Chronic Somatic Diseases Research Articles

The Possibilities of Modern Client-Centered and Experiential Psychotherapy

In Ukraine, important processes are underway to identify those areas of psychotherapy that deserve official recognition by law. The official recognition of psychotherapeutic methods and techniques is associated with the fact that they are recognized as clinically and statistically effective. Such psychotherapy is reimbursed by insurance and is actively promoted in training courses, often "at the expense of other methods of psychotherapy." The psychotherapeutic procedure itself is becoming more and more standardized and impersonal, conforming to a protocol. The fate of client-centered and experiential psychotherapy (PCE-therapy) is not so easy in the world: evidence of its effectiveness is not reflected in the NICE (National Center for Collaboration in Mental Health) guidelines for depression and schizophrenia, which to some extent determine health policy. Therefore, there are widespread prejudices about the ineffectiveness of this type of therapy: it is not effective for severe mental illness, crisis states, specific phobias and traumas, behavioral problems, for those clients who need a directive approach, for assessing and diagnosing clients, etc. The article presents specific studies of the effectiveness of client-centered and experiential psychotherapy for specific symptoms (anxiety, depression, schizophrenia, borderline personality disorders, and some somatic disorders), as well as data from a meta-analysis of the effectiveness of client-centered and experiential therapy. PCE-therapy proved to be highly effective according to the criteria: "before-after" treatment; 2) "treatment-no treatment"; 3) "comparison with other types of psychotherapy" - the data obtained are generally statistically and clinically equivalent in terms of effectiveness to other methods of psychotherapy. PCE therapy proved to be the most effective in the following cases: interpersonal problems, self-harming behavior, coping with chronic somatic diseases, psychosis. It turned out that cognitive behavioral therapy (CBT) has mixed benefits compared to PCE therapy. However, Elliott et al. note that, firstly, these "studies were mostly performed by CBT therapists" and, secondly, "low-quality versions of PCE therapy were used as comparison conditions". The most effective methods of PCE therapy were EFT and PCT. A list of approaches included in PCA-therapy is given, and their general characteristics are given.

Aspects and Problems of Local Anesthesia in Older Patients: State of the Question

Dental care is one of the types of medical care most demanded by various age groups of patients. In the process of human aging, pathological and dystrophic changes develop in all organs and tissues, including the tissues of the maxillofacial region, which increases the need for patients to contact various specialists. Older and oldest-old often have several chronic somatic diseases and age-related mental characteristics, for the treatment of which several groups of drugs are used simultaneously. In geriatric dentistry, anesthesia should be applied taking into account polypharmacy, somatic and cognitive health. When deciding on a dosing regimen and assessing the risks of local anesthesia, it is important to consider not only the length of each visit to the dentist but also the total number of visits required to achieve dental health.

40 Disorders Of The Anterior Attentional-Intentional System In COVID-19 Survivors - Preliminary Results

Objective:In December 2019, the first reports came from China about cases of pneumonia caused by a previously unknown coronavirus, SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), responsible for a disease called COVID-19. Since then, the pandemic has spread worldwide, affecting people’s physical and mental health and as well as quality of life. Currently, many people are experiencing the health consequences of contracting COVID-19, also due to the impact this disease has on the central nervous system. As a result, in addition to well-known ailments, such as headaches, chronic fatigue or smell and taste disorders, COVID-19 survivors may develop neuropsychological problems such as executive-attentional deficits. However, the specificity of these executive-attentional problems has not been determined. Thus, the purpose of this study was to learn if survivors of COVID-19 may present with more generalized or rather specific dysfunction(s) of the anterior attentional-executive system.Participants and Methods:The study group consisted of 37 individuals who underwent COVID-19 (age M=44, education M=17). The comparison group consisted of 25 matched controls tested before the COVID-19 pandemia. The experimental procedures included (1) a clinical interview, (2) an assessment of selected cognitive functions (3) and attentionalexecutive functioning, which was assessed using the ROtman-Baycrest Battery to Investigate Attention (ROBBIA); a battery was designed to measure three attentional processes (i.e., energizing, task setting, and monitoring). Overall, four reaction time (RT) subtests from ROBBIA were administered: (1) Simple RT, (2) Choice RT, (3), Prepare RT, and (4) Concentrate. For each subtest, the instruction was to press an appropriate button on a response pad as quickly as possible when a target stimulus (one of the following capital letters: A, B, C, or D) is detected, but also (in Choice RT, Prepare RT and Concentrate) to make as few errors as possible.Results:Overall, the analyses revealed that individuals who survived COVID-19 exhibited a different effect of the warning stimulus compared to controls. Specifically, COVID19 survivors presented an increase in reaction time from 1s warning condition to 3s warning condition being significantly greater than the control group’s increase (p < .05). Also, only in the COVID-19 group, reaction time in the Concentrate task tended to be longer (p = 0.01). No group differences in monitoring (e.g., number of errors) or task setting emerged.Conclusions:The patients’ problems appear analogous to those observed in other chronic somatic diseases, likely due to the impact of COVID-19 on the frontal lobe’s medial regions. However, due to a small sample size, future neuroimaging research, including computerized studies of attentional-execution networks, is needed to confirm that COVID-19 may predominantly affect the energization system that contributes to these patient’s cognitive slowing and defective ability to sustain attention.

