Gynecological morbidity in girls and adolescent girls in a large industrial city

The results of randomized complex clinical andlaboratory examination of 1540 girls and juveniles are drawn, which characterize the rate and the structure of gynecological pathology under conditions of an industrial city. Gynecological morbidity proved to be closely associated with the state of somatic health in girls. Disorders of menstrualfunction occupy the most important place in the structure of gynecological pathology, dysfunctional uterine bleedings prevailing over other kinds of pathology. Anonymous questionnaire of 1700juveniles revealed some peculiarities of their reproductive and contraceptive behavior. The age of the beginning of sexual life at the average comes up to 14,6 0,5 years in the city of Ufa (an average age over Russia 16,1 years), the rate of juveniles who use adequate contraceptives being very low (9,5%). The article gives light to the problems of elaborating the system of organizational and medico-prophy lactic measures for girls and juveniles with gynecological pathology andputtingthem into practice.

Harmful health effects of snus consumption

From a pharmacological point of view, snus is an addictive nicotine-containing substance that also contains carcinogenic nitrosamines. The level of nicotine in the blood of a snus user and a tobacco smoker is approximately the same. Dentists, educators, social workers, parents, as well as consumers of snus are poorly informed about the consequences of its use for health, including for the oral cavity. The article contains materials on the dangers of snus consumption on general somatic health, as well as on precancerous lesions and neoplasms of the oral cavity resulting from snus use, and ways to detect changes in the oral mucosa in the early stages of snus consumers.

Psychotherapy for comorbid depression and somatic disorders: a systematic review and meta-analysis

Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. Methods We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. Results Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52–0.79), with sustained effects at 6–11 months (g = 0.38; 95% CI 0.22–0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04–0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17–0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16–0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). Conclusions Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.

THE INFLUENCE OF THE PHYSICAL AND HEALTH PROGRAM ON THE SOMATIC HEALTH OF MIDDLE SCHOOL-AGE CHILDREN WITH COMPLEX DEVELOPMENTAL DISORDERS IN THE TRAINING AND REHABILITATION CENTER

The article reveals the problem of improving the somatic health of children with complex developmental disorders through the use of physical culture and health program in the training and rehabilitation center. The purpose of the work is to substantiate the impact of physical culture and wellness program for middle school children with complex developmental disorders on the level of their physical health. Researchmaterial and its methods: theoretical research methods (analysis, synthesis, induction, deduction); empirical (determination of the level of somatic health); mathematical statistics methods. The study involved 90 middle school children with complex developmental disorders (intelligence and hearing impairment). Results. The tested physical training and health program for middle school students with complex developmental disorders rationally combined exercises of different orientation, duration and intensity, taking into account the individual capabilities of a child with complex developmental disorders, as well as concomitant somatic pathology and factors of general physical health. The implementation of the physical culture and health program was carried out for nine months and was divided into three consecutive periods: preparatory, training and maintenance, with the selection of tools and methods according to the periods. The implementation of the physical culture and health program was carried out for nine months and was divided into three consecutive periods: preparatory, training and maintenance with the separation of tools and methods according to the periods. After the application of the developed program it was found that the low level of somatic health was only in 25% of experimental group boys (at baseline was 60%), below average – in 35% (was 40%), the average – in 40% (no case was reported at the beginning of the study); in girls the above levels were distributed as follows: 30% (60%), 40% (30%) and 30% (10%), respectively. Conclusions. The positive influence of the developed physical culture and health program on the level of somatic health of middle school children on the level of their somatic health has been established. Key words: somatic health, means, physical culture and wellness program, training and rehabilitation center, children with complex developmental disorders. Стаття присвячена проблемі поліпшення соматичного здоров’я дітей зі складними порушеннями розвитку шляхом застосування фізкультурно-оздоровчої програми в умовах навчально-реабілітаційного центру. Мета роботи полягає у визначенні впливу засобів програми у дітей середнього шкільного віку зі складними порушеннями розвитку на рівень їх соматичного здоров’я. Матеріал дослідження та його методи: теоретичні методи дослідження (аналіз, синтез, індукція, дедукція); емпіричні (визначення рівня соматичного здоров’я); методи математичної статистики. У дослідженні брали участь 90дітей середнього шкільного віку зі складними порушеннями розвитку (порушення інтелекту та слуху). Результати. Апробована фізкультурно-оздоровча програма для учнів середнього шкільного віку зі складними порушеннями розвитку раціонально поєднувала вправи різної спрямованості, тривалості та інтенсивності з урахуванням індивідуальних можливостей дитини зі складними порушеннями розвитку, а також супутньої соматичної патології і показників факторного навантаження загального рівня фізичного здоров’я дітей. Реалізація фізкультурно-оздоровчої програми здійснювалася протягом дев’яти місяців і поділялася на три послідовні періоди: підготовчий, тренувальний та підтримувальний з виокремленням засобів і методів відповідно до періодів. Після застосування розробленої програми з використанням засобів оздоровчого фітнесу в умовах навчально-реабілітаційного центру у хлопчиків експериментальної групи низький рівень фізичного здоров’я було відзначено лише у 25% (було 60%), нижчий за середній – у 35% (було 40%), середній – у 40% (на констатувальному етапі педагогічного експерименту жодного випадку не було виявлено); у дівчат зазначені вище рівні розподілилися таким чином: 30% (було 60%), 40% (було 30%) та 30% (було 10%) відповідно. Висновки. Встановлено позитивний вплив розробленої фізкультурно-оздоровчої програми на рівень соматичного здоров’я дітей середнього шкільного віку на рівень їх соматичного здоров’я. Ключові слова: соматичне здоров’я, засоби,фізкультурно-оздоровча програма, навчально-реабілітаційний центр, діти зі складними порушеннями розвитку.

