A Neglected Case of Wilson’s Disease Presenting as Symptomatic Urolithiasis and Proteinuria

We report a short-statured, 39-year-old male presenting with recurrent kidney stones, history of refractory rickets, and bone deformity. He had been consuming multiple doses of calcium supplements and multiple courses of vitamin D over past 30 years beforeprior to reporting in our clinic without any significant laboratory or clinical improvement. The patient was diagnosed as having Fanconi’s syndrome attributable to Wilson’s disease. This patient highlighted that in case of resistant rickets, a high index of uncertainty must be invoked for Wilson’s disease. Appropriate timely recognition of this entity results in prompt ministrations and prevention of disability. We also presented and discussed reviews on Wilson’s disease from literature.

Analysis of statistical data on primary disability is the basis for planning measures for its prevention

The current stage of health protection and social protection of the population poses new challenges for the ITU institutions to improve the quality of expertise, address issues of disability prevention, and there is no doubt that statistical analysis still plays an important role in their implementation. Considering the issues of disability, the dynamics of a social phenomenon that has all the rights to public attention is reflected. Materials on disability and the activities of ITU institutions, when adequately analyzed and used, are an effective tool in the work of government bodies to organize and improve measures to prevent and reduce disability, improve expert and rehabilitation services for the population. The purpose of this article is to present one of the organizational forms of the work of the ITU Bureau for the study of the causes and factors that directly led to disability, the prevention of disability, taking into account the task set by the Ministry of Labor and Social Protection of the Russian Federation to the Federal State Institutions of Medical and Social Expertise.

«Дизайнерские дети» как профилактика инвалидизации общества

Медикализация человеческой жизни расширяет свои возможности и права в сферах, которые были/есть табу в координатах традиционной морали. В статье анализируется проблема конструирования будущего общества через создание «дизайнерских детей», в том числе для предотвращения инвалидизации населения с помощью биомедицинских ГМ-технологий. В отличие от ученых общественное мнение пока не готово к прогнозированию последствий, рассматривая биомедицину только как эффективный способ борьбы с болезнями. На уровне обыденного сознания нет предубеждений к исследованиям в данном направлении, лишь незначительная часть населения задумывается об отдаленных медицинских и социальных последствиях данных операций. В мире всегда существовали «ученые-еретики», работающие вне границ академий и институтов. Сегодня среди них могут быть и «биохакеры», чьи исследования финансируются частными лицами, заинтересованными в результатах для решения собственных целей и проконтролировать их работу не в силах ни один закон, ни одно государство, Среди ученых всегда были люди, готовые рискнуть всем ради нового слова в науке. В средние века они шли на костер, тем более не остановит научный прогресс наказание в несколько лет тюремного срока сегодня. Изменив этические границы для себя, они будут изменять мораль большинства. Пассивность общества сегодня спровоцирует политиков завтра на принятие решений, способствующих дальнейшей десакрализации человеческого тела в самых разных направлениях. The medicalization of human life expands its capabilities and rights in areas that were / are taboo in the coordinates of traditional morality. The article analyzes the problem of constructing a future society through the creation of “designer children”, including prevention of disability of the population with the help of biomedical GM-technologies. Unlike scientists, public opinion is not yet ready to predict the consequences, considering biomedicine only as an effective way to fight diseases. At the level of everyday consciousness, there are no prejudices towards research in this direction, only a small part of the population thinks about the long-term medical and social consequences of these operations. There have always been “heretic scientists” in the world who work outside the boundaries of academies and institutions. Today, there may be “biohackers” among them, whose research is funded by private individuals interested in the results to achieve their own goals and not a single law, not a single state can control their work. Among scientists there have always been people who are ready to risk everything for a new word in science. In the Middle Ages, they went to the stake, so even less the punishment of several years in prison today can stop scientific progress. By changing ethical boundaries for themselves, they will change the morality of the majority. The passivity of society today will provoke politicians tomorrow to make decisions that contribute to the further desacralization of the human body in various directions.

PROBLEMATIC FEATURES OF THE REHABILITATION PROCESS AT ITS MEDICAL STAGE

Rehabilitation, as a system of medical, psychological, socio-economic measures aimed at eliminating or possibly fully compensating for disabilities, is of great importance in the social protection of disabled people and the prevention of disability. In the article, based on the analysis of the current legislative and regulatory acts, scientific articles on the topic of rehabilitation and our own research, it is shown that there is no proper correspondence between the theory of rehabilitation, regulations and the organization of the rehabilitation process in medical institutions. The authors have proposed a number of ideas and activities that, in their opinion, should help in resolving existing inconsistencies and contradictions.

Occupational Asthma in Hospital Healthcare Worker

Occupational asthma is defined as an adult onset of asthma triggered by specific exposures or combinations from the workplace. Occupational asthma is classified into a sensitizer-induced occupational asthma or allergic occupational asthma caused by exposure or sensitization by a causative agents induced by immunological reactions; and irritant-induced occupational asthma or non-allergic occupational asthma caused by agents that are irritative to the airway. Occupational asthma can occur in health workers at hospitals. In the hospital there are various exposure of agents, medicines, and health equipments which can induce the asthma symptoms for health workers. The diagnosis of occupational asthma established by history taking, physical examination, supporting examination (spirometry, bronchial hyper-responsiveness test, exhaled nitric oxide, and immunological tests), and biomarker test. Management of occupational asthma includes principle management by avoiding exposure, pharmacological therapy, and immunotherapy. Precautions taken by primary, secondary (medical surveilance) and tertiary prevention (prevention of disability through worker’s compensation system).

Can Multidisciplinary Inpatient and Outpatient Rehabilitation Provide Sufficient Prevention of Disability in Patients with a Brain Tumor?—A Case-Series Report of Two Programs and A Prospective, Observational Clinical Trial

Brain tumor (BT) patients have a high incidence of disability due to the effects of the tumor itself or oncological treatment. Despite the incidence of neurological and functional deficits caused by BT, rehabilitation of those patients is not as properly established as in patients with other neurological conditions. The aim of the research was to evaluate the effectiveness of a multidisciplinary rehabilitation, carried out as an out- or in-patient program, as prevention of disability in BT patients. This was developed as a case-series report of two programs and a prospective, observational clinical study in BT patients who were allocated to inpatient (n = 28) or outpatient (n = 26) rehabilitation programs. The patients were assessed using the Barthel Index, Berg Balance Scale, Functional Independence Measure (FIM), Functional Assessment of Cancer Therapy—Brain and Cognitive Function, and Addenbrooke’s Cognitive Examination III (ACE III) upon admission and after 12 weeks of rehabilitation. Analysis of the results showed that patients in both programs significantly improved their physical functioning scores in daily activities (p < 0.0001). We also observed significant reductions in most post-intervention cognitive complaints (p < 0.05), except for the FIM social functioning and ACE III language functioning in the outpatient group (p > 0.05) in contrast to inpatients (p < 0.001). This is evidence that early multidisciplinary rehabilitation is an effective therapeutic strategy to reduce BT symptoms and disability in this group of patients.

Main directions and types of medical rehabilitation

Medical rehabilitation refers to the process of systematic and continuous restoration of a patient’s physical and mental health and ability to work, basis for the development of which is physical or mental injuries, occupational diseases, or severe organic lesions of organs and systems. The purpose of medical rehabilitation is to organize quick and effective return of the patients to society to fulfill work skills and domestic functions which they lost. The main objective of medical rehabilitation is prevention of disability, recovery and extension of active life, social integration and ensuring the proper level of quality of life. The “maximum” program during medical rehabilitation consists in achieving the full social and everyday level that existed before the disease or injury; the “minimum” program is to ensure the patient’s ability to elementary self-care.

Perilaku Pencegahan Cacat Pada Pasien Kusta

Leprosy occurs due to impaired neurological function in the eyes, hands or feet. The principle of the prevention of disability and the severity of disability is essentially 3M: Checking the eyes, hands and feet regularly, protecting the eyes, hands and feet from physical trauma and self-care. The purpose of this study is to study the behavior of prevention of defects and the increase of defects in leprosy patients in the Outpatient Installation of Leprosy Hospital Kediri. The design of this study is descriptive. The population of this research is leprosy patient with purposive sampling technique of 92 subjects. Variables are preventive behaviors, data collection using structured interviews. Analyzed using frequency distribution. The result of this research is 54,3% leprosy patients have defect prevention behavior and less defect and 45,7% of leprosy patients have defect prevention behavior and sufficient defect increase. It was concluded that leprosy patients in the Outpatient Installation of Leprosy Hospital Kediri have defect prevention behavior and less defect increment.

Higher Adherence to the Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern Is Inversely Associated with Incidence of Disability Among Puerto Rican Adults

Objectives Emerging evidence suggests that overall dietary quality is important for the prevention of disability, which maybe be due to protective effects on cardiovascular risk factors. Few studies have investigated adherence to a DASH diet and disability and muscle strength prospectively, particularly among Puerto Rican adults. This study examined the relationship between a DASH dietary index and incidence of disability and change in muscle strength over 5 years of follow up. Methods Data are from the Boston Puerto Rican Health Study, a prospective cohort of Puerto Rican adults aged 45 to 75 y (n = 1408). The DASH dietary quality index (DASH) was derived from averaged dietary data assessed by validated food frequency questionnaire at baseline and 2-y follow up. Self-reported disability included activities of daily living (ADL) and instrumental ADL assessed at baseline, 2-y and 5-y follow up. Hand grip measures were obtained using a hand dynamometer at baseline, 2-y and 5-y follow up. Cox Proportional Hazards models were adjusted for sex, age, cardiovascular disease, smoking status, educational attainment, alcohol consumption, physical activity, hypertension, diabetes, cholesterol concentration, C-reactive protein and body mass index. Multivariable linear regression was used to model changes in handgrip. Interactions by sex, age and diabetes status were examined. Results The prevalence of ADL and IADL disability at baseline was 70.8% and 48.6%. Mean change in handgrip from baseline to 5 y was −2.19 kg. Interactions by age, sex and diabetes status were not significant. Participants with higher adherence to the DASH diet had lower incidence of impaired ADL (HR = 0.95, 95% CI: 0.92, 0.99) and IADL disability (HR = 0.96, 95% CI: 0.93, 0.98). The relationship between the DASH dietary index and change in handgrip measures from baseline to 5-y follow up approached significance (β = 0.14 ± 0.08, P = 0.07). Conclusions These findings suggest that higher adherence to a DASH diet may reduce risk of disability and mitigate muscle strength loss among Puerto Rican adults. This may be an important intervention strategy for prevention of disability in this population. Funding Sources National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases.