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To present a synthesis of recent literature regarding the risk factors and management for MTSS. Risk factors include female sex, prior history of MTSS, less running experience, female athlete triad/RED-S, higher BMI, smoking, and biomechanical abnormalities. Management includes activity modification, gait retraining, orthotics, medications, and, very rarely, surgery. MTSS is an overuse injury commonly seen in runners. The pathophysiology remains disputed, and diagnosis is often determined from clinical presentation alone. For unclear reasons, women are at increased risk for development of MTSS. Other risk factors include increased BMI, prior history of MTSS, less running experience, smoking, presence of at least one component of the female athlete triad/RED-S, and biomechanical abnormalities. Treatment often includes cessation of high-impact activity, gait retraining, neuromuscular training, and orthotics. In rare circumstances, surgery may be considered. Identifying risk factors is important for prevention and individualized management.

При идиопатическом цистите кошек морфологические изменения выявлены, в основном, в слизистой оболочке и подслизистом слое стенки мочевого пузыря. Они характеризуются гиперплазией и переполнением кровеносных сосудов. При морфометрической оценке основных структур стенки мочевого пузыря установлено увеличение толщины слизистой оболочки за счет снижения толщины подслизистого слоя и мышечной оболочки. При применении антистрессовой терапии на 14 сутки от начала лечения наблюдали снижение аналогичного показателя за счет увеличения толщины подслизистого слоя и мышечной оболочки. У контрольных кошек после применения общепринятой схемы лечения процессы регенерации стенки мочевого пузыря выражены незначительно., In autopathic cystitis of cats, morphological changes are found mainly in the mucous and submucous membranes of the bladder wall. They are characterized by hyperplasia and congestion of blood vessels. Morphometric evaluation of the main structures of the bladder wall revealed an increase in the thickness of the mucous membrane due to the reduced thickness of the submucosal layer and the muscular coat. When antistress therapy was applied on the 14th day from the beginning of treatment, a decrease in the same parameter was observed due to an increase in the thickness of the submucous layer and the muscular coat. The regeneration processes of the bladder wall were insignificantly expressed in the control cats after the conventional treatment protocol., Международный научно-исследовательский журнал, Выпуск 11 (125) 2022

Context Women's cross-country is a thriving sport at the National Collegiate Athletic Association (NCAA) level with over 1000 sponsored programs association-wide. Background Routine examinations of women's cross-country injuries are important for identifying emerging time trends in injury incidence and outcomes. Methods Exposure and injury data collected in the NCAA Injury Surveillance Program from 2014–2015 through 2018–2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. Results The overall injury rate was 3.96 per 1000 athlete-exposures. Most reported injuries were inflammatory conditions (33.6%), strains (17.7%), and fractures (9.1%). The most commonly reported injuries were medial tibial stress syndrome (10.0%) and lateral ligament complex tears (ankle sprains; 4.2%). Summary Findings of this study were not entirely consistent with existing evidence. Future studies are needed to examine the nature of inflammatory conditions and fractures in this population, as well as temporal patterns in commonly reported injuries.

Context: Medial tibial stress syndrome (MTSS) is an overuse injury studied in endurance (ED) runners with minimal data on sprint (SP) athletes. Incorporating patient-reported outcome measures (PROMs) into clinical practice with running athletes may provide an objective way to track and treat MTSS. Purpose: To investigate PROMs as a means to monitor MTSS and general wellness in all running (i.e., ED and SP) track athletes during a competitive season. Results: The PROMs overall showed few MTSS symptoms and good global health (mean MTSS score: 0.35 ± 0.85, mean Global Health score: 33.6 ± 3.5). Sprinters reported significantly poorer MTSS scores and Global Health scores (0.544, 95% confidence interval, CI, [0.370, 1.050], p = .04]; 32.50, 95% CI [30.84, 34.16], p = .028) than ED runners (0.04, 95% CI [0.000, 0.041]; 35.5, 95% CI [33.29, 37.65]). There was a main deteriorating effect over time for the MTSS score (p = .047). Conclusions: Sprinters reported more symptoms than ED runners and need to be further researched as an independent population. The PROMs may be useful in tracking symptoms and modifying practices for individual track athletes.

