The management of a patient with multiple infarcts with different etiologies

72 yo male, presents for abdominal pain and motor deficiency of the left upper limb. Clinical examination reveal severe general condition, left brachial hemiparesis, right arm blood pressure (BP) 240/120 mmHg, left arm BP 210/100 mmHg, heart rate (HR) 110 bpm, arrhythmic, abdominal pain at superficial palpation, without other abnormalities. Biological: negative hs troponin I, positive D-dimers, positive CRP, GFR 38 ml/min/m2, potassium 2.97 mmol/l. ECG: Atrial fibrillation. Abdominal ultrasound: abdominal dilated aorta, dissection flap. Abdominal and pelvic CT scan: right renal infarction, multiple splenic infarction, abdominal aortic aneurysm with dissection. Underwent interventional treatment of the abdominal aortic dissection (EVAR). Particularity of the case: concomitant diagnosis of multiple infarction with different etiologies, for which therapeutic decision was challenging.

Synthesis, Spectral Characterization and Anticonvulsant Studies of the Novel Triazolothiadiazoles Bearing Benzoxazole Moiety

In this study, new fused triazolo-thiadiazoles (4a-o) were synthesized viamethyl 2-[bromo(phenyl)methyl]-1,3-benzoxazole-5-carboxylate. The structure of novel derivatives was recognized on the basis of spectral data results and screened their anticonvulsant action by means of maximal electroshock seizure (MES) and subcutaneous pentylenetetrazol (scPTZ) procedures. Minimal motor studies were completed by a rotarod method. Compounds 4e, 4g, 4j, 4l, 4m and 4n showing better anticonvulsant action corresponding to hydrophobicity. Other molecules remained fewer lipophilic and have less effectiveness. Most of the compounds positively tolerable the rotarod test deprived of motor deficiency. In conclusion, the prepared derivatives with distal aryl moiety exhibited higher lipophilic character and lead to improved pharmacological achievement, which can be a forthcoming promise.

Neurobiology of fine motor skills. Up-to-date status

The main goal of the current overview is to assess major trends in studying of fine motor skills neurobiology.Materials and techniques. PubMed (MedLine), Embase databases have been used for Information search. Search depth is 5 years (2016 – 2021). 12 papers that are more relevant to the topic have been chosen from the primary paper array (n=49). MAXQDA (Verbi Software GmbH, Germany) has been used for content analysis.Results and discussion. The current state is characterized by interdisciplinary integration using both complex experimental laboratory models and modern bionic and information technologies.Conclusion. Contemporary trends in the problem studying is the widespread utilization of information technologies and the development of approaches to neurorehabilitation with motor deficiency consideration. Fine motor skills recovery in patients with CNS lesions requires further interdisciplinary integration.

Influence of comprehensive physical rehabilitation on the restoration of motor deficiency in patients suffered ischemic stroke

The article consideres the issue of restoring lost motor function through comprehensive physical rehabilitation. The results of a study of 84 patients with cerebral ischemic stroke (CIS) are presented. The study of patients was conducted in the recovery period (from 3 to 6 months after the vascular accident). The average age of patients was 64.2±1.7 years. During the study all patients were divided into two groups depending on the type of rehabilitation treatment. The main group consisted of 43 patients who received standard medicines therapy aimed at secondary prevention (antihypertensive, hypocholesterolemic, hypoglycemic and other medicines), as well as therapy aimed at the correction and prevention of neurocognitive and dyscirculatory disorders (medicines with metabolic and vasoactive action) during the entire period of supervision. All patients of the main group underwent a course of comprehensive physical rehabilitation treatment. The latter included classes in kinesiotherapy, occupational therapy, speech therapy classes and, if necessary, patients received psycho-correctional and psychotherapeutic methods of treatment. The second (comparison) group consisted of 41 patients who received only drug treatment: standard basic therapy in the framework of secondary prevention of CIS and therapy aimed at the correction and prevention of neurocognitive, dyscirculatory disorders. The results of our study showed that the use of a comprehensive rehabilitation treatment program consisting of physical and medical methods are signifi cantly more eff ective for patients with motor disorders who have suff ered an ischemic stroke compared with the use of only drug therapy in these patients.

Spinal muscular atrophy: a perspective outlook

Background. Recent decades have witnessed a leap in understanding the molecular genetic bases of spinal muscular atrophy for a considerable improvement in diagnosis and treatment of this disease and development of innovative therapies for correcting genetic deficiencies. Given scarcity of etiotropic therapies for spinal muscular atrophy, traditional effective approaches remain relevant to target pathophysiological mechanisms of the disease progression and demand further development and improvement.Objectives. Efficacy assessment of proactive therapy to spinal muscular atrophy based on electromyographic techniques using verifiable patient-specific functional scales.Methods. The study is designed as a prospective cohort study conducted at the Republican Clinical Centre for Neurorehabilitation. We used a 15-year monitoring data on 95 children (66 boys and 29 girls) with genetically confirmed proximal spinal muscular atrophy. Patients were divided in two cohorts. The main cohort (65 children) received personalised therapy based on a proactive comprehensive stepwise approach to isolate a stem pathological pattern with clinical and electromyographic data. The comparison cohort (30 children) received conventional symptomatic therapy, including neurometabolic, cholinotropic drugs, classical massage and physiotherapy. In the study design, functional capacities and electromyographic data were estimated in a standardised time scheme with reference points («baseline», «1 year», «3 years», «5 years»).Results. The proposed methodology for clinical and electromyographic data sampling at different points of the disease progression has yielded results. We registered a weaker pathological progression in the main cohort reflected by less pronounced motor deficiency and electromyographic pathology compared to the comparison group receiving conventional symptomatic therapy.Conclusion. Dynamic monitoring of clinical and neurological disorders using modern assessment scales and extended electromyography of morbid motor markers enables a personalised proactive clinically justified treatment to suppress complications and manifestation of pathology.

