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
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: 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
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for m...Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.展开更多
Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: ...Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a cross-sectional, descriptive study with data collection over a period of 10 years;The data collection was retrospective over nine years from January 1, 2013 to December 31, 2021 and prospective over one year from January 1, 2022 to December 31, 2022. This study focused on all patients whose death was noted on arrival during pregnancy, labor or in the postpartum period in the Gynecology-Obstetrics Department of Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of statistical data were carried out using SPSS 20.0 software. Results: During the study period, we recorded 93 cases of death noted on arrival out of a total of 606 maternal deaths, i.e., a frequency of 15.34%. The average age was 27 years with the extremes of 20 years and 34 years. They came mainly from rural areas at 74%, were married at 82%, uneducated at 51.6%, housewives at 87.1%. The profession of the spouses is worker at 37.6%. In our sample, evacuated patients were the most represented with 75.3%. Postpartum hemorrhage was the most frequent reason for admission with 22.6%. The deceased patients had no medical history at 86%. In our series, 59.5% of the deceased patients had not had antenatal consultations (CPN). Patients who died on arrival and who had given birth at home were the most represented with 54.8%. Deaths from immediate postpartum hemorrhage complicated by shock were the most frequent with 25.8% followed by severe anemia 8.6%. Deaths were mainly due to direct obstetric causes at 76.3%. In these deaths observed on arrival, the 2nd delay was identified at 48.4%. Conclusion: Maternal deaths observed on arrival remain frequent in the Kayes region. The main causes are immediate postpartum hemorrhage and anemia, which are almost all preventable causes of maternal death following the 1st and 2nd delay.展开更多
Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading pr...Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.展开更多
Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due...Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.展开更多
Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuarie...Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuaries for treatment and recovery, making the quality of paramount importance. This study investigates the impact of traffic-related emissions on indoor air quality within a Level 5 Hospital outpatient ward. Measurements were taken over five consecutive days, revealing that while CO2 levels generally remained within safe limits, there were instances where concentrations exceeded 3000 ppm, categorizing them as “Hazardous.” Notably, particulate matter (PM2.5 and PM10) levels fluctuated significantly, with peak concentrations observed during working hours correlating with increased vehicle activity. The data indicated that PM2.5 levels reached as high as 75 µg/m3, with 91.68% of recorded values exceeding the World Health Organization’s (WHO) and Environmental Protection Agency 24-hour mean threshold of 25 µg/m3. Similarly, PM10 concentrations peaked at 120 µg/m3, with 61.19% of values surpassing the WHO threshold of 50 µg/m3, both of which pose serious health risks, particularly to vulnerable populations such as pregnant women, infants, and the elderly. Additionally, the study highlighted the critical role of wind direction in pollutant dispersion, with specific patterns contributing to elevated indoor concentrations. These findings underscore the urgent need for targeted interventions and proactive air quality management strategies in healthcare facilities, including the strategic design of hospital wards away from primary emission sources and the promotion of electric vehicle use to mitigate traffic-related emissions.展开更多
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
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
This paper exhibits the construction and development of Acupuncture and Moxibustion Hospital of China Academy of Chinese Medical Sciences(CACMS),based on Lian ZHU’s acupuncture academic thought,focusing on the practi...This paper exhibits the construction and development of Acupuncture and Moxibustion Hospital of China Academy of Chinese Medical Sciences(CACMS),based on Lian ZHU’s acupuncture academic thought,focusing on the practice of the hospital development during the past 74 years,from 1951 to 2025,and by analyzing the development trajectory and elaborating the four-dimensional collaborative development mode guided by Lian ZHU’s thought,grounded in clinical evidence,driven by scientific innovation,guided by international standards,and rooted in educational inheritance.(1)After more than 70 years of development,Acupuncture and Moxibustion Hospital of CACMS has developed into the typical small-scaled general hospital of traditional Chinese medicine(TCM)with acupuncture-moxibustion as the main intervention,and has obtained a fruitful achievement in academic research.(2)The Hospital has led and participated in the formulation of a number of clinical practice guidelines of China Association of Acupuncture and Moxibustion,is entitled as the World Health Organization Collaborating Centre for traditional medicine,and has been ranked among the top in the outpatient visits of acupuncture-moxibustion department of TCM hospitals in Beijing for years.(3)There is a well-known professional team of acupuncture-moxibustion of TCM in the Hospital,and with the characteristic modes of acupuncture-moxibustion diagnosis and treatment delivered,the remarkable curative effects have been obtained in treatment of diseases in neurological,gynecological diseases,orthopedic departments,as well as pain disorders,allergic diseases.(4)In the future,facing the opportunities and challenges in the development of global healthcare,it is necessary to deepen the research on“intelligent acupuncture and moxibustion”,integrating modern technologies such as artificial intelligence and big data,exploring the potential value of acupuncture and moxibustion,discovering and innovating theoretical research on acupuncture and moxibustion,establishing scientific methods,standardizing clinical operation techniques,and driving the creative transformation of TCM.(5)The hospital lays the great consideration to the cultivation of acupuncture-moxibustion talents by means of multiple approaches,in order to deeply grasp the essence of TCM and improve the comprehensive quality of talents.(6)The hospital keeps on the leading role of international communication,advancing the international exchange and cooperation of acupuncture and moxibustion,and contributes more eastern wisdom to global health governance,and promote acupuncture and moxibustion of TCM,the treasure of the Chinese nation to display its importance in the world.展开更多
Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the resu...Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the results of bone density examinations,they were divided into a normal bone density group,a low bone mass group,and an osteoporosis group.The normal bone density group was used as the control group to analyze the clinical characteristics of bone loss.Results:The incidence of bone loss in patients with Graves’disease was 80.72%,with osteoporosis accounting for 39.16%and low bone mass accounting for 41.57%.The incidences of hyperthyroid heart disease,Graves’ophthalmopathy,and leukopenia in the osteoporosis group and the low bone mass group were significantly higher than those in the normal bone density group,reaching 84.62%,60.87%,and 34.38%,respectively(P<0.05).The age of the osteoporosis group with Graves’disease was 50.88±12.03 years old,which was higher than that of the normal bone density group(40.03±12.58 years old).The disease course was 55.66±14.21 days,longer than that of the normal bone density group(43.38±8.55 days).FT4 was 61.69±8.42 pmol/L,higher than that of the normal bone density group(51.01±6.77 pmol/L),while TSH was 0.08±0.51μIU/ml,lower than that of the normal bone density group(0.22±0.55μIU/ml).The blood phosphorus was 1.25±0.29 mmol/L,lower than that of the normal bone density group(1.34±0.27 mmol/L),with statistical significance(P<0.05).In the low bone mass group,FT3(13.08±9.05 pmol/L)and FT4(46.14±3.46 pmol/L)were lower than those in the normal bone density group,with statistical significance(P<0.05).Logistic regression analysis revealed that age,disease course,and TSH were contributing factors to bone loss.Conclusion:Patients with Graves’disease are prone to bone loss,and age,disease course,and TSH are contributing factors to bone loss.展开更多
The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,central...The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.展开更多
Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction ...Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction of completion times for porter tasks.To address this gap,we utilized real-world porter delivery data from Taiwan University Hospital,China,Yunlin Branch,Taiwan Region of China.We first identified key features that can influence the duration of porter tasks.We then employed three widely-used machine learning algorithms:decision tree,random forest,and gradient boosting.To leverage the strengths of each algorithm,we finally adopted an ensemble modeling approach that aggregates their individual predictions.Our experimental results show that the proposed ensemble model can achieve a mean absolute error of 3 min in predicting task response time and 4.42 min in task completion time.The prediction error is around 50%lower compared to using only the historical average.These results demonstrate that our method significantly improves the accuracy of porter task time prediction,supporting better resource planning and patient care.It helps ward staff streamline workflows by reducing delays,enables porter managers to allocate resources more effectively,and shortens patient waiting times,contributing to a better care experience.展开更多
Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chines...Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.展开更多
Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall per...Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.展开更多
Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(AD...Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(ADL)scores,quality of survival,and caregiver burden,and to provide a reference basis for the effective implementation of health education for disabled oncology patients in the home and the improvement of their quality of life.Methods:From May 2021 to May 2024,112 patients with ADL Scale scores<60 who were hospitalized in 7 tertiary-level hospitals in Guangdong Province were selected for the questionnaire survey and implementation of the intervention analysis.The 112 study subjects chosen were randomly divided into 56 in the intervention group and 56 in the control group.The patients in the control group were discharged from the hospital and followed up once a month by telephone,health education,and disease rehabilitation guidance.The intervention group constructed a home network hospital on a routine basis,utilized the micro letter public number and APP applet intervention guidance for 6 consecutive months,and used the general information questionnaire,Barthel index,SF-36 quality of life scale(the Medical Outcomes Study item short-form health survey,SF-36),the caregiver’s quality of life scale(the SF-36),and the Caregiver Burden Scale ZBL(Zarit Burden Interview,ZBI),to investigate the number of care needs,quality of life,and the degree of caregiving burden of the 2 groups of patients.Results:The quality of survival of all patients with disabling tumors was poor.Patients with moderate to severe dependence on ADL were not only impaired in physiological dimensions but also had varying degrees of reduction in psychological dimensions,with the lowest scores in physiological functioning and the highest scores in somatic pain.There was no statistically significant difference in the comparison of the general information and scores of patients in the 2 groups(P>0.05).After 3 months and 6 months of intervention,the difference in scores between the 2 groups was statistically significant(P<0.05),in which the SF-36 score of the intervention group was higher than that of the control group,and the ADL score was lower than that of the control group.There was a statistically significant difference in ADL and ZBI scores between the intervention and pre-intervention(P<0.05)groups.In the control group,after 3 months of intervention,ADL and ZBI scores were statistically different compared with pre-intervention(P<0.05);after 6 months of intervention,there was no statistical difference(P>0.05).Conclusions:Health education based on home network hospitals can reduce the healthcare needs of disabled oncology patients and meet their safety and physiological health guidance needs.The quality of life of disabled oncology patients is at the bottom level,the burden of family care is heavy,and the burden of care for the primary caregiver is heavy.At the root of the problem,there is a lack of scientific,effective,and practical interventions,which can be sorted by clarifying the patients’needs for home care and providing targeted nursing skills can improve the quality of life of the patients and reduce somatic discomfort.展开更多
Objective Chronic obstructive pulmonary disease(COPD)is a major health concern in northwest China;however,the impact of particulate matter(PM)exposure during sand-dust storms(SDS)remains poorly understood.Therefore,th...Objective Chronic obstructive pulmonary disease(COPD)is a major health concern in northwest China;however,the impact of particulate matter(PM)exposure during sand-dust storms(SDS)remains poorly understood.Therefore,this study aimed to investigate the association between PM exposure on SDS days and COPD hospitalization risk in arid regions.Methods Data on daily COPD hospitalizations were collected from 323 hospitals from 2018 to 2022,along with the corresponding air pollutant and meteorological data for each city in Gansu Province.Employing a space-time-stratified case-crossover design and conditional Poisson regression,we analyzed 265,379 COPD hospitalizations.Results PM exposure during SDS days significantly increased COPD hospitalization risk[relative risk(RR)for PM2.5,lag 3:1.028,95%confidence interval(CI):1.021–1.034],particularly among men and the elderly,and during the cold season.The burden of PM exposure on COPD hospitalization was substantially high in Northwest China,especially in the arid and semi-arid regions.Conclusion Our findings revealed a positive correlation between PM exposure during SDS episodes and elevated hospitalization rates for COPD in arid and semi-arid zones in China.This highlights the urgency of developing region-specific public health strategies to address adverse respiratory outcomes associated with SDS-related air quality deterioration.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
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: 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Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
文摘Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.
