Features of mental disorders among victims of crimes against sexual inviolability of the person

On the example of data obtained during psychological and psychiatric examination and further rehabilitation of women and adolescent girls victims of crimes against sexual inviolability of the person, the article describes mental and behavioral disorders developed as a result of psychotrauma. Reflected features of the posttraumatic mental and behavioral disorders course and differences in manifestations in the age aspect. It has been established that the clinical picture of the course of the disease depends on such factors as the age, the psychological maturity of the victim of violence, the severity of committed violence. Also, the analysis of the work allowed us to identify a number of negative phenomena that contributed to the protracted, undulating course of reactive states. These include a high degree of stigmatization (self-stigmatization) in society about sexual offenses and, as a result, bullying victims of sexual violence, as well as the need to participate in forensic investigative events. It is shown that the frequency of face-to-face interrogation and the duration of the trial affect the severity and duration of the mental consequences of the psychological trauma

Factors that contribute to the stigmatization of victims in emergency situations

The technique of studying of processes of stigmatization of victims in emergency is insufficiently developed now and is based on results of practical observations of certain experts and methodical adaptations. Surveying features of internal and external stigmatization which is traumatic for victims and leads to weighting of experiences, negative development of the cognitive scheme "I-in-the-event", its dynamics, the authors define them as the adverse prognostic moments in a psychotherapy of the studied category of persons. In the article there is made an attempt of survey systematization of a series of social and demographic and environmental factors which have to be known to the expert working with the victim in emergency that in due time and precisely to diagnose character of consequences of a psychological trauma, to prognosticate the course of post-stressful disorders and to plan psychocorrectional influence. There are selected the characteristics of victims in emergency (an invalidism and traumatization, age, gender factors, education level) having significant effect on stigmatization development. The author analyses some of the problems arising during a psychotherapy of patients with stigma, defines the factors increasing probability of a delay with the request for the specialized help or refusal of therapy

Structural and Functional Peculiarities of the Cardiovascular System of Athletes in the Upright Body Position

Мехдиева Камилия Рамазановна, кандидат медицинских наук, доцент кафедры сервиса и оздоровительных технологий Института физической культуры, спорта и молодежной политики, заведующая лабораторией «Технологии восстановления и отбора в спорте», Уральский федеральный университет имени первого Президента России Б.Н. Ельцина. 620002, г. Екатеринбург, ул. Мира, 19. E-mail: [email protected], ORCID: 0000-0003-2967-2655. Зиновьева Юлия Александровна, кандидат медицинских наук, заведующая отделением функциональной диагностики, Свердловская областная больница № 2. 620014, Свердловская область, г. Екатеринбург, набережная Рабочей молодежи, 3. E-mail: [email protected], ORCID: 0000-0002-5866-3400. Захарова Анна Валерьевна, кандидат педагогических наук, профессор, профессор кафедры физической культуры Института физической культуры, спорта и молодежной политики, старший научный сотрудник лаборатории «Технологии восстановления и отбора в спорте», Уральский федеральный университет имени первого Президента России Б.Н. Ельцина. 620002, г. Екатеринбург, ул. Мира, 19. E-mail: [email protected], ORCID: 0000-0002-8170-2316. Тарбеева Наталия Михайловна, кандидат педагогических наук, доцент кафедры физической культуры Института физической культуры, спорта и молодежной политики, Уральский федеральный университет имени первого Президента России Б.Н. Ельцина. 620002, г. Екатеринбург, ул. Мира, 19. E-mail: [email protected], ORCID: 0000-0001-8765-7424. K.R. Mekhdieva1, [email protected], ORCID: 0000-0003-2967-2655, Yu.A. Zinovieva2, [email protected], ORCID: 0000-0002-5866-3400, A.V. Zakharova1, [email protected], ORCID: 0000-0002-8170-2316, N.M. Tarbeeva1, [email protected], ORCID: 0000-0001-8765-7424 1Ural Federal University named after the first President of Russia B.N. Yeltsin, Ekaterinburg, Russian Federation, 2Sverdlovsk Regional Clinics № 2, Yekaterinburg, Russian FederationЦель – определить структурные причины различной качественной реакции сердца и сосудов спортсменов на вертикализацию. Материалы и методы. По результатам гемодинамического мониторинга при проведении активной ортостатической пробы участники исследования – 12 квалифицированных спортсменов (средний возраст 17,9 ± 6,4 лет, длина тела – 168,8 ± 6,9 см, масса тела – 59,9 ± 9,6 кг). Изучали ультразвуковые структурно-функциональные параметры сердца и сосудов методом трансторакальной эхокардиографии и допплерографии сосудов по стандартному протоколу исследования (в положении лежа), а также в вертикальном положении. Результаты. Было установлено, что большинство показателей структуры и функции сердца всех исследуемых соответствуют норме для взрослых спортсменов. Тем не менее были отмечены особенности функции сердечно-сосудистой системы при перемене положения тела. Заключение. При вертикализации (переходе из горизонтального в вертикальное положение) у спортсменов происходит увеличение ЧСС и уменьшение объемных параметров сердца (УО и КДО). Причем чем больше ΔЧСС, тем значительнее уменьшаются объемные показатели кардиосистемы спортсмена. Aim. The article deals with establishing structural reasons for heart and vessels reaction to the upright body position in athletes. Materials and methods. Twelve professional athletes participated in the study (mean age 17.9 ± 6.4, body length – 168.8 ± 6.9 cm, body weight – 59.9 ± 9.6 kg). Participants underwent hemodynamics monitoring followed by standard transthoracic echocardiography (TTE) and Doppler sonography in the supine and upright body position. Results. We found out that, in general, TTE parameters of all participants corresponded with standard values for adult athletes. Meanwhile, we revealed some structural and functional peculiarities of the cardiovascular system during the orthostatic test (upright position of the body). Conclusion. The change from the supine to upright body position results in the increase in heart rate and decrease in cardiac volumetric parameters. Moreover, higher ΔHR is associated with a significant decrease in volumetric parameters of the cardiovascular system

