Preventive Check-ups Research Articles

Acceptance of preventive colonoscopy in rural areas in Germany.

e16143 Background: Colorectal cancer is one of the most common types of cancer in Germany. Colonoscopy is certainly one of the most efficient diagnostic methods in preventing and early detection of colorectal cancer. Nevertheless, acceptance of colonoscopy as a useful screening method among the population in Germany is moderate, with around 22% of those entitled to claim. Methods: In order to better assess the reasons for the low level of acceptance, patients who presented themselves from March 2016 to June 2017 in the General Surgery Clinic of the Johanniter Hospital Stendal were randomly selected and interviewed using a questionnaire. These randomized patients did not suffer from colorectal cancer. The questionnaire asked whether the patients had participated in Colon Cancer Screening and if not for what reasons. Respondents were asked to choose among 8 preselected reasons or give their own. The options for not having participated in colorectal cancer screening were: lack of knowledge about the offer of colorectal cancer screening, fear of the examination, fear of cancer as an outcome, lack of time for the examination, didn't get an appointment for the exam, place of examination is too far away, excessive travel costs, examination makes no sense, and other (free text entry). Results: A total of 238 questionnaires were completed, 235 of which could be evaluated with regard to gender and age. The proportion between women and men was balanced (m 123, w 112). Surprisingly, contrary to expectations, significantly more respondents participated in colorectal cancer screening than not. There were no differences between females and males. The participation rate in colorectal cancer screening was 71%, which was significantly higher than expected. A significantly lower rate was found in respondents ages between 55 to 60 years old, with 41% of men and 67% of women having participated in a colorectal screening. Asked specifically about the reasons why they did not take advantage of the preventive medical check-up, the men of the affected age group (55-60 years) gave: fear of the examination, fear of cancer as an outcome, and examination makes no sense. Conclusions: The results underline the importance of determining why the acceptance of colorectal cancer screening has not yet reached the desired level. Considering and discussing these three main reasons show that there are opportunities to continuously increase awareness of the importance of participation rates in colonoscopy as a screening method for colorectal cancer through target public education.

The corporative programs of prevention of occupational diseases

The prevention of occupational and production-conditioned diseases is expressed in complex of systemic measures of medical (sanitary epidemiological, sanitary hygienic, medical preventive, etc.) and non-medical (state, public, economic, legal, technical, organizational technical, environmental, etc.) nature, targeted to decrease risk of developing diseases and deviations in health of employees, to prevent or slow down their progression and to decrease development of unfavorable consequences. The corporate programs and strategies of prevention of occupational and production-conditioned diseases are implemented at enterprise, individual, group, municipal and state levels. The assertion is considered related to accounting in development of prevention of certain risk factors affecting the specific organizational requirements in addition to general principles of prevention of unfavorable effects on organism of workers of such production factors as maintenance of MPC levels, collective means of protection, time protection, distance protection, personal protection, preventive medical check-ups, manufacturing inspection, etc. It is important to pay attention to personal protective equipment for employees of enterprises. Among the priority preventive measures, personal protective equipment is, according to actual standards, to be applied only in cases of impossibility of limiting unfavorable effect of particular risk factor using other methods. The system of prevention of occupational diseases in corporate programs is implemented through complex measures including effectual practice of knowledge and skills in prevention, correction, treatment and rehabilitation health exercises to reduce level of occupational morbidity.

Exploring the Impact of ACA on Rural-Urban Disparity in Oral Health Services Among US Noninstitutionalized Adults.

To explore the effect of the Affordable Care Act (ACA) on rural disparities in oral health services utilization based on disability status. Comparing the 2011-2013 with the 2014-2016 Medical Expenditure Panel Survey, the study estimated the impacts of ACA on the likelihood of having preventive checkup and utilization of dental treatments in adults older than 18. The sample consists of 216,184 noninstitutionalized adults with 14.5% living in rural areas. There was a slight improvement in the receipt of oral health services after ACA, but the improvement was not statistically significant. Disability remains a barrier to receiving preventive oral health checkups, and living in rural areas is a barrier for both utilization of preventive checkups and dental treatments. Unmet needs for preventive checkups may result in unnecessary, costly dental treatments. More strategies are needed to reduce the disparities in oral health services.

Prevention of cardiovascular diseases in childhood and adolescence

Cardiovascular diseases are among the leading causes of death worldwide. Apart from afew exceptions heart attack, stroke and peripheral arterial occlusive disease first occur in later adulthood. The cornerstone for these diseases, however, is already laid by accelerated vascular aging in childhood. Apart from pediatric medical preventive check-ups, the medical care of the parents should also be a reason for taking action. Adetailed family history enables many conclusions to be drawn about the cardiovascular risk of the next generation This requires targeted diagnostics and appropriate interventions in childhood ranging from lifestyle measures up to pharmaceutical therapy. In this context the current guidelines on the diagnostics and treatment of hypercholesterolemia and arterial hypertension in children and adolescents are also presented.

Dietary habits and nutritional status of adolescents

<p>The concept of proper nutrition implies meeting the needs of the body concerning daily energy intake and a sufficient amount of nutrients and protective substances necessary to maintain the physiological functions of the body and its health. Nutrients are divided into macronutrients (proteins, carbohydrates and fats) and micronutrients (vitamins and minerals). Accelerated growth and development during adolescence increase nutrient requirements. Therefore, energy and nutrition requirements must meet the needs of adolescents. During their growth and development, there is an increased need for vitamins and minerals, especially for calcium, iron, zinc and vitamin D. During intensive growth, adolescents require more vitamins, especially B-complex vitamins and vitamin C, the intake of calcium and phosphorus is necessary as well, and the insufficient needs for proteins affect the development of muscles and energy levels. Proper nutrition and eating habits during the period of growth are of the utmost importance for the appropriate physical, psychosocial and cognitive growth and development of a child. Eating disorders usually occur as a result of low or high energy intake, and the most common types of these disorders are anemia, anorexia and bulimia, obesity and comorbidities, and poor eating habits. When it comes to the implementation of various programs concerning the prevention of bad eating habits and eating disorders, the school management, expert teams and student parents should bear the overall responsibility. Once or twice a year, preventive check-ups and BMI measurements are recommended to identify eating disorders.</p>

Specialized care provided to patients with rectal cancer in Kyiv city.

The major trends in the rectal cancer incidence, detectability, morbidity, and mortality in Kyiv city as well as the state of medical care organization for cancer patients based on the statistical data of Kyiv City Clinical Oncology Center were analyzed. Despite the decrease in morbidity (‒6.3%) and mortality (‒8.1%), the cohort of rectal cancer patients in Kyiv city is increasing (+18.2%). At the same time, one-year mortality (27.0% in 2017), the detection rate at preventive check-ups, the detection rates at the early (I-II) stages are decreasing and at late-stage (IV) are rising (from 14.9% in 2011to 17.6% in 2017). The above indicates the need for improving the organization of medical care of cancer patients and early diagnostics of rectal cancer.

Cancer diagnosis and care among rural-to-urban migrants in China

IntroductionCancer is a leading cause of death in China. Rural-to-urban migrants are a group of over 260 million people in China sometimes termed the ‘floating’ population. This study assessed the...

Factors affecting vitamin D status in Moscow adolescents

Justification of the study. The normalization of vitamin D levels in both children and adults is the goal of numerous studies around the world, and the setting of a number of objectives related to this vector of preventive medicine, dictates the need for a more detailed study of regional features of the status of calcidiol and the identification of both risk factors and risk groups. Aim of the study: to analyze the impact of risk factors on the provision of vitamin D to adolescents in the Moscow region. Methods: 360 children over 11 years of age (average age was 14.74 ± 1.92 years) who attended a children’s polyclinic for preventive check-ups or are under observation in a day-care centre. After the examination, all schoolchildren were determined to have serum content of calcidiol – active metabolite of vitamin D. Results: the analysis revealed low vitamin D levels in children, with a median of 16.1 ng/ml. Normal vitamin D levels were found in only 6.7% of cases. The following risk factors for vitamin D deficiency were identified in Moscow schoolchildren: time of year (p < 0.001), inclusion of such foods as fish (p = 0.021) and liver (p = 0.036), gastrointestinal pathology (p < 0.001), endocrine system pathology (p < 0.001), musculoskeletal system pathology (p = 0.045): course of chronic inflammatory process (p = 0.01) in the body. The correlation between acute respiratory diseases and calcidiol supply was analyzed: at low frequency of acute respiratory infections during the year, the median level of vitamin D was 17.1 ng/ml (Q1-Q3: 12.6-22.1 ng/ml), at an average frequency – 11.4 ng/ml (Q1-Q3: 8.45-16.05 ng/ml), at high frequency – decreased to 7.94 ng/ml (Q1-Q3: 5.89-9.06 ng/ml). Conclusion: Vitamin D deficiency prophylaxis should be provided to children all year round, without a break for the summer months. If a child has a risk factor for vitamin D deficiency, the metabolite correction should be controlled by the calcidiol serum content.

Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study

BackgroundBoth type 1 and type 2 diabetes are well-established risk factors for cardiovascular disease and early mortality. However, few studies have directly compared the hazards of cardiovascular outcomes and premature death among people with type 1 diabetes to those among people with type 2 diabetes and subjects without diabetes. Furthermore, information about the hazard of cardiovascular disease and early mortality among Asians with type 1 diabetes is sparse, although the clinical and epidemiological characteristics of Asians with type 1 diabetes are unlike those of Europeans. We estimated the hazard of myocardial infarction (MI), hospitalization for heart failure (HF), atrial fibrillation (AF), and mortality during follow-up in Korean adults with type 1 diabetes compared with those without diabetes and those with type 2 diabetes.MethodsWe used Korean National Health Insurance Service datasets of preventive health check-ups from 2009 to 2016 in this retrospective longitudinal study. The hazard ratios of MI, HF, AF, and mortality during follow-up were analyzed using the Cox regression analyses according to the presence and type of diabetes in ≥ 20-year-old individuals without baseline cardiovascular disease (N = 20,423,051). The presence and type of diabetes was determined based on the presence of type 1 or type 2 diabetes at baseline.ResultsDuring more than 93,300,000 person-years of follow-up, there were 116,649 MIs, 135,532 AF cases, 125,997 hospitalizations for HF, and 344,516 deaths. The fully-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MI, hospitalized HF, AF, and all-cause death within the mean follow-up of 4.6 years were higher in the type 1 diabetes group than the type 2 diabetes [HR (95% CI) 1.679 (1.490–1.893) for MI; 2.105 (1.901–2.330) for HF; 1.608 (1.411–1.833) for AF; 1.884 (1.762–2.013) for death] and non-diabetes groups [HR (95% CI) 2.411 (2.138–2.718) for MI; 3.024 (2.730–3.350) for HF; 1.748 (1.534–1.993) for AF; 2.874 (2.689–3.073) for death].ConclusionsIn Korea, the presence of diabetes was associated with a higher hazard of cardiovascular disease and all-cause death. Specifically, people with type 1 diabetes had a higher hazard of cardiovascular disease and all-cause mortality compared to people with type 2 diabetes.

Roma health mediators in Serbia – good example of multisectoral cooperation in health promotion

Abstract Issue Within the framework of the JA CHRODIS plus participants of the WP5 worked on identification of factors that contribute to collaboration within healthcare and between the broader health system and other sectors, as well as their enablers and barriers. In Serbia, practice that was identified and elaborated was aimed at improvement of health of Roma population. Description of the problem Based on available data, health indicators among Roma population in Serbia were two to three times worse than national averages. In order to tackle this issue, government of the Republic of Serbia, started with implementation of the project of education and inclusion of Roma health mediators in the health system. This project has been implemented in Serbia since 2009. Roma Health mediators (Roma ethical minority females) were trained for fast and efficient provision of support to Roma families. Results As a result of the project there was increased number of visits to health institutions and preventive check-ups of target population. Established cooperation between Roma health mediators and other health professionals in centers for primary health care, social care, and local self-government helped them in fulfilling their tasks, but also built capacity of other service providers to work in Roma communities. Through trainings they increase knowledge on various health, social and child care topics. Lessons Capacity building and inclusion of memebrs of vulnerable population into health promotion of the own to this population in terms of better acceptance of specific population population is useful to access groups as they can better understand and adapt to the needs of groups they want to reach. They should have opportunity to share their experience and lessons learned with experts involved in planning interventions for other vulberable groups. Key messages Building capacity of Roma mediators empowers them for integration into society beyond the scope of the Project. Lessons learned should be used for planning further actions for vulnerable groups.

