Global resurgence of pertussis: A perspective from China.

Pertussis (or whooping cough) is a highly infectious acute respiratory disease primarily caused by Bordetella pertussis, which is also one of the most important causes of infant death worldwide. The widespread use of vaccines has greatly reduced the morbidity and mortality of pertussis. However, since the 1980s, in a number of countries with high vaccine coverage, the incidence of pertussis has risen again after remaining low for many years, with outbreaks even occurring in some areas. The peak onset of pertussis is shifting from infancy to adolescence, and adolescence is becoming the main source of infection for infants. Despite the increasing incidence of pertussis, serological findings suggest that the true prevalence of the disease may be significantly underestimated. Therefore, in this narrative review, we summarize the pathogenic process and immune characteristics of bacteria, the diagnosis and treatment of diseases, as well as vaccination and prevalence of pertussis at home and abroad, and attempt to analyze the causes and influencing factors of pertussis resurgence and summarize some prevention and control strategies to assist in improving the understanding of pertussis and preventing unexpected outbreaks.

High Adherence to COVID-19 Public Health Preventive Measures in Indigenous Communities in the Canadian Northwest Territories.

The aim of this project is to explore perceptions towards and adherence to COVID-19 public health preventive measures in Indigenous communities within Northwest Territories, Canada. Utilizing a cross-sectional study design the project took place within ten Northwest Territories communities between 1st April and 30th November 2021. Convenience sampling methods were utilized and adhered to public health restrictions. Self-identifying Indigenous adults (≥ 18 years old) were invited to complete a semi-structured interviewer-administered questionnaire. Participants (n = 287; 33.1% men, 66.6% women) had a mean age of 41.6 years (SD ± 13.5). Preventive measures were practiced by 98.6% of participants. Most participants reported often or always practicing three measures: avoiding gatherings (67.2%), avoiding usual greetings (63.3%), and limiting contact with high-risk individuals (71.4%). Most participants reported rarely/never practicing self-isolation (67.5%) and self-quarantining (76.5%) measures. Significant associations existed between the August 2021 COVID-19 outbreak and self-quarantining (p = 0.0023), self-isolating (p = 0.0023), and going onto the land (p = 0.0001). Participants found masking and travel restrictions challenging. Sadness and loneliness resulted from limited access to Elders. Kinship and community safety were important to Indigenous community members and influenced COVID-19 preventive measure utilization. The findings can inform culturally specific COVID-19 public health policy development.

Road Fatalities in Children Aged 0-17: Epidemiological Data and Forensic Aspects on a Series of Cases in a Single-Centre in Romania.

INTRODUCTION: Road Traffic Accidents (RTAs) are the leading cause of premature death in young people aged 5-29. Globally, 186,300 children aged 9 years and under die from RTAs each year. Romania had the highest mortality rate in children aged 0 to 14 for 2018-2020. This study aimed to assess the involvement of children aged 0-17 years in fatal RTAs by analyzing medico-legal autopsy records in a 5-year period at Timisoara Institute of Legal Medicine (TILM), Romania. MATERIALS AND METHODS: A retrospective analysis of medico-legal autopsy records of road fatalities in children aged 0-17 years, from TILM in a 5-year period (2017-2021), was conducted. RESULTS: Of all medico-legal autopsies in the 5-year period, 23 cases (5.8%) involved road fatalities in children aged 17 and under. Preschoolers accounted for 10 cases, followed by the age group 15-17 years (n = 9). Most children sustained fatal injuries as passengers (n = 13), followed by child pedestrians (n = 7). This research follows four representative cases, each being a different type of child road fatality regarding the type of road user, the age of the victim, and the involvement of other risk factors. CONCLUSIONS: Our findings emphasize the tragedy of road fatalities in children and the need to determine risk factors and prevention strategies to reduce the enormous global crisis involving these vulnerable victims.

Knowledge and perception among adults of their congenital heart disease: A single center cross-sectional study.

