Anxiety and Comorbidities Differences in Adults with Chronic Pulmonary Diseases: Serbian Single Center Experience.

Background and objectives: The purpose of this study is to investigate the differences in the degree of the anxiety and comorbidity levels in patients with different chronic pulmonary diseases such as chronic obstructive bronchitis (COPD) without emphysema phenotype, pulmonary emphysema, bronchial asthma and lung cancer. Materials and Methods: The prospective clinical study included 272 patients that were diagnosed and treated of pulmonary pathology. COPD (without emphysema phenotype) (Group-1), pulmonary emphysema (Group-2), bronchial asthma (Group-3) and lung cancer (Group-4) were assessed. For the evaluation of the anxiety degree, we used Hamilton Anxiety Rating Scale (HAM-A). Results: The degree of cardiovascular symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p = 0.001) and Group-4 (p = 0.013), and significantly higher in Group-4 versus Group-2 (p = 0.046). The degree of respiratory symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.002), and significantly higher in Group-4 versus Group-2 (p = 0.013) and versus Group-3 (p = 0.023). For gastrointestinal symptoms, the degree of one was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.017). Somatic subscale values were significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.015), and significantly higher in Group-4 versus Group-2 (p = 0.024). Total HAM-A score was significantly higher in Group-1 versus Group-2 (p = 0.002) and Group-3 (p = 0.007). Conclusions: Patients with COPD (without emphysema phenotype) followed by the lung cancer are at elevated risk of being more mentally challenged in terms of increased anxiety. Furthermore, patients with exacerbation of evaluated pulmonary pathologies have various levels of comorbidities degrees.

Morphogenetic Variability as Potential Biomarker of Functional Outcome After Ischemic Stroke.

The aim of our study was to evaluate the role of morphogenetic variability in functional outcome of patients with ischemic stroke. The prospective study included 140 patients with acute ischemic stroke, all of whom were tested upon: admission; discharge; one month post-discharge; and three months post-discharge. The age was analyzed, as well. The Functional Independence Measure (FIM) test and the Barthel Index (BI) were used for the evaluation of functional outcomes for the eligible participants. We analyzed the presence of 19 homozygous recessive characteristics (HRC) in the studied individuals. There was a significant change in FIM values at discharge (p = 0.033) and in BI values upon admission (p = 0.012) with regards to the presence of different HRCs. Age significantly negatively correlated for the FIM score and BI values at discharge for the group with 5 HRCs (p < 0.05), while for BI only, negative significant correlation was noticed for the group with 5 HRCs at three months post-discharge (p < 0.05), and for the group with 3 HRCs at one month post-discharge (p < 0.05) and three months post-discharge (p < 0.05). Morphogenetic variability might be one among potentially numerous factors that could have an impact on the response to defined treatment protocols for neurologically-impaired individuals who suffered an ischemic stroke.

Morphogenetic Variability and Hypertension in Ischemic Stroke Patients-Preliminary Study.

In this study, we evaluated and compared the morphogenetic variability and the degree of recessive homozygosity in patients with manifested ischemic stroke compared to healthy controls. We have evaluated 120 patients with manifested ischemic stroke, of which 64 did not have hypertension and 56 have hypertension. For comparison, we additionally tested 194 healthy individuals without manifested ischemic stroke (controls). For the estimation of the degree of recessive homozygosity, we have performed the homozygously recessive characteristics (HRC) test and tested 19 HRCs. There was a significant difference in the individual variations of 19 HRCs between the controls and patients with manifested ischemic stroke (∑χ² = 60.162, p < 0.01). The mean values of the tested HRCs significantly differed between the controls and group with manifested ischemic stroke (Controls − 5.71 ± 1.61, Ischemic stroke group − 6.25 ± 1.54, p = 0.012). For the tested individuals with hypertension, the mean values of HRCs did not significantly differ between the controls and those that had manifested ischemic stroke (Controls − 5.28 ± 1.75, Ischemic stroke group − 5.64 ± 1.48, p = 0.435). We found a significant difference in the frequencies of HRCs between those with and without hypertension for controls (p < 0.003) and for those with manifested ischemic stroke (p < 0.001). There are increased degrees of recessive homozygosity along with decreased variability in patients with manifested ischemic stroke compared to controls.

Functional status measured by Levine questionnaire in surgically and conservatively treated patients with carpal tunnel syndrome regarding nerve conduction studies.