Assessment of Fascin by immunohistochemistry in colorectal carcinoma

Background: The increased incidence of colon cancer may be attributed to an increase in the awareness of the disease, accessible screening modalities through widespread availability of preventive health check-ups & affordable newer imaging techniques. One of the essential components of clinical management of colon cancer is histopathological diagnosis and the role of Fascin-1 expression in colon cancers remains unexplored. This study was carried out to evaluate the fascin-1 expression in colon cancer specimens. Methods: This retrospective study was carried out on 60 paraffin blocks of colorectal carcinoma specimens received for a period of four years. IHC for Fascin was done on the sections along with controls. Clinical data regarding the participant’s demographics and medical history were captured from the hospital medical records. Gross findings were recorded from the blocks. Blocks with section containing normal epithelium and tumour were chosen for immunohistochemistry. Results: There was a significant association between pT1/pT2 staging and grade 0 fascin expression (80%) compared to those with pT3/pT4 staging (50%) (p<0.05). Similarly, grade 1 had strong positive correlation with fascin expression (70%) compared to other grades of the tumor (p<0.05). Conclusion: Presence of fascin expression significantly indicates the metastatic potential of colon carcinomas. Further research is required to delineate the mechanism of fascin expression at the cellular level in determining the prognosis of colon cancers.

Ocena stanu słuchu u pracowników Zakładu Metalurgicznego WSK Rzeszów (Wydział W-68) po 3 i 10 latach pracy

Cel pracyOcena stanu słuchu pracowników Wydziału W-68 Zakładu Metalurgicznego WSK Rzeszów narażonych na działanie hałasu – po upływie 3 i 10 lat pracyMateriał i metodaDo badań zakwalifikowano 30 pracowników zatrudnionych w latach 2003–2014 na stanowiskach z dużym narażeniem narządu słuchu na hałas. Badanie retrospektywne przeprowadzono za pomocą analizy kart badań profilaktycznych pracowników Zakładu. W badaniu wzięto pod uwagę: wiek, czas pracy, narażenie na hałas oraz narażenie na inne czynniki mogące mieć wpływ na narząd słuchu. Porównano średni ubytek słuchu po 3 i 10 latach pracyWynikiŚredni wiek badanych pracowników wynosił 46,1 lat i mieścił się w przedziale od 35 do 60 lat. Wszyscy pracowali w systemie 3-zmianowym, 8 godzin dziennie, w narażeniu na hałas. Dodatkowym czynnikiem mogącym oddziaływać na narząd słuchu były wibracje, przy czym średni ich poziom wynosił 0,96 NDN (najwyższe dopuszczalne natężenie). Zakres hałasu, na który narażeni byli pracownicy, wynosił od 80 do 88 dB w miejscu pracy, a jego średni poziom wynosił 87 dB. Średni ubytek słuchu – wyliczony jako średnia arytmetyczna dla 0,5 Hz, 1 kHz, 2 kHz i 4 kHz – po 3 latach pracy wynosił 11,7 dB HL dla ucha prawego i 11,9 dB HL dla ucha lewego. Natomiast po 10 latach pracy średni ubytek słuchu wynosił 16 dB HL dla ucha prawego oraz 17,2 dB HL dla ucha lewego. Największy ubytek słuchu odnotowano dla częstotliwości 2 i 4 kHz po 10 latach pracy – wynosił odpowiednio 14 i 24 dB HL dla ucha prawego oraz 15 i 28 dB HL dla ucha lewego.WnioskiAnaliza przedstawionych wyników wykazuje szkodliwy wpływ hałasu na stan narządu słuchu. Zaobserwowano podwyższenie progu słuchu średnio o 4,3 dB dla ucha prawego i o 5,3 dB dla ucha lewego po 10 latach pracy. Charakterystyczne jest podwyższenie progu słuchu dla częstotliwości powyżej 2 kHz, co wiąże się z wpływem hałasu przemysłowego na narząd słuchu.