СЛУЖБА ПРОФПАТОЛОГИИ ФМБА РОССИИ

All the centers of occupational pathology of the FMBA of Russia have been established on the basis of multidisciplinary specialized healthcare institutions. The chief freelance professional pathologist annually collects reports on the results of the centers of occupational pathology. According to the data of the Centers of Occupational Pathology of the FMBA of Russia, the profile of the causes of medical contraindications has its own characteristics. The most common causes of medical contraindications include: diseases of the circulatory system, diseases of the eye and its appendage, neoplasms, diseases of the ear and mastoid process, diseases of the blood, hematopoietic organs and individual disorders involving the immune mechanism, which necessitates the implementation of preventive programs in the indicated directions. The main classes of chronic somatic diseases first identified during medical examinations include: diseases of the digestive system, diseases of the endocrine system, eating disorders and metabolic disorders, diseases of the eye and its accessory apparatus, diseases of the circulatory system. In 2022, 8725 examinations of aptitude and connection of the disease with the profession were conducted in the Centers of Occupational Pathology within the established scope of the state task, 514 of them examinations of aptitude for complex cases, 908 examinations of the connection of the disease with the profession.

Depression in somatic hospital patients

The purpose of this work was to assess the prevalence and socio-demographic risk factors for depression in patients of a somatic hospital in the city of Izhevsk. The study group (100 adult patients) was compiled by a continuous sampling method. The MINI 5.0.0 questionnaire and the DEPS Depression Scale were used to diagnose depression. The prevalence of current depression was 18%. Depression was more often diagnosed in patients with chronic somatic diseases (94.4%), men (66.7%), and married patients (72.2%). None of the patients with diagnosed depression applied for medical help with the corresponding complaints or received antidepressant therapy.

Structure and dynamics of the course of chronic non-infectious somatic diseases in patients during war events on the territory of Ukraine

BackgroundThe work studied and compared the dynamics of changes in the course of hypertension, type 2 diabetes, and somatized disorders in Ukrainian population, in the 1st period before war (October 2021 – February 2022) and 2nd period during the war (March -July 2022). The choice of the study of the above-mentioned nosology is due, first of all, to the increase in cases of referrals to outpatient doctors regarding hypertensive crises, the increase in the frequency of patients’ complaints about the lability of glycemic indicators during routine monitoring of glucose levels with ambulatory glucometers, the appearance of chronic pain syndrome of unspecified pathology with the beginning of war events.Methods272 people were examined in Mykolaiv Region (Ukraine). The patients were divided into three clinical groups: 1st group − 90 people patients with arterial hypertension; 2nd group – 92 people with type 2 diabetes; the 3rd group – 90 people with somatiform disorders.ResultsIn the patients of the 1st group during the 2nd period, amount of people with hypertension of the 1st stage increased in 1.8 times (p = 0.0412), with 2nd stage hypertension increased in 2 times (p = 0.0491) and 3rd stage hypertension increased in 2.5 times (p = 0.0391); somatized disorders in 3rd group also increased in 4.1 times (p = 0.001 < 0.05); in 2nd group recorded an increase in HbA1c by 0.99 ± 0.57 mmol/l (p = 1.795e-07 < 0.05), in comparison with the indicators for the 1st observation period.ConclusionsThe war events in Ukraine not only changed the life of every Ukrainian, but also had a significant impact on the dynamics and structure of chronic somatic diseases, in particular due to an increase in patient referrals for hypertensive crises, exacerbations of type 2 diabetes, somatized disorders, and chronic pain syndrome of unknown etiology. Considering these results, it is important to increase the equipment of regional primary care centers with antihypertensive, hypoglycemic and sedative drugs.

