The health of children and adolescents in school ontogenesis as a basis for improving the system of school health care and sanitary-epidemiological wellbeing of students

Introduction. Against the background of socio-economic transformations and the digitalization of education, the health indicators of students are changing, which requires in-depth research. Aim of the study: based on the longitudinal observation of the health of schoolchildren, to identify the patterns of its formation for the scientific justification of improving the medical care of students. Material and methods. From the 1st to the 11a grade (2005-2015), the same students (199 boys and 227 girls) of 4 Moscow schools were examined annually with the performance of anthropometry, electrocardiography, functional tests, and questionnaire to identify complaints and anamnesis; specialist doctors carried out 25,298 examinations. In addition to the analysis of morbidity, a qualitative analysis of the course of pathological processes in students was carried out to determine positive and negative dynamics. Results. Over 11 years, the prevalence of functional disorders increased by 14.7%, chronic diseases by 52.8%, the frequency of visual disturbances, diseases of the musculoskeletal system, digestive organs, neurotic reactions increased; new forms of risk behaviour and information dependence appeared. An unfavourable period of development of pathological processes in schoolchildren is training in grades 9-11. Compared with the 1990 morbidity rates obtained by similar methods, there was an increase in the prevalence of functional disorders among adolescents by 2-3 times and chronic diseases by 20-70%. When comparing physical development with peers of the second half of the XX century, the observed schoolchildren increased the average values of body length and weight with a decrease in functional indicators. Distance learning during the first wave of COVID-19 in spring 2020 has increased the prevalence of computer vision, carpal tunnel syndromes, and neurotic reactions. Discussion. The main patterns of health formation in school ontogenesis, coinciding with the change of generations and the transition to the digitalization of education, are revealed. Conclusion. The study results allow predicting an increase in the prevalence of neuropsychiatric disorders, myopia, scoliosis, computer-visual and carpal tunnel syndromes. To preserve students’ health, to counteract COVID-19, a modern model of school health care is proposed.

Treatment of Peripheral Nerve Compression Syndromes of the Upper Extremities: a Systematic Review

Background Nerve compression syndromes are referred to as chronic irritation or pressure palsies of peripheral nerves in areas of preformed anatomical constriction. Carpal tunnel syndrome is the most common nerve compression syndrome, followed by cubital tunnel syndrome. In addition, less frequent nerve compression syndromes of the upper extremities that affect the median, ulnar or radial nerves have been described. This review provides an overview of current treatment options for nerve compression syndromes of the upper extremities. Study Design Systematic overview. Methods Based on established national (AWMF) and international guidelines as well as the Cochrane Library, we performed a systematic literature search on PubMed (NLM), focusing on randomised controlled trials. Results Over the research period (2012 – 2020), there were 43 randomised trials that investigated surgical carpal tunnel release methods, 68 that compared different conservative therapies and 12 that compared surgical versus conservative treatments. Furthermore, eight studies analysed surgical techniques and four analysed conservative techniques for cubital tunnel syndrome. No randomised trials were conducted on the less common peripheral nerve compression syndromes, but case reports and observational studies were conducted. Conclusion For carpal and cubital tunnel syndromes, there are evidence-based diagnostic methods as well as therapeutic recommendations based on randomised and controlled trials. When diagnosis is made after clinical examination and supported by radiological and electrophysiological evaluation, surgical treatment is considered superior to conservative treatment. In particular, excellent long-term results can be achieved by surgery for carpal and cubital tunnel syndromes. More controlled studies are needed to establish evidence-based therapeutic recommendations for the less common nerve compression syndromes, which are somewhat controversially and inconsistently defined.

Carpal and cubital tunnel syndromes

Tingling, pain and numbness in the hand can be a major cause of morbidity for many people. Adequate hand and wrist function are required for a huge variety of daily tasks, therefore disorders of the hand and wrist can have significant detrimental effects on the quality of life for affected individuals. With any upper limb issue, it is important to consider hand dominance, occupation and pastimes of the affected person. This article focuses on the optimal diagnosis and management of carpal and cubital tunnel syndromes from a primary care perspective.

Upper limb entrapment neuropathies in multiple sclerosis

Introduction Entrapment neuropathies of upper limbs such as carpal tunnel and cubital tunnel syndromes are common in the general population. Identification of entrapment neuropathies of upper limbs in patients with multiple sclerosis can be clinically challenging as signs and symptoms could be attributed to multiple sclerosis. People at later stages of multiple sclerosis use mobility aids and wheelchairs. Weakness of hands in this cohort due to entrapment neuropathies could adversely affect their mobility and independence. Methods This was a retrospective review of records of patients with multiple sclerosis referred for clinical neurophysiological studies with clinical suspicion of upper limb entrapment neuropathies over a 10-year period. We collected demographic details, clinical features, clinical neurophysiological data and details of aids and appliances used for mobility. Results Among 71 patients, 38 (53.5%) patients had at least one entrapment neuropathy of upper limb confirmed by clinical neurophysiological studies. Twelve (31%) patients had median nerve entrapment, 20 (53%) had ulnar nerve entrapment and six (16%) had both. Risk of ulnar nerve entrapment was significantly higher in patients using a powered wheelchair (odds ratio 5.7, 95% confidence interval (1.7–18.7, p = 0.0037). Discussion Entrapment neuropathies should be considered in patients with multiple sclerosis reporting sensory and motor symptoms of hands.

