Regional Hospital Research Articles

Missed nursing care and associated factors among nurses and midwives in maternity wards of Sidama region public hospitals, Ethiopia

BackgroundMissed nursing care refers to any aspect of care performed by nursing staff that is omitted or significantly delayed. Even though the potential impact of missing nursing care on maternal and fetal outcomes is significant, there is currently limited evidence regarding the extent of this issue specifically within the maternity wards. Therefore, this study aimed to assess missed nursing care and associated factors in the maternity wards of public hospitals in the Sidama region, Ethiopia 2022.MethodsA hospital-based cross-sectional study was conducted among 361 nurses and midwives in maternity wards of Sidama region public hospitals from March 28 to April 26, 2022. Simple random sampling was used to select participants. The data was collected using the MISSCARE survey tool and analyzed with SPSS version 26. Simple linear and multiple linear regression analyses were used to identify the factors associated with missed nursing care.ResultsThe overall mean missed nursing care score was 67 out of 130 (95% CI: 65.92, 68.02) and the average score for each nursing intervention was 2.58 out of 5 (95% CI: 2.54, 2.62). The intention to leave the institution (β = 3.812, 95% CI: 2.285, 5.340) and increasing weekly work hours (β = 0.203, 95% CI: 0.134, 0.272) were factors positively associated with missed nursing care. However, increased work experience (β= -0.963, 95%CI: -1.475, -0.452) and job satisfaction (β= -4.976, 95%CI: -6.431, -3.522) were negatively associated with missed nursing care.ConclusionThis study found that the level of missed nursing care was significant. Factors positively associated with missed nursing care included an intention to leave the institution and an increase in weekly work hours. In contrast, an increase in work experience and higher job satisfaction were negatively associated with missed nursing care.

Embodied suffering: Uncovering the illness experiences of patients with severe psoriasis.

The visibility of skin lesions significantly burdens people with psoriasis, leading to social hostility and numerous emotional and psychological problems. These issues adversely affect self-esteem, can result in chronic mental health challenges and cause numerous life problems. This study aimed to explore patients' long-term experiences with severe psoriasis. A qualitative study was conducted with 20 patients with psoriasis (PASI ≥12) recruited from general and specialist dermatology practices in a regional teaching hospital in Taiwan. Interviews lasted 60-90 min and data were analysed using content analysis. A core theme emerged: 'Embodied suffering-life worse than death'. This overarching concept comprised three interrelated themes: (i) Experiencing physical suffering, (ii) Experiencing psychological suffering and (iii) Experiencing the stigma of suffering. This study highlights the holistic nature of suffering among individuals with severe psoriasis. It emphasises the need for healthcare professionals to consider the entirety of a patient's circumstances when addressing their suffering.

Malnutrition defined by global leadership initiative on malnutrition criteria impedes home discharge in acute care hospital admissions

Background & aimsLimited evidence exists on the association between malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospitalized acute care patients and their outcomes; several aspects still require clarification. This study aimed to evaluate the relationship between malnutrition, as defined by the GLIM criteria, at the time of acute hospital admission and discharge to home. MethodsThis retrospective observational study was conducted at a hospital that provides acute care in Japan. Adult patients admitted between July 2023 and April 2024 were included in this study. The primary outcome was the number of patients discharged to home, with in-hospital mortality as the secondary outcome. To ensure the reliability of the cohort-wide results, background factors were adjusted using propensity score matching. The two groups were compared based on the presence or absence of malnutrition, as defined by the GLIM criteria at admission. Furthermore, multiple logistic regression analysis was conducted, with the outcome as the dependent variable and malnutrition, diagnosed using the GLIM criteria, as the explanatory variable, adjusting for covariates. ResultsA total of 1,007 patients were included in the final analysis, of whom 492 (49%) were diagnosed without malnutrition, while 515 (51%) were diagnosed with malnutrition according to the GLIM criteria. In the multivariate logistic regression analysis after matching, malnutrition defined by the GLIM criteria emerged as an independent factor associated with discharge to home (odds ratio [OR] = 0.37, 95% confidence interval = 0.25–0.56, P < 0.001) when adjusting for age, sex, and various comorbidities. Among the GLIM sub-criteria, reduced muscle mass, reduced food intake or assimilation, and disease burden or inflammation were independently associated with discharge to home. Notably, disease burden/inflammation exhibited the lowest OR among the GLIM sub-criteria for discharge. ConclusionMalnutrition diagnosed using the GLIM criteria upon admission in patients admitted to a regional hospital providing acute care was associated with decreased rates of discharge to home and increased in-hospital mortality. Specifically, attention should be paid to the criteria for reduced muscle mass and disease burden or inflammation within the GLIM framework.

