Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including pene...Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including penetrating the cranium. TBI is a public health concern worldwide due to its economic impact. Most TBIs are survivable, do not need hospitalization but may influence productivity. A smaller percentage of TBI due to falls or penetrating TBI (PTBI) needs hospitalization and accounts for largest fraction of TBI care costs.展开更多
Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiar...Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiarized with more complex vascular surgical techniques that often require a vascular surgeon. Pará State is the most populated one in the Brazilian Amazon region and a single hospital with vascular surgeons permanently on call is available. Objectives: To evaluate demographic data on vascular trauma victims;to establish the mechanism, anatomic location, injury pattern and surgical techniques used to manage the vascular lesions treated at the Metropolitan Emergency Hospital;to ascertain associated non-vascular injuries and victim’s clinical outcome. Methods: Retrospective analysis of medical records of patients treated for vascular injuries from February 2011 to February 2013 at the institution in case. All arterial and venous injuries were analyzed. Patients who were not operated by the vascular surgery team, iatrogenic injuries and those who underwent primary or sustained traumatic amputation were excluded. Results: 173 cases;95.95% were male;54.90% were between 25 and 49 years;penetrating trauma mechanisms were found in 88.44%;lower limb was the most affected topography (41.50%);the most injured vessels were the superficial femoral and ulnar arteries (in 15.75% of cases each) and the superficial femoral vein (17.77 %);autologous vein graft was the most performed technique for arterial repair (36.57%) and ligature was performed in 85.00% of venous trauma;amputation rate was 15.60% and mortality rate was 6.35%. Conclusions: Vascular injuries occurred predominantly in men from 24 to 49 years old;penetrating mechanisms were most frequent;lower limb was the most affected topography;the most frequently injured vessels were the ulnar and superficial femoral arteries and the superficial femoral vein;complete vessel transection was the most common injury pattern;arterial trauma was most frequently treated by autologous venous graft interposition and ligature was performed for most of venous injuries;fractures were the most common associated lesions;the majority of patients recovered uneventfully, ischemic and infectious complications were the most frequent ones;deaths were caused by hypovolemic and septic shocks.展开更多
Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systemati...Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large number of children and adolescents dying from NTUIs,and those experiencing social-economic disadvantages remained at high mortality.Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities,which ensures that no one is left behind.展开更多
目的了解2008-2017年北京市门头沟区户籍居民损伤和中毒的死亡情况和特征,为制定防治措施提供依据。方法采用描述性流行病学方法对2008-2017年门头沟区居民损伤和中毒死因进行分析。结果2008-2017年,北京市门头沟区户籍居民损伤和中毒...目的了解2008-2017年北京市门头沟区户籍居民损伤和中毒的死亡情况和特征,为制定防治措施提供依据。方法采用描述性流行病学方法对2008-2017年门头沟区居民损伤和中毒死因进行分析。结果2008-2017年,北京市门头沟区户籍居民损伤和中毒年均粗死亡率为25.10/10万(男性为30.54/10万,女性为19.41/10万),是门头沟区户籍居民第5位死亡原因。损伤和中毒累计潜在减寿年数(potential years of life lost,PYLL)为8344人年,前3位为机动车交通事故、自杀和意外中毒。结论损伤和中毒严重危害门头沟区居民的健康和寿命,不同性别、年龄的损伤和中毒的死亡分布特征不同,应依据其分布特征,采取针对性防控措施,降低死亡率。展开更多
目的探索PDCA循环管理在国际疾病分类(international classification of dis eases,ICD)编码质量管理中的应用价值。方法选取2020年10月—2021年8月湛江中心人民医院收治的8000例出院病案首页疾病分类编码以及手术操作编码作为本次研究...目的探索PDCA循环管理在国际疾病分类(international classification of dis eases,ICD)编码质量管理中的应用价值。方法选取2020年10月—2021年8月湛江中心人民医院收治的8000例出院病案首页疾病分类编码以及手术操作编码作为本次研究对象,对其进行核对、检查等,并用在ICD编码工具,开展PDCA循环管理,比较管理效果。结果管理后病理诊断漏编、损伤以及重度外因编码遗漏、手术操作编码错误等问题低于管理前,差异有统计学意义(P<0.05);管理后的ICD编码质量评分高于管理前,差异有统计学意义(P<0.05)。结论在ICD编码质量管理中应用PDCA循环管理,可以明显降低诊断选择错误、病理诊断漏编、损伤以及重度外因编码遗漏、手术操作编码错误等发生率。展开更多
文摘Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an external force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including penetrating the cranium. TBI is a public health concern worldwide due to its economic impact. Most TBIs are survivable, do not need hospitalization but may influence productivity. A smaller percentage of TBI due to falls or penetrating TBI (PTBI) needs hospitalization and accounts for largest fraction of TBI care costs.