High Prevalence of CHF and Diabetes in AML Long-Term Survivors - a Patient Forever?

Introduction: As outcomes of patients with acute myeloid leukemia (AML) have improved over the past decades, the fraction of patients surviving long-term is increasing. Information on long-term somatic and psycho-social health consequences of AML and its treatment is sparse. Previous studies suggested a higher prevalence of cardiovascular diseases in AML survivors, especially those treated with allogeneic stem cell transplantation (alloHSCT). The aim of our study was to perform a multi-dimensional analysis of health outcomes in AML long-term survivors (AML-LTS). This report focuses on somatic, especially cardiovascular, morbidity in AML-LTS. Overall and health-related quality of life are reported separately (Telzerow et al.). Methods: We conducted a cross-sectional study including AML survivors who had been enrolled in clinical trials or the patient registry of the AML-CG study group and were alive ≥5 years after initial diagnosis. Data concerning somatic health status were collected through patient questionnaires, assessment by the patients' physicians, and medical and laboratory reports. An age- and sex-matched control cohort was derived from German population-based health surveys (Robert Koch Institute, DEGS1 survey; n=6013; persons diagnosed with leukemia [n=11] were excluded). Results: 427 AML-LTS, aged 28 to 93 years, participated in this study. Data on somatic health status is available for 355 survivors, 5 to 19 years after their AML diagnosis. Thirty-eight percent of survivors were treated with chemotherapy with or without an autologous transplant (autoHSCT), whereas 62% had undergone alloHSCT. Focusing on cardiovascular diseases and risk factors, we found that that 49% of AML-LTS had hypertension, 33% had hypercholesterolemia, 15% had type 1/2 diabetes, 10% had congestive heart failure (CHF), and 9% had coronary artery disease (Figure A). The mean body-mass index (BMI) of AML-LTS was 26.7, similar to the DEGS1 cohort (mean BMI, 26.8). Next, we compared the prevalence of cardiovascular diseases and risk factors between AML-LTS and the general German population (represented by the DEGS1 sample), using multivariate models adjusting for age and sex (Table B). Compared to persons not diagnosed with leukemia, AML survivors had similar risks of hypertension, coronary heart disease and myocardial infarction. Prevalence of diagnosed hypercholesterolemia was higher in AML-LTS compared to non-AML controls. In addition, AML-LTS had a 2-fold higher risk of having type 1/2 diabetes, and a 3.5-fold increased risk of CHF compared to the general population. To identify factors associated with the increased risks of diabetes and CHF among AML-LTS, we constructed multivariate models incorporating patient- and treatment related covariables (age, sex, BMI, smoking, prior AML relapse, treatment [chemotherapy + autoHSCT vs. alloHSCT], and type of leukemia [de novo versus secondary / therapy-related]). We found an increased risk of CHF for AML-LTS who had had a relapse (OR, 3.16; 95% CI: 1.46 - 6.83; P=0.004) and, in trend, for patients with sAML or tAML (OR 2.19; 95%CI: 0.92 - 5.22, P=0.076). In addition, we found an increased risk of type 1/2 diabetes for AML-LTS who are smokers (OR: 3.43; 95% CI: 1.43 - 8.21; p: 0.006). Disease- or treatment-related factors did not significantly associate with any of the other comorbidities we studied. Conclusion: To the best of our knowledge, this is the largest analysis of somatic health outcomes in AML-LTS. Strengths of our study include the relatively large cohort representing a wide age range, the long follow-up period of 5 to nearly 20 years, and the heterogeneity regarding therapy regimens (chemotherapy + autoHSCT vs. alloHSCT). We found that, compared to the general population, AML-LTS have increased risks for CHF and diabetes, but not for hypertension or coronary artery disease. We identified AML relapse as a risk factor for the development of CHF, suggesting that cumulative chemotherapy exposure might be causally involved. On the other hand, we found no treatment- and disease-related risk factors that might explain the higher prevalence of diabetes in AML-LTS. Notably, AML-LTS who had undergone alloHSCT did not have increased risks of CHF, cardiovascular disease, hypertension or diabetes, compared to survivors treated with chemotherapy only. Our results may guide future recommendations for follow-up and inform personalized treatment decisions. Figure 1 Figure 1. Disclosures Berdel: Philogen S.p.A.: Consultancy, Current equity holder in publicly-traded company, Honoraria, Membership on an entity's Board of Directors or advisory committees. Hiddemann: Janssen: Research Funding; F. Hoffmann-La Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding. Metzeler: Jazz Pharmaceuticals: Consultancy; Novartis: Consultancy; AbbVie: Honoraria; Celgene/BMS: Consultancy, Honoraria, Research Funding; Daiichi Sankyo: Honoraria; Pfizer: Consultancy; Astellas: Honoraria.

Use of basketball in extracurricular forms of classes with children of senior school age

Basketball, as an important means of physical education and health improvement of children, is included in the compulsory programs of general education schools. Basketball provides versatile development, an increase in almost all motor and coordination qualities, agility and accuracy. Purpose: to assess the effectiveness of using basketball equipment in extracurricular activities with children of senior school age. Materials and methods: theoretical analysis of scientific literature data, anthropometric methods, physiological methods, assessment of the level of somatic health, pedagogical methods, statistical methods of data processing. The experiment involved 20 children aged 15-17 years old, students of 9-11 grades of a comprehensive school. Results. The use of training lessons in basketball in senior school age should take into account the functional state of the body of children. In the experimental group, 80% of children had an average level of somatic health and 20% below average. Above average, low and high levels were not identified. In the control group, 40% of the pupils had a low level of somatic health, 30% of those studied had a lower than average level of somatic health and 30% had an average level. Above average and high levels were not revealed. According to the results, it can be noted that there were no deviations in the regulation of the cardiovascular system, both in the control and in the experimental groups. The analysis of the results of pedagogical testing made it possible to establish in the age aspect their gradual, but, as a rule, uneven growth. The analysis of testing the long jump found that: in the experimental group, all students showed better results at the initial stage than at the final stage. Conclusions. Comparing the results, we can conclude that the results in the two groups were quite high and corresponded to the indicators of physical fitness of senior schoolchildren.

Somatic health care professionals’ stigmatization of patients with mental disorder: a scoping review

Background Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals’ stigmatization toward patients with mental disorders. Methods We conducted a scoping review using Arksey and O’Malley’s framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May–June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008–2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. Results A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. Conclusions The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.

Sleep Paralysis among Professional Firefighters and a Possible Association with PTSD—Online Survey-Based Study

The prevalence of sleep paralysis (SP) is estimated at approximately 7.6% of the world’s general population. One of the strongest factors in the onset of SP is PTSD, which is often found among professional firefighters. Our study aimed to assess in the professional firefighter population (n = 831) (1) the prevalence of SP, (2) the relationship between SP and PTSD and (3) the relationship between SP and other factors: the severity of the stress felt, individual tendency to feel anxious and worried and lifestyle variables. The incidence of SP in the study group was 8.7%. The high probability of PTSD was found in 15.04% of subjects and its presence was associated with 1.86 times the odds of developing SP [OR = 1.86 (95% CI: 1.04–3.33); p = 0.04]. Officers who experienced at least 1 SP during their lifetime had significantly higher results in the scales: PCL-5, STAI-T, PSWQ. The number of SP episodes was positively correlated with the severity of symptoms measured by the PCL-5, PSS-10, STAI and PSWQ questionnaires. Further research is needed to assess the importance of SP among the firefighter population in the context of mental and somatic health and to specify methods of preventing SP episodes.