[Surftherapy, an innovative mediation in an addiction treatment program]. / La surfthérapie, une médiation innovante dans un parcours de soins en addictologie.

Imagine a dream where ocean waves become allies for the caregiver. This vision took shape in a project begun in 2020 at the Clinique de l'Odet, the addictology department of the public mental health establishment in South Finistère: surf therapy as a tool for addictology care, the ocean as an ecological framework for rehabilitation. In this exceptional adventure, the dream of a care team to support patients' recovery through surfing has become a reality, where every wave is a step towards freedom; every take-off a victory on the road to recovery.

[Physical methods of correction of arterial hypertension: modern concepts. (A literature review)]. / Fizicheskie metody korrektsii arterial'noi gipertenzii: sovremennye predstavleniya. (Obzor literatury).

Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.

Using Drugs or Non-Drugs Alternatives to Alter Mental States in the Online, Virtual Era.

Background: In the 1970s a body of literature was generated advocating the alternatives approach for drug misuse prevention and rehabilitation which encouraged healthy nonchemical behaviors leading to reinforcing moods. Although this behaviorally oriented approach was overshadowed with the popularity of cognitive therapy in the 1980s, many of the recommended alternative behaviors remain embedded in cognitive approaches for drug misuse prevention and rehabilitation. One objective of the present study was to replicate, in part, two studies conducted in the 1970s which examined usage patterns of non-drug alternatives. A second objective was to explore of the use of newer technologies like the internet and the smartphone to alter emotional states. A third objective was to examine perceived stress and discrimination experiences on preferences for drug and non-drug alternatives. Methods: Three questionnaires were administered: use of drugs and non-drug alternatives in response to everyday emotions; the Everyday Discrimination Scale; and the Perceived Stress Scale. A total of 483 adults participated; their mean age was 39 years. Results: The results revealed that non-drug alternatives were preferred to drugs in treating experiences of anxiety, depression, and hostility, and to induce pleasure. Drugs were used most often to deal with pain. Experiences of discrimination increased perceptions of stress, and stress, in turn, affected the use of drugs to cope with a range of emotions. Social media and virtual activities were not preferred methods for altering negative moods. Conclusions: Social media may actually be a contributor or cause of distress, rather than a means for reducing it.

Cost effectiveness of non-drug interventions that reduce nursing home admissions for people living with dementia.

INTRODUCTION: Six million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health-care cost driver. We evaluated the cost effectiveness of non-pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD. METHODS: We used a person-level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence-based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer's and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality-adjusted life years and incremental cost-effectiveness ratios. RESULTS: All four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1-way, 2-way, structural, and probabilistic sensitivity analyses. CONCLUSION: Dementia-care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non-pharmacologic interventions.

[Factors influencing analgesic use patterns in patients with chronic tumor-associated pain. : A qualitative pilot study considering different groups of medications]. / Einflussfaktoren auf das Einnahmeverhalten von Analgetika bei Patient*innen mit chronischen tumorassoziierten Schmerzen : Eine qualitative Pilotstudie unter Berücksichtigung verschiedener Medikamentengruppen.

BACKGROUND: Patients are surviving tumor diseases longer and longer due to the improvement of tumor-specific therapy and pain is a common symptom. The gold standard for tumor-associated chronic pain is multimodal therapy. Non-adherence causes high costs and may put patients at risk. The aim of this study was to investigate the adherence behavior and subjective treatment compliance of patients with tumor-associated chronic pain. The focus was on the patients' perspective. Different groups of medications, such as NOPA, opioids, co-analgesics and cannabinoids, as well as non-drug treatments were included. METHODS: Semistructured guided interviews with 10 patients with chronic tumor pain were conducted within a qualitative research approach. The interviews were recorded and transcribed. The evaluation was using a focused content structuring interview analysis according to Kuckartz and Rädiker. RESULTS: Five main categories were defined. The central category based on the research question was "Adherence behavior from the patient's perspective." The category "Medication therapy" formed the framework of the study. Other main categories were "History of illness", "Relationship with treatment providers" and "Attitudes and beliefs". A total of 77 additional subcategories were formed and interpreted. Adherence behavior from the patients' perspective differed between the different medication groups. A palliative setting influenced treatment decisions and adherence. The medication regimens used were complex and dynamic, especially when there were multiple practitioners involved. Furthermore, there was ambiguity in the use of cannabinoids. Non-drug therapies were marginalized by patients. From the point of view of the patients interviewed, it was not so much the treatment providers who influenced their adherence behavior, but rather their own experiences, attitudes, and convictions. DISCUSSION: The study included all medication groups and non-drug therapies equally, complementing previous literature in a qualitative setting. Adherence factors known from previous research were reflected in the subjective perception of the group of patients with chronic pain after tumor diseases. Marginalization of non-medication methods could be explained by the fact that multimodal therapy approaches were too rarely constantly used and controlled in the phase of chronification. Therefore, drug and non-drug therapies should be applied even more consistently to patients with tumor-associated pain.