"Moral spaces": A feasibility study to build nurses' ethical confidence and competence.

Background: Pre-licensure ethics nursing education does not adequately prepare and instill confidence in nurses to address ethical issues, and yet ethics education provides nurses with greater confidence to take moral action, which can mitigate the negative effects of moral distress. Objectives: To assess the feasibility and acceptability of a nursing ethics education program that included simulated case-based ethics competencies as a form of evaluation. The program aimed at building nurses' ethical knowledge and confidence to respond to ethical challenges in practice. Research design: A prospective, longitudinal, correlational, single-cohort feasibility study using an investigator-developed survey and intervention field data. Participants and research context: Registered nurses were recruited from an academic quaternary-care medical center and 9 small- to mid-sized regional hospitals within one health system in the Midwest United States. Ethical considerations: IRB approval was obtained. Participants could complete the educational program regardless of research process participation. Findings: Of 20 participants, 19 (95%) provided post-program surveys and 18 completed competencies. Median (IQR) scores with quartiles for scheduling, timing, and length of sessions were all 10.0 [9.0, 10.0], and participants perceived that the content was interesting, increased knowledge and confidence in ethics, increased skills in providing ethical care, and would recommend the program to colleagues. Of factors, an increase in ethics knowledge had the highest "always agree" (17, 89.5%) response. Most participants reported that ethics competencies were appropriate 9.0 [9.0, 10.0] and sufficiently challenging 10.0 [9.0, 10.0]. Discussion: The education program developed nurses' ethics knowledge and confidence. The single-cohort feasibility design provided early-stage intervention outcomes; however, a larger randomized controlled trial would substantiate program value. Conclusion: This novel ethics education program was highly feasible and acceptable to hospital-based nurses who reported increased knowledge and confidence in providing ethical care. Simulated case-based ethics competencies were an appropriate evaluation method.

Identification of the Application of Midwifery Care Documentation by Midwives in RSUD Pulang Pisau

Midwifery documentation is important because it serves as legal evidence in health care, helping to enforce accountability and liability related to patient care. It also serves as a source of information about the patient's health status and an instrument of protection for patients and midwives. The use of standardized documentation methods such as SOAP has significant benefits in organizing midwives' thought processes, but there are still midwives who have not adopted it. Further efforts are needed to improve understanding and application of documentation standards in midwifery practice. Identifying Integrated Patient Progress Notes by Midwives at Pulang Pisau Regional Hospital in 2023. This study used a descriptive method that describes integrated patient development records by midwives at Pulang Pisau Regional Hospital. The samples in this study were 45 midwives who were in the delivery room, postpartum room and obstetric clinic room. Based on research from 45 midwives, the majority were 21-40 years old, 14 midwives (31.1%) had DIV Midwifery and S1 Midwifery education, 32 midwives (71.1%) had a working period of 6-10 years. 27 respondents (60%) of the completeness of integrated patient progress notes by midwives in the delivery room, postpartum room and obstetric clinic room of Pulang Pisau Hospital were incomplete, and as many as 18 respondents (40%) with complete progress notes. The majority of integrated patient progress notes made by midwives in the labor and delivery room, postpartum room, and obstetric clinic room of Pulang Pisau Regional Hospital were incomplete, with only a small proportion being complete. This suggests the need for improvement in the documentation process and integration of patient progress notes by midwives at RSUD Pulang Pisau.

Effectiveness of Treating Obstructive Sleep Apnea by Surgeries and Continuous Positive Airway Pressure: Evaluation Using Objective Sleep Parameters and Patient-Reported Outcomes.