Objective: To study the Peacekeeping Stress syndrome and see its relationship with various demographic variables (age, years of service and marital status). Study Design: Cross sectional study. Place and Duration of Study: Study was carried out on Pakistani Peacekeepers who were deployed in Democratic Republic of Congo in Jun 2019. Methodology: About 536 Pakistani male peacekeepers with mean age of 33 years, deployed in Democratic Republic of Congo were taken as study sample. By group testing method, all participants were assessed through Depression, Anxiety and Stress Scale (DASS-21), Urdu version and demographic form consisted of age, marital status, education, years of service and rank. Results: Results revealed that DASS-21 has good reliability (α=0.71) for the present sample and prevalence of depression, anxiety and stress among Pakistani peacekeepers was low (2.9%, 4% and 4% respectively). Further to it, there was significant negative correlation of depression and stress with the age and years of service whereas relationship of anxiety with these variables (age and years of service) was non-significant. There were significant mean differences between the married and unmarried peacekeepers on Anxiety and Stress and non-significant on depression. Conclusion: Present study provided useful information regarding the mental health of peacekeepers and highlighted the fact that Pakistani peacekeepers are resilient enough to handle the challenges of international environment.

The Yamalo-Nenets Autonomous Okrug (YNAO), located in the north of the Tyumen Region, is part of the Arctic zone of the Russian Federation. The severe climatic conditions impose a heavy strain on the human body, affect its functional systems and can lead to an early onset of health problems. Most researchers recognize the northern regions as an extreme habitat, where humans are exposed to a set of negative climatic factors, the proximity of the Arctic Ocean being of particular importance. All metabolic processes in the human body are closely linked with trace elements, and the elemental status of the population depends on the geochemical characteristics of the area of residence. It has been proven that the natural waters of the Tyumen Region are ultra-fresh with a low content of Ca and Mg, which may be a predictor of the development of many, primarily cardiovascular, diseases. Adaptive changes are manifested in “northern” metabolism – a new level of functioning of the bodyʼs key systems with hormonal and metabolic rearrangements – both in the indigenous population and in newcomers. What distinguishes the human body in the North is the formation of polar stress syndrome, which determines rapid restructuring of physiological parameters. This syndrome serves as the leading mechanism of the onset and development of diseases in the North. The negative effects of climatic and geographical factors on the human body act as a resolving factor that potentiates the clinical manifestations of pathological reactions. This is confirmed by the consistently higher rates of incidence and overall morbidity in the regions of the Far North, including YNAO, over many years compared with the figures for the Russian Federation. The basic component of polar stress syndrome is oxidative stress, which develops when the antioxidant stores are depleted during the bodyʼs adaptation to the extreme environmental conditions. It is oxidative stress that underlies the pathogenesis of more than 200 diseases, primarily cardiovascular, developing early and progressing rapidly.For citation: Korchin V.I., Korchina T.Ya., Ternikova E.M., Bikbulatova L.N., Lapenko V.V. Influence of Climatic and Geographical Factors of the Yamalo-Nenets Autonomous Okrug on the Health of Its Population (Review). Journal of Medical and Biological Research, 2021, vol. 9, no. 1, pp. 77–88. DOI: 10.37482/2687-1491-Z046

Chronic exertional compartment syndrome (CECS) is one of the wide range of causes of exercise-related leg pain in athletes. It is defined as a transient increase in compartment pressures during activity, which causes pain, because of the inability of the fascial compartments to accommodate and is usually relieved by cessation of exercise. Exercise-induced leg pain in the athletic population is a common complaint, with reports of up to 15% of all runners arriving to initial evaluation with this presentation. Often, this lower-extremity exertional pain is grouped into the common term of "shin splints" by athletes, which is a nondiagnostic term that implies no specific pathology. It may, however, encompass much of the differential for CECS, including medial tibial stress syndrome, muscle strain, and stress fracture. Improving diagnostic techniques, as well as treatments, will continue to help athletes and patients with leg pain in the future.

The distal radial physis is a common site for injury in gymnasts because of the significant amount of load applied during upper extremity weight-bearing. Wrist pain has been reported in up to 88% of gymnasts. The long-term consequences of overuse wrist injuries, such as distal radial physeal arrest, include degenerative conditions that often cause pain and functional limitations. In the more immediate stage of many overuse injuries, early diagnosis can promote quicker care and recovery and thus faster return to play. Less time lost to injury can be very important in maintaining an athlete's quality of life.

