Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.
Food handling practices playa key role in the prevalence of food-borne illness. Despite the fact that pregnant women are high risk groups for food-borne disease, little is known about their actual food handling practices at home. The objective of this study was to investigate behaviors regarding food-related hygienic practices of pregnant women. The questionnaire included questions in five major areas : personal hygiene ; adequate cooking ; avoiding cross contamination ; keeping food at safe temperatures ; and avoiding food from unsafe sources. Analysis of 488 questionnaires showed the respondents were unaware of the importance of safe food handling practices. Especially, pregnant women in our study should be encouraged to be careful about either risk of adequate cooking $(2.08\pm0.66)$ and keeping foods at safe temperatures $(2.69\pm0.63)$. Residency and number of children were consistent independent predictors of food handling behaviors. Previous food safety education also was found to have significant effect on food handling practices. TV news and newspapers were considered the most usable sources of food safety information by respondents. The behaviors identified in this study represent ones of particular importance for high-risk populations, like pregnant women. These population characteristics identified in this study could be incorporated in development of food safety educational programs for pregnant women being vulnerable on food-borne illness. Our results could have implications for the design of effective food safety educational efforts. This study indicates the need for continued and improved food safety education and for enforcing systematic food safety education for pregnant women.
Cervical cancer is an important woman's health problems worldwide, especially in low socio-economic countries. The aim of this study was to compare the Pap smear screening results between Akha hill tribe and urban women who live in Chiang Rai province, Thailand. Screening was conducted for 1,100 Akha women and 1,100 urban women who came to have the Pap smear at Chiangrai Prachanukroh Hospital and 1 private cytology laboratory from January to June 2008. The demographic characteristics and factors related to abnormal Pap smears of these women were gathered using closed model questionnaires. Abnormal Pap smears were defined according to the Bethesda 2001 system. The results showed that the prevalence of abnormal Pap smears was 12.2% in Akha women and 4.5% in urban women. The highest prevalence of Pap abnormalities was found in the 41-50 years age group in both populations (4.5% in Akha and 1.7% in urban women). In both populations, abnormal Pap smears were found in <21 years age groups. From the questionnaires, the possible risk factors related to the higher prevalence of abnormal Pap smears in Akha women were early age at marriage (${\leq}17$ years), high frequency pregnacies and high parity and no/low education level. In conclusion, cervical cancer control by education and early detection by Pap smear screening is necessary for hill tribe women. More Pap smear screening service units should be set to improve the coverage for the risk group women who got married in young age, especial in ethnic groups.
Taylor, Victoria M.;Ko, Linda K.;Hwang, Joo Ha;Sin, Mo-Kyung;Inadomi, John M.
Asian Pacific Journal of Cancer Prevention
/
v.15
no.24
/
pp.10565-10571
/
2015
Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trials have provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventing gastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancer mortality following the implementation of programs to detect early stage gastric cancers. There are currently no clear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrant populations. However, it is likely that a proportion of US physicians are already recommending gastric cancer screening for Asian patients and some Asian immigrants to the US may be completing screening for gastric cancer in their native countries. Surveys of US primary care physicians and Asian American communities should be conducted to assess current provider practices and patient uptake with respect to gastric cancer prevention and control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groups could consider a shared decision-making approach to helicobacter pylori identification and eradication, as well as gastric endoscopy.
Background and Objectives: Yanting in Sichuan Province is one of the highest risk areas of esophageal cancer (EC) in the world. We here summarize the epidemiology of EC in Yanting using data from the national screening programme during 2006-2011. Methods: Random cluster sampling was used to select a proportion of natural villages from six towns in Yanting, and residents aged 40-69 years old were invited for screening. Participants were screened using endoscopy with iodine staining and then confirmed by histological examinations. Results: The overall detection rates of low-grade hyperplasia (LH), moderate hyperplasia (MH), high-grade hyperplasia (HH), carcinoma in situ (CIS), intramucosal carcinoma (IC) and invasive carcinoma (INC) were 5.33%, 1.28%, 0.68%, 0.15%, 0.06% and 0.29%, respectively. The detection rates of LH, MH, HH and INC increased with age, reaching the peak among those aged 60-65 years, and the prevalences of LH and MH were higher among men than among women. In addition, the detection rates of hyperplasia were much higher in mountainous than in hilly areas. Conclusions: Among the high risk population, there are a great number of people with early-stage EC or precancerous conditions who do not have presenting symptoms. In particular, the elderly, men, or those living in mountainous areas are the most vulnerable population. It is therefore important to reinforce health education and screening services among such high risk populations.
Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.