Background/Objectives: Uvulopalatopharyngoplasty (UPPP), palatal plus nasal surgery (PNS), and continuous positive airway pressure (CPAP) are widely implemented treatments for obstructive sleep apnea (OSA). This study aims to explore the long-term effects on objective sleep parameters and patient-reported outcomes (PROs) following different therapeutic interventions for OSA. Methods: Data from patients with moderate-to-severe OSA were retrospectively collected from a medical center and a regional hospital, spanning from December 2011 to August 2018. Objective evaluations included the Apnea-Hypopnea Index (AHI), minimum O2 saturation, and sleep efficiency. The PROs consisted of the Snore Outcomes Survey and Epworth Sleepiness Scale. Using mixed-effects models, we evaluated longitudinal changes in sleep parameters and PROs, accounting for repeated measures and variations within individuals over time. Results: Among 448 patients with moderate-to-severe OSA, follow-up data were collected for 42 patients undergoing UPPP surgery, 171 undergoing PNS, 127 using CPAP, and 108 in the non-treated group. The mean follow-up was 16.7 months (SD = 11.9, range: 1.6-77.3). Significant improvements were observed in AHI, minimum O2 saturation, and hypersomnia immediately following interventions with UPPP, PNS, and CPAP therapy (p < 0.05). Moreover, the analysis revealed no significant rate of change in these parameters over time, suggesting that the benefits of these treatments were sustained in the long term. Furthermore, all interventions exhibited a significant short-term effect on self-reported snoring when compared to the control group, with a p-value of less than 0.001. However, the magnitude of this improvement gradually decreased over time. The snore scores seemed to return to pre-treatment levels among the UPPP, PNS, and CPAP groups after averages of 46.4, 63.5, and 74.4 months, respectively (all p < 0.05). Conclusions: Surgical interventions and CPAP therapy showed potential long-term effectiveness in managing OSA. Snoring symptoms reappeared about 3.9-5.3 years after surgical treatments, which seemed earlier than the average of 6.2 years in patients receiving CPAP and should be considered in patient-participatory decision-making processes.

Effectiveness of Reproductive Biology Educational Interventions in Reducing the Prevalence of Elective Caesarean Sections

Indonesia has the highest caesarean section rate globally, with a prevalence of 17.6% in 2018, rising to 22.50% among urban women by 2021, far exceeding the WHO recommendation of 10-15%. Although caesarean sections can be life-saving, they carry higher risks of complications for both mother and baby compared to normal delivery. This study aims to evaluate the impact of reproductive biology educational interventions on reducing elective caesarean sections at Aulia Pandeglang Regional Hospital in Banten in 2024. Utilizing a quasi-experimental design with a One Group Pre and Post Test approach, the research shows that such educational interventions significantly lower elective caesarean rates. Pre-test data revealed that 70% of cases were in the medium category, while post-test data showed a reduction to 43% in the low category. All respondents participated in both pre-test and post-test evaluations. The findings strongly support the effectiveness of reproductive biology education in decreasing elective caesarean sections, prompting Aulia Pandeglang Regional Hospital to continue its educational program for pregnant women to promote normal delivery.

Peritonsillar Abscess: An Update on Diagnosis and Medical-Surgical Management. A Review of the Literature and Case Report

Introduction: Peritonsillar abscess is an acute pharyngeal infection located between the tonsillar capsule and the aponeurosis of the superior constrictor muscle of the pharynx, being an important cause of consultation in emergency services. Its management includes antibiotic treatments and/or emptying of the abscess. Objective: To describe the diagnosis and medical-surgical management of a 47-year-old male patient with peritonsillar abscess; Regarding the case, a review of the updated literature on the topic was carried out. Method: Presentation of the case report: 47-year-old male patient, who attended the Libertador Bernardo O'Higgins Regional Hospital due to increased tonsillar volume. Sudden onset. Clinically, guttural voice, odynophagia, dysphagia, trismus and intermittent fever were notable. Discussion: After the clinical, imaging and laboratory study, a diagnosis of peritonsillar abscess was reached, which underwent medical-surgical management, presenting satisfactory evolution of this case, a review of the literature was carried out in the last 10 years in Spanish. English in the search engines PubMed and Science Direct. Conclusions: Surgical management of peritonsillar abscess continues to be the treatment of choice; however, based on the review of the literature that was carried out, medical management can also be chosen in some cases.

