CRUSH SYNDROME IN EARTHQUAKES - STAY AND PLAY OR LOAD AND GO?

Earthquakes are unpredictable natural disasters accompanied by material damage and many victims. In the case of a person remaining trapped under the collapsed material, the development of crush syndrome can occur. Crush syndrome is the result of traumatic rhabdomyolysis and is present in 2%-15% of all injured persons in an earthquake. It is not easy to recognize, and proper treatment is challenging. Persons who have a clear crush injury and/or have been immobilized for more than four hours should be considered potential victims of crush syndrome. Therefore, knowledge about crush syndrome must be comprehensive and accessible to all parties involved. In this paper, the management of crush syndrome victims, which includes the principles of triage, and medical and logistic principles as well, is presented. Triage principles are presented at the level of triage priorities, places, and diagnoses. Medical principles, crucial for crush syndrome, are presented regarding the duration of compression and time before or after extraction of the patient. Logistic principles provide an overview of the priorities and modes of transport in relation to distance of health institutions, and the importance of management and education associated with crush syndrome. Each country with recognized disasters (natural or man-made) in which crush-related victims are expected, will benefit if the knowledge about triage, medical and logistic principles for crush syndrome is incorporated in their educational programs and regularly updated.

Overtraining Syndrome as a Risk Factor for Bone Stress Injuries among Paralympic Athletes.

Background and Objectives: In this review, we have explored the relationship between overtraining syndrome (OTS) and bone stress injuries among paralympic athletes. OTS is a complex condition that arises from an imbalance between training volume, nutrition, and recovery time, leading to significant negative effects on paralympic athlete's performance and overall well-being. On the other hand, bone stress injuries occur when abnormal and repetitive loading is applied to normal bone, resulting in microdamage accumulation and potential. The prevalence of overtraining syndrome and bone stress injuries among athletes highlights the need for a better understanding of their relationship and implications for prevention and management strategies. Methods: A literature review from the PubMed, Web of Science, and Google Scholar databases including the MeSH keywords "overtraining syndrome", "bone", and "paralympic athletes". Results: Studies have consistently shown that athletes engaged in endurance sports are particularly susceptible to overtraining syndrome. The multifactorial nature of this condition involves not only physical factors, but also psychological and environmental determinants. In addition, the diagnosis and management of OTS and bone stress injuries present challenges in clinical practice. Conclusions: Currently, there are no definitive biochemical markers for overtraining syndrome. The diagnosis is based on a combination of subjective measures such as questionnaires, symptoms checklists, and objective biomarkers, including hormone levels, inflammatory markers, and imaging studies. However, these diagnostic approaches have limitations regarding their specificity and sensitivity.

Epigenetic Imprint of "Compassionate Society" Triggered by Vulnerability and Mental Illnesses.

Epigenetics investigates connection between our genes and our environment. It has been hypothesized that certain conditions we experience can influence our gene expression and can probably be passed onto our children, transgenerational transfer of trauma being one of them. We postulate that the notion of compassion has also been passed on from one generation to another. Our ancestors discovered that groups have a higher chance of survival than individuals. Thus, psychological traits that help form social cohesion, like compassion, are proven beneficial and passed onto the next generation. However, our perception of compassion has changed through time. In the beginning, it was expressed as a feeling of sympathy for the vulnerable, for example the elderly, the sick, pregnant women and children. These groups were innately perceived as deserving compassion. As our social awareness grew, so did the list of vulnerable groups, including members of different races, sexual or gender orientations, etc. Over time, a shift in the way we feel compassion has occurred. Nowadays, it almost seems like only those belonging to a vulnerable group are justified to feel suffering or oppression. At the same time, the suffering of those who do not belong to these exclusive vulnerable groups is marginalized. Mental illnesses like anxiety or depression are trivialized if the person in question is perceived as being privileged (in any sense), while at the same time, they are seen as warning signs if the person suffering is vulnerable. If one truly needs attention, help, or both, the easiest way is to declare oneself vulnerable. If this trend continues, we postulate that a lack of compassion in our modern society will have an impact on future societies as well. Through transgenerational epigenetic inheritance, this can create future societies whose sense of compassion will be shaped only by the definition/perception of those who are currently perceived as vulnerable.