イリョウ ニオケル ダンジョ ドウケン : ダイガク ビョウイン キンムイ ノ タチバ カラ

To be realized the equality between men and women in the medical institution, we must solve the following problem. The women doctors manage to work and care of her child at the same time. They want to have child care leave after maternity leave and return to their former position. The population of the women doctor increase in recent years, and each of them should have sense of purpose to improve their environment. Moreover, the social support for the women doctors who care for their child is necessary

High daily doses of benzodiazepines among Quebec seniors: prevalence and correlates

BACKGROUND: Use of high daily doses of benzodiazepines is generally contraindicated for seniors. While both patient and physician factors may influence the use of high daily doses, previous research on the effect of patient factors has been extremely limited. The objectives of this study were to determine the one year prevalence of use of high daily doses of benzodiazepines, and examine physician and patient correlates of such use among Quebec community-dwelling seniors. METHODS: Patient information for 1423 community-dwelling Quebec seniors who participated in the Canadian Study of Health and Aging was linked to provincial health insurance administrative data bases containing detailed information on prescriptions received and prescribers. RESULTS: The standardized one year period prevalence of use of high daily doses of benzodiazepines was 7.9%. Use of high daily doses was more frequent among younger seniors and those who had reported anxiety during the previous year. Patients without cognitive impairment were more likely to receive high dose prescriptions from general practitioners, while those with cognitive impairment were more likely to receive high dose prescriptions from specialists. CONCLUSION: High dose prescribing appears to be related to both patient and physician factors

Assessment and Technical Simulation of Biomass Fuel Instead of Diesel Fuel Supply System and Its Advantages for Sustainable Development of Power Generators in National Iranian Tankers Company (Ship in Question: Caey Praid)

ABSTRACT Since Hormozgan Province, especially Bandar Abbas Exclusive Zone is a potential region for municipal waste disposal. Thus, construction of a biomass power plant in the area is inevitable. In this paper, use of biomass in place of diesel for generators of Caeypraid using Homer software was technically analyzed, when all generator and their loading capacity were examined and monthly demand curve was obtained during a one-period in this vessel. Then a composite system consisted of 4 synchronized biomass generators (3 main and 1 for emergency cases), which were used to inject the load (2.4 MWPeak) were explored. Finally, conditions of each biofilm-fuelled generator were evaluated against required demand. Also in this paper, the analysis of environmental contaminants was calculated using Homer software in two options: use of diesel and biomass fuels

An Interrupted Time Series Analysis of the Impact of the COVID-19 Pandemic on Routine Vaccination Uptake in Kenya

A strategic priority of the World Health Organization’s Immunization Agenda 2030 is to increase vaccination coverage and equity through reaching “zero-dose” children. Through an ecological study, we sought to quantify the impact of the COVID-19 pandemic on the coverage of the pentavalent and the measles/rubella vaccines in Kenya, without implying causality. The monthly number of doses from January 2017 to August 2022 were obtained from the Kenya Health Information System for the pentavalent and the measles/rubella vaccines. Immediate (step) and long-term (ramp) changes following interruptions occurring during the period from March 2020 to December 2020 were assessed through an interrupted time series analysis using an autoregressive integrated moving average (ARIMA) model, accounting for seasonality. In December 2020, there was an immediate decrease of 8337, 12,212, and 20,848 in the number of doses for the first, second, and third dose of the pentavalent vaccine, respectively (statistically significant for the third dose only). This corresponded to a percentage relative difference of −21.6, −20.1, and −24.5, respectively, for three doses of pentavalent vaccines, while for measles/rubella vaccine it was −27.3 and −33.6, respectively, for the first and second dose. COVID-19 resulted in interruptions affecting routine immunization, but recovery occurred within four months

Prescription channeling of COX-2 inhibitors and traditional nonselective nonsteroidal anti-inflammatory drugs: a population-based case–control study

This pharmacoepidemiologic study was conducted to determine whether risk factors for upper gastrointestinal bleeding influenced the prescription of cyclo-oxygenase (COX)-2 inhibitors and traditional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) at the time when COX-2 inhibitors were first included in the formulary of reimbursed medications. A population-based case–control study was conducted in which the prevalence of risk factors and the medical histories of patients prescribed COX-2 inhibitors and traditional nonselective NSAIDs were compared. The study population consisted of a random sample of members of the Quebec drug plan (age 18 years or older) who received at least one dispensation of celecoxib (n = 42,422; cases), rofecoxib (n = 25,674; cases), or traditional nonselective NSAIDs (n = 12,418; controls) during the year 2000. All study data were obtained from the Quebec health care databases. Adjusting for income level, Chronic Disease Score, prior use of low-dose acetylsalicylic acid, acetaminophen, antidepressants, benzodiazepines, prescriber specialty, and time period, the following factors were significantly associated with the prescription of COX-2 inhibitors: age 75 years or older (odds ratio [OR] 4.22, 95% confidence interval [CI] 3.95–4.51), age 55–74 years (OR 3.23, 95% CI 3.06–3.40), female sex (OR 1.52, 95% CI 1.45–1.58), prior diagnosis of gastropathy (OR 1.21, 95% CI 1.08–1.36) and prior dispensation of gastroprotective agents (OR 1.57, 95% CI 1.47–1.67). Patients who received a traditional nonselective NSAID recently were more likely to switch to a coxib, especially first-time users (OR 2.17, 95% CI 1.93–2.43). Associations were significantly greater for celecoxib than rofecoxib for age, chronic NSAID use, and last NSAID use between 1 and 3 months before the index date. At the time of introduction of COX-2 inhibitors into the formulary, prescription channeling could confound risk comparisons across products

Epidemiology of ssymptomatic pre-heart failure:a systematic review

Purpose of Review: To quantify the prevalence of asymptomatic pre-heart failure (pre-HF), progression to more severe stages, and associated mortality. Recent Findings: A systematic review was conducted between 01 January 2010 and 12 March 2020 (PROSPERO: CRD42020176141). Data of interest included prevalence, disease progression, and mortality rates. In total, 1030 sources were identified, of which, 12 reported on pre-HF (using the ACC/AHA definition for stage B HF) and were eligible. Prevalence estimates of pre-HF ranged from 11 to 42.7% (10 sources) with higher estimates found in the elderly, in patients with hypertension, and in men. Three studies reported on disease progression with follow-up ranging from 13 months to 7 years. The incidence of symptomatic HF (HF/advanced HF) ranged from 0.63 to 9.8%, and all-cause mortality from 1.6 to 5.4%. Summary: Further research is required to investigate whether early detection and intervention can slow or stop the progression from asymptomatic to symptomatic HF

Effectiveness of brentuximab vedotin monotherapy in relapsed or refractory Hodgkin lymphoma:a systematic review and meta-analysis

This systematic review and meta-analysis aimed to determine the effectiveness of brentuximab vedotin (BV) in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) in the clinical practice setting using most recent results. A total of 32 observational studies reporting on treatment patterns, overall response rate (ORR), complete response (CR) rate, progression-free survival (PFS), overall survival (OS), and adverse events were found. After four cycles, a random-effect model yielded pooled ORR and CR rates of 62.6% (95% confidence interval (CI): 56.0-68.9; I-2 = 9.7%) and 32.9% (95% CI, 20.8-46.3, I-2 = 64.8%), respectively. Regarding survival, 1-year, 2-year, and 5-year PFS ranged from 52.1% to 63.2%, 45.2% to 56.2%, and 31.9% to 33.0%, respectively. OS rates were 68.2-82.7%, 58.0-81.9%, and 58.0-62.0%, respectively. Most common adverse events were hematological toxicities (neutropenia: 13.3-23%, anemia: 8.8-39.0%, and thrombocytopenia: 4-4.6%), and grade >= 3 peripheral neuropathy (3.3-7.3%). This study supports the effectiveness and safety of BV in R/R cHL patients in the real-world setting

Does the bromocriptine-rebound method improve embryo quality?

Aim: To examine whether the bromocriptine-rebound (BR) method improves pregnancy outcomes after previous unsuccessful assisted reproductive technology (ART) attempts. Patients/study design : In this study we retrospectively analyzed data from a total of 121 women with normal serum prolactin (PRL) levels and a history of repeated unsuccessful ART procedures. Pregnancy outcomes and hormonal data were compared between the long protocol and BR method. Both procedures were similar, except that in the BR method, bromocriptine was administered daily from day 5 of the preceding cycle until 7 days before ovarian stimulation. Results : The number of fertilized oocytes, cleaved embryos and transplant embryos were significantly higher with the BR method than with the long protocol even though the numbers of retrieved oocyte were same in both groups. The ratio of the good embryos, the clinical pregnancy rate was higher with the BR method than with the long protocol. The embryo score with the BR method were significantly higher than that with the long protocol. Conclusion : BR method could provide the better embryos and improve the transplantation rate in women with previous unsuccessful ART attempts J. Med. Invest. 58 : 63-66, February, 201