BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization r...BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.展开更多
Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), mu...Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), multifactorial diseases due to obesogenic environment (availability of convenience food, media influence, etc.), psycho-social factors (social support systems, cultural/environmental influence, etc.) and genetic variants. Other causes are a subgroup of etiological factors (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome). Obesity is measured clinically by several common tools apart from body mass index (BMI), such as waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio, and neck circumference. WC and WHR are common tools for measuring central obesity while BMI measures generalized obesity. Aims: The goal of this study is to assess the prevalence of obesity amongst health workers of David Umahi Federal University Teaching Hospital, Uburu, Ebonyi state, Southeast Nigeria and to note the prevailing factors. A reliable estimate of the prevalence of obesity among health workers will contribute to the statistics needed to sway policymakers in the country to take urgent and substantial action on the increasing prevalence of obesity, especially in the healthcare industry. Methodology: The study was carried out between May 2024 and June 2024 at the David Umahi Federal University Teaching Hospital situated in Uburu, Ohaozara Local government area of Ebonyi state, Southeast Nigeria. The questionnaire was designed using the Finnish diabetic risk score (FINDRISC). It contained basic comprehending questions on age, gender, exposure to high blood pressure medication, and anthropometric measurement amongst others. Weight was taken with a portable weighing scale and height, with a stadiometer. Both were taken with shoes and headgear removed. The BMI was calculated using the weight (kg) divided by the square of the height (m2). Result: Generally, the prevalence of obesity (>30 kg/m2) in this study was low 17.6% (38), Overweight (BMI 25 - 30), 38.9%, (84) healthy Weight, (BMI 18.5 - 24.9), 43.5% (94). The study revealed that a family history of diabetes was significantly related to higher BMI, with participants more likely to be overweight or obese (p = 0.00030). Similarly, participants with a personal history of diabetes were predominantly in the obese category (p = 0.00038). Waist circumference also showed a strong association with BMI, as larger waist measurements were more common among obese individuals (p = 9.2 × 10−8). In contrast, the analysis found no significant relationships between BMI and age, gender, high blood pressure, or exercise habits. Conclusion: The socio-demographic determinants of obesity in this study were gender, age < 45 years and exposure to exercise. These determinants should form the areas of focus for interventions such as health education and the design of work environments as environments designed to promote physical activities while working will reduce the prevalence of obesity in tertiary institutions.展开更多
Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within...Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.展开更多
Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for m...Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.展开更多
Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuarie...Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuaries for treatment and recovery, making the quality of paramount importance. This study investigates the impact of traffic-related emissions on indoor air quality within a Level 5 Hospital outpatient ward. Measurements were taken over five consecutive days, revealing that while CO2 levels generally remained within safe limits, there were instances where concentrations exceeded 3000 ppm, categorizing them as “Hazardous.” Notably, particulate matter (PM2.5 and PM10) levels fluctuated significantly, with peak concentrations observed during working hours correlating with increased vehicle activity. The data indicated that PM2.5 levels reached as high as 75 µg/m3, with 91.68% of recorded values exceeding the World Health Organization’s (WHO) and Environmental Protection Agency 24-hour mean threshold of 25 µg/m3. Similarly, PM10 concentrations peaked at 120 µg/m3, with 61.19% of values surpassing the WHO threshold of 50 µg/m3, both of which pose serious health risks, particularly to vulnerable populations such as pregnant women, infants, and the elderly. Additionally, the study highlighted the critical role of wind direction in pollutant dispersion, with specific patterns contributing to elevated indoor concentrations. These findings underscore the urgent need for targeted interventions and proactive air quality management strategies in healthcare facilities, including the strategic design of hospital wards away from primary emission sources and the promotion of electric vehicle use to mitigate traffic-related emissions.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading pr...Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.展开更多
Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due...Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.展开更多
Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: ...Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a cross-sectional, descriptive study with data collection over a period of 10 years;The data collection was retrospective over nine years from January 1, 2013 to December 31, 2021 and prospective over one year from January 1, 2022 to December 31, 2022. This study focused on all patients whose death was noted on arrival during pregnancy, labor or in the postpartum period in the Gynecology-Obstetrics Department of Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of statistical data were carried out using SPSS 20.0 software. Results: During the study period, we recorded 93 cases of death noted on arrival out of a total of 606 maternal deaths, i.e., a frequency of 15.34%. The average age was 27 years with the extremes of 20 years and 34 years. They came mainly from rural areas at 74%, were married at 82%, uneducated at 51.6%, housewives at 87.1%. The profession of the spouses is worker at 37.6%. In our sample, evacuated patients were the most represented with 75.3%. Postpartum hemorrhage was the most frequent reason for admission with 22.6%. The deceased patients had no medical history at 86%. In our series, 59.5% of the deceased patients had not had antenatal consultations (CPN). Patients who died on arrival and who had given birth at home were the most represented with 54.8%. Deaths from immediate postpartum hemorrhage complicated by shock were the most frequent with 25.8% followed by severe anemia 8.6%. Deaths were mainly due to direct obstetric causes at 76.3%. In these deaths observed on arrival, the 2nd delay was identified at 48.4%. Conclusion: Maternal deaths observed on arrival remain frequent in the Kayes region. The main causes are immediate postpartum hemorrhage and anemia, which are almost all preventable causes of maternal death following the 1st and 2nd delay.展开更多
BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This resear...BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This research article explores the relationship between these two conditions.AIM To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF,focusing on inpatient mortality,septic shock,length of stay,and hospital costs.METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample.Cases were identified as pa-tients with both NF and cirrhosis,while controls were non-cirrhotic.The study focused on inpatient mortality as the primary outcome,with secondary outcomes including surgical limb amputation,mechanical ventilation rates,septic shock,length of stay,and hospital costs.RESULTS A total of 14920 patients were admitted to the hospital for management of NF,of which 2.11%had liver cirrhosis.Inpatient mortality was higher in cirrhotic patients(9.5%vs 3%;adjusted odds ratio=3.78;P value=0.02).Cirrhotic patients also had higher rates of septic shock(10.5%vs 4.9%,P value<0.01).Length of hospital stay,total charges,and rates of mechanical ventilation were not statistically different between groups.CONCLUSION Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF.Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.展开更多
BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vul...BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vulnerable populations such as people who use illicit drugs,those experiencing homelessness,and men who have sex with men disproportionately affected.AIM To assess the trends in HAV hospitalizations over the past decade and evaluate the impact of substance use on these hospitalizations.METHODS We conducted a retrospective study using the National Inpatient Sample database from 2011 to 2020.Adults(≥18 years)hospitalized with a primary diagnosis of HAV infection were included.We identified active substance use as a secondary diagnosis.Statistical analysis involved descriptive statistics,trend analysis,and propensity score matching to compare HAV hospitalizations with and without substance use.Outcomes included hospitalization trends,complications,length of stay(LOS),and mortality.RESULTS From 2011 to 2020,there were 56972 hospitalizations for HAV infections.Hospitalizations increased from 3917 in 2011 to 8290 in 2020,peaking at 9800 in 2018.Caucasian males(55%)were the most affected,with a mean age of 49 years.The prevalence of active substance use among HAV hospitalizations was 27%,with these patients being younger(mean age:39 years)and predominantly male(63.1%).HAV hospitalizations associated with substance use increased significantly,rising from 235 cases in 2011 to 3200 in 2020(P<0.001).Compared to HAV hospitalizations without substance use,those with substance use had higher rates of co-infections(hepatitis C virus 45%vs 11%,hepatitis B virus 11%vs 6%)and complications,including sepsis(1.9%vs 1%)and infective endocarditis(1.4%vs 0.15%,P<0.001).Hospitalizations with substance use also had longer LOS(4.34 days vs 3.97 days,P<0.05),but mortality rates were comparable.Predictors of mortality in HAV-substance use hospitalizations included acute liver failure,sepsis,and acute respiratory failure.CONCLUSION HAV hospitalizations in the United States have significantly increased over the past decade,with the rise driven by cases involving substance use.These patients face a higher burden of complications and healthcare utilization.Tailored public health strategies,including targeted vaccination and outreach programs for at-risk populations,are essential to reduce the morbidity,mortality,and economic burden associated with HAV.展开更多
Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction ...Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction of completion times for porter tasks.To address this gap,we utilized real-world porter delivery data from Taiwan University Hospital,China,Yunlin Branch,Taiwan Region of China.We first identified key features that can influence the duration of porter tasks.We then employed three widely-used machine learning algorithms:decision tree,random forest,and gradient boosting.To leverage the strengths of each algorithm,we finally adopted an ensemble modeling approach that aggregates their individual predictions.Our experimental results show that the proposed ensemble model can achieve a mean absolute error of 3 min in predicting task response time and 4.42 min in task completion time.The prediction error is around 50%lower compared to using only the historical average.These results demonstrate that our method significantly improves the accuracy of porter task time prediction,supporting better resource planning and patient care.It helps ward staff streamline workflows by reducing delays,enables porter managers to allocate resources more effectively,and shortens patient waiting times,contributing to a better care experience.展开更多
Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,...Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.展开更多
The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,central...The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.展开更多
Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chines...Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.展开更多
Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intel...Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intelligence(AI)has the potential to transform Fangcang shelter hospitals into intelligent,responsive systems that are capable of significantly improving emergency preparedness,operational efficiency,and patient outcomes.Key application areas include site selection and design optimization,clinical decision support,AI-assisted clinical documentation and patient engagement,intelligent robotics,and operational management.However,realizing AI's full potential requires overcoming several challenges,including limited data accessibility,privacy and governance concerns,inadequate algorithmic adaptability in dynamic emergency settings,insufficient transparency and accountability in AI-driven decisions,fragmented system architectures due to proprietary formats,high costs disproportionate to the temporary nature of Fangcang shelter hospitals,and hardware reliability in austere environments.Addressing these challenges demands standardized data-sharing frameworks,development of explainable and robust AI algorithms,clear ethical and legal oversight,interoperable modular system designs,and active collaboration among multidisciplinary stakeholders.展开更多
Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall per...Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.展开更多
With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements ...With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.展开更多
Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemi...Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemic hotspot for DENV transmission in Vietnam[2,3].The largest outbreak occurred in 2017,with more than 36000 cases and 7 deaths reported,causing by all four serotypes with the predominance of DENV1,following by DENV2[4,5].During the following dengue season,we collected 390 blood and serum samples from 197 hospitalized patients in a national hospital in Hanoi city,Northern Vietnam to identify the circulating DENV serotypes responsible for the 2018-2019 outbreak.展开更多
BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of A...BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of AF on hospital outcomes in patients undergoing ERCP.METHODS We performed a retrospective cohort study using the Nationwide Inpatient Sample database.Adult patients with AF who underwent an inpatient ERCP were identified,then stratified by timing of ERCP,via international classification of diseases-10 codes.The primary outcome was all-cause in-hospital mortality.Secondary outcomes,including resource utilization,were assessed.Statistical analysis was performed using STATA software.RESULTS Of the 433245 patients that underwent an ERCP,49615 had a diagnosis of AF.Patients with AF had a significantly higher in-hospital mortality compared to those without AF[3.82%vs 1.13%,odds ratio(OR)=1.93,P<0.01].AF was significantly associated with increased hospital stay(+1.71 days),hospital charges($21210),shock(OR=2.17),sepsis(OR=1.34),intensive care unit admission(OR=2.41),acute kidney injury(OR=1.51),as well as a decreased likelihood of discharge to home(OR=0.59),(all with P<0.01).These results were consistent after propensity score matching.Upon subgroup analysis,patients with AF,whom underwent ERCP>72 hours,had worse outcomes including higher inhospital mortality(adjusted OR=1.47,P<0.01).CONCLUSION By way of this large,national analysis it appears AF is associated with significantly worse hospitalization outcomes,inducing increased mortality,in those undergoing ERCP.Further prospective investigation is warranted to potentially guide clinical recommendations for patients with AF undergoing ERCP in this setting.展开更多
文摘BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.