Vulvovaginitis in childhood and adolescence in a gynecologist practice

Background. The study of the etiology and pathogenesis of vulvovaginitis in different age periods of girls in order to preserve their reproductive health. Objective. The aim of the study is — to identify risk factors for the development of vulvovaginitis at different girls age periods. Methods. Retrospective analysis of information from electronic medical records of 100 girls of various ages with inflammatory diseases of the vulva and vagina treated on an outpatient basis. Results. Risk factors identified: children in the period of neonatality and infancy this is an incorrect conduct of hygiene measures due to insufficient awareness of parents; in the period of neutral childhood — allergic reactions, somatic diseases, antibiotic treatment, enterobiosis and childhood masturbation, children in the period of acute respiratory viral infections, inability to take care of the genitals; in adolescent girls — the presence of chronic somatic inflammatory diseases, antibiotic therapy, early onset of sexual activity, lack of contraception, non-compliance with personal hygiene rules, violation of menstrual hygiene, belated access to a doctor. The main causative agents of vulvovaginitis in the period of neutral childhood were representatives of coccal flora and E. coli, in adolescence — Candida and microbial associations. Conclusion. Preventive conversations with patients and their parents about the identified risk factors for vulvovaginitis are necessary in order to prevent the development of inflammatory diseases of the genitals and to preserve reproductive health.

Health status of coal industry workers

Health status of coal industry workers

MARKERS OF IMMUNE INFLAMMATORY REACTION IN PATIENTS WITH GENERALIZED PERIODONTITIS AND CONCOMITANT GOUT

Among the main groups of chronic somatic diseases, it is rheumatological diseases that make the biggest contribution to the aggravation of the health. In the structure of causes for primary disability, rheumatological pathology ranks the second position after cardiovascular diseases. Gout is a chronic, progressive disease associated with a purine metabolism disorder, characterized by an increase in the level of uric acid in the blood (hyperuricemia) and deposition in the tissues of the musculoskeletal system and internal organs of the sodium salt of uric acid (urates) with the development of acute arthritis and the formation of gouty nodules (tophus). Gout and periodontitis are inflammatory diseases by their genesis and characterized by an underlying inflammation, which is known as a protective response triggered by cellular damage caused by inflammatory agents and activation of non-specific resistance factors. This study aimed at investigating the markers of the immune-inflammatory reaction in patients with comorbidity of generalized periodontitis and gout. The results obtained can serve as essential elements for the development of effective treatment and prevention strategies for this type of comorbidity. A biochemical study was conducted on venous blood samples from 60 male inpatients with gout aged from 30 to 59 years, who received treatment at the rheumatology department of Lviv Regional Clinical Hospital. Two study groups were formed: the main group consisted of 30 patients with the comorbidity of generalized periodontitis and gout; the comparison group included 30 people with generalized periodontitis but without rheumatological pathology. The results were compared with data obtained from 20 healthy individuals (control group). The patients with generalized periodontitis and concomitant gout demonstrate a significant increase in the levels of the acute-phase protein C-RB and pro-inflammatory interleukin IL-1β. The elevated concentration of C-reactive protein confirms the presence of latent inflammation that can be potentially attributed to the comorbid course of gout and periodontitis, which may irritate the endothelium through microcrystals of uric acid and toxins from periodontal pocket microorganisms. Increased activity of IL-1β, which is known as an important factor in initiating the inflammatory process and the release of various inflammatory mediators, indicates the presence of persistent subclinical activation of autoinflammatory mechanisms.

