Search Results (1,415)

Background: Pelvic fractures are complex injuries often associated with significant morbidity and mortality, requiring multidisciplinary management. This case series highlights the presentation, management strategies, and outcomes of patients with pelvic fractures treated at our institution. Methods: The medical records of 13 patients diagnosed with pelvic fractures from 1 January 2020 through 31 December 2023 were retrospectively reviewed. Demographic data, mechanism of injury, fracture pattern, associated injuries, treatment modalities, and outcomes were analyzed. Results: A total of 13 patients were included in the study, with ages ranging from 18–95 years. Six of the patients were male and seven were female. The most common mechanisms of injury were falls and pedestrians struck by vehicles. Associated injuries included traumatic brain injury (TBI), fractures including extremities, ribs, and vertebrae, visceral injury, and spinal cord injury. Treatment strategies ranged from conservative, non-surgical management to operative intervention, including interventional radiology embolization, external traction, open reduction and internal fixation (ORIF), and percutaneous screw stabilization. Additional interventions included chest tube placement, exploratory laparotomy, and craniectomy. Two patients died while in the hospital, one was discharged to a shelter, and the remaining 10 were discharged to various inpatient rehab facilities. Conclusions: Pelvic fractures pose significant clinical challenges due to their complexity and associated injuries. This case series underscores the importance of multidisciplinary intervention and treatment strategies in optimizing outcomes. Further studies should focus on the effectiveness of interventions, utilization of new technology, and multidisciplinary team planning. Full article

Background: The emergence and spread of antimicrobial-resistant bacteria (ARB) has become an urgent global concern as a silent pandemic. When taking measures to reduce the impact of antimicrobial resistance (AMR) on the environment, it is important to consider appropriate treatment of wastewater from medical facilities. Methods: In this study, a continuous-flow wastewater treatment system using ozone and ultraviolet light, which has excellent inactivation effects, was implemented in a hospital in an urban area of Japan. Results: The results showed that 99% (2 log₁₀) of Gram-negative rods and more than 99.99% (>99.99%) of ARB comprising ESBL-producing Enterobacterales were reduced by ozone treatment from the first day after treatment, and ultraviolet light-emitting diode (UV-LED) irradiation after ozone treatment; UV-LED irradiation after ozonation further inactivated the bacteria to below the detection limit. Inactivation effects were maintained throughout the treatment period in this study. Metagenomic analysis showed that the removal of these microorganisms at the DNA level tended to be gradual in ozone treatment; however, the treated water after ozone/UV-LED treatment showed a 2 log₁₀ (>99%) removal rate at the end of the treatment. The residual antimicrobials in the effluent were benzylpenicillin, cefpodoxime, ciprofloxacin, levofloxacin, azithromycin, clarithromycin, doxycycline, minocycline, and vancomycin, which were removed by ozone treatment on day 1. In contrast, the removal of ampicillin and cefdinir ranged from 19% to 64% even when combined with UV-LED treatment. Conclusions: Our findings will help to reduce the discharge of ARB and antimicrobials into rivers and maintain the safety of aquatic environments. Full article

With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article

This article investigates the paradox of disappearance as both an aesthetic and a political phenomenon. Taking inspiration from Radiohead’s song “How to Disappear Completely,” it argues that aesthetic representations of disappearance never achieve total erasure; instead, they give rise to new forms of visibility. A true aesthetics of disappearance does not exist. Through case studies such as H.G. Wells’s The Invisible Man and Guy Debord’s Society of the Spectacle, the article demonstrates that disappearance is always mediated: the invisible man becomes hyper-visible through his clothing, bandages, and mask, while the spectacle conceals marginalized lives only to expose them through mechanisms of institutional control (e.g., prisons, medical facilities, schools—as analyzed in Michel Foucault’s work). An investigation of the “novel of the institution” (Campe), especially as it appears in the works of Franz Kafka and Robert Walser, eventually explores the nexus between aesthetic representation and institutionalized forms of coerced visibility. Ultimately, the essay argues that disappearance, as an aesthetic and political event, destabilizes regimes of visibility—not by erasure alone, but by exposing the fragility of appearance itself. The tension between opacity and exposure suggests that resistance lies not in pure absence but in subverting the very mechanisms of representation. Full article

Background/Objectives: In many parts of the world, pharmacists hold the primary responsibility for providing safe and effective pharmacotherapy. A key aspect is the availability of appropriate medicines for each individual patient. When industrially manufactured medicines are unsuitable or unavailable, pharmacists can prepare tailor-made medicines. While this principle applies globally, practices vary between countries. In the Netherlands, the preparation of medicines in pharmacies is well-established and integrated into routine healthcare. This narrative review explores the role and significance of extemporaneous compounding, pharmacy preparations and related product care in the Netherlands. Methods: Pharmacists involved in pharmacy preparations across various professional sectors, including community and hospital pharmacies, central compounding facilities, academia, and the professional pharmacists’ organisation, provided detailed and expert insights based on the literature and policy documents while also sharing their critical perspectives. Results: We present arguments supporting the need for pharmacy preparations and examine their position and role in community and hospital pharmacies in the Netherlands. Additional topics are discussed, including the regulatory and legal framework, outsourcing, quality assurance, standardisation, education, and international context. Specific pharmacy preparation topics, often with a research component and a strong focus on product care, are highlighted, including paediatric dosage forms, swallowing difficulties and feeding tubes, hospital-at-home care, reconstitution of oncolytic drugs and biologicals, total parenteral nutrition (TPN), advanced therapy medicinal products (ATMPs), radiopharmaceuticals and optical tracers, clinical trial medication, robotisation in reconstitution, and patient-centric solid oral dosage forms. Conclusions: The widespread acceptance of pharmacy preparations in the Netherlands is the result of a unique combination of strict adherence to tailored regulations that ensure quality and safety, and patient-oriented flexibility in design, formulation, and production. This approach is further reinforced by the standardisation of a broad range of formulations and procedures across primary, secondary and tertiary care, as well as by continuous research-driven innovation to develop new medicines, formulations, and production methods. Full article

The significant advances in the surgical and medical treatment of gynecological cancer have led to improved survival outcomes of several subgroups of patients that were until recently opted out of treatment plans. Surgical cytoreduction has evolved through advanced surgical complexity procedures and the need for critical care of gynecological cancer patients has increased. Despite that, however, articles focusing on the need of perioperative monitoring of these patients completely lack from the international literature; hence, recommendations are still lacking. Critical care may be offered in different types of facilities with specific indications. These include the post-anesthesia care unit (PACU), the high dependency unit (HDU) and the intensive care unit (ICU) which have discrete roles and should be used judiciously in order to avoid unnecessary increases in the hospitalization costs. In the present review we focus on the pathophysiological alterations that are expected in gynecological cancer patients undergoing surgical treatment, provide current evidence and discuss indications of hospitalization as well as discharge criteria from intensive care facilities. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

Background/Objectives: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain scarce. This study aimed to investigate sex differences in clinical presentation, diagnostic workup, therapeutic interventions, and outcomes among hospitalized PE patients. Methods: We conducted a retrospective cohort study including all adult patients (≥18 years) admitted with a main diagnosis of acute PE at the Cantonal Hospital Baselland between January 2018 and December 2020. Data were extracted from electronic medical records and included demographics, comorbidities, symptoms, diagnostics, treatments, and outcomes. Sex-based comparisons were performed using univariate analyses. Results: Among 197 patients, 54% were women. Compared to men, women were more often admitted by ambulance (42% n = 45 vs. 24% n = 22, p = 0.009), had more frequent tachycardia (38% n = 41 vs. 23% n = 21, p = 0.024), and received lysis therapy more often (10% n = 11 vs. 2% n = 2, p = 0.023). DVT was more frequently diagnosed in women when sonography was performed (82% n = 49 vs. 64% n = 34, p = 0.035). Men had higher rates of B symptoms, smoking, and family history of PE. Women had longer hospital stays and were more frequently discharged to rehabilitation facilities. No sex differences were found in in-hospital mortality, 6-month rehospitalization, or adherence to diagnostic guidelines. Conclusions: This study reveals sex-based differences in PE presentation and management, suggesting potential disparities in care pathways. Further research is needed to promote equitable, personalized treatment strategies. Full article

Background: Vaccination effectively reduces the risk of infection, including COVID-19 yet older adults often receive insufficient attention despite their increased vulnerability. The study aimed to correlate serological results with underlying conditions, vaccination status, and COVID-19 history. Methods: This non-interventional, multicenter study aimed to assess vaccination coverage and SARS-CoV-2 antibody levels among residents of eight long-term care facilities (LTCFs) in Southern Poland. Data collection took place between January and June 2022, with 429 participants recruited based on their ability to provide informed consent and their residency in LTCFs. Sociodemographic data, medical history, and COVID-19-related information—including infection history and vaccination status—were collected through surveys. Blood samples were obtained for serological testing using enzyme-linked immunosorbent assays (ELISA) to detect anti-SARS-CoV-2 antibodies. Statistical analysis, including Spearman’s correlation, revealed significant associations between antibody levels and vaccination status, as well as between RT-PCR-confirmed COVID-19 infections and higher antibody titers. Results: Among the seven different qualitative serological, only the Anti-SARS-CoV-2 NCP (IgG) and Anti-SARS-CoV-2 (IgA) tests showed a positive correlation with the Anti-SARS-CoV-2 QuantiVac (IgG) test, which was used as a comparator. A weak correlation was noted with the age of the residents. Conclusions: Our findings suggest that vaccination positively influences antibody responses, underscoring the importance of immunization among LTCF residents. Additionally, certain comorbidities—such as degenerative joint disease and diabetes—showed weak correlations with higher antibody levels. This study provides valuable insights into the humoral immune response to COVID-19 in vulnerable populations residing in LTCFs. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article

This study investigates the accessibility of public healthcare services in Olsztyn County, a major urban center in the Warmia and Mazury region of Poland. The aim was to develop a methodological framework using Geographic Information System (GIS) tools and spatial data to assess the local availability of healthcare infrastructure. The analysis included key facilities such as hospitals, clinics, pharmacies, and specialized outpatient services. A spatial accessibility indicator was constructed to evaluate and compare access levels across municipalities. The results show a clear disparity between urban and rural areas, with significantly better access in cities. Several rural municipalities were found to have limited or no access to essential healthcare services. These findings highlight the uneven spatial distribution of medical infrastructure and point to the need for targeted strategies to improve service availability in underserved areas. The proposed methodological approach may support future studies and inform local and regional planning aimed at reducing healthcare inequalities and improving access for all residents, regardless of their location. This research contributes to the growing body of evidence emphasizing the role of spatial analysis in assessing public service accessibility and supports the development of more equitable healthcare systems at the local level. Full article

Recently, solar energy technologies are a cornerstone of the global effort to transition towards cleaner and more sustainable energy systems. However, in many rural areas of developing countries, unreliable electricity severely impacts healthcare delivery, resulting in reduced medical efficiency and increased risks to patient safety. This review explores the transformative potential of solar energy as a sustainable solution for powering healthcare facilities, reducing dependence on fossil fuels, and improving health outcomes. Consequently, energy harvesting is a vital renewable energy source that captures abundant solar and thermal energy, which can sustain medical centers by ensuring the continuous operation of life-saving equipment, lighting, vaccine refrigeration, sanitation, and waste management. Beyond healthcare, it reduces greenhouse gas emissions, lowers operational costs, and enhances community resilience. To address this issue, the paper reviews critical solar energy technologies, energy storage systems, challenges of energy access, and successful solar energy implementations in rural healthcare systems, providing strategic recommendations to overcome adoption challenges. To fulfill the aims of this study, a focused literature review was conducted, covering publications from 2005 to 2025 in the Scopus, ScienceDirect, MDPI, and Google Scholar databases. With targeted investments, policy support, and community engagement, solar energy can significantly improve healthcare access in underserved regions and contribute to sustainable development. Full article

Very-high-energy electrons, coupled with ultra-high dose rates, are being explored for their potential use in radiotherapy to treat deep-seated tumours. The dose per pulse needed to achieve ultra-high dose rates far exceeds the limit of current medical linear accelerator capabilities. A high dose per pulse has been observed as the limiting factor for many existing dosimeters, resulting in saturation at doses far below what is required. The MOSkin, an existing clinical quality assurance dosimeter, has previously been demonstrated as dose rate independent but has not been subjected to a high dose per pulse. Within this study, the MOSkins dose-per-pulse response was tested for linearity, with a dose per pulse as high as 23 Gy within 200 ns at the ANSTO Australian Synchrotron’s Pulsed Energetic Electrons for Research facility. While using EBT-XD film as a reference dosimeter, a dose rate dependence of the EBT-XD was discovered. Once confirmed and a correction factor established, EBT-XD was used as an independent reference measurement. This work presents confirmation of the MOSkin suitability for ultra-high dose-rate environments with an electron energy of 100 MeV, and a theoretical discussion of its dose-rate and dose-per-pulse independence; the MOSkin is the only detector suitable for both clinical quality assurance, and ultra-high dose-rate measurements in its standard, unmodified form. Full article

Background: Older adults living in aged care are at risk of poor health outcomes due to influenza, pneumococcal disease, and herpes zoster infections. Despite these conditions being vaccine-preventable, little is known about vaccine uptake rates in the residential elderly care setting in Australia. Methods: This was a retrospective cohort study examining the medical records of residents of 31 aged care homes in Australia (n = 1108). Data were extracted from medical records for the period March 2023 to September 2023. The proportion of residents vaccinated against influenza, pneumococcal disease, and herpes zoster was calculated. Univariate and multivariate logistic regressions were used to identify possible demographic and other characteristics associated with the vaccination uptake. Results: This study included 1108 residents. Two-thirds (68%) were female, and the median age was 87 years. All residents had one or more comorbidities. Most (92.6%) had received an influenza vaccine within the prior two years, but only 38.3% had received a pneumococcal vaccine, and 16.8% had received herpes zoster vaccination. In all models, receipt of the other vaccines was a significant predictor for vaccine administration. The other factor associated with influenza vaccination was non-consumption of alcohol and younger age for herpes zoster vaccination. Conclusions: While there is a high uptake of influenza vaccines, there is a low uptake of both pneumococcal and herpes zoster vaccines in residents of aged care facilities. Further research into the barriers and enablers of vaccine uptake should be undertaken, with the goal of increasing the vaccination uptake in this vulnerable population. Full article

Pseudomonas aeruginosa is a highly adaptable opportunistic pathogen with significant clinical relevance in both human and veterinary medicine. Despite its well-documented role in hospital-acquired infections in human healthcare settings, its persistence and transmission within veterinary clinics remain underexplored. This review highlights the overlooked status of veterinary facilities as environmental reservoirs and amplification points for multidrug-resistant (MDR) P. aeruginosa, emphasizing their relevance to One Health surveillance. We examine the bacterium’s environmental survival strategies, including biofilm formation, resistance to disinfectants, and tolerance to nutrient-poor conditions that facilitate the long-term colonization of moist surfaces, drains, medical equipment, and plumbing systems. Common transmission vectors are identified, including asymptomatic animal carriers, contaminated instruments, and the hands of veterinary staff. The review synthesizes current data on antimicrobial resistance in environmental isolates, revealing frequent expression of efflux pumps and mobile resistance genes, and documents the potential for zoonotic transmission to staff and pet owners. Key gaps in environmental monitoring, infection control protocols, and genomic surveillance are identified, with a call for standardized approaches tailored to the veterinary context. Control strategies, including mechanical biofilm disruption, disinfectant cycling, effluent monitoring, and staff hygiene training, are evaluated for feasibility and impact. The article concludes with a One Health framework outlining cross-species and environmental transmission pathways. It advocates for harmonized surveillance, infrastructure improvements, and intersectoral collaboration to reduce the risk posed by MDR P. aeruginosa within veterinary clinical environments and beyond. By addressing these blind spots, veterinary facilities can become proactive partners in antimicrobial stewardship and global resistance mitigation. Full article