文摘Background: Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity occurs as a result of an imbalance in diet (energy intake) and physical activity (energy expended), multifactorial diseases due to obesogenic environment (availability of convenience food, media influence, etc.), psycho-social factors (social support systems, cultural/environmental influence, etc.) and genetic variants. Other causes are a subgroup of etiological factors (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome). Obesity is measured clinically by several common tools apart from body mass index (BMI), such as waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio, and neck circumference. WC and WHR are common tools for measuring central obesity while BMI measures generalized obesity. Aims: The goal of this study is to assess the prevalence of obesity amongst health workers of David Umahi Federal University Teaching Hospital, Uburu, Ebonyi state, Southeast Nigeria and to note the prevailing factors. A reliable estimate of the prevalence of obesity among health workers will contribute to the statistics needed to sway policymakers in the country to take urgent and substantial action on the increasing prevalence of obesity, especially in the healthcare industry. Methodology: The study was carried out between May 2024 and June 2024 at the David Umahi Federal University Teaching Hospital situated in Uburu, Ohaozara Local government area of Ebonyi state, Southeast Nigeria. The questionnaire was designed using the Finnish diabetic risk score (FINDRISC). It contained basic comprehending questions on age, gender, exposure to high blood pressure medication, and anthropometric measurement amongst others. Weight was taken with a portable weighing scale and height, with a stadiometer. Both were taken with shoes and headgear removed. The BMI was calculated using the weight (kg) divided by the square of the height (m2). Result: Generally, the prevalence of obesity (>30 kg/m2) in this study was low 17.6% (38), Overweight (BMI 25 - 30), 38.9%, (84) healthy Weight, (BMI 18.5 - 24.9), 43.5% (94). The study revealed that a family history of diabetes was significantly related to higher BMI, with participants more likely to be overweight or obese (p = 0.00030). Similarly, participants with a personal history of diabetes were predominantly in the obese category (p = 0.00038). Waist circumference also showed a strong association with BMI, as larger waist measurements were more common among obese individuals (p = 9.2 × 10−8). In contrast, the analysis found no significant relationships between BMI and age, gender, high blood pressure, or exercise habits. Conclusion: The socio-demographic determinants of obesity in this study were gender, age < 45 years and exposure to exercise. These determinants should form the areas of focus for interventions such as health education and the design of work environments as environments designed to promote physical activities while working will reduce the prevalence of obesity in tertiary institutions.
文摘Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.
文摘Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.
文摘Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuaries for treatment and recovery, making the quality of paramount importance. This study investigates the impact of traffic-related emissions on indoor air quality within a Level 5 Hospital outpatient ward. Measurements were taken over five consecutive days, revealing that while CO2 levels generally remained within safe limits, there were instances where concentrations exceeded 3000 ppm, categorizing them as “Hazardous.” Notably, particulate matter (PM2.5 and PM10) levels fluctuated significantly, with peak concentrations observed during working hours correlating with increased vehicle activity. The data indicated that PM2.5 levels reached as high as 75 µg/m3, with 91.68% of recorded values exceeding the World Health Organization’s (WHO) and Environmental Protection Agency 24-hour mean threshold of 25 µg/m3. Similarly, PM10 concentrations peaked at 120 µg/m3, with 61.19% of values surpassing the WHO threshold of 50 µg/m3, both of which pose serious health risks, particularly to vulnerable populations such as pregnant women, infants, and the elderly. Additionally, the study highlighted the critical role of wind direction in pollutant dispersion, with specific patterns contributing to elevated indoor concentrations. These findings underscore the urgent need for targeted interventions and proactive air quality management strategies in healthcare facilities, including the strategic design of hospital wards away from primary emission sources and the promotion of electric vehicle use to mitigate traffic-related emissions.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
文摘Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.
文摘Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.
文摘Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a cross-sectional, descriptive study with data collection over a period of 10 years;The data collection was retrospective over nine years from January 1, 2013 to December 31, 2021 and prospective over one year from January 1, 2022 to December 31, 2022. This study focused on all patients whose death was noted on arrival during pregnancy, labor or in the postpartum period in the Gynecology-Obstetrics Department of Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of statistical data were carried out using SPSS 20.0 software. Results: During the study period, we recorded 93 cases of death noted on arrival out of a total of 606 maternal deaths, i.e., a frequency of 15.34%. The average age was 27 years with the extremes of 20 years and 34 years. They came mainly from rural areas at 74%, were married at 82%, uneducated at 51.6%, housewives at 87.1%. The profession of the spouses is worker at 37.6%. In our sample, evacuated patients were the most represented with 75.3%. Postpartum hemorrhage was the most frequent reason for admission with 22.6%. The deceased patients had no medical history at 86%. In our series, 59.5% of the deceased patients had not had antenatal consultations (CPN). Patients who died on arrival and who had given birth at home were the most represented with 54.8%. Deaths from immediate postpartum hemorrhage complicated by shock were the most frequent with 25.8% followed by severe anemia 8.6%. Deaths were mainly due to direct obstetric causes at 76.3%. In these deaths observed on arrival, the 2nd delay was identified at 48.4%. Conclusion: Maternal deaths observed on arrival remain frequent in the Kayes region. The main causes are immediate postpartum hemorrhage and anemia, which are almost all preventable causes of maternal death following the 1st and 2nd delay.
文摘BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This research article explores the relationship between these two conditions.AIM To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF,focusing on inpatient mortality,septic shock,length of stay,and hospital costs.METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample.Cases were identified as pa-tients with both NF and cirrhosis,while controls were non-cirrhotic.The study focused on inpatient mortality as the primary outcome,with secondary outcomes including surgical limb amputation,mechanical ventilation rates,septic shock,length of stay,and hospital costs.RESULTS A total of 14920 patients were admitted to the hospital for management of NF,of which 2.11%had liver cirrhosis.Inpatient mortality was higher in cirrhotic patients(9.5%vs 3%;adjusted odds ratio=3.78;P value=0.02).Cirrhotic patients also had higher rates of septic shock(10.5%vs 4.9%,P value<0.01).Length of hospital stay,total charges,and rates of mechanical ventilation were not statistically different between groups.CONCLUSION Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF.Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.
文摘BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vulnerable populations such as people who use illicit drugs,those experiencing homelessness,and men who have sex with men disproportionately affected.AIM To assess the trends in HAV hospitalizations over the past decade and evaluate the impact of substance use on these hospitalizations.METHODS We conducted a retrospective study using the National Inpatient Sample database from 2011 to 2020.Adults(≥18 years)hospitalized with a primary diagnosis of HAV infection were included.We identified active substance use as a secondary diagnosis.Statistical analysis involved descriptive statistics,trend analysis,and propensity score matching to compare HAV hospitalizations with and without substance use.Outcomes included hospitalization trends,complications,length of stay(LOS),and mortality.RESULTS From 2011 to 2020,there were 56972 hospitalizations for HAV infections.Hospitalizations increased from 3917 in 2011 to 8290 in 2020,peaking at 9800 in 2018.Caucasian males(55%)were the most affected,with a mean age of 49 years.The prevalence of active substance use among HAV hospitalizations was 27%,with these patients being younger(mean age:39 years)and predominantly male(63.1%).HAV hospitalizations associated with substance use increased significantly,rising from 235 cases in 2011 to 3200 in 2020(P<0.001).Compared to HAV hospitalizations without substance use,those with substance use had higher rates of co-infections(hepatitis C virus 45%vs 11%,hepatitis B virus 11%vs 6%)and complications,including sepsis(1.9%vs 1%)and infective endocarditis(1.4%vs 0.15%,P<0.001).Hospitalizations with substance use also had longer LOS(4.34 days vs 3.97 days,P<0.05),but mortality rates were comparable.Predictors of mortality in HAV-substance use hospitalizations included acute liver failure,sepsis,and acute respiratory failure.CONCLUSION HAV hospitalizations in the United States have significantly increased over the past decade,with the rise driven by cases involving substance use.These patients face a higher burden of complications and healthcare utilization.Tailored public health strategies,including targeted vaccination and outreach programs for at-risk populations,are essential to reduce the morbidity,mortality,and economic burden associated with HAV.
基金supported by National Taiwan University Hospital Yunlin Branch Project NTUHYL 110.C018National Science and Technology Council,Taiwan.
文摘Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction of completion times for porter tasks.To address this gap,we utilized real-world porter delivery data from Taiwan University Hospital,China,Yunlin Branch,Taiwan Region of China.We first identified key features that can influence the duration of porter tasks.We then employed three widely-used machine learning algorithms:decision tree,random forest,and gradient boosting.To leverage the strengths of each algorithm,we finally adopted an ensemble modeling approach that aggregates their individual predictions.Our experimental results show that the proposed ensemble model can achieve a mean absolute error of 3 min in predicting task response time and 4.42 min in task completion time.The prediction error is around 50%lower compared to using only the historical average.These results demonstrate that our method significantly improves the accuracy of porter task time prediction,supporting better resource planning and patient care.It helps ward staff streamline workflows by reducing delays,enables porter managers to allocate resources more effectively,and shortens patient waiting times,contributing to a better care experience.
基金supported by Guangdong Medical Science and Technology Research Fund Project(No.A2022458)Guangdong Provincial People's Medical Climbing Plan(Nursing Research Project)(No.DFJH2020011)。
文摘Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.
文摘The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.
文摘Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.
文摘Fangcang shelter hospitals are modular,rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations.Artificial intelligence(AI)has the potential to transform Fangcang shelter hospitals into intelligent,responsive systems that are capable of significantly improving emergency preparedness,operational efficiency,and patient outcomes.Key application areas include site selection and design optimization,clinical decision support,AI-assisted clinical documentation and patient engagement,intelligent robotics,and operational management.However,realizing AI's full potential requires overcoming several challenges,including limited data accessibility,privacy and governance concerns,inadequate algorithmic adaptability in dynamic emergency settings,insufficient transparency and accountability in AI-driven decisions,fragmented system architectures due to proprietary formats,high costs disproportionate to the temporary nature of Fangcang shelter hospitals,and hardware reliability in austere environments.Addressing these challenges demands standardized data-sharing frameworks,development of explainable and robust AI algorithms,clear ethical and legal oversight,interoperable modular system designs,and active collaboration among multidisciplinary stakeholders.
文摘Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.
文摘With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.
基金the“Metropolitan Mosquitoes Project”funded by the Swedish Research Council for Environment,Agricultural Sciences and Spatial Planning(Formas,grant number 2016-00364).
文摘Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemic hotspot for DENV transmission in Vietnam[2,3].The largest outbreak occurred in 2017,with more than 36000 cases and 7 deaths reported,causing by all four serotypes with the predominance of DENV1,following by DENV2[4,5].During the following dengue season,we collected 390 blood and serum samples from 197 hospitalized patients in a national hospital in Hanoi city,Northern Vietnam to identify the circulating DENV serotypes responsible for the 2018-2019 outbreak.
文摘BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of AF on hospital outcomes in patients undergoing ERCP.METHODS We performed a retrospective cohort study using the Nationwide Inpatient Sample database.Adult patients with AF who underwent an inpatient ERCP were identified,then stratified by timing of ERCP,via international classification of diseases-10 codes.The primary outcome was all-cause in-hospital mortality.Secondary outcomes,including resource utilization,were assessed.Statistical analysis was performed using STATA software.RESULTS Of the 433245 patients that underwent an ERCP,49615 had a diagnosis of AF.Patients with AF had a significantly higher in-hospital mortality compared to those without AF[3.82%vs 1.13%,odds ratio(OR)=1.93,P<0.01].AF was significantly associated with increased hospital stay(+1.71 days),hospital charges($21210),shock(OR=2.17),sepsis(OR=1.34),intensive care unit admission(OR=2.41),acute kidney injury(OR=1.51),as well as a decreased likelihood of discharge to home(OR=0.59),(all with P<0.01).These results were consistent after propensity score matching.Upon subgroup analysis,patients with AF,whom underwent ERCP>72 hours,had worse outcomes including higher inhospital mortality(adjusted OR=1.47,P<0.01).CONCLUSION By way of this large,national analysis it appears AF is associated with significantly worse hospitalization outcomes,inducing increased mortality,in those undergoing ERCP.Further prospective investigation is warranted to potentially guide clinical recommendations for patients with AF undergoing ERCP in this setting.