Healthy aging and oral health

Currently, much attention is paid to healthy aging and aspects affecting it, such as, for example, oral health. Oral health determines the social, physical and mental well-being of an elderly person. A large proportion of the dentists patients are elderly people with numerous concomitant chronic somatic diseases who regularly take numerous medications. Along with this, this category of people is characterized by specific dental symptoms and syndromes. The review analyzes geriatric syndromes associated with oral health problems. It is proposed to include questionnaires to identify dental problems in a comprehensive geriatric assessment.

The relationship of the prevalence of caries with the immune status of preschool and schoolage children in the city of Makhachkala

Relevance. The study of the relationship between dental morbidity and immune status is relevant due to the high prevalence of caries and the level of somatic health of children in Makhachkala.Materials and methods. The survey involved 425 children aged 2 to 17 years, long-term residents in Makhachkala. The average value of the CPI index corresponds to 5.5. To determine the relationship between the presence of caries and the immune status of children, 33 patients were selected from the examined to participate in a study to determine immunoglobulins in oral fluid in three age periods (11 children aged 6, 12 and 15 years). Oral fluid intake in patients was carried out 2 hours after meals. Determination of the concentration of immunoglobulins (secretory sIgA, IdA, IgM and IgG) was carried out using a set of reagents for enzyme immunoassay determination of the concentration of secretory immunoglobulins in "Invitro". Statistical analysis of the material was carried out using the IBM SPSS Statistics Standard program.Results. In Makhachkala, an increase in the prevalence of caries with age was revealed in preschoolers (6 years) 78.2 ± 0.3%, in adolescence (12 years) 78.9 ± 0.2%, in children with permanent bite (15 years) reaches 85.2 ± 0.6%. Studies of the immune status showed that immunoglobulins varied individually and by age groups. sIgA immunoglobulin, which allows to control immunity before the disease, decreased by more than 3 times by the period of permanent bite. Immunoglobulin IgA, which plays a protective function in humoral immunity, decreased by more than 70% by the period of permanent bite. IgM immunoglobulin increased by more than 40% in children by the age of 15. Changes also occurred with the content of the enzyme lysozyme, decreasing by the age of 15 years almost 6 times from the norm.Conclusions. The high morbidity rate of the children's population in Makhachkala is associated with anthropogenic impact, poor-quality drinking water, air and indicates the need for early detection of chronic somatic diseases and the organization of preventive and medical-dental care for children from an early age.

Роль взаимоотношений подростков с социальным окружением как фактор защиты от рисковых форм поведения

Background. Adolescence is associated with a high probability of the debut of risky behaviours. At the same time, social environment and the need for it can determine the potential for the implementation of this behavior. Family relationships play a leading role in shaping the behaviour of a teenager. Among all the factors of a dysfunctional social environment that can form emotional experiences or strengthen them, family types of parent-adolescent relationships, as well as the individual needs of adolescents in peer communication, are considered to be the leading ones Objective. The study aims to characterize the factors of protection against risky behaviours among adolescents. Sample. The study involved 865 healthy adolescents aged 15–17 years, among whom 120 adolescents were selected according to the inclusion criteria (voluntary informed consent from a teenager and legal representatives; exclusion criteria: adolescents with official diagnoses according to ICD-10 related to behavioral disorders; chronic mental and somatic diseases), 70 of them were (57.4%) boys and 50 subjects were (41.6%) girls. From the same sample, a study of “parental tolerance” was conducted in 50 parent pairs of adolescents. Methods. The empirical study was conducted with psychodiagnostic methods: (Shipitsyna, 2001) “Study of risk factors and protection”; modified technique of Bern questionnaire version “Ways to overcome critical situations” (Goncharova, 2006); “PSM-25 psychological stress scale” (Taylor, 1953, Nemchin, 1966), and “Questionnaire for determining nervous-mental stability, risk of maladjustment in stress “Prognosis” (Rybnikov, 1985); “Parental tolerance” (Ovcharova, 2018); methodology “Relationship profile test” (Bornstein, Girshfield, 2001, Makushina, 2005). Correlation analysis was applied to study the relationship between indicators of “parental tolerance”, the severity of stress, and stress resistance. Pearson and Spearman coefficients, their determination coefficients (r2) and the reliability of the correlation were calculated. Results. It is shown that for every second teenager, the factors of protection against risky behaviours included social environment (61.6%), family (65.4%), school (46.9%). At the same time, a high degree of need to overcome negative situations in adolescents was revealed in the search for support (in every fourth teenager); self-esteem increase (in 22.2% of adolescents); problem analysis (in 24.2% of adolescents). Among all the components of parental tolerance, 4 indicators of the cognitive component and 6 indicators of the emotional component had a reliable strong relationship that determines the severity of stress resistance. The etiology of interpersonal dependence of moderate severity was based on emotional reliance on others in 72.3% of students; self-doubt in 80.5% of students and the desire for autonomy in 55.5% of students. Conclusion. The materials of the study indicate the need to monitor factors of protection against risky behaviours, as well as their correction through work not only directly with the adolescents themselves, but also with their families, as well as the actualization of preventive work aimed at teaching adolescents to overcome negative emotional experiences with effective methods.