INTRODUCTION AND OBJECTIVE: Congenital heart disease (CHD) is a complex condition requiring a multidisciplinary approach. It is crucial that adults with CHD (CHD) have adequate knowledge of their condition, enabling them to engage in their healthcare decisions and self-management. We aimed to investigate knowledge and perception among adults of their CHD. METHODS: Single-center, observational, cross-sectional study. A 25-item adapted survey of Leuven Questionnaire for CHD was used to assess four main domains: (1) disease and treatment, (2) endocarditis and preventive measures, (3) physical activity and (4) reproductive issues. RESULTS: One hundred forty-eight patients participated in the study. Patients had a significant lack of knowledge localizing their heart defect, recognizing drug side effects, acting in case of experiencing drug side effects, recognizing at least two symptoms of clinical deterioration, to adequately define endocarditis and most typical signs and risk factors, to acknowledge the hereditary nature of their CHD and risk of clinical deterioration during pregnancies. Patients with an education level ≥12th grade have higher knowledge in various items and, overall, the complexity of CHD was not associated with a better performance. CONCLUSION: This study highlights the existing knowledge gaps among adults with CHD. It underscores the need for tailored information and structured educational programs to improve management. By addressing these challenges, healthcare providers can enhance patient outcomes, improve quality of life, and promote long-term well-being for individuals with CHD.

Next-Generation swimming pool drowning prevention strategy integrating AI and IoT technologies.

Drowning, as a leading cause of unintentional injury-related deaths worldwide, is a major public health concern. Swimming pool drowning is the main cause of most drowning incidents, and even with preventive measures such as surveillance cameras and lifeguards, tens of thousands of lives are lost to drowning every year. To address this issue, technology is being utilized to prevent drowning accidents and provide timely alerts for rescue. This paper explores the use of drowning prevention technology in embedded systems within enclosed environments, artificial intelligence (AI), and the Internet of Things (IoT) to decrease the likelihood of drowning incidents. Embedded systems play a critical role in such technology, enabling real-time monitoring, identification of dangerous situations, and prompt alerting. Due to their ease of installation and technical implementation, embedded devices are especially effective as drowning prevention devices. The image recognition capabilities of drowning prevention systems are enhanced through computer vision. Swimming pool drowning situations can be identified with the help of cameras and deep learning technologies, thereby increasing rescue efficiency. Finally, the IoT endows drowning prevention systems with comprehensive intelligence by connecting various devices and communication tools. Real-time alert transmission and analysis have become possible, enabling the early prediction of dangerous situations and the implementation of preventive measures, significantly reducing drowning incidents. In summary, the integration of these three types of drowning prevention technologies represents significant progress. The flexibility, accuracy, and intelligence of drowning prevention systems are enhanced through the incorporation of these technologies, providing robust support for safeguarding human lives and thus potentially saving tens of thousands of lives each year.

The I-OPTA Questionnaire: A National Assessment of Patients with Neovascular Age-Related Macular Degeneration.

INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is the leading cause of irreversible vision loss in developed countries. However, a significant gap persists in understanding this population, exacerbated by their advanced age and visual impairments, which can hinder research participation and access to healthcare. The purpose of this study was to describe the content of the questionnaire and the participating patients with nAMD. METHODS: The survey includes patients diagnosed with nAMD who had previously received treatment or were currently undergoing intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Participants were recruited using various methods, as reaching out to patients who are no longer receiving treatment poses a particular challenge. A patient and public advisory board assisted throughout the study period. RESULTS: Of the 713 electronic invitations sent out, 494 (69.3%) patients responded to the questionnaire, with an additional 57 responses obtained through e-mail or telephone interviews. Due to the exclusion of 16 responses, there were a total of 535 valid responses, including 176 from patients previously treated and 359 from those currently undergoing treatment for nAMD. The median age of respondents was 79.9 years (interquartile range [IQR] 75.5-84.7), with 59.8% being women. Among them, 53.2% were married, while 43.1% lived alone. CONCLUSIONS: Data from the I-OPTA (Identification of Patient-Reported Barriers in Treatment for nAMD) questionnaire allows future exploration of patients who are no longer receiving treatment, patients' knowledge about preventive measures, and the impact of nAMD on visual function and quality of life. Future research, including studies that integrate data from corresponding retinal images and Danish national registers, has the potential to generate invaluable knowledge, providing benefits to both patients and healthcare professionals.