OBJECTIVES The purpose of this study was to compare plantar flexor force due to different foot strike patterns during running in barefoot and shod condition with and without medial tibial stress syndrome (MTSS).METHODS Fifteen collegiate soccer players who volunteered to participate were divided into MTSS group and controls. Participants’ running at 3.3 m/s with and without shoes were recorded with a 12-camera system at a sampling frequency of 250 Hz. Each subject completed different foot strike patterns of running as the forefoot strike pattern (FFS) and rearfoot strike pattern (RFS) were collected. Plantar flexor forces were investigated by software for interactive musculoskeletal modeling.RESULTS Normalized plantar flexor forces in barefoot running with the FFS pattern had greater soleus and peroneus brevis muscle forces in the MTSS group than in controls during the first half of stance, although there were no statistically significant differences for other plantar flexor muscle forces between groups and shod running. In plantar flexor forces due to foot strike pattern, the FFS pattern showed higher plantar flexor forces than the RFS pattern.CONCLUSIONS The results of musculoskeletal modeling suggest that subjects with MTSS have greater muscle forces of the plantar flexor during running, especially barefoot running with the FFS pattern. It also suggests increased forces in some plantar flexors generated great traction force by repetitively landing on connective tissues in the deep crural fascia causing inflammation at the posteromedial site of the tibia in MTSS.

Medial tibial stress syndrome (MTSS) is characterized by the presence of diffuse pain in the posteromedial portion of the medial border of the tibia. Current evidence from the literature has not established an effective treatment and has not been able to demonstrate effectiveness of numerous modalities commonly used to treat MTSS pain.This report describes an 18-year-old male collegiate soccer player who presented with pain along the distal medial tibial border bilaterally consistent with the diagnosis of medial tibial stress syndrome (MTSS). Treatment focused on correcting clinical and kinesiological findings likely contributing to the patient's condition including fascial mobilization, interferential currents (IFC), strengthening and stretching exercises. After 10 sessions over 10 weeks the patient was able to return to training and competition without pain.

PURPOSE: The purpose of this study was to confirm the kinematic characteristics of overuse leg injuries during gait through a systematic review.METHODS: Electronic databases from 1960 to 2018 were used to search studies. Physiotherapy Evidence Database Scale was used for quality of studies. Effect sizes (ES) of between-groups and its 95% confidence intervals were calculated.RESULTS: Seven studies were selected for review. The average Physiotherapy Evidence Database Scale score was 4.3 of 10-point scale. The ES for maximum rearfoot eversion from 5 studies ranged from -0.34 to 0.67 with 3 of 5 studies statistically significant. The ES of eversion excursion from 4 studies ranged from -0.24 to 2.37 and 3 of 4 studies showed statistically significant. The ES of maximum eversion velocity ranged from 0.29 to 0.38 from all of 2 studies. With abduction, the ES for abduction excursion ranged from -0.04 to 0.35, and 2 of 3 studies revealed statistically significant. The ES of maximum abduction velocity showed statistically significant with the ES of 0.23 and 0.61. However, maximum abduction from 3 studies showed non-significant with ES ranges from 0.00 to 0.62.CONCLUSIONS: The rearfoot motion (eversion) associates with overuse leg injuries during gait more than tibial motion (internal rotation).

Job Burnout is different work-related stress syndrome portrayed by three-dimension Emotional Exhaustion, Professional inefficacy, and Cynicism. Earlier burnout research has centered on the human service professions such as nursing and teaching, where they are assumed to be the most exposed to experience burnout. However, Burnout is not confined only to social service professions but spreads to other working professions such as banking employees and managers. This paper traces the evolution of Job Burnout. It addresses the factors and the Outgrowths of job burnout and the intervention strategies to decrease or overcome it. It also presents the primary measurement of Job Burnout, the Maslach Burnout Inventory (MBI), the Burnout Measure (BM), and the Oldenburg Burnout Inventory (OLBI). Lastly, the paper closes with a brief conclusion.Keywords: Stress, Job Burnout, Emotional Exhaustion, Cynicism, Maslach Burnout Inventory.JEL Classifications: D23, J24, M10, M54DOI: https://doi.org/10.32479/irmm.9398

This study aimed to reveal differences in exposure to coronavirus disease (COVID-19) during the first (W1) and the second (W2) waves of the pandemic in six countries among university students and to show the prevalence and associations between exposure to COVID-19 and coronavirus-related post-traumatic stress syndrome (PTSD) risk during W2. The repeated cross-sectional study was conducted among university students from Germany, Poland, Russia, Slovenia, Turkey, and Ukraine (W1: n = 1684; W2: n = 1741). Eight items measured exposure to COVID-19 (regarding COVID-19 symptoms, testing, hospitalizing quarantine, infected relatives, death of relatives, job loss, and worsening economic status due to the COVID-19 pandemic). Coronavirus-related PTSD risk was evaluated by PCL-S. The exposure to COVID-19 symptoms was higher during W2 than W1 among students from all countries, except Germany, where, in contrast, the increase in testing was the strongest. Students from Poland, Turkey, and the total sample were more frequently hospitalized for COVID-19 in W2. In these countries, and Ukraine, students were more often in quarantine. In all countries, participants were more exposed to infected friends/relatives and the loss of a family member due to COVID-19 in W2 than W1. The increase in job loss due to COVID-19 was only noted in Ukraine. Economic status during W2 only worsened in Poland and improved in Russia. This was due to the significant wave of restrictions in Russia and more stringent restrictions in Poland. The prevalence of coronavirus-related PTSD risk at three cutoff scores (25, 44, and 50) was 78.20%, 32.70%, and 23.10%, respectively. The prediction models for different severity of PTSD risk differed. Female gender, a prior diagnosis of depression, a loss of friends/relatives, job loss, and worsening economic status due to the COVID-19 were positively associated with high and very high coronavirus-related PTSD risk, while female gender, a prior PTSD diagnosis, experiencing COVID-19 symptoms, testing for COVID-19, having infected friends/relatives and worsening economic status were associated with moderate risk.

Background Medial tibial stress syndrome (MTSS) is a common overuse injury that lacks effective evidence-based treatment options. Reduced leg girth has been associated with MTSS development because it is hypothesised to impair the ability of the leg to modulate tibial loading generated during foot–ground contact. Measuring total leg girth, however, does not provide specific information about the structural composition or functional capacity of individual leg muscles. Consequently, uncertainty remains as to which specific muscles are compromised and contribute to MTSS development. Therefore, this paper aimed to systematically review the body of literature pertaining to how the structure and function of the leg muscles are thought to be associated with MTSS injury. Methods The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Medline, PubMed, SCOPUS, SPORTDiscus with Full-texts and Web of Science were searched until March 2021 to identify articles in which lower limb muscle structural or functional variables associated with MTSS injury were investigated. Results Seventeen studies, which were predominately case–control in design and captured data from 332 individuals with MTSS symptoms and 694 control participants, were deemed appropriate for review. The average Downs and Black Quality Assessment score was 71.7 ± 16.4%, with these articles focussing on leg girth, tendon abnormalities, muscle strength and endurance, shear modulus and neuromuscular control. Of the risk factors assessed in the 17 studies, decreased lean leg girth and higher peak soleus muscle activity during propulsion were most strongly correlated with MTSS development. Individuals with MTSS also displayed deficits in ankle plantar flexor endurance, greater isokinetic concentric eversion strength, increased muscle shear modulus and altered neuromuscular recruitment strategies compared to asymptomatic controls. Conclusions Future prospective studies are required to confirm whether decreased lean leg girth and higher peak soleus muscle activity during propulsion are associated with MTSS development and to elucidate whether these structural and functional differences in the leg muscles between MTSS symptomatic and asymptomatic controls are a cause or effect of MTSS.