文摘Introduction: The objective of this work was to study maternal deaths noted on arrival in the Gynecology and Obstetrics Department at Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a cross-sectional, descriptive study with data collection over a period of 10 years;The data collection was retrospective over nine years from January 1, 2013 to December 31, 2021 and prospective over one year from January 1, 2022 to December 31, 2022. This study focused on all patients whose death was noted on arrival during pregnancy, labor or in the postpartum period in the Gynecology-Obstetrics Department of Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of statistical data were carried out using SPSS 20.0 software. Results: During the study period, we recorded 93 cases of death noted on arrival out of a total of 606 maternal deaths, i.e., a frequency of 15.34%. The average age was 27 years with the extremes of 20 years and 34 years. They came mainly from rural areas at 74%, were married at 82%, uneducated at 51.6%, housewives at 87.1%. The profession of the spouses is worker at 37.6%. In our sample, evacuated patients were the most represented with 75.3%. Postpartum hemorrhage was the most frequent reason for admission with 22.6%. The deceased patients had no medical history at 86%. In our series, 59.5% of the deceased patients had not had antenatal consultations (CPN). Patients who died on arrival and who had given birth at home were the most represented with 54.8%. Deaths from immediate postpartum hemorrhage complicated by shock were the most frequent with 25.8% followed by severe anemia 8.6%. Deaths were mainly due to direct obstetric causes at 76.3%. In these deaths observed on arrival, the 2nd delay was identified at 48.4%. Conclusion: Maternal deaths observed on arrival remain frequent in the Kayes region. The main causes are immediate postpartum hemorrhage and anemia, which are almost all preventable causes of maternal death following the 1st and 2nd delay.
文摘Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.
文摘Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.
文摘Air quality is a critical factor in maintaining health and well-being, influencing both current conditions and future outcomes. Hospitals are one of the sensitive areas of our society, for they are built as sanctuaries for treatment and recovery, making the quality of paramount importance. This study investigates the impact of traffic-related emissions on indoor air quality within a Level 5 Hospital outpatient ward. Measurements were taken over five consecutive days, revealing that while CO2 levels generally remained within safe limits, there were instances where concentrations exceeded 3000 ppm, categorizing them as “Hazardous.” Notably, particulate matter (PM2.5 and PM10) levels fluctuated significantly, with peak concentrations observed during working hours correlating with increased vehicle activity. The data indicated that PM2.5 levels reached as high as 75 µg/m3, with 91.68% of recorded values exceeding the World Health Organization’s (WHO) and Environmental Protection Agency 24-hour mean threshold of 25 µg/m3. Similarly, PM10 concentrations peaked at 120 µg/m3, with 61.19% of values surpassing the WHO threshold of 50 µg/m3, both of which pose serious health risks, particularly to vulnerable populations such as pregnant women, infants, and the elderly. Additionally, the study highlighted the critical role of wind direction in pollutant dispersion, with specific patterns contributing to elevated indoor concentrations. These findings underscore the urgent need for targeted interventions and proactive air quality management strategies in healthcare facilities, including the strategic design of hospital wards away from primary emission sources and the promotion of electric vehicle use to mitigate traffic-related emissions.
文摘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.
