CLINICAL, INSTRUMENTAL AND BIOCHEMICAL ASSOCIATIONS OF THE DEGREE OF PHYSICAL RECOVERY IN PATIENTS SUFFERED FROM ACUTE CORONARY SYNDROME AT THE COMPLETION OF IN-HOSPITAL REHABILITATION PERIOD

OBJECTIVE

The aim: To determine the clinical, instrumental and biochemical factors associated with the degree of physical recovery in patients suffered from acute coronary syndrome (ACS) at the completion of in-hospital rehabilitation period.

PATIENTS AND METHODS

Materials and methods: We enrolled 88 patients (all were males); 77 patients had ACS/STEMI and 11 with ACS/unstable angina. The mean age was (median, interquartile range) was 58 (49-64) years. We analyzed clinical, laboratory (including the circulating proprotein convertase subtilisin/kexin type 9 (PSK9) level in blood serum), transthoracic echocardiography and (urgent or delayed) coronary angiography data. Symptom-limited exercise tolerance (ET) test was performed predominantly at the second week of in-hospital stay. According to ET-test results, patients were subdivided into the groups with low (G1; 43 [48,9 %]) and high ET (G2; n=45 [51,1 %]).

RESULTS

Results: G1 (vs. G2) was characterized by older age, lower estimated glomerular filtration rate (eGFR) and higher left atrial (LA) dimension. The cases of any left anterior descending artery (LAD) lesion were more frequent in G1 (25 % vs. 2 % in G2, respectively; p=0,004). We revealed a decrease in PSK9 level after ET-test (pre-ET vs. post-ET: 824,0 (371,0-1073,0) vs. 676,0 (441,9-995,9) ng/ml, respectively; p=0,004 [N=35]).

CONCLUSION

Conclusions: At the completion of in-hospital rehabilitation period, the insufficient physical recovery in patients suffered from ACS associated with older age, lower eGFR, higher LA dimension, and more frequent any LDA lesion cases. Physical exercises favored the decrease in PCSK9 levels in blood serum.

[Heterotopic ossifications after hospitalisation in intensive care for SARS-CoV-2 pneumopathy]

We report the case of a 63-year old patient admitted in the intensive care unit for 25 days because of a severe SARS-CoV-2 pneumonia. With diverse symptoms of critical illness polyneuropathy the patient has been taken care of in a rehabilitation centre. Ankylosis and joint motion limitation led to a more extensive imaging assessment. The later showed advanced periarticular heterotopic calcification in both hips and in right shoulder. Although hypothesis about this complication's physiopathology remains unclear, early identification would allow a better management. It is the first time heterotopic ossification involving three large joints is reported after a SARS-CoV-2 infection.

PREVENTION OF ASTHENIC SYNDROME AS CONCOMITANT CIRCUMSTАINS IN POST-COVID-19 PATIENTS

OBJECTIVE

The aim: Is research into development of asthenic syndrome and its effect on the productivity in post-COVID-19 patients.

PATIENTS AND METHODS

Materials and methods: All patients underwent neuropsychological testing immediately after the COVID-19 treatment and one month after a comprehensive rehabilitation program.

RESULTS

Results: The research proved that of all post-COVID-19 patients, who showed signs of asthenic syndrome from predominantly moderate to extreme severity, the patients who followed the complete comprehensive rehabilitation intervention significantly reduced verifiable severity of asthenic syndrome as well as the disability duration.

CONCLUSION

Conclusions: Early administration of combined rehabilitation methods enables preventing the development of long-term side effects, reduces recovery time and enchases the productivity in post-COVID-19 patients.

[Cartilage ageing and treatment possibilities]

Osteoarthritis is the disease connected with aging which is characterised by progressive degeneration of all elements building the joint but also influencing the muscles constituting motor unit with the affected joint. The effective and unified therapy has not been yet introduced despite the broad multi-site studies concentrating on metabolic pathways responsible for the development of the disease. The reason of which is probably its multifactorial aetiology. The treatment methods are based on decreasing of cartilage destruction activity, retardation of proinflammatory factors activity and fighting with pain. Physiotherapy, movement rehabilitation, painkillers, anti-inflammatory drugs, glucosamine sulphates and hyaluronic acids are used as therapeutic strategies. The methods recently introduced are platelet rich plasma concentrates and stem cells injected directly into the affected joint. The aim of this review article was the presentation of differential therapeutic options offered to patients in different stages of osteoarthritis.

[Psychological resources of coping with somatic illness in adolescents]

OBJECTIVE

Introduction: Somatic illness, objectively and subjectively, can become a difficult life situation for a person. The adolescent's experience of illness is determined by the specifics of a particular age period. To develop an effective rehabilitation program, it is necessary to study the personal characteristics of the adolescent and his social environment, which may be resourceful. The aim: To conduct a theoretical analysis of publications about psychological resources coping with somatic illness in adolescents.

PATIENTS AND METHODS

Materials and methods: The analysis of scientific publications on this topic.

RESULTS

Review and conclusions: In the process of overcoming the illness, the adolescent accumulates his internal and external resources. External resources are mostly described as support from the family. Personal resources are described by a wide range of personal qualities. It is necessary to develop a system of psychological resources for coping with somatic illness in adolescents.