Analysis of the health status of medical workers based on the results of mandatory periodic examinations

Objective: to analyze the results of periodic medical examinations of employees of a large medical organization in dynamics, according to the final acts. Materials and methods: the research material was the final acts (2019–2021), compiled based on the results of periodic medical examinations of employees of the Novosibirsk Regional Clinical Hospital of War Veterans (Novosibirsk Regional Clinical Hospital of War Veterans). For the analysis, data on the structure of diseases for 2019–2021 were also used, with which medical workers underwent treatment courses in the day hospital of the hospital. Results: in just 3 years, 546 hospital employees under-went periodic medical examination, 489 of them women. The results of the studies have shown that in the dynamics of three-year follow-up, the number of persons subject to additional examination, treatment and dispensary observation has sharply increased, which may indicate a certain effectiveness of PMT. The detectability of chronic somatic diseases according to the results of the PMT has increased by more than 10 times in dynamics. 69 medical workers underwent treatment courses on the basis of the GNOCGV day hospital for 3 years. Of these, 22 medical workers were treated and rehabilitated in a day hospital with the consequences of a new COVID-19 coronavirus infection. Conclusion: when analyzing the final acts based on the results of the PMOS of GNOCGV employees for the period from 2019 to 2021, it was found that the efficiency and quality of inspections has increased dramatically.

ASSESSMENT OF NOSOLOGICAL STRUCTURE ASSOCIATED WITH ANEMIC SYNDROME

The anemic syndrome at the stage of primary health care delivery on an outpatient basis is a risk factor for an unfavorable outcome in patients with chronic somatic diseases, primarily cardiovascular and oncological pathologies. In order to understand the true prevalence of anemia among outpatients it is necessary to improve the registration of patients with this disease. Aim: to analyze the features of managing patients with anemia in the primary health care system using a computerized patient monitoring system. The study included 1498 patients aged 18 to 80 who were under dispensary observation by family physicians. For the analysis of the medical records, a computer program developed by the authors "Monitoring system for patients with anemic syndrome" was used. The structure of morbidity in two selected areas of the outpatient department in the context of the main classes of diseases of ICD-10 is analyzed. According to the analysis of the medical records carried out using the program developed by us, anemia was recorded in 208 patients (13.89%), while in the analysis using the computer register according to the WHO criteria, 500 people had anemic syndrome (33.38%), which indicates the underdiagnosis of this pathological condition and the need to direct the efforts of healthcare organizers to the early revealing of patients with anemia.