基金Supported by the Basic Scientific Research Business Foundation of the Institute of Acupuncture and Moxibustion,CACMS:ZZ-2023014。
文摘This paper exhibits the construction and development of Acupuncture and Moxibustion Hospital of China Academy of Chinese Medical Sciences(CACMS),based on Lian ZHU’s acupuncture academic thought,focusing on the practice of the hospital development during the past 74 years,from 1951 to 2025,and by analyzing the development trajectory and elaborating the four-dimensional collaborative development mode guided by Lian ZHU’s thought,grounded in clinical evidence,driven by scientific innovation,guided by international standards,and rooted in educational inheritance.(1)After more than 70 years of development,Acupuncture and Moxibustion Hospital of CACMS has developed into the typical small-scaled general hospital of traditional Chinese medicine(TCM)with acupuncture-moxibustion as the main intervention,and has obtained a fruitful achievement in academic research.(2)The Hospital has led and participated in the formulation of a number of clinical practice guidelines of China Association of Acupuncture and Moxibustion,is entitled as the World Health Organization Collaborating Centre for traditional medicine,and has been ranked among the top in the outpatient visits of acupuncture-moxibustion department of TCM hospitals in Beijing for years.(3)There is a well-known professional team of acupuncture-moxibustion of TCM in the Hospital,and with the characteristic modes of acupuncture-moxibustion diagnosis and treatment delivered,the remarkable curative effects have been obtained in treatment of diseases in neurological,gynecological diseases,orthopedic departments,as well as pain disorders,allergic diseases.(4)In the future,facing the opportunities and challenges in the development of global healthcare,it is necessary to deepen the research on“intelligent acupuncture and moxibustion”,integrating modern technologies such as artificial intelligence and big data,exploring the potential value of acupuncture and moxibustion,discovering and innovating theoretical research on acupuncture and moxibustion,establishing scientific methods,standardizing clinical operation techniques,and driving the creative transformation of TCM.(5)The hospital lays the great consideration to the cultivation of acupuncture-moxibustion talents by means of multiple approaches,in order to deeply grasp the essence of TCM and improve the comprehensive quality of talents.(6)The hospital keeps on the leading role of international communication,advancing the international exchange and cooperation of acupuncture and moxibustion,and contributes more eastern wisdom to global health governance,and promote acupuncture and moxibustion of TCM,the treasure of the Chinese nation to display its importance in the world.
文摘Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the results of bone density examinations,they were divided into a normal bone density group,a low bone mass group,and an osteoporosis group.The normal bone density group was used as the control group to analyze the clinical characteristics of bone loss.Results:The incidence of bone loss in patients with Graves’disease was 80.72%,with osteoporosis accounting for 39.16%and low bone mass accounting for 41.57%.The incidences of hyperthyroid heart disease,Graves’ophthalmopathy,and leukopenia in the osteoporosis group and the low bone mass group were significantly higher than those in the normal bone density group,reaching 84.62%,60.87%,and 34.38%,respectively(P<0.05).The age of the osteoporosis group with Graves’disease was 50.88±12.03 years old,which was higher than that of the normal bone density group(40.03±12.58 years old).The disease course was 55.66±14.21 days,longer than that of the normal bone density group(43.38±8.55 days).FT4 was 61.69±8.42 pmol/L,higher than that of the normal bone density group(51.01±6.77 pmol/L),while TSH was 0.08±0.51μIU/ml,lower than that of the normal bone density group(0.22±0.55μIU/ml).The blood phosphorus was 1.25±0.29 mmol/L,lower than that of the normal bone density group(1.34±0.27 mmol/L),with statistical significance(P<0.05).In the low bone mass group,FT3(13.08±9.05 pmol/L)and FT4(46.14±3.46 pmol/L)were lower than those in the normal bone density group,with statistical significance(P<0.05).Logistic regression analysis revealed that age,disease course,and TSH were contributing factors to bone loss.Conclusion:Patients with Graves’disease are prone to bone loss,and age,disease course,and TSH are contributing factors to bone loss.
文摘The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.
基金supported by National Taiwan University Hospital Yunlin Branch Project NTUHYL 110.C018National Science and Technology Council,Taiwan.
文摘Porters play a crucial role in hospitals because they ensure the efficient transportation of patients,medical equipment,and vital documents.Despite its importance,there is a lack of research addressing the prediction of completion times for porter tasks.To address this gap,we utilized real-world porter delivery data from Taiwan University Hospital,China,Yunlin Branch,Taiwan Region of China.We first identified key features that can influence the duration of porter tasks.We then employed three widely-used machine learning algorithms:decision tree,random forest,and gradient boosting.To leverage the strengths of each algorithm,we finally adopted an ensemble modeling approach that aggregates their individual predictions.Our experimental results show that the proposed ensemble model can achieve a mean absolute error of 3 min in predicting task response time and 4.42 min in task completion time.The prediction error is around 50%lower compared to using only the historical average.These results demonstrate that our method significantly improves the accuracy of porter task time prediction,supporting better resource planning and patient care.It helps ward staff streamline workflows by reducing delays,enables porter managers to allocate resources more effectively,and shortens patient waiting times,contributing to a better care experience.