Tunnel Syndromes in the Upper Limbs with Diabetes (Literature Review)

Tunnel syndromes are the most common form of damage of the peripheral nerves of the upper limbs with diabetes mellitus and often progress unnoticed and cause persistent motor defects, worsening the course and prognosis of diabetic polyneuropathy of the upper limbs. This review demonstrates the most common focal neuropathies of the upper limbs encountered in diabetes mellitus: Carpal and cubital syndromes.

Overuse injuries in musicians. Part II: prevention and treatment

Overuse injuries are encountered by 50-85% of instrumental musicians and manifest themselves in tendovaginitis, bursitis and tunnel syndromes, leading to long-term temporary loss of ability to work (and in severe cases, to permanent disability). For Ukraine, the problem is of particular relevance for several reasons: first, there have been no studies of the professional diseases of musicians in the country in the last decade; second, there are a very large number of music schools in the country, but none of them teaches future musicians how to prevent occupational diseases; thirdly, there are no specialized medical centres for the treatment of professional pathology of musicians. The aim of the research was to analyze the latest achievements in diagnosing, treating and preventing stress injuries in musicians. The analysis was performed by studies published in 2016-2020 in journals indexed in the Scopus, WoS, Medline and PubMed scientific databases. It has been established that the effective prevention of stress injuries in musicians is possible only through a comprehensive approach involving the reorganization of musical education and medical support for the professional activity of instrumental musicians. For the formation of ergonomic performing techniques, as well as providing future musicians with knowledge and skills to maintain health in the context of their profession, it is necessary to introduce the appropriate discipline into the curriculum, the teaching of which should be conducted with the participation of specialists in physical rehabilitation and physical education. To ensure the effective treatment of professional injuries in musicians, it is necessary to create a specialized republican rehabilitation center, as well as expanding the training program for trauma surgeons and rehabilitologists at the postgraduate stage through thematic refresher courses. Downloads

Оveruse injuries in musicians. part i: etiopathogenesis, diagnostics

Overuse injuries are encountered by 50-85 % of instrumental musicians and manifest themselves in tendovaginitis, bursitis and tunnel syndromes, leading to long-term temporary loss of ability to work (and in severe cases, to permanent disability). For Ukraine, the problem is of particular relevance for several reasons: first, there have been no studies of the professional diseases of musicians in the country in the last decade; second, there are a very large number of music schools in the country, but none of them teaches future musicians how to prevent occupational diseases; thirdly, there are no specialized medical centres for the treatment of professional pathology of musicians. The aim of the research was to analyze the latest achievements in diagnosing, treating and preventing stress injuries in musicians. The analysis was performed by studies published in 2016-2020 in journals indexed in the Scopus, WoS, Medline and PubMed scientific databases. It has been established that the etiopathogenesis of overuse injuries in musicians is associated with a whole complex of primary and secondary factors. The non-physiological performing technique is of greatest importance: the inability to evenly distribute the load on the muscles involved in performing practice, as well as the non-ergonomic posture. Excessive playing duration is no less harmful: more than three hours of continuous practice every day. Serious aggravating factors are: impairment of range of joint movement (hyper- or hypomobility), weak physical strength of the muscles of the shoulder girdle and spine, a small hand with short fingers (for pianists and string players), and low awareness of instrumental musicians (both students and teachers) in the prevention of occupational diseases, due to the imperfection of the music education system.

MULTI-LEVEL DAMAGE OF PERIPHERAL NERVOUS SYSTEM IN CLINICAL PRACTICE OF NAVAL AND MILITARY MEDICINE

Damage to the peripheral nerves and spinal roots in natural anatomical tunnels is not only a common form of damage to the nervous system, but also an important medical and social problem; because tunnel neuropathy and degenerative-dystrophic diseases of the spine are one of the most common reasons for the release of citizens from the call, the dismissal of military personnel from the Armed Forces of the Russian Federation, seafarers, changes in the category of fitness for military service. According to various authors, the combination of compression — ischemic neuropathies with signs of spinal cord lesions occurs in 30–70% of cases of tunnel syndromes. This is especially true for seafarers, because they are more likely to be affected by the musculoskeletal system, as long-term, monotonous load can lead to micro-traumatization and micro-hemorrhage, followed by scarring of muscles, tendons, ligaments, fascia and, as a consequence, the narrowing of natural anatomical tunnels. Revealed the existence of a relationship between the sea and the frequency of lesions of the spine, the shoulder girdle, with the emergence of the syndrome of the rotator cuff and carpal tunnel syndrome. In military personnel, this may occur during excessively long compression of the upper arms during shooting, training, work in low temperatures and vibration.