Current management strategies in Osgood Schlatter: A cross-sectional mixed-method study.

BACKGROUND: Osgood Schlatter disease (OSD) is the most common knee condition in adolescent athletes aged 9-16. Without evidence to guide clinical practice, it is unclear how OSD is managed. The aim of this study was to investigate how international healthcare professionals (general practitioners, physiotherapists, rheumatologists, sports and exercise medicine doctors, and orthopedic surgeons) diagnose and manage OSD. METHODS: This mixed-method study used a convergent parallel design. A quantitative questionnaire and semi-structured interview covered prognosis, diagnosis, treatment, and return to play of adolescents with OSD. For quantitative data, those who reported likely/very likely considered "for" and unlikely/very unlikely "against" (for specific diagnostic/management strategy). Qualitative data analysis used a phenomenological approach. RESULTS: Two hundred and fifty-one healthcare professionals completed the questionnaire. The most common diagnostic criterion was pain at the tibial tuberosity (97% for). The most common treatments were patient education (99%) and exercise therapy (92%). Other treatment options were more heterogeneous, for example, pain medication (31% for and 34% against). Managing training load (97%), pain intensity (87%), and psychological factors (86%) were considered the most important factors influencing the return to activities. Several themes emerged from the interviews (on N = 20) including imaging, pain management, family, and psychosocial factors influencing prognosis. CONCLUSION: Diagnosis criteria of OSD were relatively well agreed upon, whereas the triangulation of qualitative and quantitative data showed heterogeneity of treatments. Psychosocial factors including family were highlighted as critical in the management of OSD.

[Evaluation of bio-inverse communication and Cytoflavin effects on the dynamics of the clinical and psychophysiological condition of elderly patients with osteochondrosis].

We conducted a study of 150 patients on the basis of polyclinic № 91 in St. Petersburg. The effect of Cytoflavin and bio-inverse communication therapy on the dynamics of the condition of elderly patients with osteochondrosis was evaluated. A number of positive effects from such an addition to existing therapy, potentiating the nominal effect, were revealed.

To be blamed or pitied? The effect of illness on social behavior, cytokine levels and feed intake in undocked boars.

Tail biting is detrimental to animal welfare and has negative consequences for producer economy. Poor health is one of the risk factors for tail biting. The first aim of this study was therefore to test for links between health status and behavior related to tail biting at the individual level. The second aim of this study was to test whether variation in cytokines was related to variation in social behavior. These small molecules produced upon immune activation are known to influence behavior both in the direction of withdrawal and increased aggression. This could potentially increase non-functional social behavior and thereby the risk of a tail biting outbreak. To investigate this, we collected behavioral data, health data, feeding data and blood samples from undocked boars at a test station farm in Norway. We compared groups with three different diagnoses: osteochondrosis diagnosed by computer tomography scanning (OCSAN), osteochondrosis diagnosed by clinical examination (OCCLIN) and respiratory tract disease (RESP), with healthy controls (CTR). We tested whether the diagnoses were associated with feeding and growth, social behavior and cytokine levels. We then tested whether there were correlations between cytokine levels and social behavior. We also provide raw data on cytokine levels in the extended sample (N=305) as there are few publications on cytokine levels measured in pigs living under commercial conditions. OCCLIN pigs visited the feeder less, and fed longer compared to CTR pigs. Pigs diagnosed with RESP showed a large drop in growth the first week after filming, which corresponds to the week they were likely to have been diagnosed with illness, and a tendency to compensatory increase in the week after that. Social behavior differed between experimental groups with OCSCAN pigs receiving more social behavior (both aggressive and non-aggressive) compared to CTR, and RESP pigs tending to perform more ear- and tail-biting than controls. There were no differences in absolute levels of cytokines between categories. However IL1-ra and IL-12 showed correlations with several behaviors that have been shown by others to be associated with current or future tail biting activity. To our knowledge, this is the first published study indicating a role for illness in non-functional social behavior in pigs and the first showing a correlation between cytokine levels and social behavior.

[The application of the biological feedback technique for the treatment of the patients presenting with chronic somatic diseases]. / Primenenie metoda biologicheskoi obratnoi svyazi pri lechenii patsientov s khronicheskimi somaticheskimi zabolevaniyami.

The objective of the present work was to study the influence of the application of the biological feedback (BFB) technique on the dynamics of the psychological and clinical status of the patients presenting with various chronic somatic diseases (CSD) and to identify the predictors of the effectiveness of the treatment by this method. PATIENTS AND METHODS: The study included 337 patients suffering from CSD who were interviewed with the use of the concise standardized multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomly distributed into two groups. Group 1 (main) was comprised of 168 patients who underwent psychotherapeutic treatment based on the BFB method, group 2 (control) consisted of 169 patients who did not receive the psychotherapeutic treatment. In order to identify the predictors of the effectiveness of the treatment by the biological feedback technique, the patients of the main group were subdivided into two subgroups at the end of the study period. Subgroup A contained 112 (67%) patients whose health status was normalized under the influence of psychotherapy, subgroup B included 56 (33%) patients who experienced the improvement of the somatic conditions. We undertook the comparative analysis of the background characteristics of the patients belonging to each group. RESULTS AND DISCUSSION: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of the parameters estimated based on the scales 1, 2, and 7 and an increase of those evaluated based on the (SMPI) scale 9. Simultaneously, the levels of state and trait anxiety estimated based on the Spielberger и Beck inventory scales decreased. These findings give evidence of the improvement of psychological adaptation of the patients, decrease of the anxiety level and emotional stress under the influence of the treatment with the use of the biological feedback technique; these changes were concomitant with the enhancement of the general activity of the patients, the improvement of their working capacity, mood, and feelings of optimism. The study of the predictors of the effectiveness of the BFB method revealed the significantly higher background values estimated based on the SMPI scales 1, 4, and 6 in the patients with the improvement of the health status compared with those exhibiting normalized conditions (p<0,01). In 12% of the patients in the former subgroup (but in none of the patients of the latter subgroup), the values obtained based on the Beck scale were higher than 20 scores which suggested either the moderate or high level of depression. These data give reason to conclude that the patients that exhibited a relatively weak response to the treatment with the application of the biological feedback technique were initially predisposed to the un-necessary excessive fixation of attention on their sensations in the combination with enhanced impulsivity, rigidity of attitudes, and the presence of depressive disorders.

Sever's disease--does it effect quality of life?

BACKGROUND: Sever's disease is a condition which has been described inconsistently in the literature with respect to pathology, aetiology and management. In particular, the impact of this condition has been overlooked, probably because it is usually self-limiting. METHOD: This study used a prospective comparative design study to determine the impact of Sever's disease on the quality of life of its sufferers. RESULTS: Three scales--Happiness, Satisfaction with symptoms and Pain/comfort scale--from the POSNA musculoskeletal questionnaire showed significant differences between the symptomatic and control groups. CONCLUSION: Although the condition may resolve with time, these results show that it has a considerable impact on children's lives.