AIM: To evaluate and compare the functional status in surgically treated patients with Carpal tunnel syndrome (CTS) compared with those treated conservatively by Levine Questionnaire (LQ) in relation to electroneurographic findings. METHODS: The prospective study included 80 patients with diagnosed CTS. Patients were assessed clinically and electrophysiologically. The main outcome measures were sensory latency of median nerve (SL II), and terminal (distal) motor latency of median nerve (TML). For the assessment of functional status we performed Levine Questionnaire (LQ) scoring examination which was divided in two sections: symptoms severity scale (SSS) and functional status scale (FSS). Regarding treatment options patients were divided into 2 groups: group that underwent surgical procedure (Group A) and group that underwent only conservative treatment (Group B). Patients were assessed neurophysiologically twice: before treatment and 12 months after treatment. RESULTS: There is significant increase in LQ-FSS (p=0.021) and LQ-SSS (p=0.038) scores for increased TML and significant increase of LQ-SSS scores (p=0.027) for increased SL II for Group A, while in Group B, LQ-FSS (p=0.034) and LQ-SSS (p=0.018) were significantly increased in patients with increased SL II. After treatment there was significant increase in LQ-FSS (p=0.037) and LQ-SSS (p=0.041) scores for increased SL II for Group B, while in Group A after treatment, we have noticed non-significant differences both regarding TML and SL II values. CONCLUSION: We have demonstrated the benefits of surgical treatment and better functional improvement with symptoms reduction particularly in more severe cases of patients with CTS. KEY WORDS: Carpal tunnel syndrome, Conservative treatment.

Influence of Pulmonary Rehabilitation on Lung Function Changes After the Lung Resection for Primary Lung Cancer in Patients with Chronic Obstructive Pulmonary Disease.

Influence of physiotherapy on the outcome of the lung resection is still controversial. Study aim was to assess the influence of physiotherapy program on postoperative lung function and effort tolerance in lung cancer patients with chronic obstructive pulmonary disease (COPD) that are undergoing lobectomy or pneumonectomy. The prospective study included 56 COPD patients who underwent lung resection for primary non small-cell lung cancer after previous physiotherapy (Group A) and 47 COPD patients (Group B) without physiotherapy before lung cancer surgery. In Group A, lung function and effort tolerance on admission were compared with the same parameters after preoperative physiotherapy. Both groups were compared in relation to lung function, effort tolerance and symptoms change after resection. In patients with tumors requiring a lobectomy, after preoperative physiotherapy, a highly significant increase in FEV1, VC, FEF50 and FEF25 of 20%, 17%, 18% and 16% respectively was registered with respect to baseline values. After physiotherapy, a significant improvement in 6-minute walking distance was achieved. After lung resection, the significant loss of FEV1 and VC occurred, together with significant worsening of the small airways function, effort tolerance and symptomatic status. After the surgery, a clear tendency existed towards smaller FEV1 loss in patients with moderate to severe, when compared to patients with mild baseline lung function impairment. A better FEV1 improvement was associated with more significant loss in FEV1. Physiotherapy represents an important part of preoperative and postoperative treatment in COPD patients undergoing a lung resection for primary lung cancer.

Avaliação dos efeitos a longo prazo da acupuntura e exercícios terapêuticos em ombro congelado de pacientes com acidente cerebral vascular / Evaluation of long term effects of acupuncture and therapeutic exercises on frozen shoulder in stroke patients

Objetivo do estudo: Determinar como a acupuntura e a terapia com exercícios afetam a função motora e espasmodicidade das mãos de pacientes com acidente cerebral vascular 6 meses após eles terem recebido este tipo de terapia. Métodos: Estudo clínico prospectivo, aleatório e cego de 20 pacientes, com idades entre 60-70 anos, na fase crônica de 6 meses após o AVC. Os sujeitos do estudo foram divididos em dois grupos: Grupo A, o qual foi tratado com acupuntura e terapia de exercícios (AP-ET) 6 meses atrás e Grupo B, o qual foi tratado apenas com terapia de exercícios (ET) 6 meses atrás. A avaliação incluiu uma entrevista ampla e a administração dos estágios de Brunnstrom, a Medida de Independência Funcional (MIF), a Escala Modificada de Ashworth (MAS), o Teste de Funcionalidade das Extremidades Superiores (UEFT), o Registro de Atividade Motora (MAL), a Série de Movimentos ativos e passivos (ROM, pROM), o teste de FUGL-Meyer da função da extremidade superior (FMA), o Questionário de Croft sobre Incapacidade do Ombro (CSDQ) e a Escala Analógica Visual (VAS) de dor. O Teste-t de Gosset foi usado para uma análise estatística. Resultados: As análises mostraram uma diferença estatisticamente significativa nos SCORES do pós-tratamento em comparação com 6 meses após o tratamento com cada grupo de estudo, para todos os parâmetros examinados (p<0.01 em todos os casos) exceto pelo MAS.

Aim of the study: To determine how acupuncture and exercise therapy affect motor function and spasticity on the hands of stroke patients 6 months after they had received this kind of therapy. Methods: Prospective, randomized, single blind clinical study of 20 patients, age 60-70 years, in the chronic phase 6 months after stroke. Subjects were divided into two groups: Group A, which was treated with acupuncture and exercise therapy (AP-ET) 6 months ago and Group B, which was treated with exercise therapy (ET) alone 6 months ago. the assessment included a comprehensive interview and administration of the Brunnstrom?s stages, Functional Independence Measure (FIM), Modified Ashworth Scale (MAS), Upper Extremity Function Test (UEFT), Motor Activity Log (MAL), active and passive Range of Motion (aROM, pROM), Fugl-Meyer test of upper extremity function (FMA), Croft Shoulder Disability Questionnaire (CSDQ) and Visual Analogue Scale (VAS) of pain. The Gosset t-Test was used for the statistical analysis. Results: Analyses showed a statistically significant difference in the post-treatment SCORES as compared to 6 months after treatment within each study group for all parameters examined (p<0.01 in all cases) except for MAS. Analyses showed a statistically significant difference in some parameters in the ET group as compared to the AP-ET group with greater mean values recorded in the AP-ET group for MAS and CSDQ. All other parameters showed no statistical differences between the two different therapy groups 6 months after the therapy. Conclusion: The results confirm the hypothesis that acupuncture and exercise therapy are useful in the treatment of frozen shoulder in stroke patients and that their effects are still present after 6 months of therapy, however, given the small patient population, further studies are needed to verify these results.

Efeitos da reabilitação precoce no desfecho da reabilitação pós-acidente vascular encefálico (AVE) em mulheres com mais de 65 anos e sua correlação com a gravidade do deficit neurológico inicial / Efeitos da reabilitação precoce no desfecho da reabilitação pós-acidente vascular encefálico (AVE) em mulheres com mais de 65 anos e sua correlação com a gravidade do deficit neurológico inicial

Este trabalho visa examinar os efeitos da reabilitação precoce, a curto e longo prazo, no desfecho do acidente vascular encefálico (AVE) em mulheres com mais de 65 anos; estabelecer a correlação entre o impacto da gravidade do déficit neurológico na predição dos resultados do tratamento de Reabilitação e, ainda, investigar a possibilidade do acompanhamento de parâmetros individuais da Medição de Independência Funcional (MIF) na predição do desfecho da reabilitação do AVE. Atualmente, o AVE é a terceira maior causa de mortalidade na população mundial, bem como a maior causa de invalidez permanente. No cenário atual, as doenças cardiovasculares e cerebrovasculares - que antes eram tidas como exclusivas da população masculina ? têm afetado também as mulheres. Por outro lado, observamos uma correlação linear entre o envelhecimento e a ocorrência destas doenças. Concluímos que a implantação do método de reabilitação precoce conduz a uma aceleração significativa do processo de tratamento e recuperação após o AVE em mulheres com mais de 65 anos. Concluímos também que certos parâmetros da MIF, por apresentarem o mesmo padrão de evolução, podem ser utilizados na predição da recuperação global do paciente.

This study aims at verifying the effects of short- and long-term rehabilitation on the outcome of encephalic vascular accident (EVA) in women older than 65 years; establishing the correlation between the impact of the neurological deficit severity on the prediction of the rehabilitation treatment outcome as well as investigating the possibility of the follow-up of individual parameters at the Functional Independence Measure (FIM) when predicting the EVA rehabilitation outcome. The EVA is currently the third major cause of death in the world?s population, as well as the main cause of permanent disability. In the present scenario, cardiovascular and cerebrovascular diseases, which used to be observed almost exclusively in the male population, now affect the female population as well. On the other hand, we observe a linear correlation between aging and the occurrence of these diseases. We conclude that the implementation of early rehabilitation leads to a significant acceleration in the treatment and recovery process post-EVA in women older than 65 years. We also conclude that certain FIM parameters can be used to predict the patient?s overall recovery, as they present the same evolution pattern.