A Rare Case of Meningitis Caused by Elizabethkingia meningoseptica in a Baby at the Buea Regional Hospital, South West Region, Cameroon

Aim: This report was aimed at determining the possible source, risk factors, antimicrobial susceptibility pattern and clinical management of the first recorded case of meningitis in Cameroon caused by Elizabethkingia meningoseptica. Presentation of case: A 10 months old baby previously diagnosed with otitis media was admitted at the Buea regional hospital on the 21st of October 2023 after a referral following unsuccessful treatment. Upon admission, the baby had persistent fever, catarrh (evidence of an upper respiratory tract infection) and abdominal discomfort. Patient developed decreased body movement, altered consciousness and neck stiffness even after being placed on ampicillin and cefotaxime for two days. Based on cerebrospinal fluid analysis, the patient was considered a probable meningitis case and put on ceftriaxone to no avail. CSF culture later revealed the presence of Elizabethkingia meningoseptica susceptible to ciprofloxacin and resistant to imipenem, amoxicillin-clavulanic acid, cotrimoxazole, ampicillin and ceftriaxone. Marked improvement was noticed and the patient was discharged following full recovery after treatment with ciprofloxacin for 21 days. Epidemiological investigations and active case search did not provide any evidence of the Elizabethkingia being acquired in the hospital. Discussion and conclusion: The Elizabethkingia in this case was most likely community acquired associated with acute otitis media probably linked to a recent upper respiratory tract infection. The isolate was resistant to ceftriaxone and susceptible to ciprofloxacin. In case of meningitis caused by this pathogen, empirical treatment with fluoroquinolones may most likely be an effective option in the absence of antimicrobial susceptibility testing.

Occurrence of coccidioidomycosis in a tertiary hospital in the Brazilian semi-arid region: diagnostic challenges

Occurrence of coccidioidomycosis in a tertiary hospital in the Brazilian semi-arid region: diagnostic challenges

Influence of the Quality of Pharmacy Services and Non-Pharmacy on the Decision to Redeem the Prescription and Its Impact on Retreatment of General Outpatient at Pasar Minggu Hospital

The study examines the influence of pharmaceutical and non-pharmaceutical service quality on prescription redemption decisions and subsequent re-treatment decisions among general outpatients at Pasar Minggu Regional Hospital. The hospital has faced challenges, including a decline in outpatient visits and filled prescriptions, affecting its revenue during the 2022-2023 period. Patient perceptions of the pharmacy services significantly impact their decision to return for further medical care. The research aims to assess both direct and indirect effects of service quality on prescription redemption and re-treatment decisions. The study employs a verification approach with a cross-sectional design, using accidental sampling to survey 342 general outpatients between October 2023 and February 2024. Data were analyzed descriptively and inferentially using SEM PLS 3.0, encompassing both outer and inner model analyses through PLS Algorithm, Bootstrapping, and Blindfolding techniques. The findings reveal that the quality of pharmaceutical and non-pharmaceutical services significantly influences the decision to redeem a prescription (P = 0.000). Moreover, non-pharmaceutical service quality and the decision to redeem a prescription significantly affect the decision to re-medicate (P = 0.002 and 0.000, respectively). However, pharmaceutical service quality alone does not positively impact repeat treatment (P = 0.041). Both service variables have a significant indirect effect on re-treatment decisions through the mediating role of prescription redemption (P = 0.000).

Prevalence and Antibiotic Resistance Profile of Bacteria Isolated from Patients Pus at the Bafoussam Regional Hospital, West Region, Cameroon

Prevalence and Antibiotic Resistance Profile of Bacteria Isolated from Patients Pus at the Bafoussam Regional Hospital, West Region, Cameroon

Epidemiological Study and Seropositivity in Viral Panel Testing Among Corneal Tissue Donors.

Corneal tissue is a critical component for vision restoration through transplantation, yet the availability of suitable corneal tissue is limited. This limitation results in long waiting lists and high demand, especially in countries with lower donation rates compared to global benchmarks. In Mexico, the corneal donation rate remains significantly behind other Latin American countries and leading nations such as Spain. Understanding the characteristics of corneal tissue donors is essential for improving donation practices and addressing the shortage of available tissues. This descriptive retrospective study analyzed electronic medical records of cadaveric corneal donors at the General Regional Hospital 1 of the Mexican Social Security Institute of Querétaro from January 2022 to December 2023. Donors were included based on criteria such as age (2-85 years) and known cause of death. Exclusion criteria included age outside the specified range, neoplastic diseases, active systemic infections, and prior ocular surgeries. Serological testing for human immunodeficiency virus (HIV), Venereal Disease Research Laboratory (VDRL), coronavirus disease 2019 (COVID-19), hepatitis B virus (HBV), and hepatitis C virus (HCV was performed to assess viral reactivity. Statistical analyses were conducted usingIBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States), summarizing data with descriptive statistics. The study included 185 corneal donors with a mean age of 56.34 years. The majority were male (109; 58.9%), and the leading causes of death were cardiogenic shock (34; 18.4%), hypovolemic shock (31; 16.8%), and acute respiratory failure (30; 16.2%). Exclusion due to positive serological tests included seven donors (3.8%) for HIV and seven (3.8%) for SARS-CoV-2. A total of 16 donors (8.6%) were excluded due to positive results in the viral serological panel. The most common comorbidities were chronic kidney disease (36; 19.5%), type 2 diabetes mellitus (28; 15.1%), and systemic hypertension (31; 16.8%). The study highlights a predominantly male donor profile with a mean age of 56.34 years and emphasizes cardiogenic shock as a leading cause of death. The notably higher seropositivity rate of 8.6% for various viral infections compared to international reports indicates a need for improved health interventions and screening processes. The focus on cardiovascular and respiratory causes of death underscores regional health issues affecting donation patterns. To address the organ and tissue donation shortfall, it is crucial to enhance coordination within donation teams and increase public awareness, given the significant gap in donation rates compared to leading countries.

Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: a retrospective analysis

BackgroundAmong people living with HIV(PHIV) with unsuppressed viral load after six or more months of anti-retroviral therapy (ART), three intensive adherence counseling sessions (IAC) sessions are recommended. However, there is limited information about IAC completion rates. We investigated the factors associated with IAC completion among PLHIV with an unsuppressed viral load on first and second-line ART in mid-western Uganda.MethodsIn this retrospective review of medical records, we abstracted routine HIV data between January 2018 and September 2019 at the Fort Portal Regional Hospital. IAC completion was the primary outcome measured as the receipt of ≥ 3 consecutive good ART adherence scores of ≥ 95.0% during the IAC sessions, spaced one month apart within three months. The modified Poisson regression analysis with robust standard errors was used to determine factors associated with the outcome, reported as risk ratio (RR) and 95% confidence interval (CI).ResultsWe studied 420 participants of whom 204 (48.6%) were aged 20–39 years (mean age, 33.6 ± 13.3 years) and 243 (57.9%) were female. 282 (67.1%) participants completed their IAC sessions. Secondary or higher levels of education (Adjusted RR (aRR) 0.79, 95% CI 0.64–0.98), no follow-up for IAC (aRR 0.76, 95% CI 0.67–0.87), malnutrition (aRR 0.65, 95% CI 0.43–0.99) were associated with a lower likelihood of IAC completion while being in a separated/widowed or divorced relationship (aRR 1.23, 95% CI 1.01–1.49) was associated with a higher likelihood of IAC completion.ConclusionsWe found a low IAC completion rate compared to the desired target of 100%. Nutritional support for malnourished PLHIV receiving IAC, follow-ups, and targeted health education on the importance of IAC are needed to improve the IAC completion rate.

Seismic vulnerability analysis of hospitals and school buildings considering the Gaussian regression algorithm

This study combines the Gaussian regression algorithm to propose a nonlinear regression model that can be used to evaluate the seismic vulnerability of regional hospitals and school buildings. The failure features and disaster mechanisms of hospital and school buildings affected by the Jishishan (JSS) earthquake on December 18, 2023, and the Wenchuan (WC) earthquake on May 12, 2008, were reported. The samples of 252 damaged buildings (37 hospitals and 215 schools) in Dujiangyan city affected by the Wenchuan earthquake for which the author participated in the survey were collected and counted. Hospitals and school buildings were classified according to the types of reinforced concrete (RC) and masonry structures, and earthquake vulnerability probability matrices for hospital and school building clusters were established considering the actual failure probabilities. A total of 2103,213 acceleration records (from the Wenchuan earthquake) monitored by 12 real stations were selected. Using dynamic time history and response spectrum analysis methods, time history and spectrum curves were generated, considering the influence of different seismic directions. Using the developed Gaussian regression model, vulnerability comparison curves and parameter matrices considering multiple regression algorithms were generated. This paper considers the effects of the construction year and number of floors on the seismic vulnerability of hospital and school buildings. Seismic vulnerability curves and failure probability matrices were generated and established on the basis of actual structural failure probabilities. According to regression and vulnerability surface analysis, the evaluation results of the proposed model are highly consistent with actual field observations.

Hospitalisations for non-specific low back pain in people presenting to South Australian public hospital emergency departments.

The present study sought to investigate predictors of hospitalisation in adults diagnosed with non-specific low back pain (LBP) and/or sciatica from an ED. A 5-year, multicentre retrospective observational study was conducted across six public hospitals (metropolitan and regional) using data from electronic medical records. Patient presentations were identified using LBP diagnostic codes and key data extracted (patient demographics, clinical activity, discharge destination). Descriptive statistics and logistic regression were used to measure associations between identified variables and hospitalisation. There were 11 709 ED presentations across the study period. People aged ≥65 years (odds ratio [OR] 2.84, 95% confidence interval [CI] 2.61-3.10) and those who arrived at the ED via ambulance (age-adjusted OR 2.68, 95% CI 2.44-2.95) were more likely to be hospitalised. People were also more likely to be hospitalised when triaged as more urgent, when blood tests or advanced spinal imaging were ordered, and when i.v./subcutaneous opioids or oral benzodiazepines were administered. Hospitalisation rates for LBP were lower in regional hospitals, in people residing in lower socioeconomic areas and in Indigenous Australians. Certain patient characteristics and ED clinical activity are associated with hospitalisations for LBP. Understanding these factors will better inform the design and delivery of appropriate high-quality care.

Optimizing Employee Performance: The Role of Competence, Motivation, Knowledge, Work Environment, and Technology Utilization

This study aims to see the occurrence of updates due to environmental uncertainty post-pandemic on the affected of variables Competence, Motivation, Knowledge, Work Environment and Utilization of Information Technology on Employee Performance. A total of 844 Brebes, Central Java Indonesia Regional Hospital employees were the population in this study. The sample size of 271 people was determined using the Slovin formula. Data was taken in the form of questionnaire results obtained from respondents through questionnaires (google form and paper) The data was gathered using a Likert scale and then analyzed using SPSS software. The findings indicated that Competence, Motivation, Knowledge, Work Environment, and Utilization of Information Technology had a favorable and huge impact on Employee Performance. Competence, Motivation, Knowledge, Work Environment, and Utilization of Information Technology partially demonstrated a noteworthy positive influence on Employee Performance. The outcomes of the research contribute to the knowledge about the application of information technology to enhance staff performance. Information technology provides benefits to employee performance and has a positive influence on employees to improve their performance so as to produce better quantity and quality in improving services.

Teleradiology-Based Referrals for Patients with Gastroenterological Diseases Between Tertiary and Regional Hospitals: A Hospital-to-Hospital Approach.

Teleradiology is recognized for fostering collaboration between regional and tertiary hospitals. However, its application in gastroenterological diseases remains underexplored. This study aimed to assess the effectiveness of teleradiology in improving gastroenterological care. This retrospective study analyzed patients with gastroenterological diseases in a tertiary hospital who were referred from a regional hospital using a cloud-based radiology image-sharing system between July 2020 and June 2023. Our primary focus was to conduct a descriptive statistical analysis to evaluate patient characteristics and the referral process and analyze the timeframes from referral to transfer and from the start of treatment to discharge and the outcomes. We analyzed 56 patients, with 45 (80.4%) presenting hepatobiliary pancreatic disease. The most frequent condition was common bile duct stones (17 cases). Forty-nine cases were transferred for inpatient treatments, four underwent endoscopic examinations as outpatients, and two had imaging consultation without subsequent hospital visits. On referral day, 16 patients were transferred, and the remaining 33 (67.3%) were placed on a waiting list starting from the subsequent day. The median time from referral to admission was 1day (range: 0-14days), and the median time from referral to treatment was 2days (range: 0-14days). Remote image-sharing systems ensure accurate imaging at referral, preventing care delays. In collaboration with regional and tertiary hospitals, teleradiology may also be useful for gastroenterological diseases.

