Search

Blood pressure (BP) often rises before surgery. This study investigated whether BP elevation immediately before surgery was associated with adverse outcomes. Medical records of 11,732 patients (average age: 61 years; male: 47.4%) who underwent non-cardiac elective inpatient surgery under general anesthesia at Kagawa University Hospital between January 2011 and June 2019 were reviewed. Differences between the first BP values measured on the day before surgery and the first BP values in the operating room were defined as Δ systolic BP (ΔSBP) and Δ diastolic BP (ΔDBP). The relationships between ΔSBP/ΔDBP and 30-day mortality, 30-day readmission, and over-the-standard length of hospital stay (OSLOS) were assessed. OSLOS was defined as a hospital stay longer than mean+2 standard deviations and was calculated using the Japanese Diagnosis Procedure Combination data. In univariate analysis, the differences in ΔSBP and ΔDBP between the OSLOS and standard LOS groups were both 2 mmHg. In multivariate logistic regression analysis, only ΔDBP was associated with OSLOS. The adjusted odds ratio (95% confidence interval) for the largest quartile was 1.31 (1.02-1.69) (p

The number of patients who survive for a long time after cancer diagnosis is rapidly increasing; however, such patients experience major problems such as returning to work and changes in their income. This study aimed to determine the extent of income changes of cancer patients during the first year after cancer diagnosis and identify the influencing factors. From November 2019 through January 2020, we conducted a multicenter, self-administered anonymous survey of cancer patients in Kagawa Prefecture, Japan. The number of questionnaires collected was 483 (recovery rate 60.4%), and the number of participants who met the inclusion criteria was 72. Mean year-on-year income level one year since cancer diagnosis was 66% (SD: 32%; median: 70%). Cancer stage (p = 0.016), employment status at diagnosis (p = 0.006), and continued employment at the same workplace (p = 0.001) were associated with income change. Findings from this study showed that cancer patients lost one-thirds of their income one year after their diagnosis. It was related to the stage of their illness, employment status, and continued employment at their workplace just before the diagnosis. Employers should provide cancer patients with the support they need to keep them employed.

The SARS-CoV-2 (COVID-19) pandemic has had a tremendous impact on the functionality of health systems and world affairs. We assessed knowledge, attitudes, and practices (KAPs) of healthcare workers (HCWs) in the Democratic Republic of the Congo (DRC). This was a cross-sectional study conducted in 23 referral hospitals located in three towns of the DRC (Lubumbashi, Kamina, Mbuji-Mayi). In total, 613 HCWs were surveyed using the World Health Organization’s (WHO’s) “Exposure Risk Assessment in the Context of COVID-19” questionnaire. Participants included medical doctors (27.2%) and other categories of HCWs (72.8%). The mean age was 40.3 ± 11.7 years. Over 80% (range: 83–96%) of respondents had sufficient knowledge on each of the three domains: COVID-19 symptoms, disease transmission, and patient care approach. However, attitudes and practices scores were relatively low. Only 27.7% of HCWs were willing to receive a COVID-19 vaccine when it is available, whereas 55% of HCWs complied with good practices; 49.4% wore masks consistently and, surprisingly, only 54.9% used personal protective equipment (PPE) consistently at work and during contact with patients. Knowledge level was positively associated with the use of social media as a primary source of COVID-19-related information and the category of residence, with HCWs from towns already affected by the COVID-19 epidemic being more likely to have positive attitudes (adjusted OR, 1.64; 95%CI, 1.32–2.20) and comply with good practices (aOR, 2.79; 95%CI, 1.93-4.06). This study showed that most Congolese HCWs had sufficient knowledge on COVID-19, whereas the majority did not comply with consistent PPE use. The government of the DRC should urgently take major steps in capacity building for HCWs in outbreak preparedness and supplying hospitals with PPE.

We analyzed the temporal trends and significant changes in apparent energy and macronutrient intakes in the Bangladeshi diet from 1961 to 2017. Due to the lack of a long-running national dietary intake dataset, this study used the Food and Agriculture Organization (FAO)&rsquo, s old and new food balance sheet dataset. We used the joinpoint regression model and jump model to analyze the temporal trends in apparent energy and macronutrient intakes. The annual percentage change (APC) was computed for each segment of the trends. Bangladesh has experienced a late energy revolution in their dietary history. During the 1960s, 1970s, 1980s, and 1990s, Bangladesh was suffering from substantive calorie deficits, where in apparent energy intake was less than 2200 kcal/day/person. Since the late 1990s, Bangladesh has made significant progress in raising the apparent energy consumption in the diet. Since the late 1970s, apparent fat intake started to increase significantly at a marked rate (APC = 2.16), whereas since the early 1990s, protein intake increased significantly by 1.33% per year. Plant sources have mostly governed the protein and fat intake trends in the Bangladeshi diet since 1960, whereas animal sources began to contribute significantly in protein intake since 1990 (APC = 3.43) and in fat intake since 2000 (APC = 2.88). Bangladesh overcame the substantive calorie deficit condition in the diet from the late 1990s. Excessive carbohydrate intake along with imbalanced and low-quality protein and fat intakes have been the central features in the diet in Bangladesh.

ラリンジアルマスク（LMA）は，小児においても手術時の気道確保のみならず，挿管困難や緊急時の気道確保，ファイバースコープを用いての挿管や声帯の観察に対して有用なデバイスである．小児の麻酔に用いる際は，分泌物が多いときは避け，十分な麻酔深度を保ち，位置がずれないよう配慮し，さらに抜去のタイミングには十分注意する．困難気道に対しては，明らかな声門以下の病変がなければ小児であってもLMAは高い確率でエアウェイとして機能し，レスキューのデバイスとして準備する価値がある．LMAガイド下ファイバー挿管は成人では基本的手技であるが，小児ならではの難しさがあり，十分な準備と慣れが必要である．