Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.展开更多
BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents(MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This stud...BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents(MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients.METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department(ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death def ined by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied.RESULTS: In the 100 patients, 21(21%) patients were female and 79(79%) male. Fortythree patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31% of the patients, and 33% had a hypo-volemic shock. About 80% of deaths were due to intra-cranial hemorrhage(ICH) or intra-ventricular hemorrhage(IVH), and spinal injuries were not preventable. Autopsy revealed that 28% of the patients suffered from internal injuries. Autopsy revealed that 19% of the deaths were not preventable and 81% were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services(EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2% of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6% deaths occurred between 6 and 10 minutes.CONCLUSIONS: The rate of hospital preventable deaths is about 80%, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries.展开更多
Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in ...Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A;B) To carry out periodic catch-up vaccination campaigns against measles and mumps.展开更多
Background: In Tanzania elders are respected as repositories of inherited wisdom, experienced and principal decision makers in the community. However, evidence shows that such repositories are no longer considered imp...Background: In Tanzania elders are respected as repositories of inherited wisdom, experienced and principal decision makers in the community. However, evidence shows that such repositories are no longer considered important in most societies. As a result elders are neglected with some mistreatment in terms of provision of health and social services for instance;at times they get denied and ignored of their obvious rights, ignoring their retirement benefits and the rights onto free social services as per the Tanzania National Ageing Policy of 2003. Elders are therefore faced with physical, psychological and geriatric social suffering. It is on this basis that this study tries to explore the common preventable health and social problems encountered by elderly in Shinyanga Region in northern part of Tanzania. Methods: Across sectional community based study of 465 subjects randomly selected was done in three wards of Kahama District. The district was selected randomly out of 8 districts of Shinyanga Region, structured questionnaires with both closed and opened endower used;the information was collected from house to house and other information collected from health facilities within the wards as every ward had one public health facility;subjects (respondents) were obtained using purposive sampling technique aiming at elderly with 60 years of age and above. Results: Kahama district has a population of approximately 36,014 of which 1500 (4%) are in the elderly age group of 60 years and above. The study population was 465 which is 30% (465/1500) of the geriatric population of Kahama. Among this group 5% were female while 41% were male and 53% (248/465) were married. 64% (297/465) were taking care of themselves, 32% (150/465) cared by relatives and 4% (18/465) cared by the community. Among the respondents, 40% (185/465) were affected by HIV/AIDs in one way or another either living with orphans whose parents died of HIV/AIDS or asking care of the infected patients within the family. It was also found that 73% of the geriatrics were not exempted from medical treatment fees so they had to pay for their medical care. However, only 32% were aware of getting free treatment and 61% of the study populations were not satisfied with the medical care provided at the public health facilities. The common diseases affecting this age group are: Eye problem 59% (273/465);Arthritis 52% (241/465);Dental problems 27% (124/465);Hypertension 23% (107/465);Backache 22% (105/465);Malaria 28% (132/465);Hearing problems 26% (121/645);Urinary tract Infection 35% (165/465);Depression 8% (36/465). Dementia was also a problem though we had no tools to confirm the diagnosis;some of the geriatrics had more than two diseases. Conclusion: The majority of the elderly age group in Kahama District are not aware of their rights that they deserve free treatment according to Tanzania policy, furthermore for assessment and screening of health problems. A majority of the elderly die prematurely due to preventable diseases and more than half of the diseases affecting geriatrics are preventable.展开更多
AIM: To calculate the proportion of potentially preventable hospitalizations due to peptic ulcer disease (PUD), erosive gastritis (EG) or duodenitis (ED).
BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investig...BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer patients.METHODS:Data of patients who readmitted to intensive care unit(ICU)at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences(CAMS)and Peking Union Medical College(PUMC)between January 2013 and November 2016 were retrospectively collected and reviewed.RESULTS:A total of 39 patients were included in the final analysis,and the overall readmission rate between 2013 and 2016 was 1.32%(39/2,961).Of 39 patients,32(82.1%)patients were judged as unpreventable and 7(17.9%)patients were preventable.There were no significant differences in duration of mechanical ventilation,ICU LOS,hospital LOS,ICU mortality and in-hospital mortality between patients who were unpreventable and preventable.For 24 early readmission patients,7(29.2%)patients were preventable and 17(70.8%)patients were unpreventable.Patients who were late readmission were all unpreventable.There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable(100%vs.66.8%,log rank=1.668,P=0.196).CONCLUSION:Most readmission patients were unpreventable,and all preventable readmissions occurred in early period after discharge to ward.There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.展开更多
Tuberculosis (TB) incidence within Healthcare workers remains one of the lowest occupation specific rates in the United States. We report a case of a 33-year-old African American male presented with a right chest mass...Tuberculosis (TB) incidence within Healthcare workers remains one of the lowest occupation specific rates in the United States. We report a case of a 33-year-old African American male presented with a right chest mass and without fever, chills or cough. Bacterial and Fungal cultures were sent during the initial visit and were negative throughout the entire management of his care. After several months of surgical interventions, the patient appeared positive for TB;however a staff member contracted the disease. The patient was managed successfully with the four-drug regimen of Isoniazid, Rifampin, Pyrazinamide and Ethambutol and recovered well from his surgeries.展开更多
Objectives Coroners in England and Wales have a duty to write Prevention of Future Deaths(PFDs)reports when they believe that action should be taken to prevent similar deaths.We conducted a systematic case series of t...Objectives Coroners in England and Wales have a duty to write Prevention of Future Deaths(PFDs)reports when they believe that action should be taken to prevent similar deaths.We conducted a systematic case series of the reports involving maternal deaths to characterise these deaths in terms of demographics,explore the concerns raised by the coroners and understand what actions were reported by organisations in their responses to the coroner.Methods All coroners'PFDs published between July 2013 and 1 August 2023 in England and Wales were collected and reviewed(n=4435).Reports were searched for keywords related to maternal deaths.Case information was extracted into pre-specified domains and compared to other data on maternal deaths.Results Twenty nine(n=29)cases were found involving a maternal death.The median age at death was 33.5 years(IQR 29±36 years)and three-quarters(75.9%)of deaths occurred in hospitals.The most common cause of death was haemorrhage.Coroners frequently voiced concerns around the failure to provide appropriate treatment(48.2%)and failure of timely escalation(37.9%).Specific lessons we have highlighted include gaps in national guidance,failure to follow national protocols,communication issues and lack of resources or staff cover.Only 38%of PFDs had published responses from the organisations they were sent to.When organisations did respond to the coroner,80%reported that they implemented changes,including publishing new local policies,increasing training or committing to increased staffing.Conclusions Poor response rates to PFDs indicate underutilisation of these reports as a resource for improvement in maternal care.PFDs highlighted gaps in obstetric care and national guidance which,if appropriately addressed and regularly and routinely monitored,could prevent similar deaths.展开更多
Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available....Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available.Evaluations of the association of actionable genotypes in these genes with life span are currently lacking.展开更多
China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfall...China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfalls under global change is critical for effective disaster risk management.This study utilizes future typhoon track data simulated by the regional climate model version 4(RegCM4),combined with projected population and Gross Domestic Product(GDP)data for China’s coastal regions under three Shared Socioeconomic Pathways(SSPs:SSP1,sustainability;SSP2,middle of the road;SSP5,fossil-fueled development).We analyze typhoon impact zones for future periods(2030s,2050s,and 2090s)under Representative Concentration Pathways(RCPs:RCP2.6,RCP4.5,and RCP8.5,representing low,medium,and high greenhouse gas emission scenarios,respectively).Exposure levels for 2030,2050,and 2100 are calculated based on the annual average frequency of typhoon impacts during these periods,aiming to quantify the distribution characteristics of typhoon-affected population and GDP in China’s coastal regions.Key findings reveal two high-frequency typhoon im-pact zones:the Taiwan Strait region and the northern Qiongzhou Strait region.Furthermore,under RCP2.6,typhoon impacts may ex-tend to Liaoning,while RCP4.5 and RCP8.5 scenarios indicate potential impacts reaching further north to Heilongjiang.Under RCP4.5,Northeast China will experience the largest typhoon-affected area(43.800×10^(4) km^(2))by the 2030s.High population and GDP exposure concentrates in the Yangtze River Delta,the Pearl River Delta,and the Taiwan Strait coastal areas.Notably,Liaoning’s cumulative ex-posed population may exceed 0.100×10^(8) by 2030 and 2050 under RCP4.5 and RCP8.5 due to typhoon track migration.Given China’s location within the Western Pacific typhoon high-incidence region,the northward expansion of impacts will substantially escalate socio-economic exposure in mid-latitude regions previously at lower risk.These findings underscore the imperative for enhanced disaster pre-vention,mitigation strategies and targeted countermeasure research.展开更多
Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmenta...Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.展开更多
BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accom...Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accompanied by a surge in the incidence of incurable neurodegenerative diseases(NDDs).These diseases primarily affect the cognitive and behavioral functions of older adults by impacting brain activity.Mild cognitive impairment(MCI)is a neurodegenerative condition that affects a significant portion of the population.展开更多
Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typicall...Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.展开更多
1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”o...1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”or“injury prevention”are likely to grab the readers’attention.Meanwhile,studies on injury prevention might assess the impact of interventions on mitigating injury risk factors(e.g.,strength,range of motion(ROM))but fail to report injury data(e.g.,incidence).1,2 Likewise,observational studies may include“injury risk”in their titles,but fail to provide injury data.3 Without injury data.展开更多
Dementia and Alzheimer's disease (AD) are both age-related conditions that predominantly affect older adults.According to prevalence studies,the burden of these diseases on society is expected to increase in the c...Dementia and Alzheimer's disease (AD) are both age-related conditions that predominantly affect older adults.According to prevalence studies,the burden of these diseases on society is expected to increase in the coming years,particularly in relation to rising longevity and life expectancy.Advances in therapeutic and preventive strategies are needed to help reduce their global burden,which remains among the most significant health challenges in aging populations (Brookmeyer et al.,2007).展开更多
This article examines the intelligent forest sentry system in the Mount Tai Scenic Area, analyzing its applications, accomplishments, and significance in forest fire prevention. It highlights the system's critical...This article examines the intelligent forest sentry system in the Mount Tai Scenic Area, analyzing its applications, accomplishments, and significance in forest fire prevention. It highlights the system's critical role in enhancing comprehensive forest fire prevention and control capabilities, accelerating emergency response times, and safeguarding the heritage resources of Mount Tai. Furthermore, the system is evolving into a "Smart Forest and Grassland Resources Supervision Platform" that integrates forest fire early warning, ecological environment monitoring, and pest and disease management to promote the sustainable development of forest resources.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the...Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.展开更多
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
文摘BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents(MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients.METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department(ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death def ined by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied.RESULTS: In the 100 patients, 21(21%) patients were female and 79(79%) male. Fortythree patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31% of the patients, and 33% had a hypo-volemic shock. About 80% of deaths were due to intra-cranial hemorrhage(ICH) or intra-ventricular hemorrhage(IVH), and spinal injuries were not preventable. Autopsy revealed that 28% of the patients suffered from internal injuries. Autopsy revealed that 19% of the deaths were not preventable and 81% were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services(EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2% of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6% deaths occurred between 6 and 10 minutes.CONCLUSIONS: The rate of hospital preventable deaths is about 80%, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries.
文摘Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A;B) To carry out periodic catch-up vaccination campaigns against measles and mumps.
文摘Background: In Tanzania elders are respected as repositories of inherited wisdom, experienced and principal decision makers in the community. However, evidence shows that such repositories are no longer considered important in most societies. As a result elders are neglected with some mistreatment in terms of provision of health and social services for instance;at times they get denied and ignored of their obvious rights, ignoring their retirement benefits and the rights onto free social services as per the Tanzania National Ageing Policy of 2003. Elders are therefore faced with physical, psychological and geriatric social suffering. It is on this basis that this study tries to explore the common preventable health and social problems encountered by elderly in Shinyanga Region in northern part of Tanzania. Methods: Across sectional community based study of 465 subjects randomly selected was done in three wards of Kahama District. The district was selected randomly out of 8 districts of Shinyanga Region, structured questionnaires with both closed and opened endower used;the information was collected from house to house and other information collected from health facilities within the wards as every ward had one public health facility;subjects (respondents) were obtained using purposive sampling technique aiming at elderly with 60 years of age and above. Results: Kahama district has a population of approximately 36,014 of which 1500 (4%) are in the elderly age group of 60 years and above. The study population was 465 which is 30% (465/1500) of the geriatric population of Kahama. Among this group 5% were female while 41% were male and 53% (248/465) were married. 64% (297/465) were taking care of themselves, 32% (150/465) cared by relatives and 4% (18/465) cared by the community. Among the respondents, 40% (185/465) were affected by HIV/AIDs in one way or another either living with orphans whose parents died of HIV/AIDS or asking care of the infected patients within the family. It was also found that 73% of the geriatrics were not exempted from medical treatment fees so they had to pay for their medical care. However, only 32% were aware of getting free treatment and 61% of the study populations were not satisfied with the medical care provided at the public health facilities. The common diseases affecting this age group are: Eye problem 59% (273/465);Arthritis 52% (241/465);Dental problems 27% (124/465);Hypertension 23% (107/465);Backache 22% (105/465);Malaria 28% (132/465);Hearing problems 26% (121/645);Urinary tract Infection 35% (165/465);Depression 8% (36/465). Dementia was also a problem though we had no tools to confirm the diagnosis;some of the geriatrics had more than two diseases. Conclusion: The majority of the elderly age group in Kahama District are not aware of their rights that they deserve free treatment according to Tanzania policy, furthermore for assessment and screening of health problems. A majority of the elderly die prematurely due to preventable diseases and more than half of the diseases affecting geriatrics are preventable.