Anatomo-clinical and Etiological Profile of Nephropathies Biopsied in the Nephrology Department of the Thies Regional Hospital (Senegal)

Introduction: In many developing countries, particularly in Africa, the use of renal biopsy (RB) in clinical nephrology is severely lacking. The objectives were to describe the anatomoclinical and etiological profile of these biopsied nephropathies, as well as the factors associated with the etiology of the nephropathies. Patients and method: This was a retrospective descriptive and analytical study from 1 April 2020 to 30 October 2022. The patients were selected from the renal biopsy register of the nephrology department of the Thiès Regional Hospital. Sociodemographic, clinical, biological, and histological parameters were studied. Results: 75 renal biopsies were included. The mean age was 33.3 ± 14.8 years, with a male predominance (65.3%). The main indications were nephrotic syndrome in 50.67% of cases. RB was adequate in 82.7%, inadequate in 13.3%, and borderline in 4%. Glomerular nephropathies predominated, with focal segmental glomerulosclerosis (FSGS) in 34.7%, membranous nephropathy (MN) in 17.3%, minimal change disease (MCD) in 10.67%, extracapillary glomerulonephritis (ECGN) in 5.3% and lupus nephritis (LN) in 3.9%. Thrombotic microangiopathy (TMA) was found in 9.3%. Chronic tubulointerstitial nephropathy (CTIN) accounted for 5.3% of all RB and acute tubular necrosis (ATN) for 4%. The etiologies were primary in 48%, secondary in 28%, and undetermined in 24%. In the bivariate analysis, the etiology was correlated with the mean SBP (p = 0.023), the mean level of hemoglobin (p = 0.028), the levels of GFR (p = 0.017), and the type of kidney disease (p = 0.000). Conclusion: Glomerular nephropathy was more frequent and FSGS was the most common histological lesion found. Primary causes predominated. Associated factors were identified to improve patient management.

Prevalence Characteristics of Osteoporosis Fractures in the Elderly in Two Regions of China and Analysis of the Lag Effect of Air Pollutants on them.

Air pollution is increasing and threatening human health. The objective of this study is to investigate the population distribution characteristics of elderly osteoporosis fractures in Hebei Province and Xinjiang Uygur Autonomous Region and to analyze the effects of air pollutants on the number of elderly osteoporosis fracture inpatients in the two regions. A retrospective collection of elderly osteoporosis fracture cases was conducted in selected hospitals in Hebei Province and Xinjiang Uygur Autonomous Region from January 1, 2018 to December 31, 2022. The chi-square test was used to compare the distributional characteristics of the population in the two regions. Additionally, we used a distributed lag nonlinear model (DLNM) in order to assess the effect of air pollutants on the number of daily hospital admissions of elderly osteoporosis fracture patients in different regions. A total of 19,203 elderly osteoporosis fracture patients were included in the study. The average age of these patients was 76.66 ± 7.55 years, and the majority of them were female (13,514 instances, 70.37%). The disparities in age distribution (χ2 = 133.9 p < 0.001), fracture site (χ2 = 62.0 p < 0.001), and hospitalization cost (Z = -15.635 p < 0.001) between the two regions were statistically significant. The lag effect curves of PM2.5, PM10, and NO2 on the number of elderly osteoporosis fracture hospitalizations in Xinjiang Uygur Autonomous Region exhibited a similar pattern resembling a "W"-shaped curve. All three pollutants reached their highest values after a lag time of 14 days (PM2.5: RR = 1.053, 95% CI: 1.031, 1.074; PM10: RR = 1.031, 95% CI: 1.018, 1.043; NO2: RR = 1.125, 95% CI: 1.070, 1.182). In Hebei Province, the largest impacts of PM2.5 and PM10 were observed after a lag of 14 days (PM2.5: RR = 1.022, 95% CI: 1.013, 1.028; PM10: RR = 1.013, 95% CI: 1.008, 1.018). Similarly, the maximum effect of NO2 was observed after a lag of 11 days (RR = 1.020, 95% CI: 1.010, 1.028). There were differences in the epidemiological characteristics of hospitalized patients with osteoporosis fractures between the two regions, PM2.5, PM10, and NO2 increased the number of hospitalizations for osteoporosis fractures. Exposure to air pollutants such as PM2.5 increases the risk of osteoporosis fractures in the elderly population.