ОСОБЕННОСТИ ПСИХОЛОГИЧЕСКОГО БЛАГОПОЛУЧИЯ СТУДЕНТОВ С РАЗЛИЧНЫМ СОМАТИЧЕСКИМ ЗДОРОВЬЕМ ДО И ВО ВРЕМЯ ПАНДЕМИИ COVID-19

Statement of the problem. The article focuses on one of the priority tasks of the state – the preservation and strengthening of the health of the population. The purpose of the study was to identify the features of the psychological well-being in students with different somatic health in the pre-pandemic and pandemic period associated with COVID-19. The hypothesis of the study was based on the assumption that students of the second and third groups of dispensary observation with a low level of psychological well-being during the pandemic associated with COVID-19 will have lower psychological well-being than in the pre-pandemic period, and students of the first group of dispensary observation will have psychological well-being not changed. The methodological basis of the study was the concept of psychological well-being by С. Riff and approaches to understanding dispensary observation based on the legislative framework in the field of healthcare. Materials and methods. The presented results of an empirical study were obtained on a sample of medical university students. The study was carried out in 2 stages: stage 1 – in the pre-pandemic period, stage 2 – in the pandemic period. The study was conducted using a specially developed module for psychological diagnostics https://krasgmu.ru/index.php?page[common]=psy, which allows for data collection, automatic processing, and obtaining statistical data on a specific population of respondents. In an automated mode, the technique of “The scales of psychological well-being” by С. Riff was used. The study involved 311 students of KrasSMU at each stage of the study. Research results. No significant differences were found in the representatives of the first group of dispensary observation, which suggests a relationship between somatic health and the ability to maintain psychological well-being in difficult life situations (for example, during the Covid-19 pandemic). Noticeable differences were found in a number of parameters among representatives of the second and third groups of dispensary observation, indicating that for the respondents with somatic diseases it is more difficult to survive the pandemic period (confirmed by a decrease in the second stage of the number of respondents demonstrating a high level on the scale “Autonomy” and “Environmental Management” in both groups, as well as a decrease in the number of respondents in the third group of dispensary observation, belonging to the average level on the “Environment Management” scale and the average and high level on the “Goal in life” scale). The absence of significant differences on the scales “Positive Relations with Others”, “Personal Growth”, “Self-Acceptance” in all three groups was recorded, indicating stability of these indicators of psychological well-being during the pandemic period. Conclusion. It is concluded that it is the respondents with chronic somatic diseases who are more difficult to survive the pandemic period. The data obtained indicate the need to develop special programs for the psychological support of students with somatic diseases during the epidemiological regime.

Features of personality traits in smoking students — residents of the Northern territories of Russia

AIM: To identify psychological factors of the risk of tobacco addiction among students of the European North of Russia.&#x0D; MATERIAL AND METHODS: The study involved 137 students of Arkhangelsk state universities, comprising 37 men and 100 women aged from 17 to 25 years, preselected for a number of characteristics (born in Arkhangelsk or the Arkhangelsk region; raised in a full, socially prosperous family; without financial and household problems; without chronic somatic and neurological diseases). Identification and analysis of tobacco smoking experience were carried out by retrospective self-assessment of the subjects. The psychological status of the respondents was determined by assessing the indicators of the Freiburg multifactorial personality questionnaire (FPI); accentuations of temperament and character, suggestibility, frustration, irritability and resentment; adventurousness, behavioral, social, professional, economic, political activity, and social destructiveness. The WilcoxonMannWhitney method and Fishers F-criterion were used for statistical analyzes.&#x0D; RESULTS: In the group of smoking men, high values of hyperthymia (Me=18 units), masculinity (Me=8 units), sociability (Me=9 units), behavioral activity (Me=7 units), and social activity (Me=7 units) were recorded. In the group of smoking women, high values of exaltation (Me=24 units), masculinity (Me=8 units), sociability (Me=9 units), and social activity (Me=7 units) were recorded.&#x0D; CONCLUSION: This study reports, for the first time, the features of personality traits in smoking boys and girls permanently residing in the Northern territories of the Russian Federation. Psychological factors of the risk of tobacco addiction formation in boys and girls permanently residing in the Northern territories of the Russian Federation have been determined.

Development of a set of priority measures for the integration of tools for assessing working conditions for the formation of occupational risk levels