[Prescription-based digital interventions in psychiatry : Methodology, possible areas of application, and legal framework of digital tools for panic disorder and agoraphobia available in Germany]. / Digitale Gesundheitsanwendungen mit psychotherapeutischem Fokus : Therapieprinzipien, Einsatzmöglichkeiten, rechtlicher Rahmen und Verordnungspraxis am Beispiel der Anwendungen für die Panikstörung und Agoraphobie.

In 2020, prescription-based digital interventions were introduced in Germany. These digital courses have to meet safety and data privacy requirements and must prove positive effects on symptoms and/or other outcome parameters. Interventions are available for a range of mental disorders. For patients with panic disorder and agoraphobia, several applications based on cognitive behavioral therapy have been developed. Within these digital courses, patients can typically access psychoeducational content and practice psychotherapeutic strategies such as exposure therapy. Recent meta-analyses prove the effectiveness of such interventions when compared with waitlist control conditions. According to current German guidelines, digital courses can be used to prepare psychotherapy and as an accompanying tool during psychotherapy. In Germany, physicians and psychotherapist can prescribe digital interventions for outpatients and as a post-hospital treatment..

Non-drug and surgical treatment algorithm and recommendations for the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis-secondary publication.

OBJECTIVES: The aim of this study was to update the Japan College of Rheumatology (JCR) clinical practice guidelines (CPGs) for the management of rheumatoid arthritis (RA) and prepare an algorithm for non-drug and surgical treatments. This article is a digest version of the guidelines. METHODS: The Japanese Ministry of Health, Labour and Welfare's research group, in collaboration with the JCR, used the Grading of Recommendations, Assessment, Development, and Evaluation method to update the 2014 JCR CPG for RA. The consensus was formed by CPG panel members. RESULTS: We raised 19 clinical questions regarding non-drug and surgical treatments for RA and developed recommendations. The treatments included exercise therapy; occupational therapy; joint injection of corticosteroids; and orthopaedic surgeries including cervical spine surgery, wrist and foot arthroplasty, ankle arthrodesis, and replacement arthroplasty of the shoulder, elbow, finger, hip, knee, and ankle. Recommendations regarding the risks of surgery and perioperative discontinuation of medications have also been developed. Based on these recommendations, we created an original algorithm for the non-drug and surgical treatment of RA. CONCLUSIONS: These recommendations are expected to serve rheumatologists, health care professionals, and patients with RA as tools for shared decision-making to treat residual limb joint symptoms and functional impairment.

[The benefits of reading aloud in geriatric wards and institutions]. / Les bienfaits de la lecture à voix haute dans les services et institutions de gériatrie.

The number of elderly patients hospitalized in geriatric wards and institutions on a temporary or more permanent basis is increasing. We know that thymic symptoms, such as depression, behavioral disorders and boredom, are common in these patients. We also know that the drug therapies used to treat these symptoms are sometimes a source of iatrogenesis and can be ineffective. That's why "non-drug" therapies are so useful. What if reading aloud could be part of the management of our elderly patients?

[Setting up, running and evaluating NMIs as part of the "ageing well" project]. / Mise en place, déroulement et évaluation des INM dans le cadre du projet "Bien vieillir".

Non-drug interventions (NDIs) are recommended as a first-line treatment in gerontology to address the psychological and behavioral symptoms of dementia. This article illustrates the NMIs implemented, how they are carried out and how they are evaluated as part of the Bien vieillir project at Nice University Hospital.

[Non-drug technologies in restoring endometrial receptivity as a cause of impaired fertility in women of reproductive age. (Literature review)]. / Nemedikamentoznye tekhnologii v vosstanovlenii retseptivnosti endometriya kak prichiny narusheniya fertil'nosti u zhenshchin reproduktivnogo vozrasta. (Obzor literatury).

Globally, 13% of the population has difficulty conceiving. In Russia, the proportion of infertile marriages ranges from 8 to 17.5%, with half of all forms of female infertility being the uterine form. The main etiological factors for impaired endometrial receptivity are infectious diseases leading to the development of chronic endometritis (most often found in tuboperitoneal infertility), dishormonal background associated with the development of hyperplastic processes in endocrine infertility, uterine fibroids, chronic endometritis and endometriosis. The frequency of detection of uterine cavity diseases in patients with repeated unsuccessful IVF programs ranges from 18 to 50%. The review examines the etiological factors and other causes of endometrial pathology leading to the development of chronic endometritis, possible mechanisms for the development of impaired growth and receptivity of the endometrium, and, as a consequence, the impossibility of pregnancy. Therapeutic strategies for restoring endometrial thickness and receptivity using pharmacological and non-pharmacological methods are described. Based on the analysis of literature data, it is shown that the use of physiotherapeutic factors in treatment programs that have pronounced anti-inflammatory, immuno- and hormone-modulating, reparative-regenerative, metabolic, vasocorrective and defibrosing effects allows for a relatively short period of time to improve endometrial receptivity, normalize hormonal levels and restore fertility in women of reproductive age, which ensures the possibility of successful embryo implantation, fetal development and childbirth.

[Recognizing acute confusional syndrome and neurocognitive disorders in the emergency department]. / Reconnaître un syndrome confusionnel aigu et des troubles neurocognitifs aux urgences.

In the heart of the emergency room, when the nurse takes charge of the patient, he/she must be able to distinguish between an acute confusional syndrome and psychobehavioral symptoms related to neurocognitive disorders. Indeed, early identification of the confusional syndrome is essential to accelerate the implementation of non-drug measures by the nurse in order to reduce its duration and the induced complications.

[Acupuncture, a non-drug approach to the management of chronic pain in geriatrics]. / L'acupuncture, une approche non médicamenteuse pour la prise en charge des douleurs chroniques en gériatrie.

It is recognized that multimodal management of chronic pain is necessary. This management requires the use of both drug and non-drug approaches. Acupuncture is a non-medicinal approach that has been shown to be effective in treating chronic musculoskeletal and arthritic pain. It has few side effects and contraindications. Its use should be developed in geriatrics as a complement to usual analgesics and other non-drug approaches.

[Thinking about the appropriation of gerontechnologies in non-drug interventions]. / Penser l'appropriation des gérontechnologies dans les interventions non médicamenteuses.

Today, many digital technical objects are introduced in geriatric care as part of non-medicinal interventions. This arrival generates both rejection and enthusiasm among caregivers. Moreover, many of these objects remain in the closet. It is therefore necessary to take into account a few elements in order to consider their appropriation.

[The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities].

The National Consensus was prepared with the participation of the National Medical Association for the Study of the Multimorbidity, Russian Scientific Liver Society, Russian Association of Endocrinologists, Russian Association of Gerontologists and Geriatricians, National Society for Preventive Cardiology, Professional Foundation for the Promotion of Medicine Fund PROFMEDFORUM. The aim of the multidisciplinary consensus is a detailed analysis of the course of non-alcoholic fatty liver disease (NAFLD) and the main associated conditions. The definition of NAFLD is given, its prevalence is described, methods for diagnosing its components such as steatosis, inflammation and fibrosis are described. The association of NAFLD with a number of cardio-metabolic diseases (arterial hypertension, atherosclerosis, thrombotic complications, type 2 diabetes mellitus, obesity, dyslipidemia, etc.), chronic kidney disease and the risk of developing hepatocellular cancer were analyzed. The review of non-drug methods of treatment of NAFLD and modern opportunities of pharmacotherapy are presented. The possibilities of new molecules in the treatment of NAFLD are considered: agonists of nuclear receptors, antagonists of pro-inflammatory molecules, etc. The positive properties and disadvantages of currently used drugs (vitamin E, thiazolidinediones, etc.) are described. Special attention is paid to the multi-target ursodeoxycholic acid molecule in the complex treatment of NAFLD as a multifactorial disease. Its anti-inflammatory, anti-oxidant and cytoprotective properties, the ability to reduce steatosis an independent risk factor for the development of cardiovascular pathology, reduce inflammation and hepatic fibrosis through the modulation of autophagy are considered. The ability of ursodeoxycholic acid to influence glucose and lipid homeostasis and to have an anticarcinogenic effect has been demonstrated. The Consensus statement has advanced provisions for practitioners to optimize the diagnosis and treatment of NAFLD and related common pathogenetic links of cardio-metabolic diseases.