A cross-sectional survey on the effects of the COVID-19 pandemic on psychological well-being and quality of life in people with spinal cord injury.

BACKGROUND: SARS-CoV-2 (COVID-19) has disrupted lives worldwide, affecting individuals from all walks of life. Individuals who have a spinal cord injury (SCI) are also affected by this phenomenon. This survey compares the quality of life (QOL), depression, and anxiety of SCI patients before and during COVID-19 in Wuhan City, China. METHODS: A cross-sectional survey utilized an online questionnaire to assess the QOL, levels of anxiety, and depression among 189 SCI patients admitted to Wuhan Tongji Hospital during pandemic from November 2020 to April 2021. Data before COVID-19 outbreak from November to December 2019 was retrieved from hospital records with the same assessment previously performed in-person or during a follow up visit. However, some participants were excluded for various reasons, such as declining to participate, not being admitted to a rehabilitation program due to the pandemic, or being under 18 years old. The World Health Organization's (WHO) QOL-Brief Version (BREF) and disability (DIS) modules, which focus on disability-related QOL, were used to assess the participants' QOL. RESULTS: SCI patients had lower QOL scores during the pandemic compared to pre-pandemic times. Mean scores on the 12-item DIS module significantly differed before and during the COVID-19 period. Participants showed higher adherence to self-isolation and quarantine measures for high-risk encounters (64.94%), but lower compliance with home disinfection and proper rest practices (23.38%). CONCLUSIONS: The COVID-19 pandemic has had a detrimental effect on the QOL of SCI patients in China, highlighting the urgent requirement for telehealth-based rehabilitation to mitigate its impact. It is crucial to provide essential.

Trend, disparities, and projection analysis of public data on shoulder fractures in Sweden: a retrospective analysis of two hundred and sixty two thousand, four hundred and forty four fractures.

PURPOSE: We aimed to identify temporal trends, seasonal changes and regional differences in shoulder fractures in Sweden during 2008-2022. METHODS: Data from the Swedish National Board of Health and Welfare were used to assess incidence rates per 100,000 people, categorized by sex, age, and month. RESULTS: Results showed an average of 17,496 fractures annually, with a decline in 2020 followed by a resurgence in 2021-2022. Elderly women, especially those over 65, had higher rates. Winter months exhibited increased incidence. CONCLUSIONS: Projection analysis indicated a gradual decrease in fractures over the next 15 years. Understanding these patterns can inform preventive strategies and resource allocation for shoulder fractures in Sweden.

Impact of a large-scale event on SARS-CoV-2 cases and hospitalizations in the Netherlands, carnival seasons 2022 and 2023.

Objectives: The COVID-19 pandemic highlights the importance of understanding facilitators for disease transmission. Events such as Carnival, characterized by large gatherings and extensive social interactions, have the potential to become 'super spreading events' for respiratory infections. This paper aims to assess the impact of large gatherings on virus transmission, providing crucial insights for the development of effective public health strategies. Study design: An ecological study was performed. Methods: The age-standardized number of COVID-19 cases reported in 2022, stratified by age (under 60 and 60+ years) was compared countrywide for Dutch provinces where Carnival was celebrated versus those where it was not. Additionally, we compared standardized hospitalization rates in 2022 and 2023 for both areas. Results: Countrywide, 2,278,431 COVID-19 cases were reported between 06-02-2022 and 10-04-2022. Daily incidence increased after Carnival, peaking at 803 per 100,000 inhabitants for under 60s in carnival provinces and 368 in non-carnival provinces. For individuals 60+ daily incidence peaked at 396 in carnival provinces and 247 in non-carnival provinces. Over the 10 weeks following the start of Carnival, the carnival provinces demonstrated a 15 % (2022) 17 % (2023) higher hospitalization rate compared to non-carnival provinces. Conclusions: The peak in cases and hospitalizations in regions actively celebrating Carnival compared to the rest of the Netherlands qualifies Carnival as a 'super-spreading' event. Our findings underscore the elevated risk of respiratory infections associated with large gatherings, advocating guided policies, including transparent risk communication and healthcare preparedness.

White Spot Lesions in Fixed Orthodontics: A Literature Review on Etiology, Prevention, and Treatment.

White spot lesions (WSLs) are a common complication after treatment using fixed orthodontic appliances. Decalcification of enamel surrounding fixed orthodontic appliances, known as WSLs, poses a significant aesthetic difficulty during and after treatment, as the purpose of fixed orthodontic therapy is to improve facial and dental appearance. Modern dentistry utilizes remineralization therapies to non-invasively treat WSLs to prevent the progression of disease and enhance the strength, appearance, and functionality of the affected tooth. This review aims to identify and assess the etiology, formation, and risk factors, as well as current treatment approaches used in achieving WSLs remineralization, induced by fixed orthodontic appliances. An electronic search on the PubMed and ScienceDirect databases was performed using a selected keyword. A total of 172 studies (from 2013 to 2023) were retrieved. Their references were also checked to find other relevant studies. Duplicate copies were excluded. After the abstract and full-text screening, only 39 studies were included. Even though numerous studies address the different treatment modalities for managing post-orthodontic WSLs, such as antiseptics; fluorides such as dentifrices, mouthwash, and varnish, and remineralizing agents such as casein phosphopeptides amorphous calcium phosphate, biomimetic self-assembling peptides, lasers, bleaching, microabrasion, and resin infiltration. There is a lack of evidence-based studies that examine the long-term effects of WSL treatment. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

Epidemiology of Colorectal Cancer in Saudi Arabia: A Review.

Colorectal cancer (CRC) is the second leading cause of cancer death in the world, originating from the glandular epithelial cells of the large intestine and the rectum. This article aims to review the epidemiology of CRC in Saudi Arabia, focusing on prevalence, incidence, risk factors, preventive measures, and outcomes. This narrative review utilized the PubMed database for data extraction, including freely accessible studies published in the last 15 years. Sixteen articles from different study designs were included, while awareness and non-English language studies were excluded. In 2020, the incidence and mortality rate of CRC in Saudi Arabia were 14.6% and 1.48% among all cancers, respectively. From 2006 to 2016, the number of colon cancer and rectal cancer cases increased by 8% and 7%, respectively. Risk factors for CRC in Saudi Arabia include low education level, unemployment, physical inactivity, excess weight, poor knowledge of foods rich in fiber, cigarette smoking, reduced serum vitamin D and calcium levels, and certain gene mutations. National guidelines in Saudi Arabia recommend CRC screening for all individuals above 45 years using colonoscopy, flexible sigmoidoscopy, or fecal occult blood test. The 10-year survival rate for CRC in Saudi Arabia is 44.6%. The overall 5-year survival rate for the Ministry of National Guard-Health Affairs is 52.0%. To lower the incidence and mortality of CRC, primary, secondary, and tertiary prevention are all very important. The most crucial aspect is to concentrate on primary prevention, which may involve raising public awareness of CRC risk factors and strategies for reducing or eliminating them.

Characteristics of malignant urban gas accidents in China from 2013 to 2022.

Malignant urban gas accidents, accounting for only approximately 1 % of the total gas accidents in China, are responsible for over 50 % of fatalities, thus becoming a major cause of public concern regarding gas safety. A comprehensive understanding of the characteristics of historical accidents is an effective way to prevent and reduce future accidents. In this regard, the study meticulously collects and analyzes all malignant gas accidents that occurred in China from 2013 to 2022. This approach can effectively clarify the focus of gas accident prevention, and also facilitate the implementation of more targeted preventive measures. The study provides diverse perspectives and comprehensive statistics on accidents using 10 variables in 6 dimensions: time (year, month, day, hour), location (province, place), gas source, type, cause, and level. In addition to common quantitative statistics, proportional analyses and visual displays, methods such as contingency tables, t-tests, chi-square tests, and cluster analyses were also used to provide more in-depth analyses and identify more potential patterns. The findings elucidate that: (1) Over the past decade, the yearly distribution of malignant gas accidents in China has been relatively stable; but, individual, particularly major accidents, have significantly influenced the overall severity; (2) June and July are the peak months for such accidents; (3) The most severe accidents occur during 6:00-6:59 a.m., 11:00-11:59 a.m., and 11:00-11:59 p.m.; (4) Central and eastern provinces are the epicenters of malignant gas accidents; (5) Residential accommodations, and restaurants and shops are frequently affected; (6) Liquefied petroleum gas, despite comprising merely 8.7 % of the aggregate supply, is implicated in over half of the malignant occurrences and associated fatalities; (7) Explosions account for approximately 78.49 % of these accidents; (8) Among the accident causes, violations of rules by workers stands as the foremost contributor; (9) Malignant gas accidents are generally larger accident. Moreover, this manuscript delves into the underlying reasons behind each noteworthy statistical trend and analyzes the critical issues facing the gas industry. This investigation not only bridges the gap in the statistical profiling of malignant gas accidents within China but also furnishes invaluable insights that may guide preventive measures against urban gas-related disasters. Furthermore, the methodological approaches and variable selections explored in this study lay a robust foundation for future endeavors in the realm of malignant gas accident management research and practice.

From sound waves to molecular and cellular mechanisms: Understanding noise­induced hearing loss and pioneering preventive approaches (Review).

Noise-induced hearing loss (NIHL) is a significant and urgent global public health concern, arising from prolonged exposure to elevated levels of noise. This auditory impairment harms delicate inner ear structures, particularly the essential hair cells transmitting auditory signals to the brain. Recognized by the World Health Organization as a major contributor to worldwide hearing loss, NIHL requires a comprehensive examination of its molecular and cellular mechanisms. Animal models emerge as indispensable tools for unraveling these intricacies, allowing researchers to simulate and study the impact of noise exposure on auditory structures, shedding light on the interplay of oxidative stress, inflammation and immune responses-crucial factors in NIHL progression. The present review focuses on elucidating the molecular mechanisms of NIHL, with a specific emphasis on findings derived from animal models, alongside the exploration of thorough preventive strategies, including protective measures and probing potential interventions. Understanding the molecular underpinnings not only provides insight into targeted treatment approaches, but also unlocks pathways for exploring and implementing preventive actions. This approach not only deepens the current comprehension of NIHL, but also has the potential to influence the shaping of public health policies, offering a nuanced perspective on this prevalent auditory disorder.

Evaluation of Seroprevalence and Risk Factors of Heartworm Infection for Dogs in Rio de Janeiro with Access to Veterinary Care.

Heartworm infection is a chronic disease with clinical signs and effects ranging from an asymptomatic condition to severe disease and death. The prevalence of heartworm disease in the state of Rio de Janeiro has been reported to be high (21.3%). The present study was conducted to evaluate the seroprevalence and risk factors of heartworm infection for the canine population with access to veterinary services in different areas of the state of Rio de Janeiro, Brazil. A total of 1787 canine blood samples were obtained from 135 practices across 8 different areas of Rio de Janeiro state (Rio de Janeiro municipality, São Gonçalo municipality, Niterói municipality, Baixada Fluminense, and the northern, southern, eastern, and mountainous areas) and tested for the presence of Dirofilaria immitis antigens and antibodies against several tick-borne disease pathogens using a commercial immunochromatography technique (Vetscan® Flex 4 Rapid Test; Zoetis; NJ USA). Pet owners reported living conditions, physical characteristics, demographics, and clinical signs for evaluation of risk factors for heartworm infection. Only two evaluated risk factors were shown to enhance the risk for D. immitis infection, including having a short hair coat vs. having a medium or long hair coat (OR 2.62) or positive for antibodies to tick-borne disease parasites (OR 3.83). Clinical signs reported for dogs with heartworm disease were typical for that condition. The overall prevalence of heartworm disease in the state was 8.2%, ranging from 2.4% in the mountainous region to 29.4% in the eastern area. It could not be determined if veterinarians were not diligent about dispensing heartworm preventatives or if poor levels of compliance by dog owners were responsible for higher infection rates in some areas of the state.

Mycotoxins in food: Occurrence, health implications, and control strategies-A comprehensive review.

Mycotoxins are secondary metabolites produced by various filamentous fungi, including Aspergillus, Fusarium, Penicillium, Alternaria, Claviceps, Mucor, Trichoderma, Trichothecium, Myrothecium, Pyrenophora, and Stachybotrys. They can contaminate various plants or animal foods, resulting in a significant loss of nutritional and commercial value. Several factors contribute to mycotoxin production, such as humidity, temperature, oxygen levels, fungal species, and substrate. When contaminated food is consumed by animals and humans, mycotoxins are rapidly absorbed, affecting the liver, and causing metabolic disorders. The detrimental effects on humans and animals include reduced food intake and milk production, reduced fertility, increased risk of abortion, impaired immune response, and increased occurrence of diseases. Therefore, it is imperative to implement strategies for mycotoxin control, broadly classified as preventing fungal contamination and detoxifying their toxic compounds. This review aims to discuss various aspects of mycotoxins, including their occurrence, and risk potential. Additionally, it provides an overview of mycotoxin detoxification strategies, including the use of mycotoxin absorbents, as potential techniques to eliminate or mitigate the harmful effects of mycotoxins and masked mycotoxins on human and animal health while preserving the nutritional and commercial value of affected food products.

Socioeconomic Status and Adherence to Preventive Measures During the COVID-19 Pandemic in Switzerland: A Population Based Digital Cohort Analysis.

Objectives: To assess the association between socioeconomic status (SES) and self-reported adherence to preventive measures in Switzerland during the COVID-19 pandemic. Methods: 4,299 participants from a digital cohort were followed between September 2020 and November 2021. Baseline equivalised disposable income and education were used as SES proxies. Adherence was assessed over time. We investigated the association between SES and adherence using multivariable mixed logistic regression, stratifying by age (below/above 65 years) and two periods (before/after June 2021, to account for changes in vaccine coverage and epidemiological situation). Results: Adherence was high across all SES strata before June 2021. After, participants with higher equivalised disposable income were less likely to adhere to preventive measures compared to participants in the first (low) quartile [second (Adj.OR, 95% CI) (0.56, 0.37-0.85), third (0.38, 0.23-0.64), fourth (0.60, 0.36-0.98)]. We observed similar results for education. Conclusion: No differences by SES were found during the period with high SARS-CoV-2 incidence rates and stringent measures. Following the broad availability of vaccines, lower incidence, and eased measures, differences by SES started to emerge. Our study highlights the need for contextual interpretation when assessing SES impact on adherence to preventive measures.

Examining the educational experiences of Behvarzes from the insufficient participation of some people in preventive measures against the COVID-19 pandemic: a lesson for the future.

BACKGROUND: This study aims to explore the experiences of Behvarzes regarding the reasons behind the insufficient participation of some individuals with the preventive protocols established during the COVID-19 pandemic. METHODS: A qualitative study was conducted from July 2021 to December 2022 using the conventional content analysis method. Purposive sampling was employed to select 14 Behvarzes working in villages covered by Kashan University of Medical Sciences. Data were collected through semi-structured in-depth individual interviews and analyzed using conventional content analysis. RESULTS: The study identified seven subcategories which were grouped into two main categories of reasons for inadequate compliance with health protocols by some individuals. These include: (1) Intentional non-compliance with preventive protocols, with the following subcategories: perceived obligation and adherence to social customs, denial of risk, belief in external health locus of control, and fear and distrust of prevention and treatment methods. (2) Unintentional non-compliance with preventive protocols, with the following subcategories: insufficient or contradictory information, negligence, and inevitability. CONCLUSION: The findings suggest that ensuring compliance with health guidelines is not a one-size-fits-all approach. providing empowerment and obstacle removal solutions to those forced to violate preventive protocols for various reasons are all critical components of successful interventions. Also, cultural familiarity can aid in the design of appropriate interventions to address these challenges.