文摘AIM: To calculate the proportion of potentially preventable hospitalizations due to peptic ulcer disease (PUD), erosive gastritis (EG) or duodenitis (ED).
文摘BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer patients.METHODS:Data of patients who readmitted to intensive care unit(ICU)at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences(CAMS)and Peking Union Medical College(PUMC)between January 2013 and November 2016 were retrospectively collected and reviewed.RESULTS:A total of 39 patients were included in the final analysis,and the overall readmission rate between 2013 and 2016 was 1.32%(39/2,961).Of 39 patients,32(82.1%)patients were judged as unpreventable and 7(17.9%)patients were preventable.There were no significant differences in duration of mechanical ventilation,ICU LOS,hospital LOS,ICU mortality and in-hospital mortality between patients who were unpreventable and preventable.For 24 early readmission patients,7(29.2%)patients were preventable and 17(70.8%)patients were unpreventable.Patients who were late readmission were all unpreventable.There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable(100%vs.66.8%,log rank=1.668,P=0.196).CONCLUSION:Most readmission patients were unpreventable,and all preventable readmissions occurred in early period after discharge to ward.There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.
文摘Tuberculosis (TB) incidence within Healthcare workers remains one of the lowest occupation specific rates in the United States. We report a case of a 33-year-old African American male presented with a right chest mass and without fever, chills or cough. Bacterial and Fungal cultures were sent during the initial visit and were negative throughout the entire management of his care. After several months of surgical interventions, the patient appeared positive for TB;however a staff member contracted the disease. The patient was managed successfully with the four-drug regimen of Isoniazid, Rifampin, Pyrazinamide and Ethambutol and recovered well from his surgeries.
文摘Objectives Coroners in England and Wales have a duty to write Prevention of Future Deaths(PFDs)reports when they believe that action should be taken to prevent similar deaths.We conducted a systematic case series of the reports involving maternal deaths to characterise these deaths in terms of demographics,explore the concerns raised by the coroners and understand what actions were reported by organisations in their responses to the coroner.Methods All coroners'PFDs published between July 2013 and 1 August 2023 in England and Wales were collected and reviewed(n=4435).Reports were searched for keywords related to maternal deaths.Case information was extracted into pre-specified domains and compared to other data on maternal deaths.Results Twenty nine(n=29)cases were found involving a maternal death.The median age at death was 33.5 years(IQR 29±36 years)and three-quarters(75.9%)of deaths occurred in hospitals.The most common cause of death was haemorrhage.Coroners frequently voiced concerns around the failure to provide appropriate treatment(48.2%)and failure of timely escalation(37.9%).Specific lessons we have highlighted include gaps in national guidance,failure to follow national protocols,communication issues and lack of resources or staff cover.Only 38%of PFDs had published responses from the organisations they were sent to.When organisations did respond to the coroner,80%reported that they implemented changes,including publishing new local policies,increasing training or committing to increased staffing.Conclusions Poor response rates to PFDs indicate underutilisation of these reports as a resource for improvement in maternal care.PFDs highlighted gaps in obstetric care and national guidance which,if appropriately addressed and regularly and routinely monitored,could prevent similar deaths.
文摘Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available.Evaluations of the association of actionable genotypes in these genes with life span are currently lacking.
