Analysis of the dynamics and structure of morbidity of athletes of the national teams of Moscow based on the results of medical examination

Objective: The aim of the study was to analyze the structure and dynamics of morbidity of athletes, members of sports teams of the city of Moscow based on the results of an in-depth medical examination in the period 2017–2021.Materials and methods: The data of the medical examination of athletes, which took place at the Moscow scientific and Practical Center for Medical Rehabilitation, restorative and sports medicine, including instrumental, functional and laboratory studies from 2017 to 2021, were analyzed. In 2017, 15176 athletes were examined, in 2018 and 2019, 11200, in 2020, 10080 people and in 2021–11922 athletes.Results: The results of the study showed an increase in the proportion of amenorrhea within the triad of athletes, an increase in general therapeutic morbidity, diseases of the gastrointestinal tract, among which the proportion of secondary hyperbilirubinemia in 2021 increased 3 times compared to 2020, which, in our opinion, is also due to the impact of the pandemic and quarantine restrictions.The high prevalence of ophthalmological morbidity of athletes and changes in the cardiovascular system is shown. During 2017–2021, a change in the structure of cardiac morbidity was revealed in the form of an increase in the proportion of cardiac arrhythmias and hypertensive response to stress.An increase in the endocrine morbidity of athletes in 2021 was revealed due to an increase in the proportion of hypothyroidism and more frequent detection of hyperthyroidism, possibly related to the COVID-19 pandemic, which requires further research.There was also an increase in diseases of the skin and genitourinary system in athletes. Psychological problems of athletes increased during the observation period from 2017 to 2021. There was no significant dynamics of surgical and traumatological diseases, otolaryngological pathologу.Conclusion: The results of the study indicate the importance of regular full-fledged examination of athletes, identification of various functional disorders and diseases for their timely prevention and treatment in order to preserve the health of athletes and improve athletic performance

Efficiency of Endovascular Haemostasis at Delivery in Patients with Previa and Placenta Invasion

Aim. Analysis of operative delivery outcomes in pregnant women with abnormal invasive placenta depending on the endovascular treatment for intraoperative haemostasis.Materials and methods. A retrospective study of operative delivery outcomes was performed in 178 patients with placental invasion using ultrasonography (US) data obtained at the Perinatal Centre of the Regional Clinic Hospital No. 2, Ministry of Health of Krasnodar Krai, in the years 2012–2018. In 2012–2014, delivery was managed without endovascular haemostasis (n = 44), and from May 2014 to December 2018 – with prophylactic balloon catheterization of common iliac arteries (n = 134). Upon intraoperative diagnosis of placental invasion, temporary balloon occlusion (TBO, n = 115) and/or uterine artery embolization (UAE, n = 33) were performed. Efficiency of endovascular methods for intraoperative haemostasis was assessed by comparing the degree of placental invasion, amount of blood loss and transfusion, frequency of hysterectomies (HE), duration of surgery, length of stay in intensive care units (ICU) and outcomes for the foetus.Results. Adoption of endovascular methods for intraoperative haemostasis allowed the blood loss (p = 0.02), haemotransfusion (p = 0.012) and HE frequency (p <0.001) to be significantly reduced. In the absence of clinical and histological manifestations of placental invasion, no difference in blood loss was detected between the groups. The amount of blood loss increased with the degree of invasion. Surgery duration in patients with TBO was signifi cantly longer (p = 0.04). No difference was detected between the groups with respect to the ICU length of stay and outcomes for the foetus.Conclusions. Establishment of endovascular haemostasis at the planned delivery of pregnant women with abnormal invasive placenta allows the blood loss and HE frequency to be reduced. Further improvement of US diagnostics of placental invasions is essential in pre-selection of patients for X-ray surgical care