Assessing the ripple effects of natural disasters on healthcare systems: a narrative review.

PURPOSE OF REVIEW: Natural disasters are on the rise, driven by shifts in climatic patterns largely attributed to human-induced climate change. This relentless march of climate change intensifies the frequency and severity of these disasters, heightening the vulnerability of communities and causing significant harm to both lives and socio-economic systems. Healthcare services are particularly strained during extreme weather events, with impacts felt not only on infrastructure but also on patient care. RECENT FINDINGS: This narrative review explored the overarching impact of natural disasters on healthcare infrastructure. We delved into how these disasters impact diverse health conditions, the healthcare systems of low and middle-income countries (LMICs), the psychological toll on both clinicians and survivors, and the ramifications for end-of-life care. SUMMARY: Natural disasters significantly impact healthcare, especially in LMICs due to their limited resources. Patients with cancer or chronic diseases struggle to access care following a natural disaster. Those in need for palliative care experience delay due to shortages in medical resources. Psychological consequences like posttraumatic stress disorder on disaster survivors and healthcare providers highlight the need for mental health support. Addressing challenges requires proactive disaster preparedness policies and urgent public policy initiatives are needed for optimal disaster response.

Smoking characteristics and years since quitting smoking of US adults diagnosed with lung and bladder cancer: A national health and nutrition examination survey analysis.

PURPOSE: Smoking is a recognized risk factor for bladder BC and lung cancer LC. We investigated the enduring risk of BC after smoking cessation using U.S. national survey data. Our analysis focused on comparing characteristics of LC and BC patients, emphasizing smoking status and the latency period from smoking cessation to cancer diagnosis in former smokers. MATERIALS AND METHODS: We analyzed data from the National Health and Examination Survey (2003-2016), identifying adults with LC or BC history. Smoking status (never, active, former) and the interval between quitting smoking and cancer diagnosis for former smokers were assessed. We reported descriptive statistics using frequencies and percentages for categorical variables and median with interquartile ranges (IQR) for continuous variables. RESULTS: Among LC patients, 8.9% never smoked, 18.9% active smokers, and 72.2% former smokers. Former smokers had a median interval of 8 years (IQR 2-12) between quitting and LC diagnosis, with 88.3% quitting within 0-19 years before diagnosis. For BC patients, 26.8% never smoked, 22.4% were active smokers, and 50.8% former smokers. Former smokers had a median interval of 21 years (IQR 14-33) between quitting and BC diagnosis, with 49.3% quitting within 0-19 years before diagnosis. CONCLUSIONS: BC patients exhibit a prolonged latency period between smoking cessation and cancer diagnosis compared to LC patients. Despite smoking status evaluation in microhematuria, current risk stratification models for urothelial cancer do not incorporate it. Our findings emphasize the significance of long-term post-smoking cessation surveillance and advocate for integrating smoking history into future risk stratification guidelines.