Introduction. The increase in life expectancy, a decrease in mortality rates of the working-age population requires the development of a set of priority measures and justification of their effectiveness in the occupational risk management system based on the transition to a personalized assessment of working conditions and the health status of employees. The study aims to develop a set of priority measures to integrate tools for assessing working conditions and to justify their effectiveness in the occupational risk management system to determine the levels and groups of occupational risks in the workplace, depending on the complex of harmful and/or dangerous factors of the production environment and the labor process and the health status of employees. Materials and methods. The researchers have conducted the analysis of qualitative and quantitative indicators of occupational risk, including indicators of health disorders of employees. We have analyzed the materials of periodic medical examinations to substantiate the algorithm for the formation of risk groups for the development of occupational diseases. Scientists have performed a cross-epidemiological study to assess the risk of developing chronic general somatic diseases in workers. We have calculated the indicators of the total risk of fatal cardiovascular diseases. Experts have studied the features of the current situation with indicators of occupational morbidity in the Russian Federation. Results. There are two groups of qualitative and quantitative indicators at the level of state supervision and enterprise, which allow assessing the effectiveness of the risk management system. Scientists have identified qualitative and quantitative indicators for early detection of violations in the employee's body from the effects of production factors. We have substantiated the algorithm and criteria for the formation of risk groups for the development of occupational diseases. Assessment of the risk of developing general somatic diseases in workers with constant exposure to high levels of harmful factors: vibration, severity and labor intensity, showed a high prevalence and increased risk of diseases of the endocrine, musculoskeletal and circulatory systems, as well as a significant increase in these indicators with an increase in work experience in harmful working conditions, which allows us to consider these diseases as production-related diseases. Individuals with endocrine diseases are significantly more likely to have a very high, high and medium overall risk of developing fatal cardiovascular diseases (CVD). With an increase in work experience, the percentage of people at high risk of developing fatal CVD increased. The level of occupational morbidity calculated for the number of employees employed in harmful working conditions is 32% higher than the indicator calculated for all employees of the enterprise. A similar recalculation of occupational morbidity indicators for individual nosologies also completely changes the picture. Conclusion. We have substantiated the necessity of transition to a personalized assessment of occupational risk among employees. Researchers have developed proposals for adjusting legislation in order to integrate tools for assessing working conditions and improving the effectiveness of the occupational risk management system. Ethics. This study did not require the conclusion of the Ethics committee.

Perinatal outcomes of pregnancy and childbirth in moderate to severe COVID-19 patients

BACKGROUND: The presence of COVID-19 caused by SARS-CoV-2 during pregnancy increases the incidence of adverse perinatal outcomes, which are manifested in more frequent spontaneous miscarriages, premature births, antenatal fetal deaths, and fetal growth retardation, as well as in the development of intraamniotic infection and respiratory distress syndrome of the newborn. The most likely cause of premature birth can be considered severe respiratory failure of the mother with hypoxemia, which leads to circulatory disorders in the hemodynamic system of the mother-placenta-fetus. Currently, there is no single expert opinion on pregnancy prolongation tactics, as well as the timing and methods of delivery in patients with COVID-19, which is decided individually by an interdisciplinary consultation of the experts, taking into account the severity of the patients condition, gestational age and fetal condition.&#x0D; AIM: The aim of this study was to analyze perinatal outcomes of pregnancy and childbirth in the presence of moderate and severe COVID-19.&#x0D; MATERIALS AND METHODS: We carried out a retrospective analysis of perinatal outcomes in patients with the novel coronavirus infection in a specialized level III infectious hospital in St. Petersburg, Russia in 20202021 (from the first to the fourth wave of COVID-19) based on the birth histories of 50 patients with moderate (n = 31) and severe (n = 19) forms of the disease.&#x0D; RESULTS: Most of the patients suffered from chronic somatic diseases, with the course of pregnancy and childbirth complicated by premature rupture of amniotic fluid and progressive fetal hypoxia (fetal distress). In severe COVID-19, preterm labor prevailed and the proportion of operative abdominal delivery more than doubled that of vaginal delivery. The course of the postpartum period was determined by the COVID-19 positive dynamics. The majority of patients in the study groups showed significant changes in laboratory parameters such as anemia, an increase in the level of neutrophilic leukocytes with a subsequent decrease in their count, lymphopenia followed by lymphocytosis, and an increase in the levels of C-reactive protein and the activities of lactate dehydrogenase, alanine aminotransferase and aspartate aminotransferase. The study of the relationship between the most characteristic laboratory parameters in the disease dynamics showed the presence of statistically significant correlations between inflammation markers and metabolic markers, which allowed for assessing the severity of the patients condition.&#x0D; Antenatal diagnosis of the fetal functional status based on cardiotocography, ultrasound and Doppler sonography data revealed a predominantly compensated fetal condition in the study groups. The condition of newborns in all patients with moderate COVID-19 and in most of patients with the severe form of the disease was satisfactory. In severe COVID-19, the birth of children with moderate asphyxia was due to prematurity and antenatal hypoxia resulted from decompensation of chronic placental insufficiency. The histopathological patterns of the afterbirth in the study groups were represented by inflammatory changes and chronic placental insufficiency.&#x0D; CONCLUSIONS: The data obtained suggest that the basis for favorable perinatal outcomes is an adequate assessment of the condition of the pregnant woman and the fetus with timely delivery before the onset of irreversible organ damage.