Study of attitudes to own health patients of multiprofile institution: instruments and main results

Among the main determinants that form a holistic view of the health of the population are the following: lifestyle, influence of genetic factors, state of health care delivery system and socio-economic status of the country. In the article, we proposed a self-administered questionnaire on self-assessment of self-esteem, the importance of prevention and risk-taking behavior at primary level, and analyzed the main results that help characterize patients' perceptions of healthy lifestyles and health.&#x0D; Purpose – to study attitudes towards one's own health, to undergo periodic preventive examinations, to be responsible for one's own health among the contingent assigned to the service of the SIS “RPC PCM” SAD, and to identify the main factors of influence.&#x0D; Material and methods. Analysis of literary sources, sociological and system analysis. The survey was conducted at the pre-doctoral counseling stage on equal terms for all patients by way of active interviewing by the same interviewer.&#x0D; Results of the study and their discussion. 349 patients participated in the survey, including 159 (45.6%) men and 190 (54.4%) women. The average age of the respondents is 40.8±9.8 year (min 19 years, max 83 years). The survey questionnaires have 7 main blocks of questions, which are designed to determine the patient's level of awareness and identify him or her as accurately as possible.&#x0D; Conclusions. Analyzing the results of a sociological survey conducted among a contingent attached to the service of the State Institution of Science "Research and Practical Centre of Preventive and Clinical Medicine" State Administration Department, it was found that more than 95% of the respondents are aware of the concepts of "healthy lifestyle", "risk factors for chronic diseases", "foul" preventive medical checkup», etc. With regard to the assessment of one's own health, it should be noted that more than half (62.8%) of the respondents consider it satisfactory, while noting that they have one or more chronic diseases (mainly in the stage of persistent remission).&#x0D; The prospects for further research are to analyze the results of the questionnaire and to correlate it with the data of the objective study, which will allow to determine, besides the attitude to the medical prophylaxis and psychological type of person, the level of patient's commitment to the doctor's appointments.

Screening and check-ups in pneumology

In pneumology, preventive check-ups have played a subordinate role so far. Current research results could change this. In the following article the focus is on lung cancer and COPD, diseases that have a considerable influence on mortality and morbidity in modern society. Approaches will be discussed that will allow earlier diagnosis of COPD or identify patients at risk. In particular Capture, a questionnaire that significantly increases the pre-test probability in COPD diagnostics, should be mentioned here. Lung carcinoma screening is a controversial topic in Germany. In an American study, the relative mortality rate from lung cancer was significantly reduced by CT screening. Results of a European study (Nelson trial) are still pending. A high pre-test probability will also be decisive for lung cancer screening. In this way, the cost-benefit ratio could be optimized. Since COPD patients have a significantly increased risk of lung cancer, there might be overlaps in the screening procedures.

The Incremental Risk of Pancreatic Cancer According to Fasting Glucose Levels: Nationwide Population-Based Cohort Study.

It has been unclear whether the risk of pancreatic cancer is different according to glucose levels. To determine the association between fasting glucose levels and pancreatic cancer risk using prospectively collected nationwide population-based cohort data in Korea. The National Health Insurance Service database of claims and preventive health check-up data recorded was used between 2009 and 2015. A total of 25.4 million patients who had participated in a preventive health check-up between 2009 and 2013 were evaluated for pancreatic cancer incidence rates according to fasting glucose level. The cumulative incidence rate for pancreatic cancer was calculated after grouping according to fasting glucose levels as follows: (i) low normal (<90 mg/dL), (ii) high normal (90 to 99 mg/dL), (iii) prediabetes level 1 (100 to 109 mg/dL), (iv) prediabetes level 2 (110 to 125 mg/dL), (v) diabetes (≥126 mg/dL), and (vi) diabetes on anti-diabetic medications. The 5-year cumulative incidence rates (per 100,000) were as follows: (i) low normal = 32; (ii) high normal = 41; (iii) prediabetes level 1 = 50; (iv) prediabetes level 2 = 64; (v) diabetes = 75; and (vi) on anti-diabetic medications = 121. The risk of pancreatic cancer increased continuously with elevating fasting glucose levels (P < 0.0001). The incidence of pancreatic cancer increased significantly with increasing fasting blood glucose levels even after adjusting for age, sex, smoking, drinking, exercise, body mass index, and diabetes duration (P < 0.0001). The cumulative incidence rate of pancreatic cancer significantly increased as the fasting glucose level elevated, even in populations with a normal glucose level range.

Self-Reported Oral Health Related Behaviour and Gum Bleeding of Adolescents in Slovakia in Relation to Socioeconomic Status of Their Parents: Cross-Sectional Study Based on Representative Data Collection.

Background: Oral health strongly affects overall health and is related to many factors. The aim of our study was to analyse oral health related behaviours (OHRBs) and gum bleeding among Slovak adolescents and assess the effect of socioeconomic factors on the outcomes. Methods: Data from the Health Behaviour in School-aged Children study (HBSC) were used (N = 8896, age range = 10–16 years, M = 13.4; SD = 1.4; 50.9% boys). Sociodemographic and socioeconomic indicators and frequency of OHRBs (dental hygiene, toothbrush changing, preventive check-up) and gum bleeding were collected. Effects of sociodemographic and socioeconomic variables on outcome variables were analysed by binary logistic regression. Results: We found that prevalence of OHRBs slightly decreases with age, and worse outcomes were reported by boys compared to girls (OHRB odds ratio range 0.45–0.75, (95% C.I. range 0.40–0.91), gum bleeding 1.38 (95% C.I. 1.19–1.61), p < 0.05). OHRBs were in most cases significantly associated with socioeconomic variables, lower affluence predicts worse outcomes (odds ratio range 0.76–0.88 (95% C.I. range 0.68–0.96), p < 0.05). Conclusion: Our study provides representative findings on ORHBs in Slovakia and shows important associations of socioeconomic factors related to adolescents’ oral health issues.

A case control study of clinical and biochemical parameters of metabolic syndrome with special attention among young and middle aged population

BackgroundMetabolic syndrome (MS) increases the risk of heart disease, stroke, and other complications. AimThe aim of this study was to assess the clinical and biochemical parameters of MS and its complications (cerebrovascular accidents, cardiovascular accidents, DN or chronic kidney disease (CKD) compared with healthy controls especially among the younger population in Northern India. Material and methodsA total of 245 (healthy, MS and it's complicated) aged 18–70 years participated in the Open-Label, Single Centered; hospital-based random selection case-control comparative study. All anthropometric and biochemical assessment was done after proper consent. The metabolic syndrome was determined by IDF criteria. ResultsThe key risk parameters in three groups i.e. Control, Metabolic syndrome, and Complicated was TG (96.5 ± 46.9, 194.1 ± 87.8, 148.0 ± 102.2). LDL (91.2 ± 27.2, 114.0 ± 31.8, 69.1 ± 42.5, BP (120.1 ± 9.9, 139.3 ± 13.3, 132.1 ± 15.0) and high fasting glucose (81.1 ± 13.7, 164.5 ± 84.3, 138.0 ± 74.5). The hs-CRP is also significantly increased in the complicated group. The subanalysis of data also indicates that younger middle age (36–55 years) group both male and female is obese, hypertensive, diabetic with lipid abnormality according to IDF criteria. Conclusion: The risk factors like high TG, low HDL, high BP, and high fasting glucose were found higher particularly in younger population which may lead to diagnosis & complications of diabetes, hypertension and lipid abnormality. Due to changing physiology in young and middle age population these individuals are moving towards metabolic syndrome easily and needs frequent monitoring, preventive checkups, and lifestyle changes to prevent complications.

Pantawid Pamilyang Pilipino Programı Nakit Teşvik Uygulamasının Kent Merkezinde Yaşayan Ailelerin Sağlık Hizmetlerine, Okul Ve Aile Gelişimi Temelli Yapılan Görüşmelere Ulaşabilmesinin Etkileri

Aim: The study determined the effects of the cash incentive implementation of Pantawid Pamilyang Pilipino Program in terms of family attendance to health consultations, school and family development sessions in an urban community. Methods: A cross-sectional study was conducted among Pantawid Pamilyang Pilipino Program Filipino families with a total sample size of 124. An assisted interview was done and the data were analyzed using Stata 14. Results: Among 124 respondents, seventy percent were housewives, 35 finished secondary education with median income of 400 pesos ($7) daily. Out of 381 pregnancies, there were 342 and 39 pregnancies before and after implementation. All pre and post-natal check-ups attended by a physician. Childbirth were in secondary and tertiary health care facilities. Preventive health check-ups for children were reported only in 45 children aged zero to five years old. Deworming were received twice a year by 261/264 children 6-14 years old. There were 96% enrolled in school for the academic year 2018-2019 and 92% receive elementary education. Family development sessions included topics of wide variety. Conclusion: Overall, the Pantawid Pamilyang Pilipino Program beneficiaries were compliant with conditionalities of the cash transfers. Mothers were seen and giving birth in health care facilities while children are receiving preventive medical care and education. Keywords: preventive health services, health promotion, cash incentive plans, Pantawid Pamilyang Pilipino Program, Philippines

Treatment of Children with Chemical Burns of Esophagus with Various Etiology

Background At present continuous growth of pathology after chemical burns of the esophagus (CBE) in children is observed. The lack of uniform statistical infor-mation about this pathology in domestic and foreign literature considerably complicates studying of that nosology. The purpose of the present study is optimization of treat-ment techniques in children with chemical burns of the esophagus with various etiology and generalization of our own experience of treatment in this contin-gent of patients. Material and Methods We have analyzed treatment techniques in 147 children with CBE with various etiology and severity for last decade. The gen-eral method of diagnosis was esophago-gastroscopy performed within the first day of hospitalization. Endoscopic examination showed following stages of CBE: I stage in 36 patients, II stage in 67 cases and 44 patients had III stage. Results In children with I stage CBE erosive inflammatory process was controlled by conservative therapy in 10-14 days. This cohort of patients from 3-4 day of disease was considered outpatient. Patients with II stage CBE erosive inflammatory changes were treated by complex therapy on 21-23 day. There were surgical complications observed. Patients with III stage CBE referred in most severe condition. Length of conservative treatment for erosive inflammatory process was 1 month. In this group of patients we observed complications in 24 cases (16.3%) and bougienage was performed according to different techniques. Duration of bougienage varied from 3 to 24 months. Later on all children wereobserved out-patiently according to the place of residence. Conclusions Performed therapy should be complex and differentiated re-garding the severity of trauma. Complex treatment technique designed in our hospital is quite efficient and could be recommended for clinical application. All children suffered from CBE are to be followed up regularly. Preventive medical check-up should include endoscopic examination, once every three months to avoid possible esophageal stenosis development. Preventive treatment for esophagitis is mandatory during the period of preventive medical check-up.

0020 Evaluating Genetic Variation as a Possible Method for Increasing Surveillance and Managing Risk of Developing Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) has been increasing within the Air Force, with a slight trend appearing to level off more recently. Untreated, OSA’s detrimental effects harm the Airman and jeopardize military operations, placing both human and materiel assets at risk. Current practice within the Air Force sleep standard of care is to evaluate a patient for OSA after appearance of symptoms and after referral from a primary care manager (PCM). When recommending sleep studies, PCMs consider many social, physiological, and environmental risk factors including age, race, obesity, and marital status. As symptoms occur at random, including during flight operations, and that lack of sleep can severely decrease aircrew alertness, we considered options for developing a proactive approach to OSA management, specifically intending to show utility in developing a genetic risk screen to provide PCMs. We evaluated five genetic markers associated with OSA in civilian populations for confirmation within a military cohort of 34 members. Using minimally invasive cheek swabs and commercially available PCR assays, we were able to rapidly genotype subjects for all markers in less than 2 hours post-collection, at less than $10 per subject. The results of our pilot study suggest that there may be a significant relationship between genetic predisposition and risk of OSA. We found that the diagnosis of OSA showed a significant dependence with three of the five polymorphisms tested. We also found that we could create a genotype score that resulted in accurately predicting 81% of the subjects, with a diagnostic odds ratio of 6.3 and a number needed to misdiagnose of 5.2. Evaluating new military accessions could increase force readiness by identifying indicators of sleep apnea during annual preventive check-ups for aviators and enablers, thereby mitigating the potential detrimental sequelae of sleep apnea. Further studies increasing the subject numbers and controlling for other known risk factors are necessary before determining a tool’s utility in aeromedical screening. Funding was provided by an intramural award to RRC.