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1.
Medicine (Baltimore) ; 98(39): e17330, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574869

RESUMO

The aim of this study was to investigate the experiences of medical transportation of Korean travelers who suffered accidents abroad and then transferred home by our aeromedical team.We collected demographic and clinical data on patients injured while traveling abroad from January 2013 to July 2017. Descriptive analyses based on 4 different transportation methods and transport time since hospitalization were performed.A total of 33 patients were repatriated during the study period. Of these, 28 (84.8%) were trauma cases with pedestrian injuries being the most common (11 cases; 39.3%). Twenty patients were repatriated by flight-stretchers, 6 by flight-prestige, 2 by ship, and 5 by air ambulance. The air ambulance was the most expensive (average 61,124 US Dollars) mode of transportation (P = .001) and the ship took the longest time (14 hours) to transport patients back to Korea from regions with similar distance (P = .0023).We experienced medical repatriation of 33 seriously injured Korean travelers back to South Korea. Transfer time should be an important considering factor and directly contacting and communicating with the specialized staff of foreign hospitals could also be very important to reduce unnecessary overseas hospital stay and cost incidence.


Assuntos
Transporte de Pacientes , Viagem/estatística & dados numéricos , Ferimentos e Lesões , Acidentes/economia , Acidentes/estatística & dados numéricos , Adulto , Resgate Aéreo , Feminino , Humanos , Incidência , Seguro Saúde , Internacionalidade , Masculino , República da Coreia , Macas (Leitos) , Transporte de Pacientes/economia , Transporte de Pacientes/métodos , Transporte de Pacientes/estatística & dados numéricos , Ferimentos e Lesões/economia , Ferimentos e Lesões/epidemiologia
3.
Isr Med Assoc J ; 21(8): 538-541, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474016

RESUMO

BACKGROUND: Travelers' diarrhea (TD) is frequently encountered in people traveling from high-income to low-income countries; however, its epidemiology in those traveling between high-income countries is not known. OBJECTIVES: To evaluate the incidence of diarrhea in North American students relocating to Israel. METHODS: A retrospective cohort study involving medical students from the United States and Canada relocating to Israel was conducted. Students who relocated to Israel during 2010-2016 were contacted by email to participate in an anonymous survey. Data included demographic information as well as occurrence, timing, duration, and outcome of diarrhea after relocation. RESULTS: Ninety-seven students participated in the survey. Most (93.7%) students relocated from the United States or Canada. The period-prevalence of diarrhea was 69.1%. The incidence of diarrhea declined from 34.8 cases per 100 student-months during the first month after relocation to 1.3 cases per 100 student-months after 1 year. The duration of diarrhea was up to 1 week in 72.7%. Students who reported diarrhea were younger than students who did not (mean age 24.0 ± 2.2 and 28.4 ± 1.8 years, respectively, P < 0.001). No other demographic parameter was significantly associated with a higher likelihood of diarrhea. CONCLUSIONS: A high proportion of North American medical students relocating to Israel reported diarrhea with clinical and epidemiological features similar to classic TD. Further studies are needed to elucidate the causative agents of TD in Israel.


Assuntos
Diarreia/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Doença Relacionada a Viagens , Doença Aguda , Adulto , Canadá/etnologia , Estudos de Coortes , Diarreia/etnologia , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Projetos Piloto , Estudos Retrospectivos , Viagem , Estados Unidos/etnologia , Adulto Jovem
4.
Ann Agric Environ Med ; 26(3): 385-391, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559790

RESUMO

INTRODUCTION: Arthropod-borne viruses are important causes of human morbidity worldwide. However, the available literatur and the epidemiological data concerning the importation to Poland of globally emerging arboviral infections, such as DENV, CHIKV, WNV, or ZIKV, are scarce. Only few seroepidemiologic studies concerning WNV in animals or humans in Poland have been published. OBJECTIVE: The aim of this review paper is to summarize and present the current state of knowledge and the perspectives for research concerning the importation and the risk posed by the introduction to Poland of the four above-mentioned arboviral diseases. CURRENT STATE OF KNOWLEDGE: Climate change may facilitate the northward expansion of both the vectors for diseases previously unseen in Europe, as well as of the viruses themselves, resulting in autochthonous cases of diseases previously exclusively imported. Little is known about the importation of arboviral diseases to Poland because of the frequently asymptomatic or self-limiting course of the disease, lack of epidemiologic studies or effective disease reporting, as well as inadequate access to diagnostic methods. CONCLUSIONS: Further epidemiologic studies in Polish travellers are necessary in order to prevent importation or introduction of the above-mentioned viruses, and to act against potential problems related to blood transfusion or organ transplantation from infected donors.


Assuntos
Infecções por Arbovirus/epidemiologia , Arbovirus/fisiologia , Viagem/estatística & dados numéricos , Animais , Infecções por Arbovirus/sangue , Infecções por Arbovirus/transmissão , Infecções por Arbovirus/virologia , Arbovirus/genética , Arbovirus/imunologia , Arbovirus/isolamento & purificação , Pesquisa Biomédica/tendências , Humanos , Conhecimento , Polônia/epidemiologia
5.
Ann Agric Environ Med ; 26(3): 405-408, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559794

RESUMO

INTRODUCTION: Carbapenemase-producing Enterobacteriaceae have spread rapidly through the countries and continents to become a global concern. One of the main reservoirs of NDM-1 positive strains from the Enterobacteriaceae family is the Indian subcontinent (Bangladesh, Pakistan, India). MATERIAL AND METHODS: During June 2017 - June 2018, rectal swab samples were collected routinely in all patients returning to Poland from South and South-East Asia. During molecular examinations gene blaNDM-1 encoding NDM-1 carbapenemase was detected. RESULTS: 31 patients were examined after returning to Poland from a trip to South and South-East Asia. The presence of New Delhi Metallo-ß-lactamase-1 producing Escherichia coli and Klebsiella pneumoniae was confirmed in three patients (9.7%) returning to Poland from travels to India. All the positive patients were hospitalized during the trip in a New Delhi hospital. CONCLUSIONS: Digestive tract carriage of NDM in a group of Polish travelers is a significant health and epidemiological problem. The study confirms the necessity for screening for carbapenemase-producing Enterobacteriaceae (CPE), particularly among travellers. Rectal swabs should be collected in every case of patients returning from international trips, and the possibility of environment-associated infections should be emphasized.


Assuntos
Proteínas de Bactérias/metabolismo , Infecções por Enterobacteriaceae/microbiologia , Escherichia coli/enzimologia , Klebsiella pneumoniae/enzimologia , Viagem , beta-Lactamases/metabolismo , Adulto , Proteínas de Bactérias/genética , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Feminino , Humanos , Índia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Polônia , beta-Lactamases/genética
9.
Braz J Infect Dis ; 23(3): 200-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31301279

RESUMO

Ciguatera poisoning is the most common form of non-bacterial food-poisoning from fish worldwide. The incidence among Brazilians returning from high-risk regions is unclear because it is not a mandatory reportable disease. We describe a previously healthy 53-year-old Brazilian woman developed Ciguatera fish poisoning while traveling to Havana, Cuba. Physicians and health care professionals should advise travelers to avoid eating ciguatoxic fish species and potentially toxic fish species in the Caribbean islands. Despite the prognosis for most cases is good with a short duration of self-limited symptoms, early recognition of the identifying clinical features of ciguatera can result in improved patient care.


Assuntos
Intoxicação por Ciguatera/diagnóstico , Viagem , Animais , Brasil , Feminino , Humanos , Pessoa de Meia-Idade , Índias Ocidentais
10.
Rev Soc Bras Med Trop ; 52: e20190014, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31188918

RESUMO

INTRODUCTION: Malaria is the main cause of death by infection among travelers and is preventable through a combination of chemoprophylaxis and personal protective measures. METHODS: Travelers were interviewed by phone 28-90 days after returning, to assess adherence to pre-travel advice for malaria prevention. RESULTS: A total 57 travelers were included. Adherence to chemoprophylaxis was significantly higher among participants prescribed mefloquine (n=18; 75%) than doxycycline (n=14; 45%). Adherence to mosquito repellent and bed net use was 65% and 67%, respectively. CONCLUSIONS: Adherence to malaria prophylaxis was lower than expected. Further studies testing innovative approaches to motivate travelers' compliance are required.


Assuntos
Antimaláricos/uso terapêutico , Doxiciclina/uso terapêutico , Malária/tratamento farmacológico , Malária/prevenção & controle , Adesão à Medicação/estatística & dados numéricos , Mefloquina/uso terapêutico , Profilaxia Pré-Exposição/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Viagem
11.
Adv Gerontol ; 32(1-2): 282-289, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31228402

RESUMO

The paper considers the problem of population aging and the impact of this multifaceted process on tourism industry developing. The authors are paying more attention on the problem of the population aging influence to the methods of creation and the essential filling of a new tourist product. Separately, the decisive role of the senior's tourists needs. In addition, there are certain gender preferences of third age people, witch becoming mandatory for the tourism industry. The new social and economic roles of senior's age people are a serious problem that urgently needs to be resolved. It is important to pay attention that the transformation of the social structure of society entails serious changes in the tourism industry.


Assuntos
Tomada de Decisões , Viagem , Idoso , Humanos , Dinâmica Populacional
13.
BMC Public Health ; 19(1): 718, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182068

RESUMO

BACKGROUND: In Ghana, limited evidence exists about the geographical accessibility to health facilities providing tuberculosis (TB) diagnostic services to facilitate early diagnosis and treatment. Therefore, we aimed to assess the geographic accessibility to public health facilities providing TB testing services at point-of-care (POC) in the Upper East Region (UER), Ghana. METHODS: We assembled detailed spatial data on all 10 health facilities providing TB testing services at POC, and landscape features influencing journeys. These data were used in a geospatial model to estimate actual distance and travel time from the residential areas of the population to health facilities providing TB testing services. Maps displaying the distance values were produced using ArcGIS Desktop v10.4. Spatial distribution of the health facilities was done using spatial autocorrelation (Global Moran's Index) run in ArcMap 10.4.1. We also applied remote sensing through satellite imagery analysis to map out residential areas and identified locations for targeted improvement in the UER. RESULTS: Of the 13 districts in the UER, 4 (31%) did not have any health facility providing TB testing services. In all, 10 public health facilities providing TB testing services at POC were available in the region representing an estimated population to health facility ratio of 125,000 people per facility. Majority (60%) of the health facilities providing TB testing services in the region were in districts with a total population greater than 100,000 people. Majority (62%) of the population resident in the region were located more than 10 km away from a health facility providing TB testing services. The mean distance ± standard deviation to the nearest public health facility providing TB testing services in UER was 33.2 km ± 13.5. Whilst the mean travel time using a motorized tricycle speed of 20 km/h to the nearest facility providing TB testing services in the UER was 99.6 min ± 41.6. The results of the satellite imagery analysis show that 51 additional health facilities providing TB testing services at POC are required to improve geographical accessibility. The results of the spatial autocorrelation analysis show that the spatial distribution of the health facilities was dispersed (z-score = - 2.3; p = 0.02). CONCLUSION: There is poor geographic accessibility to public health facilities providing TB testing services at POC in the UER of Ghana. Targeted improvement of rural PHC clinics in the UER to enable them provide TB testing services at POC is highly recommended.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Sistemas Automatizados de Assistência Junto ao Leito/estatística & dados numéricos , Tuberculose/diagnóstico , Diagnóstico Precoce , Feminino , Geografia , Gana , Humanos , Masculino , Programas de Rastreamento/métodos , População Rural/estatística & dados numéricos , Análise Espacial , Viagem
14.
Environ Monit Assess ; 191(Suppl 2): 381, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254089

RESUMO

Understanding patients' travel behavior for seeking hospital care is fundamental for understanding healthcare market and planning for resource allocation. However, few studies examined the issue comprehensively across populations by geographical, demographic, and health insurance characteristics. Based on the 2011 State Inpatient Database in Florida, this study modeled patients' travel patterns for hospital inpatient care across geographic areas (by average affluence, urbanicity) and calendar seasons, and across subpopulations (by age, gender, race/ethnicity, and health insurance status). Overall, travel patterns for all subpopulations were best captured by the log-logistic function. Patients in more affluent areas and rural areas tended to travel longer for hospital inpatient care, so did the younger, whites, and privately insured. Longer travel distances may be a necessity for rural patients to cope with lack of accessibility for local hospital care, but for the other population groups, it may indicate rather better mobility and more healthcare choices. The results can be used in various healthcare analyses such as accessibility assessment, hospital service area delineation, and healthcare resource planning.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adolescente , Adulto , Idoso , Área Programática (Saúde)/estatística & dados numéricos , Criança , Pré-Escolar , Demografia , Feminino , Florida , Humanos , Lactente , Recém-Nascido , Seguro Saúde , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Environ Monit Assess ; 191(Suppl 2): 279, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254116

RESUMO

The well-being of a population and its health are influenced by a myriad of socioeconomic and environmental factors that interact across a wide range of scales, from the individual to the national and global levels. One of these factors is the provision of health services, which is regulated by both demand and supply. Although an adequate provision can significantly improve health outcomes of a population, lopsided flow of patients to specific health centers can result in serious disparities and potentially delay the timeliness of a diagnosis. In this paper, utilization patterns during an epidemic of dengue fever in the city of Cali, Colombia for the year 2010 are investigated. Specifically, the objectives are to (1) identify health facilities that exhibit patterns of over- and underutilization, (2) determine where patients who are being diagnosed at a particular facility originate from, and (3) whether patients are traveling to their closest facility and hence (4) estimate how far patients are willing to travel to be diagnosed and treated for dengue fever. Analysis is further decomposed by age group and by gender, in an attempt to test whether utilization patterns drastically change according to these variables. Answers to these questions can help health authorities plan for future epidemics, for instance, by providing guidelines as to which facilities require more resources and by improving the organization of health prevention campaigns to direct population seeking health assistance to use facilities that are underutilized.