基金Under the auspices of National Key Research and Development Program of China(No.2017YFA0604902,2024YFF1306802)Natural Science Foundation of Fujian Province(No.2022J01497)Open Project of the Strait Meteorology Laboratory(No.2025KF03)。
文摘China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfalls under global change is critical for effective disaster risk management.This study utilizes future typhoon track data simulated by the regional climate model version 4(RegCM4),combined with projected population and Gross Domestic Product(GDP)data for China’s coastal regions under three Shared Socioeconomic Pathways(SSPs:SSP1,sustainability;SSP2,middle of the road;SSP5,fossil-fueled development).We analyze typhoon impact zones for future periods(2030s,2050s,and 2090s)under Representative Concentration Pathways(RCPs:RCP2.6,RCP4.5,and RCP8.5,representing low,medium,and high greenhouse gas emission scenarios,respectively).Exposure levels for 2030,2050,and 2100 are calculated based on the annual average frequency of typhoon impacts during these periods,aiming to quantify the distribution characteristics of typhoon-affected population and GDP in China’s coastal regions.Key findings reveal two high-frequency typhoon im-pact zones:the Taiwan Strait region and the northern Qiongzhou Strait region.Furthermore,under RCP2.6,typhoon impacts may ex-tend to Liaoning,while RCP4.5 and RCP8.5 scenarios indicate potential impacts reaching further north to Heilongjiang.Under RCP4.5,Northeast China will experience the largest typhoon-affected area(43.800×10^(4) km^(2))by the 2030s.High population and GDP exposure concentrates in the Yangtze River Delta,the Pearl River Delta,and the Taiwan Strait coastal areas.Notably,Liaoning’s cumulative ex-posed population may exceed 0.100×10^(8) by 2030 and 2050 under RCP4.5 and RCP8.5 due to typhoon track migration.Given China’s location within the Western Pacific typhoon high-incidence region,the northward expansion of impacts will substantially escalate socio-economic exposure in mid-latitude regions previously at lower risk.These findings underscore the imperative for enhanced disaster pre-vention,mitigation strategies and targeted countermeasure research.
文摘Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
基金supported by The Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(RS-2023-00244901)(to RB)。
文摘Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accompanied by a surge in the incidence of incurable neurodegenerative diseases(NDDs).These diseases primarily affect the cognitive and behavioral functions of older adults by impacting brain activity.Mild cognitive impairment(MCI)is a neurodegenerative condition that affects a significant portion of the population.
基金supported by the grants No.82370912 from the National Natural Science Foundation of ChinaNo.2022020801010499 from the Bureau of Science and Technology of Wuhan,ChinaNo.2042023kf0231 from the Fundamental Research Funds for the Central Universities,China。
文摘Tooth developmental anomalies are a group of disorders caused by unfavorable factors affecting the tooth development process,resulting in abnormalities in tooth number,structure,and morphology.These anomalies typically manifest during childhood,impairing dental function,maxillofacial development,and facial aesthetics,while also potentially impacting overall physical and mental health.The complex etiology and diverse clinical phenotypes of these anomalies pose significant challenges for prevention,early diagnosis,and treatment.As they usually emerge early in life,long-term management and multidisciplinary collaboration in dental care are essential.However,there is currently a lack of systematic clinical guidelines for the diagnosis and treatment of these conditions,adding to the difficulties in clinical practice.In response to this need,this expert consensus summarizes the classifications,etiology,typical clinical manifestations,and diagnostic criteria of tooth developmental anomalies based on current clinical evidence.It also provides prevention strategies and stage-specific clinical management recommendations to guide clinicians in diagnosis and treatment,promoting early intervention and standardized care for these anomalies.
基金Centre of Research,Education,Innovation,and Intervention in Sport(CIFI2D)is financed by the Portuguese Foundation for Science and Technology,under the DOI https://doi.org/10.54499/UIDB/05913/2020。
文摘1.Introduction Injury prevention is an essential element of science and medicine in sports,and it garners attention from stakeholders focused on minimizing athletes’injury risk.Catchy titles including“injury risk”or“injury prevention”are likely to grab the readers’attention.Meanwhile,studies on injury prevention might assess the impact of interventions on mitigating injury risk factors(e.g.,strength,range of motion(ROM))but fail to report injury data(e.g.,incidence).1,2 Likewise,observational studies may include“injury risk”in their titles,but fail to provide injury data.3 Without injury data.
文摘Dementia and Alzheimer's disease (AD) are both age-related conditions that predominantly affect older adults.According to prevalence studies,the burden of these diseases on society is expected to increase in the coming years,particularly in relation to rising longevity and life expectancy.Advances in therapeutic and preventive strategies are needed to help reduce their global burden,which remains among the most significant health challenges in aging populations (Brookmeyer et al.,2007).
文摘This article examines the intelligent forest sentry system in the Mount Tai Scenic Area, analyzing its applications, accomplishments, and significance in forest fire prevention. It highlights the system's critical role in enhancing comprehensive forest fire prevention and control capabilities, accelerating emergency response times, and safeguarding the heritage resources of Mount Tai. Furthermore, the system is evolving into a "Smart Forest and Grassland Resources Supervision Platform" that integrates forest fire early warning, ecological environment monitoring, and pest and disease management to promote the sustainable development of forest resources.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
基金supported by the Nature Science Foundation of Liaoning Province,Nos.2022-MS-211,2021-MS-064,and 2024-MS-048(all to YC).
文摘Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.