[Physiotherapeutic methods in ophthalmic rehabilitation of patients with glaucoma and cataract]. / Fizioterapevticheskie metody v oftal'moreabilitatsii patsientov s sochetannoi glaukomoi i kataraktoi.

The authors analyzed scientific data on physiotherapeutic measures in the treatment of combined glaucoma and cataracts as one of the main causes of blindness and low vision.

[Determining the time of intoxication due to non-drug use of tropicamide]. / Opredelenie srokov davnosti intoksikatsii pri nemedikamentoznom primenenii tropikamida.

The study objective is to develop approaches to the retrospective assay of tropicamide in biological fluids and hair. The study was performed using the substance of tropicamide. Sample preparation included hydrolysis with the following enzymes: papain, chymotrypsin, trypsin, chymopsin, and hyaluronidase. Extracts were analyzed using a gas chromatograph with mass selective detection Technologies (USA) 7890 A/5977 MSD. When modeling long-term use of tropicamide, male rats of white and brown natural color, about 6 months old and weighing 200-250 g, were used. Animals were injected with a tropicamide solution in the tail vein for 28 days at a dose of 40 mg/kg of body weight. After 28 days of administration of the tropicamide solution, daily urine and blood were collected, and hair was cut from the back and sides of the animal's body. After another 28 days, hair samples were taken again. Within the first 6 hours after the last tropicamide dose, its blood concentration reached the maximum (191.6 µg/ml) and within 4 days decreased by 10 times; in the urine, within the first 24 hours, tropicamide level decreased from 627.7 to 489.9 µg/ml, then for 2-3 days it remained approximately at the same level. From day 4, the tropicamide concentration significantly decreased, and on days 11-12, it was not detected in the urine. After 4 weeks, the tropicamide content in the hair was at the level of quantification (1.25-2.20 ng/mg) and could be detected only by sample preparation by enzymatic hydrolysis with papain. Thus, the developed and validated methods for the enzymatic hydrolysis of biological fluids and hair allowed retrospective studies of biological fluids and hair with high reliability.

[The effectiveness of the use of non-drug treatment complexes and their impact on quality of life indicators, the psychosomatic status of patients with residual brucellosis with lesions of the musculoskeletal system]. / Effektivnost' primeneniya kompleksov nemedikamentoznogo lecheniya i ikh vliyanie na pokazateli kachestva zhizni, psikhosomaticheskii status patsientov s rezidual'nym brutsellezom s porazheniem oporno-dvigatel'nogo apparata.

Secondary focal lesions of the musculoskeletal system that occur with residual brucellosis are characterized by a variety of localizations and simultaneous damage to several groups of joints, a deterioration in the quality of life and a high percentage of disability in people of working age. At present, there are many different schemes for the treatment and rehabilitation of developed residual brucellosis, in which, in addition to the "basic" course, including systemic anti-inflammatory therapy, much attention is paid to physiotherapeutic procedures, but the choice of the most effective treatment tactics remains an unresolved problem. PURPOSE OF THE STUDY: To determine the effectiveness of the use of options for non-drug methods of treatment in the complex rehabilitation of patients with residual brucellosis with lesions of musculoskeletal system. MATERIAL AND METHODS: Study included 140 patients treated for osteoarthritis of brucellosis etiology, who were divided into three groups matched by age, gender, average duration and stage of the disease, place of residence. Patients of all groups received standard medical treatment and different sets of physiotherapeutic procedures: in the 1st group (45 patients) - electrophoresis of novocaine on the knee joints, therapeutic massage of the cervical-collar zone; in the 2nd group (45 patients) - magnetotherapy on the area of the knee joints, sinusoidal modulated currents (SMC) on the shoulder joints, decimeter wave therapy of the lumbosacral zone (DMW-therapy); in the 3rd group (50 patients) - magnetic laser therapy on the shoulder, elbow, knee joints, therapeutic massage of the lumbosacral zone. Complaints, clinical symptoms, goniometry results, and blood parameters were assessed: ESR, C-reactive protein, fibrinogen, before the start of treatment, immediately after the course of rehabilitation, and after 6 and 12 months. At the same time, testing was carried out according to the SF-36 Health Status Survey questionnaire to monitor the quality of life. RESULTS: The applied scheme of drug treatment in combination with magnetic laser therapy and therapeutic massage in the 3rd group made it possible to achieve a significant reduction in arthralgic syndrome, a statistically significant increase in the range of motion in the joints, positive dynamics of laboratory data and an improvement in the psychological state and quality of life of patients compared to other observation groups. CONCLUSION: The results of the study indicate the high efficiency of magnetic laser therapy in the complex treatment of patients with residual brucellosis with lesions of the musculoskeletal system.

The contribution of non-drug factors to fetal malformation in anti-seizure-medication-treated pregnancy.

PURPOSE: To assess the possible contribution of factors in additional to intrauterine anti-seizure medication (ASM) exposure in the occurrence of fetal malformation in women with ASM-treated epilepsy. RESULTS: Logistic regression analysis showed that maternal age over 31 years, family histories of fetal malformation, and conception after assisted fertility treatment, and also dosage of valproate, carbamazepine, and topiramate, made statistically significant (P<0.05) contributions to the fetal malformation rate in 2223 pregnancies in Australian women with epilepsy. The malformation rates were lower in pregnancies where the non-ASM-associated contributory factors were not present: statistically significantly so for all ASM-exposed pregnancies, and those pregnancies exposed to the more potent teratogenic drugs. CONCLUSION: It is important to consider the possible roles of identified, and also possible non-identified, non-ASM factors in relation to the occurrence of fetal malformations in the pregnancies of women with ASM-treated epilepsy.

Bias estimation in study design: a meta-epidemiological analysis of transcatheter versus surgical aortic valve replacement.

BACKGROUND: Paucity of RCTs of non-drug technologies lead to widespread dependence on non-randomized studies. Relationship between nonrandomized study design attributes and biased estimates of treatment effects are poorly understood. Our purpose was to estimate the bias associated with specific nonrandomized study attributes among studies comparing transcatheter aortic valve implantation with surgical aortic valve replacement for the treatment of severe aortic stenosis. RESULTS: We included 6 RCTs and 87 nonrandomized studies. Surgical risk scores were similar for comparison groups in RCTs, but were higher for patients having transcatheter aortic valve implantation in nonrandomized studies. Nonrandomized studies underestimated the benefit of transcatheter aortic valve implantation compared with RCTs. For example, nonrandomized studies without adjustment estimated a higher risk of postoperative mortality for transcatheter aortic valve implantation compared with surgical aortic valve replacement (OR 1.43 [95% CI 1.26 to 1.62]) than high quality RCTs (OR 0.78 [95% CI 0.54 to 1.11). Nonrandomized studies using propensity score matching (OR 1.13 [95% CI 0.85 to 1.52]) and regression modelling (OR 0.68 [95% CI 0.57 to 0.81]) to adjust results estimated treatment effects closer to high quality RCTs. Nonrandomized studies describing losses to follow-up estimated treatment effects that were significantly closer to high quality RCT than nonrandomized studies that did not. CONCLUSION: Studies with different attributes produce different estimates of treatment effects. Study design attributes related to the completeness of follow-up may explain biased treatment estimates in nonrandomized studies, as in the case of aortic valve replacement where high-risk patients were preferentially selected for the newer (transcatheter) procedure.

[Dementia, effect of rocking therapy on behavioural disorders]. / Effet de la thérapie par bercement sur les troubles du comportement de la démence.

Non-medicinal interventions (NMI) are recommended as a first-line treatment in gerontology in response to a behavioural disorder. The Théra Berce pilot study at the Nice University Hospital aims to determine whether the NMI corresponding to rocking in a comfort chair allows a reduction in disruptive behavioural disorders in people with neurocognitive disorders. Benefits and limitations.