This paper highlights the problem of functional constipation, its epidemiology, etiology, features of the clinical picture during prolonged immobilization in injured patients, and approaches to therapy. Stool retention in patients undergoing prolonged immobilization is an urgent medical problem, since it occurs in most of these patients. The paper presents a clinical example of managing a patient with an injury to the musculoskeletal system and functional constipation. Functional constipation is associated with a number of pathophysiological processes: genetic characteristics, lifestyle (lack of physical activity) and eating style characteristic of Western cultures (low intake of dietary fiber and water), intestinal movement disorders that can be caused by numerous causes (neurogenic factors , diseases of the endocrine glands, circulatory disorders in the intestinal vessels, taking certain medications), anatomical features (dolichosigma), as well as social factors (late awakening, morning rush, work in different shifts, changes in the usual living and working conditions) and psychological patient features. The possibilities of lifestyle modification in patients with injuries of the musculoskeletal system are very limited, and special attention should be paid to correcting nutrition and observing the drinking regimen. The key point in the treatment of functional constipation in such patients will be the appointment of stimulant laxatives, one of which is sodium picosulfate. At the stages of treatment and rehabilitation, the patient should be recommended measures for modifying lifestyle and nutrition, exercise therapy in accordance with his physical capabilities and clinical recommendations for the treatment of constipation.
Purpose. To quantify the quality of treatment planning for patients with prostate cancer for three different radiotherapy technologies. Materials and methods. The quality of irradiation planning was assessed using the index of homogeneity, conformality and comparison of critical organs doses for 40 patients with prostate cancer using various irradiation technologies: 3D conformal radiation therapy 3DCRT, radiation therapy with intensity modulation IMRT, radiation therapy with intensity modulation in rotation mode RapidArc. The technologies are implemented on conventional electron accelerators of the Clinac iX (Varian, USA), Clinac 2300 CD (Varian, USA) and UniquePower (Varian, USA) models with a nominal photon radiation energy 6 and 18 MeV. Results. The dependences of the homogeneity indices HI, conformality CI within the target, and critical organs doses on the irradiation technology for patients with prostate cancer were obtained. Taking into account the predictive capabilities of the HI index for relapse-free survival, the optimal technology for irradiating patients was chosen. It has been shown that Rapid Arc technology dominates for prostate cancer.
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