Purpose: The purpose of this study is to compare some anatomical features and ankle isokinetic muscle strength of adolescent athletes with medial tibial stress syndrome (MTSS) and healthy control group and to examine the adequacy of ‘tibial facial traction theory in the development of MTSS.Materials and Methods: Adolescent athletes who had been diagnosed with MTSS during the season and healthy control group participants were included in the study. Demographic data and training details of the athletes were recorded. The MTSS score was used to determine the severity of the injury. The navicular drop test, lower extremity length measurement, and isokinetic muscle strength measurement were performed. Results: The complaint duration of the patients with MTSS (n:21) was 1.8 ± 1.8 months and the MTSS score was 3.9 ± 2.2. The control group (n:12) and the athletes diagnosed with MTSS had similar demographic characteristics and training details. There was no difference between the groups in terms of navicular drop and lower extremity length. There was no ‘lower extremity difference’ for right and left extremities. According to the results of the isokinetic muscle strength test in plantarflexion and dorsiflexion direction, there was no difference between the groups in terms of muscle strength at both low and high angular speeds. Conclusion: ‘The tibial traction theory’ does not sufficiently explain the pathogenesis of MTSS. Studies which evaluate isokinetic muscle strength and perform real-time dynamic analysis on the track are required to make recommendations for ideal protection and rehabilitation in cases of MTSS., Amaç: Bu çalışmanın amacı, medial tibial stres sendromu (MTSS) gelişen adolesan sporcular ile sağlıklı kontrol grubunun bazı anatomik özelliklerini ve ayak bileği izokinetik kas kuvvetini karşılaştırmaktır. MTSS gelişiminde ‘Tibial fasial-traksiyon teorisi’nin yeterliliğini incelemektir. Gereç ve Yöntem: Bir sezonluk süre içerisinde MTSS tanısı alan adolesan sporcular ve sağlıklı kontrol grubu araştırmaya alındı. Sporculara ait demografik veriler ve antrenman detayları kaydedildi. Hastalık şiddetini belirlemek için MTSS şiddet skoru kullanıldı. Sporculara naviküler çökme testi, alt ekstremite uzunluk ölçümü ve izokinetik kas kuvvet ölçümü yapıldı. Bulgular: MTSS tanısı alan (n:21) hastaların şikayet süresi 1.8 ± 1.8 ay, MTSS şiddet skoru 3.9 ± 2.2 puandı. Kontrol grubu (n:12) ile MTSS tanısı alan sporcuların demografik verileri ve antrenman detayları benzerdi. Naviküler çökme miktarı ve alt ekstremite uzunluğu gruplar arasında fark oluşturmadı. Sağ ve sol ekstremite için ‘alt ekstremite uzunluk farkı’ yoktu. Plantarfleksiyon ve dorsifleksiyon yönündeki izokinetik kas kuvvet testinin sonuçlarına göre hem düşük açısal hızda hem de yüksek açısal hızda gruplar arasında kas kuvveti açısından fark belirlenmedi. Sonuç: ‘Tibial fasial-traksiyon teorisi’ MTSS patogenezini açıklamakta yetersizdir. MTSS vakalarında, ideal düzeyde koruma ve rehabilitasyon önerilerde bulunmak için izokinetik kas kuvvetinin değerlendirildiği ve koşu alanında gerçek zamanlı dinamik analizlerin yapıldığı çalışmalara ihtiyaç vardır.

Objectives The purpose of the current study was to compare injury and running history among current and former runners who consider themselves either injured or uninjured. Design Cross-sectional survey. Setting Online survey, available to any individuals over the age of 18 who currently run (runners) or who once ran regularly but are no longer running (former runners). Participants 312 participants (age 38 ± 12 years, 219 males, 89 females, 4 did not disclose) completed the survey. Main outcome measures This study assessed injury incidence, consequences of injury such as time off, and reported injury diagnoses and treatments. Chi-square and frequency analyses were calculated to describe running status, injury counts, and response to injury. Results Most participants (80%) reported 1 + running injury. 775 total injuries were reported. The four most common injuries were iliotibial band syndrome (34%), plantar fasciitis (30%), strained thigh/hip muscle (25%), and medial tibial stress syndrome (22%). About 40% of participants continued to run with these injuries. Conclusions Injury frequencies (80%) agreed with those reported in the literature. The results of this study also support the notion that running injuries exist on a continuum of severity and that the individual response to injury is complex and determined by various factors.

To outline current evidence on the use of ESWT for the treatment of lower limb sports injuries. There is growing evidence to support the use of extracorporeal shockwave therapy (ESWT) for a variety of musculoskeletal conditions in the general population. However, research focused on the use of ESWT specifically for lower extremity injuries in the athletic population is more limited. Athletes represent a subgroup of patients that may benefit from ESWT. Compared with injections or surgical interventions, athletes undergoing ESWT often are able to continue sports participation with fewer limitations in activity during treatment. The review identifies considerable variability in study design and treatment protocols that affect the overall quality of evidence. Sports participation was allowed in most studies. One case of plantar fascia tear was identified during ESWT treatment; this injury was self-limited. Most studies report pain-relieving and/or functional benefit with the use of ESWT for common lower extremity tendinopathies, plantar fasciitis, and medial tibial stress syndrome. This review highlights the need for further investigations on optimal methods of ESWT use in athletes given the high prevalence of lower extremity injuries and favorable safety profile for treatment.