ONCOLOGY REHABILITATION - AN ALTERNATIVE TO BREAST CANCER TREATMENT

Introduction: Worldwide breast cancer is the most common malignancy disease with a frequency of more than 6 million. The treatment consists of surgical intervention, chemotherapy, radiation, and often follow-up medical care in the long-term treatment is neglected. As a result of a partial or total mastectomy, one of the complications that patients develop is lymphedema, which may occur months or years after the surgery. This necessitates the search for systematic and effective approaches for these patients in order to improve physical and mental well-being, resocialization and return to previous levels of activity in daily life. Case report: In 2019 a 58-year-old female patient, visited Medical University of Varna and University center of East medicine with the following complaints: pain in the armpit area, lymphedema of a right upper limb, a sense of weight and motor deficiency in the hand. In 2017 she is diagnosed with breast cancer by conducting an operative intervention consisting of a partial mastectomy with removal of 12 lymph nodes, followed by chemotherapy, radiotherapy treatment and medication therapy. For 2 years, the patient seeks help from a variety of healthcare professionals whose methods lead to short and unsatisfactory results. Impaired quality of life in daily activities is the main reason the patient to refer to the specialists at the University center of East medicine, offering a different and complex approach aimed at the patient’s overall recovery. Conclusion: Early diagnosis and subsequent successful treatment approach are the path to holistic, systematic and effective treatment in cancer patients.

The effectiveness of electrophoresis with caripain in the treatment of discogenic radiculopathy in the cervical spine. Clinical case.

In this article, we demonstrate a clinical case with high efficacy of Karipain electrophoresis in the treatment of a patient with discogenic radiculopathy in the cervical spine. The positive result was a complete regression of motor deficiency, restoration of sensory function and a decrease in the size of a hernia of the intervertebral disc at the level of C5C6 by 40%.

Comparative assessment of dexterity tests results using two internationally recognized scales in patients with cerebral palsy, users of medical textiles

The recent studies report an increase in the percentage of newborns diagnosed with cerebral palsy (CP) in industrialized countries due to the increased survival rate of infants with low birth weight. The assessment of the upper limb motor function and manual skills are important steps in achieving a suitable multi-modal therapeutical plan, aiming at gaining functional independence and early integration into society. The study seeks to identify how the motor deficiency present at the level of the upper limbs influences the manual skills of CP patients reflected in daily activities (Activities of Daily Living – ADL) and using medical textiles. 35 patients diagnosed with CP were assessed during hospitalization using, for the comparative reflection of ADL dexterity assessment results, at the same patient, quantified, the Action Research Arm Test (ARAT) scale and ABILHAND-Kids. A highly significant correlation was found, the ABILHAND-Kids score being moderately correlated with the ARAT score, obtained in the upper limb with more deficient functionality (0.578) and respectively with better functionality (0.570). The assessment of the child suffering of CP, using the ABILHAND-Kids questionnaire and the ARAT test provides to the rehabilitation team useful information, with the benefit of complementarity for the elaboration, based on several correlated elements, of the case management plan and methodology. Proper treatment, instituted early, can have a favorable influence on the social integration of these people. A remarkable contribution has been made by the textile domain which, through its sustained concerns regarding the research and development of biotechnologies and biomaterials, proves its permanent concern in supporting and integrating these people.

SEATED VOLLEYBALL: THE INFLUENCE OF MOTOR DEFICIENCY TYPE ON PLAYERS’ TACTICAL ROLES

ABSTRACT Introduction Sitting volleyball is an adapted sport played by players in the seated position, due to impaired mobility or amputations. Court dimensions are adjusted to the players’ average height, and during the games, the actions performed are similar to those of traditional volleyball. Objective To analyze the tactical performance of lower limb amputees and physically disabled athletes during seated volleyball games. Methods Data were collected from video footage, by a single observer, of twelve games of the Brazilian north-northeast championship 2017. The analysis investigated: i) average length of rallies; ii) frequency of attack actions; iii) game actions by amputation type; iv) outcomes of the actions by amputation type; v) direction and frequency of movements by disability. Results The average duration was 70 rallies per game, with the minimum disabled athletes performing the highest number of attack actions (43). Transfemoral amputees performed the highest number of blocking actions per game (10.5, in average). Conclusion Sitting volleyball has characteristics that are determined mainly by the type of disability. Players with minimal disabilities perform more attack actions and have higher performance per action, while amputees perform actions closer to the net, such as blocking and blocking points. The results also suggest that the type of amputation influences the direction of movement. Level of evidence II; Study Prospective.

Influence of mesenchymal stem therapy on the behavior of the process of sam-rats with brain injury

Current research suggests the potential use of mesenchymal stem cells (MSCs) in the treatment of brain injuries. Intravenous administration of MSCs to adult rats with brain injury leads to the restoration of behavioral and neurological status and helps to normalize maternal behavior. In this work, it was shown that a single transplantation of syngeneic mesenchymal stem cells (5 mln) into the bloodstream of female rats with motor deficiency has a corrective effect on the behavior of their offspring: it prevents the development of violations of research and locomotor behavior in the Open Field test and reduces emotional disorders.