Charoensook, Rangsun;Gatphayak, Kesinee;Brenig, Bertram;Knorr, Christoph
Asian-Australasian Journal of Animal Sciences
/
v.32
no.10
/
pp.1491-1500
/
2019
Objective: European pigs have been imported to improve the economically important traits of Thai pigs by crossbreeding and was finally completely replaced. Currently Thai indigenous pigs are particularly kept in a small population. Therefore, indigenous pigs risk losing their genetic diversity and identity. Thus, this study was conducted to perform large-scale genetic diversity and phylogenetic analyses on the many pig breeds available in Thailand. Methods: Genetic diversity and phylogenetics analyses of 222 pigs belonging to Thai native pigs (TNP), Thai wild boars (TWB), European commercial pigs, commercial crossbred pigs, and Chinese indigenous pigs were investigated by genotyping using 26 microsatellite markers. Results: The results showed that Thai pig populations had a high genetic diversity with mean total and effective ($N_e$) number of alleles of 14.59 and 3.71, respectively, and expected heterozygosity ($H_e$) across loci (0.710). The polymorphic information content per locus ranged between 0.651 and 0.914 leading to an average value above all loci of 0.789, and private alleles were found in six populations. The higher $H_e$ compared to observed heterozygosity ($H_o$) in TNP, TWB, and the commercial pigs indicated some inbreeding within a population. The Nei's genetic distance, mean $F_{ST}$ estimates, neighbour-joining tree of populations and individual, as well as multidimensional analysis indicated close genetic relationship between Thai indigenous pigs and some Chinese pigs, and they are distinctly different from European pigs. Conclusion: Our study reveals a close genetic relationship between TNP and Chinese pigs. The genetic introgression from European breeds is found in some TNP populations, and signs of genetic erosion are shown. Private alleles found in this study should be taken into consideration for the breeding program. The genetic information from this study will be a benefit for both conservation and utilization of Thai pig genetic resources.
Objective: To conduct a meta-analysis to investigate the value of EBV DNA in diagnosis of nasopharyngeal cancer (NPC) in Asian populations, and provide important evidence for screening. Methods: Prospective or respective case-control or cohort studies regarding the detection role of EBV DNA for NPC were included in our study. We conducted a comprehensive literature search in PubMed, EMBASE, and the Chinese Biomedical Database (CBM database between January 1980 and March 2012. Results: A total of 18 studies with 1492 NPC cases and 2641 health controls were included. Almost of the included studies were conducted in China, and only one other conducted in Thailand. The overall results demonstrated that the pooled sensitivity, specificity, positive likelihood (+LR) and negative likelihood (-LR) were 0.73 (0.71-0.75), 0.89 (0.88-0.90), 8.84 (5.65-13.84) and 0.19(0.11-0.32), respectively. The overall EBV DNA detection showed the largest area of 0.932 under the summary receiver operator curve (SROC). The accuracy of detection by plasma for NPC (0.86) was higher than in serum (0.81), with largest areas under the SROC of 0.97 and 0.91, respectively. Conclusion: Our results demonstrated the EBV DNA detection in plasma or serum has high sensitivity and specificity in diagnosis of NPC, especially in Chinese populations with a high risk of cancer.
There is a serious risk of regional extinction due to low birth rate and aging in Korea. Accordingly, the regional extinction index is applied to diagnose the extinction status of cities, counties, and districts. However, when the regional extinction index was applied to rural villages, most villages were found to be at 'high risk of extinction'. There is no differentiation in the level of extinction of rural villages. Therefore, a village extinction index was developed to apply to rural villages. This study applies and compares the existing regional extinction index and the newly developed village extinction index to rural villages. The purpose is to propose an index that can better diagnose the extinction of rural villages. As a research method, the regional extinction index and village extinction index are applied to all villages in Haengjeong-ri villages in South Chungcheong Province. And the adequacy of the index suitable for rural villages is diagnosed. For this purpose, ➂ stage distribution for each two indices, ➂ demographic aspect diagnosis, and ➂ resident awareness survey were analyzed. When the village extinction index was used, the discrimination problems seen in the regional extinction index were overcome. As a result of the demographic analysis, the regional extinction index showed that villages with a population of 200 or more were at 'high risk of extinction', but the village extinction index was derived as 'high risk of extinction' for villages with underpopulated populations. Lastly, the results of the residents' awareness survey also showed that the village extinction index was well reflected in the actual situation of rural villages when applied. When the village extinction index was applied to rural villages rather than the regional extinction index, it was found to reflect the actual state of rural extinction better.
Floods represent extreme hydrological phenomena that affect populations, environment, social, political, and ecological systems. After the catastrophic floods that have hit Europe and the World in recent decades, the flood problem has become more current. At the EU level, a legal framework has been put in place with the entry into force of Directive 2007/60/EC on Flood Risk Assessment and Management (Flood Directive). Two years after the entry into force of the Floods Directive, Bosnia and Herzegovina (B&H), has adopted a Regulation on the types and content of water protection plans, which takes key steps and activities under the Floods Directive. The "Methodology for developing flood hazard and risk maps" (Methodology) was developed for the territory of Bosnia and Herzegovina, following the methodology used in the majority of EU member states, but with certain modifications to the country's characteristics. Accordingly, activities for the preparation of the Preliminary Flood Risk Assessment for each river basin district were completed in 2015 for the territory of Bosnia and Herzegovina. Activities on the production of hazard maps and flood risk maps are in progress. The results of probable climate change impact model forecasts should be included in the preparation of the Flood Risk Management Plans, which is the subsequent phase of implementing the Flood Directive. By the foregoing, the paper will give an example of the development of the hydrodynamic model of the Zujevina River, as well as the development of hazard and risk maps. Hazard and risk maps have been prepared for medium probability floods of 1/100 as well as for high probability floods of 1/20. The results of LiDAR (Light Detection and Ranging) recording were used to create a digital terrain model (DMR). It was noticed that there are big differences between the flood maps obtained by recording LiDAR techniques in relation to the previous flood maps obtained using georeferenced topographic maps. Particular attention is given to explaining the Methodology applied in Bosnia and Herzegovina.
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