Medial Tibial Stress Syndrome MTSS is frequently diagnosed as a severe clinical issue which occurs due to the cycle loadings (fatigue failure). Since the mechanical properties of the bones are random variables, therefore, there is a need for a probabilistic approach to rationally assess the reliability level of the fatigue failure of the tibia. The main contribution of this paper is to introduce a novel limit state function to determine the fatigue damage state and the reliability index of MTSS based on the different loading and aging conditions. In this study, the tibias of the several people at the different ages are subjected to the fatigue loadings. The load carrying capacities of the considered specimen are determined based on the reliability analysis. Indeed, several 3D finite element analyses are performed to find out the damage states of the tibias. Accordingly, the reliability-based stress analysis is accomplished to localize the most vulnerable zone of the bone. As it was expected, the higher loading cycles associated with the elder bones is related to the lowest fatigue reliability level. Finally, the target reliability level of MTSS is proposed to deliberate the safe level of the loading condition on the tibia in terms of the walking distance.

Objective: To determine the levels of some biomechanical factors and vitamin D in athletes diagnosed with medial tibial stress syndrome (MTSS) and in healthy athletes. Materials and Methods: Athletes diagnosed with MTSS and healthy athletes were included in the study between April 2017 and March 2018. Physical characteristics, lower extremity length, results of the navicular drop test, shoe sizes, MTSS scores, and serum levels of 25-hydroxy vitamin D, calcium and phosphorus were examined Results: Of the 33 patients (25 men and eight women), 26 were diagnosed with MTSS for the first time. The mean duration of symptoms was 2.0±2.5 months. MTSS score was 4.7±2.1 points. No significant difference was observed between the patient and control groups (n=25) in the age, height, duration of training, and the number of yearly and weekly training sessions (p˃0.05). Athletes diagnosed with MTSS had significantly higher body weight and body mass index (p˂0.05). Results revealed a significant difference in the lower extremity length between the group with MTSS (90.2±5.3 cm) and the control group (87.8±4.4 cm, p=0.02). Independent and paired group analysis displayed no right-left side difference (p˃0.05). The levels of vitamin D were not different between the two groups (MTSS group; 21.9±9.9 ng/ml, control group; 22.8±9.0 ng/ml, p˃0.05). Conclusion: Some biomechanical factors may have greater impact than the levels of vitamin D on the development of MTSS. Although vitamin D levels of athletes diagnosed with MTSS did not differ from those of healthy athletes, they were below the normal range in both groups. Therefore, all athletes should maintain adequate vitamin D levels.

RESUMO Objetivos: Analisar a tendência temporal de mortalidade por suicídio entre adolescentes no Brasil de 2000 a 2015. Métodos: Os dados foram coletados do Sistema de Informações sobre Mortalidade (SIM) e do Instituto Brasileiro de Geografia e Estatística (IBGE). As variáveis do estudo foram sexo, ano e causa básica de morte. O estudo incluiu mortes por Lesões Autoprovocadas Intencionalmente, X60-X84 – de acordo com a 10ᵃ Revisão da Classificação Internacional de Doenças (CID-10), de adolescentes de 10 a 19 anos. A técnica estatística utilizada foi a de regressão linear simples, e os resultados foram considerados estatisticamente significativos quando p ≤ 5%. Resultados: Entre 2000 e 2015, foram observados 11.947 óbitos por suicídio em adolescentes no Brasil, e 67% deles foram no sexo masculino, o que corresponde a uma relação de 2,06:1 entre o sexo. Houve crescimento estatisticamente significativo da mortalidade por suicídio de adolescentes no Brasil (p = 0,016), a qual passou de 1,71 por 100.000 habitantes em 2000 para 2,51 em 2015, um crescimento de 47%. Essa expansão ocorreu em função do incremento nos suicídios de adolescentes do sexo masculino (p = 0,001), especificamente no norte (p < 0,001) e nordeste (p < 0,001) do Brasil. Em relação ao sexo feminino, houve tendência de diminuição da mortalidade por suicídio na região Centro-Oeste (p = 0,039), mas, quando se trata do Brasil como um todo, houve oscilação da mortalidade por suicídio. Conclusões: Houve crescimento significativo da mortalidade por suicídio entre os adolescentes no Brasil, particularmente na população masculina.