文摘Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiarized with more complex vascular surgical techniques that often require a vascular surgeon. Pará State is the most populated one in the Brazilian Amazon region and a single hospital with vascular surgeons permanently on call is available. Objectives: To evaluate demographic data on vascular trauma victims;to establish the mechanism, anatomic location, injury pattern and surgical techniques used to manage the vascular lesions treated at the Metropolitan Emergency Hospital;to ascertain associated non-vascular injuries and victim’s clinical outcome. Methods: Retrospective analysis of medical records of patients treated for vascular injuries from February 2011 to February 2013 at the institution in case. All arterial and venous injuries were analyzed. Patients who were not operated by the vascular surgery team, iatrogenic injuries and those who underwent primary or sustained traumatic amputation were excluded. Results: 173 cases;95.95% were male;54.90% were between 25 and 49 years;penetrating trauma mechanisms were found in 88.44%;lower limb was the most affected topography (41.50%);the most injured vessels were the superficial femoral and ulnar arteries (in 15.75% of cases each) and the superficial femoral vein (17.77 %);autologous vein graft was the most performed technique for arterial repair (36.57%) and ligature was performed in 85.00% of venous trauma;amputation rate was 15.60% and mortality rate was 6.35%. Conclusions: Vascular injuries occurred predominantly in men from 24 to 49 years old;penetrating mechanisms were most frequent;lower limb was the most affected topography;the most frequently injured vessels were the ulnar and superficial femoral arteries and the superficial femoral vein;complete vessel transection was the most common injury pattern;arterial trauma was most frequently treated by autologous venous graft interposition and ligature was performed for most of venous injuries;fractures were the most common associated lesions;the majority of patients recovered uneventfully, ischemic and infectious complications were the most frequent ones;deaths were caused by hypovolemic and septic shocks.
基金This study was supported by grants from the National Statistical ScientificResearch Program(No.2021LY052)the China Medical Board(21-434 to YS)the National Natural Science Foundation of China(No.82073573).
文摘Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large number of children and adolescents dying from NTUIs,and those experiencing social-economic disadvantages remained at high mortality.Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities,which ensures that no one is left behind.
文摘目的了解2008-2017年北京市门头沟区户籍居民损伤和中毒的死亡情况和特征,为制定防治措施提供依据。方法采用描述性流行病学方法对2008-2017年门头沟区居民损伤和中毒死因进行分析。结果2008-2017年,北京市门头沟区户籍居民损伤和中毒年均粗死亡率为25.10/10万(男性为30.54/10万,女性为19.41/10万),是门头沟区户籍居民第5位死亡原因。损伤和中毒累计潜在减寿年数(potential years of life lost,PYLL)为8344人年,前3位为机动车交通事故、自杀和意外中毒。结论损伤和中毒严重危害门头沟区居民的健康和寿命,不同性别、年龄的损伤和中毒的死亡分布特征不同,应依据其分布特征,采取针对性防控措施,降低死亡率。
文摘目的探索PDCA循环管理在国际疾病分类(international classification of dis eases,ICD)编码质量管理中的应用价值。方法选取2020年10月—2021年8月湛江中心人民医院收治的8000例出院病案首页疾病分类编码以及手术操作编码作为本次研究对象,对其进行核对、检查等,并用在ICD编码工具,开展PDCA循环管理,比较管理效果。结果管理后病理诊断漏编、损伤以及重度外因编码遗漏、手术操作编码错误等问题低于管理前,差异有统计学意义(P<0.05);管理后的ICD编码质量评分高于管理前,差异有统计学意义(P<0.05)。结论在ICD编码质量管理中应用PDCA循环管理,可以明显降低诊断选择错误、病理诊断漏编、损伤以及重度外因编码遗漏、手术操作编码错误等发生率。
