Rehabilitation of amputees represents a complex process during the course of which an amputee receives professional aid and support, so as to adapt to the use of prosthesis, i.e. an artificial ...supplement for the lost body part. The process aims at achieving an independent performance of the amputee in all areas of everyday life and as high quality of life as possible. The rehabilitation encompasses not only the pre-amputation, postoperative, pre-prosthetic and prosthetic stage, within which an amputee is provided with a prosthetic
aiding device, but also the subsequent long-term monitoring and follow-up. The implementation of the rehabilitation process runs in line with the biopsychosocial model and requires a multidisciplinary and an interdisciplinary approach, so as to achieve a successful reintegration of an amputee and allow for a lifestyle resembling the pre-amputation one as much as possible.
The article brings the causes and types of amputation, the principles
underpinning contemporary amputation surgery, prosthetics and rehabilitation during preoperative, postoperative, pre-prosthetic and prosthetic stages, as well as the stage goals and MOs of their attainment. Principles of evaluation of prosthetic rehabilitation outcomes in limb amputees, which make use of appraisal questionnaires, have been discussed as well.
Rehabilitacija osoba s amputacijom donjih udova kompleksan je proces u kojem se osobi koja je doživjela gubitak uda pomaže da se, uz stručnu podršku, adaptira na protezu kao artificijelni nadomjestak ...izgubljenog dijela te da uz primjenu proteze postigne maksimalno moguću neovisnost u svim područjima života, sa što boljom kvalitetom življenja. Rehabilitacija obuhvaća razdoblje od amputacije, koja može biti posljedica ozljede ili bolesti, kroz postoperacijsku i predprotetičku fazu do protetičke faze rehabilitacije u kojoj se provodi protetička opskrba, ali i kasniju fazu dugotrajnog praćenja. Medicinsku rehabilitaciju nužno mora pratiti adekvatna psihološka i socijalna rehabilitacija, po biopsihosocijalnom modelu, kako bi se ostvario konačni cilj rehabilitacije, a to je uspješna reintegracija osobe u život sa stilom koji je što sličniji onom koji je prethodio amputaciji.
U radu su prezentirani uzroci i vrste amputacije, načela suvremene protetike i rehabilitacije osoba s amputacijom donjih udova tijekom predoperacijske, postoperacijske, predprotetičke i protetičke faze s ciljevima rehabilitacije u pojedinim fazama, načinima njihova ostvarivanja, kao i načelima psihosocijalne rehabilitacije. Također su prezentirani evaluacijski upitnici i načela Međunarodne klasifikacije funkcioniranja, onesposobljenosti i zdravlja (MKF) za procjenu rezultata rehabilitacije osoba s amputacijom donjih udova.
Klasifikacija glavobolja bazira se na onoj koju postavlja Međunarodno udruženje za glavobolje (engl. International Headache Society). Zapravo se i razlikovanje migrene od drugih primarnih kao i ...sekundarnih glavobolja bazira na ovoj klasifikaciji, odnosno u oko 90 % slučajeva isključivo na temelju dobrih anamnestičkih podataka. Sukladno tome, neurološka obrada u velikom broju slučajeva nije potrebna. Problem ponekad predstavlja prisutnost više glavobolja istovremeno, promjene u karakteristici migrene, kao i glavobolje uslijed prekomjernog uzimanja lijekova, poglavito analgetika (GUPUL).
One of the challenges of radiation oncology in the era of personalized medicine is identification of biomarkers associated with individual radiosensitivity. The aim of research was to evaluate the ...possible clinical value of the associations between clinical, physical, and biological factors, and risk for development of acute radiotoxicity in patients with prostate cancer. The study involved forty four patients treated with three-dimensional conformal radiotherapy. The concentrations of IL-1β, IL-2, IL-6, IFN-γ and TGF-β1 were assessed before radiotherapy, after 5th, 15th and 25th radiotherapy fractions, at the end, and 1 month after the end of radiotherapy. Cytokine gene expression was determined in peripheral blood mononuclear cells. The univariate analysis of circulating cytokine levels during radiotherapy showed that increased serum concentrations of IL-6 were significantly associated with higher grade of acute genitourinary toxicity. The multivariate analysis demonstrated that increased level of IL-6 during the radiotherapy was significantly associated with higher grade of acute genitourinary toxicity across treatment. TGF-β expression levels significantly decreased during course of radiotherapy. Research indicates that changes in circulating cytokine levels might be important parameter of radiotoxicity in patients with prostate cancer. These findings suggest that future studies based on multi-parameter examination are necessary for prediction of individual radiosensitivity.
Parkinson's disease (PD) is neurodegenerative disease with a multifactorial etiopathogenesis with accumulating evidence identifying microbiota as a potential factor in the earliest, prodromal phases ...of the disease. Previous research has already shown a significant difference between gut microbiota composition in PD patients as opposed to healthy controls, with a growing number of studies correlating gut microbiota changes with the clinical presentation of the disease in later stages, through various motor and non-motor symptoms. Our aim in this systematic review is to compose and assess current knowledge in the field and determine if the findings could influence future clinical practice as well as therapy in PD.
We have conducted a systematic review according to PRISMA guidelines through MEDLINE and Embase databases, with studies being selected for inclusion via a set inclusion and exclusion criteria.
20 studies were included in this systematic review according to the selected inclusion and exclusion criteria. The search yielded 18 case control studies, 1 case study, and 1 prospective case study with no controls. The total number of PD patients encompassed in the studies cited in this review is 1,511.
The link between gut microbiota and neurodegeneration is a complex one and it depends on various factors. The relative abundance of various microbiota taxa in the gut has been consistently shown to have a correlation with motor and non-motor symptom severity. The answer could lie in the products of gut microbiota metabolism which have also been linked to PD. Further research is thus warranted in the field, with a focus on the metabolic function of gut microbiota in relation to motor and non-motor symptoms.
Our aim was to determine the frequency and characteristics of neurological post-COVID-19 syndrome and the diagnostic and therapeutic measures that were used for the treatment of these patients. Data ...were collected for 243 patients examined during the period of 11 May 2021 to 22 June 2022. The inclusion criteria were COVID-19 illness and neurological symptoms associated with COVID-19. The exclusion criteria were non-neurological symptoms, patients who did not suffer from COVID-19, and symptoms that occurred after vaccination against the SARS-CoV-2 virus. Data for 227 patients with neurological post-COVID-19 symptoms were analyzed. Most patients presented with multiple symptoms, most often headache, cognitive impairment, loss of smell, paresthesia, fatigue, dizziness, and insomnia. Patients were most often referred for consultative examinations, neuroradiological imaging, and EEG. The therapy was mostly symptomatic. Most patients had no change in their symptoms on follow-up visits (53.21%), while positive outcome was found in 44.95% of patients. This study found that neurological post-COVID-19 syndrome appears to be more common in women, and generally, the most common symptoms are headache and cognitive impairment. The gender distribution of symptoms was clearly visible and should be further investigated. There is a need for longitudinal follow-up studies to better understand the disease dynamic.
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