OBJECTIVES We aimed to explore, which muscle stiffness changes may be related to medial tibial stress syndrome (MTSS) and the correlation between the medial tibial periosteal thickness and lower leg muscle stiffness. METHODS This study included 63 subjects distributed into 3 groups: the symptomless group, the MTSS group, and the control group. The lower leg muscle stiffness of the tibialis anterior (TA), extensor digitorum longus (EDL), peroneus longus (PL), soleus (SOL), lateral gastrocnemius (LG), medial gastrocnemius (MG), tibialis posterior (TP), and flexor digitorum longus (FDL) in the 3 groups was obtained by two-dimensional shear wave elastography. Differences in the muscle stiffness and medial tibial periosteal thickness in the 3 groups were determined by one-way analysis of variance (ANOVA) and least significant difference tests. The relationships between the periosteal thickness and the muscle stiffness were assessed using Pearson correlations. RESULTS The shear wave velocity (SWV) of all lower leg muscles except the EDL was higher in the symptomless and MTSS groups than in the control group (TA, P = .001; PL, P = .006; SOL, P

Achilles tendinopathy (AT) and medial tibial stress syndrome (MTSS) are two of the most common running-related injuries. In a previous study investigating running biomechanics before and after a six-week transition to maximal running shoes, two runners dropped out of this study due to Achilles pain and shin pain, respectively. The purpose of this case series was to investigate running biomechanics in those two runners, identifying potential causes for injury in relation to maximal shoe use. Running biomechanics were collected in a laboratory setting for these two runners wearing both a maximal running shoe and traditional running shoe before the six-week transition using an 8-camera motion capture system and two embedded force plates. Both runners displayed prolonged eversion in the maximal shoe, which has been previously cited as a potential risk factor for developing Achilles tendinopathy and medial tibial stress syndrome. Relatively high loading rates and impact forces were also observed in the runner with shin pain in the maximal shoe, which may have contributed to their pain. More prospective research on injury rates in individuals running in maximal shoes is needed.

The COVID-19 pandemic and quarantine measures have sparked debate regarding their traumatic nature. This cross-sectional study reports the prevalence rate of probable post-traumatic stress syndrome (PTSD) and associated factors among French university students. A total of 22,883 students completed the online questionnaire. The prevalence rate of probable PTSD, assessed using the PTSD Checklist for DSM-5, was 19.5% [19.0–20.0]. Female (1.32 [1.21–1.45]) or non-binary gender (1.76 [1.35–2.31]), exposure to a non-COVID-19-related traumatic event (3.37 [3.08–3.67]), having lived through quarantine alone (1.22 [1.09–1.37]), poor quality of social ties (2.38 [2.15–2.62]), loss of income (1.20 [1.09–1.31]), poor quality housing (1.90 [1.59–2.26]), low-quality of the information received (1.50 [1.35–1.66]) and a high level of exposure to COVID-19 (from 1.38 [1.24–1.54] to 10.82 [2.33–76.57] depending on the score) were associated with PTSD. Quarantine was considered potentially traumatic by 78.8% of the students with probable PTSD. These findings suggest the pandemic context and lockdown measures could have post-traumatic consequences, stimulating debate on the nosography of PTSD.

To examine the associations between chronic physical conditions and suicidal ideation and to assess whether associations are mediated by pain, anxiety, depression, post-traumatic stress syndrome (PTSS), and functional disability.The study sample includes 1533 older adults aged 65+ recruited in primary care clinics between 2011-2013 and participating in Quebec's Health Survey on Services "PTSS, depression, and functional disability mediate the association between various chronic conditions and suicidal ideation. Although pain and anxiety are associated with many physical disorders, they did not mediate the association with suicidal ideation.Chronic physical disorders are associated with suicidal ideation, either directly or indirectly through PTSS, depression, and functional disability. The findings underscore the importance of early identification and management of older patients with specific chronic disorders in primary care as they may be most at risk for suicidal ideation.