文摘Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.
文摘Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.
文摘Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(ADL)scores,quality of survival,and caregiver burden,and to provide a reference basis for the effective implementation of health education for disabled oncology patients in the home and the improvement of their quality of life.Methods:From May 2021 to May 2024,112 patients with ADL Scale scores<60 who were hospitalized in 7 tertiary-level hospitals in Guangdong Province were selected for the questionnaire survey and implementation of the intervention analysis.The 112 study subjects chosen were randomly divided into 56 in the intervention group and 56 in the control group.The patients in the control group were discharged from the hospital and followed up once a month by telephone,health education,and disease rehabilitation guidance.The intervention group constructed a home network hospital on a routine basis,utilized the micro letter public number and APP applet intervention guidance for 6 consecutive months,and used the general information questionnaire,Barthel index,SF-36 quality of life scale(the Medical Outcomes Study item short-form health survey,SF-36),the caregiver’s quality of life scale(the SF-36),and the Caregiver Burden Scale ZBL(Zarit Burden Interview,ZBI),to investigate the number of care needs,quality of life,and the degree of caregiving burden of the 2 groups of patients.Results:The quality of survival of all patients with disabling tumors was poor.Patients with moderate to severe dependence on ADL were not only impaired in physiological dimensions but also had varying degrees of reduction in psychological dimensions,with the lowest scores in physiological functioning and the highest scores in somatic pain.There was no statistically significant difference in the comparison of the general information and scores of patients in the 2 groups(P>0.05).After 3 months and 6 months of intervention,the difference in scores between the 2 groups was statistically significant(P<0.05),in which the SF-36 score of the intervention group was higher than that of the control group,and the ADL score was lower than that of the control group.There was a statistically significant difference in ADL and ZBI scores between the intervention and pre-intervention(P<0.05)groups.In the control group,after 3 months of intervention,ADL and ZBI scores were statistically different compared with pre-intervention(P<0.05);after 6 months of intervention,there was no statistical difference(P>0.05).Conclusions:Health education based on home network hospitals can reduce the healthcare needs of disabled oncology patients and meet their safety and physiological health guidance needs.The quality of life of disabled oncology patients is at the bottom level,the burden of family care is heavy,and the burden of care for the primary caregiver is heavy.At the root of the problem,there is a lack of scientific,effective,and practical interventions,which can be sorted by clarifying the patients’needs for home care and providing targeted nursing skills can improve the quality of life of the patients and reduce somatic discomfort.
基金supported by the Innovative Talent Project of Lanzhou City,Lanzhou Science and Technology Bureau(2022-RC-42)the Fundamental Research Funds for the Central Universities,Lanzhou University,China(lzujbky-2021-ey07,lzujbky-2024-it59,lzujbky-2025-it29)the Gansu Province Postgraduate Innovation Star Program(2025CXZX-018).
文摘Objective Chronic obstructive pulmonary disease(COPD)is a major health concern in northwest China;however,the impact of particulate matter(PM)exposure during sand-dust storms(SDS)remains poorly understood.Therefore,this study aimed to investigate the association between PM exposure on SDS days and COPD hospitalization risk in arid regions.Methods Data on daily COPD hospitalizations were collected from 323 hospitals from 2018 to 2022,along with the corresponding air pollutant and meteorological data for each city in Gansu Province.Employing a space-time-stratified case-crossover design and conditional Poisson regression,we analyzed 265,379 COPD hospitalizations.Results PM exposure during SDS days significantly increased COPD hospitalization risk[relative risk(RR)for PM2.5,lag 3:1.028,95%confidence interval(CI):1.021–1.034],particularly among men and the elderly,and during the cold season.The burden of PM exposure on COPD hospitalization was substantially high in Northwest China,especially in the arid and semi-arid regions.Conclusion Our findings revealed a positive correlation between PM exposure during SDS episodes and elevated hospitalization rates for COPD in arid and semi-arid zones in China.This highlights the urgency of developing region-specific public health strategies to address adverse respiratory outcomes associated with SDS-related air quality deterioration.
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.
