Medical management determinants of the maxillofacial precancerous and benign diseases malignancy.

OBJECTIVE: Aim: To identify the medical management determinants of the maxillofacial precancerous and benign diseases malignancy. PATIENTS AND METHODS: Materials and Methods: 150 people with maxillofacial cancer and 100 people with precancerous and benign diseases of the same localization were interviewed. RESULTS: Results: There were revealed: a low percentage of detection during check-up (10.2-15.8%), more than a third of cases (35.8-37.4%) are diagnosed by chance; not all patients undergo histological verification of the diagnosis (25.7% in cancerous and 43.2% in precancerous and benign diseases); not all are under follow up observation (24.7-27.7%). The risk of precancerous and benign diseases malignancy is the highest at 40-59 years of age (OR=4.4; 95% CI: 1.9-10.5), andalso increases with the duration of the disease for more than 5 years (2.2; 1.2-4.10 ), in patients who didn't undergo histological verification (2.2; 1.3-3.8), don't follow doctors' recommendation on visits and treatment (2.4; 1.4-4.1), don't trust doctors and are dissatisfied with medical care (2.1; 1.3-3.6). The risk groups of the maxillofacial oncological, precancerous and benign diseases are men, who are 1.5 times more likely to suffer from them than women and are characterized by lower medical care activity. The risk factors of the maxillofacial precancerous and benign diseases malignancy are low financial (4.6; 1.7-12.4) and territorial (3.3; 1.1-10.3) accessibility of medical care, including dental care (2.8; 1.6-4.8). CONCLUSION: Conclusions: It is necessary to improve the prevention and medical care in order to advance the early detection of maxillofacial cancer, taking into account the established medical management determinants of malignancy.

QUALITY OF LIFE DETERMINANTS IN PERSONS WITH DISABILITY AFTER MUSKULOSCELETAL INJURIES.

OBJECTIVE: The aim: To study the intrinsic and extrinsic factors affecting quality of life in persons with disability after musculoskeletal injuries. PATIENTS AND METHODS: Materials and methods: A medical and social research was conducted on151 individuals with re-confirmed disability after musculoskeletal injuries. RESULTS: Results: It was found that a third of people with disabilities after musculoskeletal injuries (35.8±3.9%) has low quality of life (QoL), females more often than males (OR = 2.73; 95% CI: 1.33-5.59). The following physical determinants of low QoL were identified: severity of disability group (2.77; 1.29-5.92), severity of injury (2.73; 1.11-5.63) related to long-term inpatient treatment (6.36; 2.55-15.86) and need of special tools for rehabilitation (2.42; 1.20-4.92). It was found that QoL in people with disability is decreasing with unemployment (4.44; 2.13-9.23) and reduction in social interaction (2.67; 1.33-5.39) when living with children (3.04; 1.50-6.16), complicated relationship (5.28; 2.54-10.97) and no support in family (3.25; 1.62-6.50). This is accompanied by an increase in the need of psychotherapy (4.07; 2.10-8.24), risky alcohol consumption (3.29; 1.19-9.07) and taking of sedative drugs (2.97; 1.35-6.50). It was established such medical and social determinants of low QoL as inadequate awareness of persons with disability about content of their Individual rehabilitation program (3.85; 1.69-8.76), insufficient covering of special tools (3.41; 1.67-6.96) and dissatisfaction of rehabilitation efficacy (3.79; 1.55-9.28). CONCLUSION: Conclusions: It is necessary to improve the system of rehabilitation of persons with disability after musculoskeletal injuries in view of quality of life determinants.