Ultra-endurance running (UER) has seen an important increase in participation over the last few decades. Long hours of UER can lead to excessive stress on the body, resulting in musculoskeletal injuries (MSKI). UER is not a uniform sport and events can differ considerably in distance (over 42.195 km), time (e.g., events over 6 h) and multi-day or multi-stage events on various surfaces (e.g., track, on-road, off-road). The aims of this scoping review were therefore: (1) to examine the current evidence of MSKI, providing a synthesis of the most common MSKI by anatomical region and specific diagnosis; (2) categorize MSKI by type of UER activity (competition: time-limited; multi-stage; continuous UER events and training); (3) describe knowledge gaps in the literature and provide advice on potential further research. Our electronic literature search (PubMed, SPORTDiscus, Web of Science) identified a total of 13 studies (9 in competition, and 4 in training). Anatomical site, diagnosis and rate of injuries differ between competition and training as well as between different UER types. MSKI are observed in 18% of multi-stage events (0.7–1.8 injuries/runner and 7.2 injuries/1000 h). Most MSKI involve the lower leg (35.0%), ankle (16.8%), knee (13.1%) and foot (12.6%), with main diagnosis of medial tibial stress syndrome (30.1%) and patella femoral pain syndrome (PFPS; 7.2%). Single, continuous UER events differ between a 1005 km road race with almost all of the injuries due to overuse, with the main anatomical site of the knee (31%), ankle (28%) and lower leg (14%) and main diagnosis of PFPS (15.6%), compared to a 65 km trail race, with 32.8% of MSKI, mainly on the foot [plantar fasciitis (28.6%)], ankle [sprain (28.6%)] and knee. Timed-UER events (injury rate of 2.1 injuries/athlete) observed most injuries on the ankle (36%) and knee (19%), with the main diagnosis of tendinitis of the foot dorsiflexors (30%). Injuries during training most commonly affect, the back (42%), and knee (40%) and bone stress injuries (22%). Main diagnoses include ankle sprain (18%), iliotibial band injury (16%) and Achilles tendinopathy (11%). Future considerations include examining MSKI in different UER events, environments and surfaces, and on larger study populations. Establishing risk factors, examining sex differences and using a standard reporting system of MSKI in UER are also important.

Purpose of Review To review the current state of knowledge on the newly proposed COVID Stress Syndrome. Recent Findings The syndrome consists of five inter-correlated elements: (a) fear of SARSCoV2 infection and fear of coming into contact with objects or surfaces contaminated with the coronavirus; (b) fear of socio-economic impacts of the pandemic; (c) fear of foreigners for fear that they are infected; (d) pandemic-related compulsive checking and reassurance-seeking; and (e) pandemic-related traumatic stress symptoms. A severe form of the syndrome, characterized by clinically significant distress and impairment in functioning, is the COVID Stress Disorder, which is regarded as a pandemic-related adjustment disorder. Several treatment options exist but further research is needed. Summary Research during the COVID-19 pandemic has identified a pandemic-related adjustment disorder. The diagnosis of COVID Stress Syndrome should be made only after ruling out other disorders that could potentially account for the pattern of symptoms, such as obsessive-compulsive disorder and posttraumatic stress disorder. Further studies are needed to investigate the long-term course of the syndrome. Similar adjustment disorders may arise in future pandemics. Accordingly, understanding the COVID Stress Syndrome may facilitate efforts to understand and treat psychopathology in future pandemics.

Hamstring and calf injuries are common in athletes and may cause significant functional impairment. Etiologies range from acute strains to chronic overuse conditions. Accurate determination of injury location, severity, and mechanism is important for proper triage, treatment planning, and return to play discussions. This chapter describes the most common hamstring and calf injuries encountered in clinical practice: acute hamstring strains, proximal hamstring tendinopathy, distal hamstring injuries, gastrocnemius and soleus strains, medial tibial stress syndrome, chronic exertional compartment syndrome, and plantaris tendon ruptures. Specific injury characteristics, diagnostic features, and treatment recommendations are described for each condition. Most of these injuries can be managed effectively with appropriately targeted nonoperative strategies.

BACKGROUND Sharp injuries are common reasons for the transmission of blood-borne diseases in acute care settings. Fear of sharp injuries and their consequences can expose nurses to high levels of stress (sharp injuries stress). AIM To examine the occurrence of sharp injuries and to assess their relationship with stress among nurses working in acute care settings. DESIGN This was a cross-sectional study. METHODS A total of 150 nurses working in 10 acute care settings in two selected hospitals in Alexandria, Egypt, were selected as the population of this study. Data on the occurrence of sharp injuries were collected using a sharp injuries circumstances questionnaire (including questions regarding number, instrument and reasons/procedures that caused sharp injuries, etc.), and two scales were used to measure sharp injuries stress (the Impact of Event Scale-Revised and the Post-Traumatic Stress Syndrome Questions Inventory). RESULTS More than 13% of nurses experienced sharp injuries, and 25% of injuries were caused by contaminated instruments. Sharp injuries stress scores were high in nurses, with 65% of nurses experiencing sharp injuries and 30.8% of nurses who did not experience sharp injuries having high Impact of Event Scale-Revised scores. In addition, 45% of nurses who experienced sharp injuries and 15.39% of nurses who did not experience sharp injuries had high Post-Traumatic Stress Syndrome Questions Inventory (PTSSQI) scores. There was a significant relationship between the occurrence of sharp injuries and stress scales at P

This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.