Proactive psychological and psychiatric support of patients with chronic non-communicable diseases in a randomised trial: a Ukrainian experience.

Background: Presently, approaches for the early treatment of pathological anxiety in patients with chronic non-communicable diseases are lacking, thus delaying the initiation of symptom management at the early onset of the illness. Proactive psychological and psychiatric support, to alleviate subclinical symptoms of anxiety and to improve the quality of life in patients with chronic non-communicable diseases, is a promising candidate for the role of such therapy. Aims: To investigate and determine the effectiveness of proactive psychological and psychiatric support for alleviating subclinical symptoms of anxiety and improving quality of life, in patients with chronic non-communicable diseases. Methods: The study design was a monocentric randomised controlled trial with parallel groups. The study, involving 193 inpatients with chronic non-communicable diseases, complied with the ethical and deontological norms in accordance with the principles set out in the Declaration of Helsinki. Instruments used in the study included the Hamilton Anxiety Scale (HAM-A) to assess subclinical symptoms, the Scale of Somatic Symptoms and the Chaban Quality of Life Scale. Block randomisation was used to randomise patients to a 2-month-long study group with a proactive counselling psychiatry model care or a control group with standard regulated treatment for chronic non-communicable diseases. The allocation ratio was 1.15:1 owing to the expectancy of a higher percentage of dropout in the intervention group. Results: After 60 days of treatment (T2), there was a statistically significant difference in all clinical parameters between the study and control groups. The median HAM-A value differed between the groups by 4.87 points, with statistically significant lower results in the study group. The comparison of the study group's scale values on day 1 and day 60 demonstrated statistically significant changes in all three indicators. Conclusions: Our results support existing evidence for the effectiveness of proactive psychological and psychiatric support to reduce subclinical anxiety and somatisation symptoms and to improve the quality of life for patients with common chronic non-communicable diseases. However, continued research on the effectiveness of proactive psychological and psychiatric support for patients with chronic non-communicable diseases is needed.

[Changes of the auditory function in he children with chronic kidney failure]. / Izmeneniia slukhovoi funktsii u detei s khronicheskoi bolezn'iu pochek.

The risk factors that contribute to the development of hearing loss in the children with chronic kidney failure (CRF) are complications and/or manifestations of the disease itself as well as the side effects of its treatment. There are many similarities between the anatomical, physiological, and pharmacological features of the nephron and the striavascularis of the cochlea. The objective of the present study was the evaluation of the status of the auditory function in the children presenting with CRF. MATERIAL AND METHODS: A total of 62 children with CRF were examined. 40 patients were on peritoneal dialysis and 9 on hemodialysis whereas 13 children did not receive hemodialysis. Kidney was transplanted in 7 patients. The registration of transient evoked otoacoustic emission (TEOAE) was performed in all the children. For patients without TEOAE complex underwent the audiological examination. RESULTS: The TEOAE was not registered in 17 of the 62 examined children. According to the results of the comprehensive audiological examinations, 13 children suffered from the hearing loss of different forms and severity while 5 children presented with bilateral deafness. As the duration of CRF progressed, the patients became more prone to develop hearing impairment. Hearing loss is possibly genetically determined. Among the etiological factors underlying the development of the hearing loss the high doses of immunosuppressants and aminoglycosides are considered to be the principal ones.

[On the necessity of standardization of objective methods for the study of hearing function in children presenting with acute inflammatory diseases of the middle ear at the level of outpatient treatment].

The objective of the present study was to standardize the frequency of objective evaluation of the hearing function in the children presenting with acute inflammatory diseases of the middle ear at the level of the outpatient treatment. The studies carried out to this effect with the use of modern and readily available audiological method revealed functional disorders in the middle ear of more than 50% of the children suffering from acute non-perforative otitis even after the elimination of the clinical signs of inflammation. The complete restoration of the functional state of the middle ear was documented in all the patients following the rehabilitative treatment. The authors proposed the algorithm for the examination of the children presenting with acute inflammatory diseases of the middle ear with special reference to the optimal frequency of diagnostic studies.

[Photodynamic therapy of prostatic adenoma].

We were the first to study feasibility of photodynamic therapy (PDT) for prostatic adenoma using photosensitizer from chlorine group--photoditasine. We have developed and used PDT technique with application of 3-way silicon catheter with two balloons. This allows care for presenile and senile patients with compromised somatic status who are at high surgical risk of standard operations. The results demonstrate regression of both irritative and obstructive symptoms, improvement of life quality, persistence of sexual function. PDT reduces hospital stay as it can be used in outpatient conditions.

[Fluorescence detection of photosensitizer photoditazin in the tissue of benign prostatic hyperplasia].

The authors present pilot experience in investigation of accumulation, distribution and elimination of photosensitizer photoditazin from hyperplastic tissue of human prostate. Fluorescent spectroscopy showed that 2-24 hours after intravenous injection of photoditazin in a dose 1 mg/kg, it is detected in hyperplastic tissue of human prostate with maximal accumulation 3 hours after introduction. Exogenic fluorescence of photoditazin lowered 12 and 24 hours after injection this indicating its elimination. The results favor use of photoditazin for photodynamic treatment of patients with benign prostatic hyperplasia.