflexology.