BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship ...BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.展开更多
Kongthong,a remote village hidden in the hills of India's Meghalaya state,has a unique and centuriesold tradition where every inhabitant is given both a regular name and a song at birth,both of which become their ...Kongthong,a remote village hidden in the hills of India's Meghalaya state,has a unique and centuriesold tradition where every inhabitant is given both a regular name and a song at birth,both of which become their identity.Kongthong was nominated(提名)as India's No.1 recommendation for the United Nations World Tourism Organization's Best Tourism Villages contest,both for its natural beauty and hospitable villagers,and its unique naming tradition.展开更多
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
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of diffe...Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.展开更多
BACKGROUND Cholangiocarcinoma(CCA)is a heterogeneous group of aggressive malignancies arising from the biliary tree.Epidemiological data show an increase in the incidence of intrahepatic CCA in Western countries and a...BACKGROUND Cholangiocarcinoma(CCA)is a heterogeneous group of aggressive malignancies arising from the biliary tree.Epidemiological data show an increase in the incidence of intrahepatic CCA in Western countries and a stable or decrease in the incidence of extrahepatic CCA.There are conflicting results in literature regarding the trend of the incidence of gallbladder cancer.However,most studies refer to a time period before 2000.AIM To investigate the recent epidemiology of CCA and gallbladder cancer in Northeast Italy using regional data of hospital admissions.METHODS We performed a 17-year(2007-2023)retrospective analysis of hospital discharge records of the Veneto Region.During the period 10778 first hospital admissions for biliary tract cancers in the main or secondary diagnosis were recorded.Data were analyzed by theχ^(2)test for categorical data and the Student’s ttest for continuous data to assess differences in percentages and averages,respectively.Trends in the agestandardized hospitalization rate were evaluated using Joinpoint regression,estimating annual percentage changes(APC).RESULTS The total number of hospitalizations for biliary tract cancers remained stable over the past 17 years(186 hospitalizations/year for intrahepatic CCA,211 for extrahepatic CCA,and 237 for gallbladder cancer/unspecified biliary tract).Age-standardized hospitalization rates for intrahepatic and extrahepatic CCA decreased respectively from 4.9 cases to 3.4 per 100000 inhabitants(APC=-2.0,95%confidence interval:-3.2 to-0.7,P<0.001)and from 6.7 to 3.8 cases per 100000 inhabitants(APC=-3.2,95%confidence interval:-4.2 to-2.1,P<0.001).Instead,hospitalizations for gallbladder cancer remained stable,with an average rate of 5.5 per 100000 inhabitants.Overall,hospitalization rates for biliary tract cancers increased with age in both genders.CONCLUSION Our study reported a decreasing hospitalization rate for CCA and a stable trend for gallbladder cancer over a 17-year period,suggesting a change in the epidemiology of these tumors.展开更多
1.Background Dengue,commonly known as“Break Bone Fever”,is expanding widely,resulting in increased morbidity,mortality,and hospitalizations.Between 2000 and 2019,global dengue incidence surged tenfold from 0.5 to 5....1.Background Dengue,commonly known as“Break Bone Fever”,is expanding widely,resulting in increased morbidity,mortality,and hospitalizations.Between 2000 and 2019,global dengue incidence surged tenfold from 0.5 to 5.2 million cases across 129 countries,reaching a historic high of over 6.5 million cases and 7300 dengue-related deaths in more than 80 countries by 2023[1].Driven by urbanization and climate change,the primary mosquito vector for dengue,Aedes aegypti,is spreading extensively into new areas,while the less effective vector,Aedes albopictus,is also rapidly expanding its range.While most infected individuals are asymptomatic,severe cases may require hospitalization,and fatalities can occur.展开更多
Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prev...Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prevention.The purpose of this study was to investigate nurse activities in fall prevention and its relevant factors.Methods:This descriptive cross-sectional study was conducted at Can Tho Central General Hospital,with the participation of 90 nurses.Data were collected using a structured questionnaire consisting of five parts,including personal characteristics,knowledge about fall prevention,self-efficacy in fall prevention,nursing practice environment,and fall prevention activities.The data were entered and analyzed using SPSS 18.0 software with descriptive statistics,independent t-test,one-way ANOVA,and Pearson’s correlation coefficients.Results:The mean score of participants’knowledge in fall prevention was 4.67(SD=2.50)out of 11 scores;the self-efficacy score was 49.43(SD=8.55)out of 66 scores;nursing practice environment score was 29.69(SD=4.00)out of 40 scores;and the fall prevention activity scores were 75.58(SD=9.96)out of 100 scores.Factors related to fall prevention activities included gender(p=0.03),place of work(p=0.02),number of fall prevention training sessions(p=0.03),self-efficacy in fall prevention(r=0.61,p<0.001),and the nursing practice environment(r=0.25,p<0.05).Conclusions:An intervention program for fall prevention can be implemented to enhance the knowledge about fall prevention among nurses and improve the nursing practice environment to enhance patient safety.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
Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocia...Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocial,and educational outcomes among school-aged children with cancer.Materials and Methods:A quasi-experimental pre-and post-test control group design was conducted at the pediatric oncology unit of Rumah Sakit Islam Jemursari,Surabaya,Indonesia.Fifty-two hospitalized children aged 6-18 years were randomly assigned to an intervention group(n=26)or a control group(n=26).The intervention lasted 1 month and integrated hospital-based lessons aligned with the national curriculum,therapeutic play,and developmentally appropriate communication by trained staff.Outcomes included pain intensity(Wong-Baker FACES Scale),treatment adherence,quality of life(Pediatric Cancer Quality of Life-32[PCQL-32]),anxiety(Revised Children’s Manifest Anxiety Scale),and literacy-numeracy performance.Data were analyzed using paired t-tests,ANCOVA,and Cohen’s d,with significance set at P<0.05.Results:Compared with controls,the intervention group showed significant improvements in pain reduction(P<0.001),treatment adherence(P<0.001),and quality of life across all PCQL-32 domains(P<0.001).Anxiety levels decreased significantly(P<0.001),and academic performance in literacy and numeracy improved markedly(P<0.001).Conclusion:The integrative educational intervention effectively enhanced clinical recovery,psychosocial well-being,and academic continuity among hospitalized children with cancer,emphasizing the need to integrate hospital-based education and play-based communication into pediatric oncology care.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
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 Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the...BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.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
Amidst lush mountains and lucid waters,a British educator discovers inner balance and peace,embraced by the hospitality of local people and the profound Huizhou culture.
Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the w...Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.展开更多
Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission pre...Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission prediction.Methods A multi-city study was conducted in Tokyo’s 23 wards,Osaka City,and Nagoya City.Random forest models were employed to assess the synergistic short-term lag effects(lag0,lag3,and lag7)of climate and air pollutants on hospitalization for five cardiovascular diseases(CVDs)and two respiratory diseases(RDs).Furthermore,we developed hybrid deep learning models that integrated an autoencoder(AE)with a Long Short-Term Memory network(AE+LSTM)to predict daily hospital admissions.Results On the day of exposure(lag0),air pollutants,particularly nitrogen oxides(NOx),exhibited the strongest influence on hospital admissions for CVD and RD,with pronounced effects observed for hypertension(I10–I15),ischemic heart disease(I20),arterial and capillary diseases(I70–I79),and lower respiratory infections(J20–J22 and J40–J47).At longer lags(lag3 and lag7),temperature and precipitation were more influential predictors.The AE+LSTM model outperformed the standard LSTM,improving the prediction accuracy by 32.4%for RD in Osaka and 20.94%for CVD in Nagoya.Conclusion Our findings reveal the dynamic,time-varying health risks associated with environmental exposure and demonstrate the utility of deep learnings in predicting short-term hospital admissions.This framework can inform early warning systems,enhance healthcare resource allocation,and support climate-adaptive public health strategies.展开更多
To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many ...To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many women,some of whom never dreamed of living a normal life again,that Du has helped.展开更多
BACKGROUND Cardiac myxoma,a benign intracardiac tumor,is traditionally excised via conven-tional sternotomy,which is invasive and associated with longer recovery times.Minimally invasive robotic surgery has emerged as...BACKGROUND Cardiac myxoma,a benign intracardiac tumor,is traditionally excised via conven-tional sternotomy,which is invasive and associated with longer recovery times.Minimally invasive robotic surgery has emerged as a potential alternative,offe-ring reduced trauma and faster recovery.This meta-analysis compares the effi-cacy and safety of robotic surgery vs conventional sternotomy for cardiac myxo-ma excision.We hypothesized that robotic surgery would provide comparable safety outcomes with improved postoperative recovery,such as shorter hospital stays and reduced transfusion rates,despite potentially longer operative times.METHODS A systematic review was performed using EMBASE,OVID,Scopus,PubMed,Cochrane,and ScienceDirect databases to identify studies comparing robotic surgery and sternotomy for cardiac myxoma excision.Continuous outcomes were analyzed using mean differences(MDs),and categorical outcomes with odds ratios(ORs)and 95%confidence intervals(95%CIs).A random-effects model was used to pool data,accounting for study heterogeneity.RESULTS Six studies involving 425 patients(180 robotic,245 conventional)were included.Robotic surgery significantly increased cross-clamp time(MD=12.03 minutes,95%CI:2.14-21.92,P=0.02)and cardiopulmonary bypass time(MD=28.37 minutes,95%CI:11.85-44.89,P=0.001).It reduced hospital stay(MD=-1.86 days,95%CI:-2.45 to-1.27,P<0.00001)and blood transfusion requirements(OR=0.30,95%CI:0.13-0.69,P=0.007).No significant differences were observed in atrial arrhythmia(OR=0.55,95%CI:0.27-1.12)or ventilation time(MD=-1.72 hours,95%CI:-5.27 to 1.83,P=0.34).CONCLUSION Robotic surgery for cardiac myxoma excision prolongs operative times but shortens hospital stays and reduces transfusion needs,suggesting enhanced recovery without compromising safety.展开更多
文摘BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.
文摘Kongthong,a remote village hidden in the hills of India's Meghalaya state,has a unique and centuriesold tradition where every inhabitant is given both a regular name and a song at birth,both of which become their identity.Kongthong was nominated(提名)as India's No.1 recommendation for the United Nations World Tourism Organization's Best Tourism Villages contest,both for its natural beauty and hospitable villagers,and its unique naming tradition.
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Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
文摘Objective To identify risk factors contributing to prolonged postoperative length of stay(LOS)in very elderly patients following hip fracture surgery,with a focus on postoperative complications and the impact of different anesthesia approaches.Methods This retrospective single-center cohort study enrolled patients aged 90 years or older who underwent hip fracture surgery at Peking Union Medical College Hospital between January 31,2013 and December 31,2023.Relevant perioperative data were collected.The primary outcome was postoperative LOS,and the study cohort was divided into two groups:postoperative LOS≤7 days and LOS>7 days.Logistic regression was performed to identify factors related to prolonged postoperative LOS.Results A total of 155 patients were included.The average age was 92.7±2.6 years.There were 73(47%)patients with postoperative LOS>7 days.Postoperative pneumonia was the only factor associated with a prolonged postoperative LOS(OR=2.12,95%CI[1.09,4.16],P=0.028).Neither the type of anesthesia(regional vs.general anesthesia,OR=1.00,95%CI[0.53,1.90],P=0.993)nor the method of airway management(laryngeal mask ventilation vs.spontaneous breathing,OR=1.46,95%CI[0.58,3.76],P=0.424;endotracheal intubation vs.spontaneous breathing,OR=0.82,95%CI[0.39,1.69],P=0.592)showed a significant association with a prolonged postoperative LOS.Preoperative chronic obstructive pulmonary disease(OR=2.78,95%CI[1.05,7.65],P=0.040)and preoperative neutrophil count(OR=1.13,95%CI[1.01,1.26],P=0.029)were both significantly associated with the occurrence of postoperative pneumonia,while anesthesia type and airway management method were not.Conclusions Postoperative pneumonia was associated with prolonged postoperative LOS in very elderly patients undergoing hip fracture surgery,whereas anesthesia types and airway management methods show no association with prolonged postoperative LOS or postoperative pneumonia.Preoperative comorbidities,especially respiratory conditions and systemic inflammation,potentially play a substantial role in postoperative recovery.
文摘BACKGROUND Cholangiocarcinoma(CCA)is a heterogeneous group of aggressive malignancies arising from the biliary tree.Epidemiological data show an increase in the incidence of intrahepatic CCA in Western countries and a stable or decrease in the incidence of extrahepatic CCA.There are conflicting results in literature regarding the trend of the incidence of gallbladder cancer.However,most studies refer to a time period before 2000.AIM To investigate the recent epidemiology of CCA and gallbladder cancer in Northeast Italy using regional data of hospital admissions.METHODS We performed a 17-year(2007-2023)retrospective analysis of hospital discharge records of the Veneto Region.During the period 10778 first hospital admissions for biliary tract cancers in the main or secondary diagnosis were recorded.Data were analyzed by theχ^(2)test for categorical data and the Student’s ttest for continuous data to assess differences in percentages and averages,respectively.Trends in the agestandardized hospitalization rate were evaluated using Joinpoint regression,estimating annual percentage changes(APC).RESULTS The total number of hospitalizations for biliary tract cancers remained stable over the past 17 years(186 hospitalizations/year for intrahepatic CCA,211 for extrahepatic CCA,and 237 for gallbladder cancer/unspecified biliary tract).Age-standardized hospitalization rates for intrahepatic and extrahepatic CCA decreased respectively from 4.9 cases to 3.4 per 100000 inhabitants(APC=-2.0,95%confidence interval:-3.2 to-0.7,P<0.001)and from 6.7 to 3.8 cases per 100000 inhabitants(APC=-3.2,95%confidence interval:-4.2 to-2.1,P<0.001).Instead,hospitalizations for gallbladder cancer remained stable,with an average rate of 5.5 per 100000 inhabitants.Overall,hospitalization rates for biliary tract cancers increased with age in both genders.CONCLUSION Our study reported a decreasing hospitalization rate for CCA and a stable trend for gallbladder cancer over a 17-year period,suggesting a change in the epidemiology of these tumors.
文摘1.Background Dengue,commonly known as“Break Bone Fever”,is expanding widely,resulting in increased morbidity,mortality,and hospitalizations.Between 2000 and 2019,global dengue incidence surged tenfold from 0.5 to 5.2 million cases across 129 countries,reaching a historic high of over 6.5 million cases and 7300 dengue-related deaths in more than 80 countries by 2023[1].Driven by urbanization and climate change,the primary mosquito vector for dengue,Aedes aegypti,is spreading extensively into new areas,while the less effective vector,Aedes albopictus,is also rapidly expanding its range.While most infected individuals are asymptomatic,severe cases may require hospitalization,and fatalities can occur.
文摘Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prevention.The purpose of this study was to investigate nurse activities in fall prevention and its relevant factors.Methods:This descriptive cross-sectional study was conducted at Can Tho Central General Hospital,with the participation of 90 nurses.Data were collected using a structured questionnaire consisting of five parts,including personal characteristics,knowledge about fall prevention,self-efficacy in fall prevention,nursing practice environment,and fall prevention activities.The data were entered and analyzed using SPSS 18.0 software with descriptive statistics,independent t-test,one-way ANOVA,and Pearson’s correlation coefficients.Results:The mean score of participants’knowledge in fall prevention was 4.67(SD=2.50)out of 11 scores;the self-efficacy score was 49.43(SD=8.55)out of 66 scores;nursing practice environment score was 29.69(SD=4.00)out of 40 scores;and the fall prevention activity scores were 75.58(SD=9.96)out of 100 scores.Factors related to fall prevention activities included gender(p=0.03),place of work(p=0.02),number of fall prevention training sessions(p=0.03),self-efficacy in fall prevention(r=0.61,p<0.001),and the nursing practice environment(r=0.25,p<0.05).Conclusions:An intervention program for fall prevention can be implemented to enhance the knowledge about fall prevention among nurses and improve the nursing practice environment to enhance patient safety.
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Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocial,and educational outcomes among school-aged children with cancer.Materials and Methods:A quasi-experimental pre-and post-test control group design was conducted at the pediatric oncology unit of Rumah Sakit Islam Jemursari,Surabaya,Indonesia.Fifty-two hospitalized children aged 6-18 years were randomly assigned to an intervention group(n=26)or a control group(n=26).The intervention lasted 1 month and integrated hospital-based lessons aligned with the national curriculum,therapeutic play,and developmentally appropriate communication by trained staff.Outcomes included pain intensity(Wong-Baker FACES Scale),treatment adherence,quality of life(Pediatric Cancer Quality of Life-32[PCQL-32]),anxiety(Revised Children’s Manifest Anxiety Scale),and literacy-numeracy performance.Data were analyzed using paired t-tests,ANCOVA,and Cohen’s d,with significance set at P<0.05.Results:Compared with controls,the intervention group showed significant improvements in pain reduction(P<0.001),treatment adherence(P<0.001),and quality of life across all PCQL-32 domains(P<0.001).Anxiety levels decreased significantly(P<0.001),and academic performance in literacy and numeracy improved markedly(P<0.001).Conclusion:The integrative educational intervention effectively enhanced clinical recovery,psychosocial well-being,and academic continuity among hospitalized children with cancer,emphasizing the need to integrate hospital-based education and play-based communication into pediatric oncology care.
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 Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.
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.
文摘Amidst lush mountains and lucid waters,a British educator discovers inner balance and peace,embraced by the hospitality of local people and the profound Huizhou culture.
文摘Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.
基金supported by the Japan Science and Technology Agency SPRING Program(JST SPRING),Grant Number JPMJSP2108,which was partially funded by the Japan Society for the Promotion of Science(JSPS)Grant Numbers 20H03949,23K22919,23K28289the Environmental Restoration and Conservation Agency of Japan,and the Environment Research and Technology Development Fund(S-24).
文摘Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission prediction.Methods A multi-city study was conducted in Tokyo’s 23 wards,Osaka City,and Nagoya City.Random forest models were employed to assess the synergistic short-term lag effects(lag0,lag3,and lag7)of climate and air pollutants on hospitalization for five cardiovascular diseases(CVDs)and two respiratory diseases(RDs).Furthermore,we developed hybrid deep learning models that integrated an autoencoder(AE)with a Long Short-Term Memory network(AE+LSTM)to predict daily hospital admissions.Results On the day of exposure(lag0),air pollutants,particularly nitrogen oxides(NOx),exhibited the strongest influence on hospital admissions for CVD and RD,with pronounced effects observed for hypertension(I10–I15),ischemic heart disease(I20),arterial and capillary diseases(I70–I79),and lower respiratory infections(J20–J22 and J40–J47).At longer lags(lag3 and lag7),temperature and precipitation were more influential predictors.The AE+LSTM model outperformed the standard LSTM,improving the prediction accuracy by 32.4%for RD in Osaka and 20.94%for CVD in Nagoya.Conclusion Our findings reveal the dynamic,time-varying health risks associated with environmental exposure and demonstrate the utility of deep learnings in predicting short-term hospital admissions.This framework can inform early warning systems,enhance healthcare resource allocation,and support climate-adaptive public health strategies.
文摘To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many women,some of whom never dreamed of living a normal life again,that Du has helped.
文摘BACKGROUND Cardiac myxoma,a benign intracardiac tumor,is traditionally excised via conven-tional sternotomy,which is invasive and associated with longer recovery times.Minimally invasive robotic surgery has emerged as a potential alternative,offe-ring reduced trauma and faster recovery.This meta-analysis compares the effi-cacy and safety of robotic surgery vs conventional sternotomy for cardiac myxo-ma excision.We hypothesized that robotic surgery would provide comparable safety outcomes with improved postoperative recovery,such as shorter hospital stays and reduced transfusion rates,despite potentially longer operative times.METHODS A systematic review was performed using EMBASE,OVID,Scopus,PubMed,Cochrane,and ScienceDirect databases to identify studies comparing robotic surgery and sternotomy for cardiac myxoma excision.Continuous outcomes were analyzed using mean differences(MDs),and categorical outcomes with odds ratios(ORs)and 95%confidence intervals(95%CIs).A random-effects model was used to pool data,accounting for study heterogeneity.RESULTS Six studies involving 425 patients(180 robotic,245 conventional)were included.Robotic surgery significantly increased cross-clamp time(MD=12.03 minutes,95%CI:2.14-21.92,P=0.02)and cardiopulmonary bypass time(MD=28.37 minutes,95%CI:11.85-44.89,P=0.001).It reduced hospital stay(MD=-1.86 days,95%CI:-2.45 to-1.27,P<0.00001)and blood transfusion requirements(OR=0.30,95%CI:0.13-0.69,P=0.007).No significant differences were observed in atrial arrhythmia(OR=0.55,95%CI:0.27-1.12)or ventilation time(MD=-1.72 hours,95%CI:-5.27 to 1.83,P=0.34).CONCLUSION Robotic surgery for cardiac myxoma excision prolongs operative times but shortens hospital stays and reduces transfusion needs,suggesting enhanced recovery without compromising safety.