Assuntos
Dengue/epidemiologia , Surtos de Doenças , Monitoramento Ambiental , Adulto , Cidades , Colômbia/epidemiologia , Dengue/terapia , Dengue/virologia , Feminino , Sistemas de Informação Geográfica , Instalações de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Viagem
16.
J Med Microbiol ; 68(7): 986-990, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31162025

RESUMO

A colistin-resistant Salmonella enterica 4, [5],12:i:- sequence type (ST) 34 harbouring mcr-3.1 was recovered from a patient who travelled to China 2 weeks prior to diarrhoea onset. Genomic analysis revealed the presence of the mcr-3.1 gene located in the globally disseminated IncHI2 plasmid, highlighting the intercontinental dissemination of the colistin-resistant S. enterica 4, [5],12:i:- ST34 pandemic clone.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/metabolismo , Farmacorresistência Bacteriana Múltipla/genética , Plasmídeos/genética , Salmonella enterica/efeitos dos fármacos , Transferases (Outros Grupos de Fosfato Substituídos)/metabolismo , Proteínas de Bactérias/genética , China , Humanos , Salmonella enterica/genética , Salmonella enterica/isolamento & purificação , Transferases (Outros Grupos de Fosfato Substituídos)/genética , Viagem
17.
Rev Soc Bras Med Trop ; 52: e20180514, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31141055

RESUMO

INTRODUCTION: Travel medicine is aimed at promoting health risk reduction. However, travelers' perception of risk is subjective and may influence implementation of recommendations. This study reports on travelers' perception of risk, pre-travel characteristics, and recommended interventions. METHODS: This is a descriptive cross-sectional study. RESULTS: This study included 111 individuals. Most travelers (74%) perceived their risk as low. Significant differences in travel-related risk perception between practitioners and travelers were observed (Gwet's agreement coefficient [AC1] 0.23; standard error 0.10; 95% confidence interval 0.02-0.44). CONCLUSIONS: Future studies should investigate the relationship between travelers' perception of risk and implementation of recommendations.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doença Relacionada a Viagens , Viagem/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Socioeconômicos , Vacinas/administração & dosagem
19.
Am Surg ; 85(4): 327-334, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31043190

RESUMO

Studies have shown high-volume institutions have decreased mortality and increased survival for pancreatectomy. However, not all patients can travel to high-volume centers. Socioeconomic factors may influence treatment decisions. The goal of this study is to examine socioeconomic factors that determine where a patient is treated and how that location affects outcome. This is a retrospective study of the National Cancer Database of patients diagnosed with pancreatic cancer from 2004 to 2014. The primary outcome was to examine socioeconomic factors that predicted where a patient underwent their pancreatectomy. Patients treated at academic programs (APs) had to travel a mean distance of 80.9 miles, whereas patients treated at community programs (CPs) had to travel 31.7 miles (P < 0.0001). Spanish and Hispanic patients were less likely to travel to an AP (69% had surgery at an AP versus 76% of non-Hispanic patients, P < 0.001). Patients with higher comorbidities were also more likely to have care at CPs. Patients who had pancreatic cancer surgery at CPs were more likely to be Hispanic or with higher medical comorbidities. Those who had surgery at AP traveled further distances but had better perioperative outcomes and had an improvement in overall survival.


Assuntos
Adenocarcinoma/cirurgia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Fatores Socioeconômicos , Centros Médicos Acadêmicos , Adenocarcinoma/economia , Adenocarcinoma/etnologia , Adenocarcinoma/mortalidade , Adulto , Idoso , Bases de Dados Factuais , Feminino , Acesso aos Serviços de Saúde/economia , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/etnologia , Hospitais com Alto Volume de Atendimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatectomia/economia , Neoplasias Pancreáticas/economia , Neoplasias Pancreáticas/etnologia , Neoplasias Pancreáticas/mortalidade , Estudos Retrospectivos , Análise de Sobrevida , Viagem , Resultado do Tratamento , Estados Unidos/epidemiologia
20.
Rev Med Suisse ; 15(649): 898-900, 2019 May 01.
Artigo em Francês | MEDLINE | ID: mdl-31050235

RESUMO

Climate change is one of the factors explaining the increased occurrence of epidemics, their geographical spread as well as their increased severity and broader impact. Climate change makes the environment more favourable for pathogens and their proliferation, as well as for vectors of infectious diseases (such as mosquitoes). Furthermore, the globalisation and intensified travel and trade require international cooperation for epidemic response and training of health professional on emerging infectious risks.


Assuntos
Mudança Climática , Epidemias , Viagem , Medicina Tropical , Animais , Mosquitos Vetores , Clima Tropical
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