Fundamental principles of individual health: review

INTRODUCTION: Global challenges facing humanity make us take a fresh look at the problem of human health, first of all, in the context of forming a stable plan to maintain and increase health reserves. Such a plan does not appear by itself, it requires some person’s efforts to self-educate and to acquire special knowledge.OBJECTIVE: Substantiate the principles and mechanisms of individual health based on the analysis of literature sources and results of own research.MATERIALS AND METHODS: There was analysis of articles, placed in the databases and information systems: scientific electronic library Elibrary.ru, RISC, CyberLeninka, Scopus, WoS with the study about the basic components of individual health for the last 20 years. Keywords were used, such as health, homeostasis, adaptation, principles of individual health, valeology. The results of the authors’ own long-term studies have been also used in developing principles of health, relating to the issues of ensuring health of power structure specialists.RESULTS: High aerobic capacity does not only prevent the development of chronic somatic diseases, but also helps to resist different adverse environmental factors. In other words, high aerobic capacity can ensure overcoming extreme situations without activating anaerobic mechanism of energy supply. It is especially important as a part of valeological approach because, as a rule, in extreme conditions there is drastic reduction in adaptation reserves that leads to a risk of a disease.DISCUSSION: Priority principle of health is the principle of shaping health. Its essence is systematic teaching to manage your own health based upon a number of factors: gender, age, the level of physical and intellectual activity, the presence of predisposition to certain diseases, professional employment, etc. Its following ensures a person implementation of other principles — preservation and strengthening of health on somatic, mental and social levels. Knowledge about individual health mechanisms may become the theoretical basis for practical activities of medical, educational and social services in improving quality and life expectancy in Russia.CONCLUSION: In the structure of individual health pedagogical component is considered to be system-forming, the essence of which is to contribute to the formation of morality (positive personality traits and willingness to care for one’s own well-being and that of others) via continuing valeological education. Through morality an individual gets involved in activities of forming somatic, mental and social components of health, building and integration of which tend to happen over the whole period of their growth and development.

Gambling disorder and chronic diseases in Finland: a nationwide register study

Abstract Background Previous register-based studies on comorbidity have mainly focused on gambling disorder (GD) and psychiatric disorders. However, knowledge on somatic health of persons with GD is also needed. This nationwide register-based study aims to examine the gender-specific prevalence rates of chronic diseases and conditions among the Finnish adults with GD. Methods This study utilizes aggregated data of persons aged 18 and over with GD diagnosis (corresponding to pathological gambling, ICD-10; F63.0) in 2011-2020. The data were retrieved from the Finnish nationwide health registers: Register of Primary Health Care visits and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient social care. All diagnostic groups were included. Corresponding figures for the total population with same age range were presented as reference numbers. Results The preliminary results showed that 2,617 persons with the median age of 33.5-36.0 were diagnosed with GD (men n = 1,858; women n = 759). Despite the fact that the prevalence rates of the general population were not age-adjusted, many chronic diseases and conditions were more prevalent among persons with GD compared with the general population. The prevalence rates of psychiatric disorders (87.5% vs 29.2%) and nervous system diseases (23.9% vs 15.2%) were particularly high. Musculoskeletal diseases (61.6% vs 55.8%) and digestive diseases (30.2% vs 27.6%) were also slightly more prevalent. Memory disorders (1.1% vs 5.3%), cardiovascular diseases (25.3% vs 41.0%), and cancer (15.6% vs 24.4%) were less prevalent. Among persons with GD, all comorbid diseases were more prevalent among women than among men. Conclusions Psychiatric disorders and nervous system diseases are exceptionally prevalent in persons with GD. These findings highlight the need for health and social care professionals to recognize that persons with GD may additionally have other disorders that need attention. Key messages • Mental disorders are the most common comorbidity among persons with GD, however, many somatic chronic diseases are also common. • Comorbidities are more common among women with GD than among men with GD.