Measures to Prevent Infection in Cardiac Implantable Electronic Device Replacements or Upgrades.

Cardiac implantable electronic device (CIED) infections represent one of the most threatening complications associated with device implantation, due to an increase in morbidity and mortality rates, as well as healthcare costs. Besides, it is important to highlight that when compared to the initial implantation of a device, the risks associated with procedures like generator changes, lead and pocket revisions, or device upgrades double. Consequently, to address this issue, various scoring systems, like the PADIT (Prior Procedures, Age, Depressed Renal Function, Immunocompromised Status, Type of Procedure), the RI-AIAC (Ricerca Sulle Infezioni Associate a ImpiAnto o Sostituzione di CIED), and the Shariff score, along with predictive models, have been developed to identify patients at a greater risk of infection. Moreover, several interventions have been assessed to evaluate their role in infection prevention ranging from improving skin preparation and surgical techniques to considering alternative strategies such as the subcutaneous Implantable Cardioverter-Defibrillator (ICD). Methods like antimicrobial prophylaxis, pocket irrigation, chlorhexidine gluconate pocket lavage, capsulectomy, and the use of antibacterial envelopes have been also explored as preventive measures. In this review, we provide a comprehensive assessment of CIED infections in patients undergoing repeat procedures and the strategies designed to reduce the risk of these infections.

Preventive Measures for Safer Orthognathic Surgery: Key Points.

Objectives: The aim of this article is to review safer orthognathic surgery. Methods: The literature survey was performed in PubMed, EBSCO, UpToDate, ProQuest Central databases of Kirikkale University, and Google and Google Scholar databases. Results: Patients with dentofacial skeletal defects may benefit from orthognathic surgery, which entails surgically modifying parts of the facial skeleton to restore the right anatomic and functional relationship. Careful investigation of the soft tissue via clinical examination and supporting pictures, evaluation of the structure via standardized radiographs, and evaluation of the dental via study dental casts are all necessary to successfully correct maxillofacial abnormalities. Orthognathic surgery can involve either the maxilla, the mandible, or both. Improving the dynamics of nasal airflow may necessitate simultaneous intranasal surgery consisting of septoplasty and reduction of the inferior turbinate. In some patients, a genioplasty and neck liposuction may be recommended to enhance the final result. Le Fort I osteotomy, Le Fort II osteotomy, Le Fort III osteotomy, maxillary segmental osteotomies, sagittal split osteotomy of the mandibular ramus, vertical Ramal osteotomy, inverted L and C osteotomies, and mandibular body segmental osteotomies are all examples of well-established osteotomies that can be used to reposition facial skeletal elements and redefine the face. Conclusion: Preventative strategies for risk-free orthognathic surgery include maintaining blood flow, shielding teeth, bone, and neurovascular systems, and bolstering the patient's diet.

[The problematic issues of regulation and organization of labor safety of sailors as factor impacting life quality and health].

In modern conditions of maritime navigation, protection of lives of crew members plays key role for their health and quality of life. The practice testifies that shipowners underestimate real statistics of occupational injuries, since procedure for its management and investigation of accidents on ships are not sufficiently regulated in international and national legislation. Besides, approaches of shipowners to implementation of existing standards also have different levels of responsibility that leaves measures preventing such incidents unreasonably underestimated. This situation results in increasing of occupational injuries on ships and allows shipowners or insurance companies to avoid proper payments to injured sailor or his family members in case of one's death. The complexity of implementation of "belated" medical expertise to determine cause of death or injury of crew member also makes it difficult to obtain positive result of recognition of disability or death of sailor as result of occupational traumatism. All the described above testifies importance and actuality of stated research topic. The article examines in detail normative acts regulating protection of labor and life and medical care of sailors. Also are considered causes, factors and types of occupational traumatism on ships. The accident statistics and procedure of their investigation are analyzed in relation to maritime practice. The issues of medical expertise are studied and main problematic issues are identified. The recommendations for their solution are formulated.