Клинические рекомендации по семейной гиперхолестеринемии

These guidelines represent all current aspects of etiology diagnosis, and treatment of the clinical and statistical group of familial hypercholesterolemia in both adults and children in accordance with the requirements of the Ministry of Health of Russia.Данные клинические рекомендации представляют все современные аспекты этиологии, диагностики, лечения семейной гиперхолестеринемии как у взрослых, так и у детей. Рекомендации подготовлены для размещения в соответствующем рубрикаторе клинических рекомендаций Минздрава России в сети Интернет по адресу http://cr.rosmincylrav.ml

Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (p = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (p = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk

Clinical triage of patients on kidney replacement therapy presenting with COVID-19: An ERACODA registry analysis

Background: Patients on kidney replacement therapy (KRT) are at very high risk of coronavirus disease 2019 (COVID-19). The triage pathway for KRT patients presenting to hospitals with varying severity of COVID-19 illness remains ill-defined. We studied the clinical characteristics of patients at initial and subsequent hospital presentations and the impact on patient outcomes. Methods: The European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized at initial triage and those re-presenting a second time. Predictors of outcomes (hospitalization, 28-day mortality) were then determined for all those not hospitalized at initial triage. Results: Among 1423 KRT patients with COVID-19 [haemodialysis (HD), n = 1017; transplant, n = 406), 25% (n = 355) were not hospitalized at first presentation due to mild illness (30% HD, 13% transplant). Of the non-hospitalized patients, only 10% (n = 36) re-presented a second time, with a 5-day median interval between the two presentations (interquartile range 2-7 days). Patients who re-presented had worsening respiratory symptoms, a decrease in oxygen saturation (97% versus 90%) and an increase in C-reactive protein (26 versus 73 mg/L) and were older (72 vs 63 years) compared with those who did not return a second time. The 28-day mortality between early admission (at first presentation) and deferred admission (at second presentation) was not significantly different (29% versus 25%; P = 0.6). Older age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation were identified as risk predictors of mortality when re-presenting after discharge at initial triage. Conclusions: This study provides evidence that KRT patients with COVID-19 and mild illness can be managed effectively with supported outpatient care and with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19 to aid clinical triage and optimize resource utilization during the ongoing pandemic. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved