Search Results (2,365)

Objective: To analyze the evolving epidemiological characteristics of pediatric poisoning from 2019 to 2024 in Southwest China, explore the changing patterns of pediatric poisoning in the post-pandemic era, and provide a reference for poisoning prevention and the development of effective prevention and treatment strategies. Methods: This study included 3923 cases of pediatric poisoning treated at the Emergency Department of West China Second University Hospital, Sichuan University. Clinical data such as gender, age, poisonous substance, and cause of poisoning were described. The chi-square trend test was used to analyze annual changes, and multivariate Poisson regression was employed to identify risk factors for hospitalization and for intentional poisoning in children. Results: The total number of cases increased significantly from 544 in 2019 to 1006 in 2024. A marked “polarization” pattern was observed: among children aged 1–3 years, unintentional ingestion of household chemicals predominated (n = 2332), whereas among adolescents aged 12–14 years, intentional self-poisoning cases surged by 580%, with the toxic agents shifting mainly to psychotropic prescription drugs. From 2019 to 2024, the proportions of intentional poisoning, psychotropic drug poisoning, psychiatric comorbidity, and delayed presentation all increased significantly. Poisson regression indicated that the post-pandemic period, psychiatric comorbidity, and exposure to psychotropic drugs were risk factors for intentional poisoning. Conclusions: Following the COVID-19 pandemic, mental health problems among adolescents have become increasingly prominent, and pediatric poisoning has exhibited a bipolarization pattern. Clinical prevention and control strategies should shift from simple emergency treatment to early intervention, psychological screening, and comprehensive prevention, so as to reduce health damage to children and the societal disease burden. Full article

The rapid growth of the pet-humanisation trend has generated a distinct segment of tourists who regard pets as family members and seek travel experiences that accommodate both human and animal needs. This study examines the causal relationships among service quality, destination image, perceived value, and travel intention among Thai pet-humanising tourists. Using a quantitative approach, data were collected from 280 Thai respondents with experience or interest in pet-friendly tourism and analyzed via Structural Equation Modelling (SEM). The findings indicate that service quality and destination image significantly enhance perceived value, which subsequently exerts the strongest positive effect on travel intention. While service quality directly increases travel intention, destination image demonstrates a significant negative direct effect but a positive indirect effect through perceived value, highlighting a competitive mediation mechanism. By extending value-based behavioural models to this emerging segment, the study suggests that tourism and hospitality operators should prioritise tangible pet-friendly infrastructure and value-enhancing experiences over mere destination image, supporting the strategic development of inclusive pet-friendly destinations. Full article

Background and Objectives: Laryngeal cancer imposes substantial inpatient costs in middle-income health systems. We described recent trends in laryngeal cancer hospitalizations in Romania, estimated hospital expenditure, and modeled the impact of prevention scenarios to 2035. Methods: We conducted an ecological analysis of 20,056 discharges diagnosed as laryngeal cancer (ICD-10 C32.x) between 2019 and 2023. Each episode was assigned a mean unit cost of 1100 USD, with age- and residence-specific adjustments, and re-priced using EU (3900 USD) and US (30,000 USD) tariffs. We derived annual costs and projected 2035 expenditure under three prevention scenarios. Results: Annual discharges fell from 5408 in 2019 to 3151–3212 in 2020–2021, then rose to 4409 in 2023, while inpatient spending ranged from 3.47 to 5.95 million USD, reaching 4.85 million USD in 2023 (22,200 USD/100,000 population). Re-pricing 2023 activity at EU and US unit costs yielded counterfactual totals of 17.20 and 132.27 million USD. Older adults (≥65 years) generated 47.6% of discharges and 49.1% of spending in 2023, and urban residence increased the odds of age ≥65 by 48% (OR 1.48, 95% CI 1.40–1.57). Without new prevention, costs are projected to reach 12.60 million USD by 2035; a 30% smoking reduction and a combined package including radon mitigation and dysphonia screening would lower 2035 costs to 10.33 and 9.07 million USD. Conclusions: Demographic aging and sustained case volume will markedly increase hospital costs, while prevention scenarios are associated with lower projected inpatient expenditure. Full article

Introduction: Coronary artery bypass grafting (CABG) in patients with chronic kidney disease/chronic renal failure (CKD/CRF) poses additional surgical risk, both perioperatively and beyond, compared to their non-renal failure counterparts. Patients with end-stage renal disease (ESRD) are at particularly high risk for complications with prognoses limited by cardiovascular (e.g., myocardial infarction, heart failure, stroke) and non-cardiovascular (e.g., infection) conditions associated with the disease itself and the treatment of it (i.e., dialysis). For decades, cardiac surgeons have continued to offer CABG to patients with ESRD on dialysis with variable success. The purpose of this report is to describe a relatively contemporary analysis of CABG surgery in ESRD patients utilizing a pump-assisted beating-heart technique with the analysis of and comparison to outcomes reported by other investigators as well as predictions generated by the Society of Thoracic Surgery outcome tool. We report both short- and intermediate-term outcomes. Methods: From 1 January 2019 through 31 May 2025, the data from all consecutive patients undergoing BH-CABG at a single institution by a single surgeon were collected. Demographic information as well as a preoperative risk assessment was performed using the Society of Thoracic Surgeon (STS) Risk Assessment tool. The BH-CABG was performed via median sternotomy with maintenance of normothermia and ventilation throughout the case. Postoperative outcomes were recorded including mortality, major morbidity, and length of stay (LOS). Hospital/operative results were compared to the STS risk calculations. On-going intermediate-term follow-up beyond the index hospitalization was completed using direct or indirect methods (i.e., clinic, telephone, email). Results: There were 439 BH-CABG patients during the study period. Fifty-nine patients (13.4%) had ESRD on HD. There were 39 men and 20 women with a mean age of 61 years (41–76 years). Fifty-one (86%) underwent pump-assisted BH-CABG (PADCAB) and eight patients underwent complete off-pump BH-CABG (OPCAB). The mean ejection fraction (EF) was 48% (15–70%). The mean number of grafts was 2.3 (1 to 4) and the mean cardiopulmonary bypass (CPB) time for the PADCAB cases was 80 min (34 to 118 min). Patient presentation consisted of the following: one with cardiogenic shock, one with cardiac arrest, two with STEMI, 18 with NSTEMIs, 10 with CHF, five with NSTEMI/CHF, six with unstable angina (USA), and 16 with a positive stress test in preparation for renal transplant consideration. There was one operative mortality (1.7%), one stroke (1.7%), no reoperation for bleeding, no deep sternal wound infection, one prolonged ventilation (1.7%), and one prolonged length of stay (1.7%); overall mortality/morbidity was 5.1%. Comparatively, the STS-predicted mortality was 5.7%, stroke 2.2%, reoperation for bleeding 3.5%, deep sternal wound infection 0.6%, prolonged ventilation 17.8%, prolonged LOS 14.8%, and combined mortality/morbidity 26.8%. Thirty-six of the 59 patients remained alive (61%) in the follow-up period. Twenty-three patients expired (39%) in the follow-up: 11 of cardiac issues, eight of sepsis, two of stroke, one of gastrointestinal issues, and one of cancer. The average duration of survival for expired patients was 2.28 years (13 days to 5 years and 4 months). Nine patients (15%) underwent renal transplantation and six of them remained alive (67%). Conclusions: CABG surgery in patients with ESRD is complicated with historically high mortality and morbidity. The results of this study demonstrate significant improvement in the reduction in hospital mortality and morbidity. However, intermediate-term outcomes remain poor with a preponderance of cardiovascular and infectious deaths. A trend toward improved intermediate-term outcomes appears in patients in whom CABG surgery was performed for purposes of renal transplantation. Full article

Background: Postoperative bowel dysfunction, including delayed gastrointestinal recovery and postoperative ileus, is a common complication that increases morbidity and prolongs hospitalization. In this systematic review and meta-analysis, we evaluated the effects of manual therapies on postoperative bowel function. Methods: MEDLINE/PubMed, Google Scholar, the Cochrane Library, Semantic Scholar, and ClinicalTrials.gov were searched from database inception up to 17 March 2026, and studies evaluating osteopathic manipulative treatment (OMT) or abdominal massage in postoperative patients were included in our analysis. Risk of bias and certainty were assessed using validated study design-specific tools, including the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Random-effects meta-analyses were performed for the prespecified outcomes of time to first bowel movement, time to first flatus, and hospital length of stay. Results: Seventeen studies met our inclusion criteria. Both OMT and abdominal massage were associated with a significantly shorter time to first bowel movement compared with controls (OMT: mean difference [MD] −0.57 days, 95% CI −0.96 to −0.18; abdominal massage: MD −0.91 days, 95% CI −1.47 to −0.35). OMT was also associated with reduced hospital length of stay (MD −2.46 days, 95% CI −4.52 to −0.41), while time to first flatus demonstrated favorable but non-significant trends, with substantial heterogeneity. Conclusions: Manual therapy may be associated with earlier postoperative bowel recovery, although heterogeneity and methodological limitations warrant cautious interpretation. Further high-quality multicenter studies are needed to clarify the clinical significance and reproducibility of these findings. Full article

Background: Malaria remains a significant public health challenge in sub-Saharan Africa and is endemic in certain areas of South Africa despite ongoing elimination efforts. This study assessed malaria positivity, temporal trends, seasonal patterns, and factors associated with malaria positivity among clinically suspected adult in Maruleng Sub-District, Limpopo Province. Methods: A retrospective cross-sectional study analysed routine malaria surveillance records from 2018 to 2023 among suspected adult cases (≥18 years) tested for malaria at 11 clinics and one hospital. Descriptive, regression, and seasonal trend analyses were performed. Results: Of 385 adult records analysed, 366 were malaria-positive (test positivity rate = 95.1%). Cases were mostly males (66.7%) and adults aged 18–35 years (47.5%). Malaria cases were highest in 2018 and 2019, declined between 2020 and 2022, and increased in 2023. Significant seasonal variation was observed, with the highest numbers of cases occurring in April and May (p < 0.001). Exploratory regression analyses did not identify any statistically significant independent predictors of malaria positivity after adjustment for potential confounders. Behavioural risk factors showed a non-significant trend towards increased odds of malaria positivity (aOR = 3.42; 95% CI: 0.78–14.98), although estimates should be interpreted cautiously because of the limited number of malaria-negative records. Conclusions: Malaria remains an important public health concern in Maruleng. The observed temporal and seasonal patterns highlight the importance of strengthening surveillance, seasonal preparedness, and targeted vector control interventions before peak transmission periods. Larger studies with greater outcome variability are needed to better characterise factors associated with malaria positivity. Full article

Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and hospitalization in infants worldwide. In 2024, the Piedmont region introduced universal immunoprophylaxis with Nirsevimab for all infants experiencing their first RSV season. We carried out a multicenter retrospective observational study across the three pediatric units of ASL TO4 (Ivrea, Ciriè, Chivasso), comparing bronchiolitis-related hospitalizations during the 2023–2024 season (pre-Nirsevimab) with those from the 2024–2025 season (post-Nirsevimab). The primary outcome was the proportion of RSV-positive hospitalizations. Secondary outcomes included age at admission, need for respiratory support, PICU/NICU transfer, and length of stay. Immunization coverage was assessed using the regional electronic registry. Immunization coverage exceeded 88% across all centers (overall 90.4%). A total of 179 bronchiolitis hospitalizations were recorded (134 pre- vs. 45 post-Nirsevimab). RSV-positive admissions showed a reduction from 70.9% to 55.6% after implementation (OR 0.52; 95% CI 0.24–1.09). Center-specific analyses suggested reductions in Ciriè (OR 2.48; 95% CI 1.41–4.39) and Chivasso (OR 2.28; 95% CI 1.09–4.77), with a similar trend observed in Ivrea. In a supplementary denominator-based analysis restricted to infants younger than 12 months, RSV-related hospitalization incidence decreased from 42.0 to 10.3 per 1000 infants between seasons (OR 4.23; 95% CI 2.64–6.78; p < 0.0001). Disease severity remained unchanged between seasons in terms of respiratory support, length of stay, and PICU/NICU transfers. Age at admission increased significantly during the post-intervention season (mean 118.3 vs. 160.9 days; Welch’s two-sample t-test, p = 0.026). Among 15 immunized infants hospitalized in 2024–2025, 6 were RSV-positive, none required intensive care, and only two needed high-flow nasal cannula (HFNC). Universal Nirsevimab prophylaxis was associated with a trend toward reduction in RSV-related hospitalizations at the aggregate level, although the overall comparison did not reach statistical significance. Center-specific analyses suggested reductions in RSV-positive admissions in some participating units. A supplementary denominator-based analysis among infants younger than 12 months showed a lower incidence of RSV-related hospitalizations during the post-implementation season. No evidence of increased severity among breakthrough cases was observed. High coverage demonstrated the feasibility of implementation and its potential public health value. Continued longitudinal surveillance over additional RSV seasons is essential to better define the durability of protection and long-term epidemiological impact. Full article

Background: Respiratory syncytial virus (RSV) infection is a cause of respiratory morbidity in high-risk patients, including those with chronic lung disease (CLD) and those undergoing hemodialysis (HD). In HD patients, evidence on the clinical impact of RSV vaccination on respiratory complications remains limited. We aimed to assess the clinical impact of RSV vaccination in HD patients by comparing vaccinated and unvaccinated patients with a focus on CLD. Methods: We retrospectively evaluated 56 adult HD patients: 28 received the RSV vaccine in autumn 2024 and 28 did not. Clinical data were collected from electronic medical records. Outcomes included influenza-like illness (ILI), pneumonia, and respiratory infection requiring hospitalization between September 2024 and September 2025. Results: Patients had a mean age of 74.4 years and a median Charlson Comorbidity Index (CCI) of 10. The RSV-vaccinated group had a greater comorbidity burden than the unvaccinated group (CCI 11 IQR 10–12 vs. 9 IQR 8–11, p = 0.02) and a higher prevalence of CLD (46.4% vs. 25.0%, p = 0.09). During follow-up, 28 patients (50.0%) had at least one ILI episode, 23 (41.1%) developed pneumonia, and 15 (26.8%) were hospitalized for respiratory infection. The incidence of ILI was 46.4% in vaccinated patients and 53.6% in unvaccinated patients (p = 0.28), while the incidence of pneumonia was 39.3% and 42.9%, respectively (p = 0.78). Respiratory infection requiring hospitalization occurred in 14.3% of vaccinated patients and 39.3% of unvaccinated patients (p = 0.035). CLD was significantly associated with pneumonia (p = 0.001) and showed trends toward higher rates of ILI (p = 0.09) and hospitalization for respiratory infection (p = 0.1). Conclusions: In our exploratory study, RSV vaccination in HD patients was associated with fewer hospitalizations for respiratory infection, despite greater comorbidity in vaccinated patients. CLD was associated with a higher incidence of respiratory complications, particularly pneumonia. The retrospective design and small sample size do not allow definitive conclusions; future prospective studies with an adequate sample size are needed to confirm our results. Full article

Background/Objectives: Insulin resistance is increasingly recognized as a cause of colorectal neoplasms, but its measurement requires fasting insulin, which is not routinely available in clinical settings. The triglyceride–glucose (TyG) index, derived from fasting triglyceride and glucose, has emerged as a simple surrogate of insulin resistance. We aimed to evaluate the association of the TyG index with colorectal adenoma, identify a clinically usable cut-off, and examine whether the association is preserved across major subgroups. Methods: We conducted a cross-sectional analysis of 7251 asymptomatic adults who underwent screening colonoscopy and same-day biochemistry at university hospital health care centers in Daejeon and Chungcheong province of South Korea between November 2019 and June 2022. The TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Multivariable logistic regression was used to estimate odds ratios (ORs) for adenoma; discrimination was evaluated by area under the receiver-operating-characteristic curve (AUC), and the optimal cut-off was identified by Youden’s J. Large adenoma (≥10 mm) was analyzed as a secondary outcome. Results: Among 7251 participants (mean age 54.1 ± 11.2 years; 59.7% male; mean BMI 24.7 ± 3.4 kg/m²), 2402 (33.1%) had at least one colorectal adenoma. Adenoma prevalence rose monotonically across TyG quartiles (Q) (Q1, 26.3%; Q2, 32.0%; Q3, 35.5%; Q4, 38.7%; p for trend <0.001). A 1-standard deviation (SD) increase in TyG index was associated with adenoma prevalence in the fully adjusted model (OR 1.13, 95% confidence interval (CI) 1.06–1.20), and the Q4-versus-Q1 OR was 1.29 (1.09–1.53). The optimal cut-off for adenoma was TyG index = 8.55 (AUC 0.564, sensitivity 59.1%, specificity 50.8%); the association was modestly stronger for large adenoma (AUC 0.585; adjusted OR per 1-SD 1.25, 1.09–1.43). Subgroup analyses showed consistent effects across sex, age, body mass index, hypertension, diabetes, and metabolic-syndrome strata (all p for interaction >0.17). Conclusions: In a large screening cohort, an elevated TyG index was associated with the presence of colorectal adenoma, with a graded dose–response relationship and a modestly more pronounced association for large adenoma. Although discrimination by TyG index alone is too modest to support its use as a stand-alone screening tool, the index may serve as a low-cost adjunct within a multifactorial risk-stratification framework. Full article

Background: The COVID-19 pandemic disrupted healthcare systems and antimicrobial stewardship, potentially altering antimicrobial resistance patterns. This study characterized temporal changes in the proportions of multidrug-resistant organisms (MDROs) and identified associated factors before and during the pandemic at a tertiary care hospital in northeastern Thailand. Methods: A single-center retrospective observational study was conducted at Roi Et Hospital, including 5458 culture-confirmed MDRO cases (2017–2022), stratified into pre-pandemic (2017–2019) and pandemic (2020–2022) periods. Pathogen-specific resistance proportions were compared using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression identified independently associated factors within each period. Results: The proportion of MDRO cases classified as hospital-acquired increased from 40.71% to 57.41% (p < 0.001). Carbapenem-resistant Acinetobacter baumannii (CRAB) increased markedly (22.87% to 76.11%; OR 10.75, 95% CI 9.43–12.26), followed by carbapenem-resistant Enterobacterales (CRE) (4.05% to 21.61%; OR 6.54, 95% CI 5.84–7.32) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) (14.32% to 27.15%; OR 2.23, 95% CI 1.87–2.65; all p < 0.001). Vancomycin-resistant Enterococcus (VRE) declined significantly (OR 0.41, 95% CI 0.25–0.68; p < 0.001). Methicillin-resistant Staphylococcus aureus (MRSA) showed a higher proportion among clinical isolates (3.28% to 6.34%; OR 2.01, 95% CI 1.42–2.83), although without a consistent annual trend. In multivariable analyses, ICU admission was independently associated with lower odds of CRE (aOR 0.52) and CRPA (aOR 0.63) and with higher odds of CRAB (aOR 2.13; all p < 0.001). Conclusions: The COVID-19 pandemic was associated with a major proportional shift toward carbapenem-resistant Gram-negative pathogens, with distinct profiles of associated factors across CRAB, CRE, and CRPA. These findings highlight the need for pathogen-specific infection prevention and antimicrobial stewardship strategies during healthcare system disruptions. Full article

Studies on the association between green spaces and childhood allergic diseases are limited and have yielded inconsistent results across different regions. Furthermore, this relationship remains underexplored in Chengdu, China. In this study, we aimed to investigate the association between the residential greening rate, Normalized Difference Vegetation Index (NDVI), proportion of allergenic plants (proportion of allergenic woody plants, proportion of allergenic herbaceous plants), the closeness-to-nature characteristics of children’s playgrounds, and childhood allergic diseases in Chengdu. Seven representative neighborhoods were selected based on a 2018 database of pediatric patients from West China Hospital of Sichuan University. Through questionnaires in 2025, data on allergic diseases (e.g., atopic dermatitis and allergic rhinitis) were collected for 210 children aged 0–6 years. Logistic regression models were employed to analyze the data. The results indicate that in the overall sample, residential greening rate, NDVI, proportion of allergenic plants and closeness-to-nature characteristics of children’s playgrounds showed no significant association with allergic diseases. However, subgroup analyses revealed that greening rate was positively associated with allergy risk among children aged 0–3 years, whereas the proportion of allergenic woody plants was negatively associated with allergy risk in this age group; residential NDVI was significantly negatively associated with allergy risk in low-to-medium-housing-price neighborhoods (<19,000 CNY/m²), but positively associated in high-housing-price neighborhoods (≥19,000 CNY/m²); the proportion of allergenic herbaceous plants was significantly negatively associated with allergy risk in children only in high-housing-price neighborhoods. The presence of children’s playgrounds, accessibility of natural elements, integration of sites and facilities into the landscape, and use of natural materials in playgrounds and facilities showed a negative trend with allergy risk in low-to-medium-housing-price neighborhoods; the integration of sites and facilities into the landscape was significantly positively associated with allergy risk in high-rise neighborhoods. Collectively, these associations vary based on individual and neighborhood characteristics. Targeted green space planning and design interventions should be context-specific, synergistically optimizing vegetation coverage and plant composition, while enhancing the closeness-to-nature characteristics of children’s playgrounds within neighborhoods. Our results provide empirical evidence that may offer insights into the development of healthy and child-friendly cities. Full article

The rapid expansion of video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery (RATS) has reshaped thoracic surgical practice over the last two decades, offering reduced perioperative morbidity, shorter hospital stay, and oncological outcomes comparable to conventional thoracotomy in appropriately selected patients. Minimally invasive techniques now account for the majority of anatomical pulmonary resections in many high-volume centers and are being explored, in selected patients at experienced institutions, for increasingly complex procedures. This shift, however, raises a question that has received comparatively little attention: whether reduced trainee exposure to open thoracotomy may, over time, erode open thoracic surgical competence. As minimally invasive approaches become the institutional default, exposure to open surgery is declining, and the skills required to perform complex open resections or to manage intraoperative emergencies may become confined to a diminishing cohort of senior surgeons. In this narrative review, we examine the current boundaries of minimally invasive thoracic surgery, define the clinical scenarios in which open surgery remains indispensable—including bronchoplastic and angioplastic resections, post-induction hostile surgical fields, and unplanned conversion—and consider the implications of the ongoing paradigm shift for training, taking into account the substantial variability of thoracic surgical practice across different regions. We argue that open thoracic surgery is not an obsolete discipline but a foundational competence whose preservation may warrant deliberate attention through structured exposure, simulation, mentorship, and dedicated competence assessment. Throughout, we have sought to distinguish documented trends from reasonable concern and from speculative future risk, and we frame the central issue explicitly as a credible and foreseeable risk rather than a demonstrated decline. Full article

Background: Liver cancer is a major public health problem in Thailand due to its high incidence and mortality. Although hepatectomy is a potentially curative treatment, it is a complex procedure with a high risk of postoperative complications, necessitating a structured and systematic approach to care. Objectives: This study aimed to develop a clinical practice guideline (CPG) for patients with liver cancer undergoing hepatectomy and to evaluate the feasibility of its implementation in relation to outcomes for healthcare providers, the organization, and patients. Methods: This implementation research was conducted in three phases: (1) an evidence-triggered phase, (2) an evidence-supported phase, and (3) an evidence-observed phase. The CPG covered five stages of care: preoperative, intraoperative, postoperative, discharge planning, and post-discharge follow-up. It was implemented through a multidisciplinary approach, with an advanced practice nurse (APN) facilitating adherence to Enhanced Recovery After Surgery (ERAS) components. Data were analyzed using descriptive statistics. Results: Healthcare personnel demonstrated high adherence to the CPG and reported high feasibility of implementation. After implementation, favorable trends were observed in postoperative complications, length of hospital stay, hospitalization costs, and patient satisfaction compared with the historical pre-implementation period. The CPG also appeared to support clearer care standards and multidisciplinary coordination. Conclusions: The developed CPG was feasible and contextually appropriate for ERAS-based hepatectomy care in this setting. Preliminary findings suggest favorable trends in care processes and selected outcomes. Larger controlled studies with longer follow-up are needed to determine effectiveness and sustainability. Full article

Background: Very-low-birth-weight (VLBW) infants require ongoing medical follow-up and coordinated family support after discharge due to their immature physiological development and a high risk of complications. Fragmented transitional care and caregiver burden may compromise follow-up adherence and infant health outcomes. This study aimed to describe the implementation, feasibility, and service-level outcomes of a multidisciplinary transitional home care program designed to support continuity of care and family-centered transitional support for high-risk infants through a retrospective descriptive program evaluation. Methods: Since 2022, our hospital has implemented a government-supported transitional home care program for low and VLBW infants. A multidisciplinary team provided individualized discharge planning, risk stratification, home-based follow-up, telehealth consultations, developmental monitoring, caregiver education, and psychosocial support. Program outcomes were evaluated using enrollment coverage, follow-up completion, developmental assessment attendance, caregiver stress scores, and service utilization. Results: From 2022 to September 2025, enrollment coverage reached 97.7–100% for infants ≤ 1500 g and 100% for preterm infants > 1500 g. A total of 949 video consultations and 2168 telephone or in-person follow-ups were conducted, totaling 3117 service encounters. Developmental assessment attendance rates reached 95%, 93%, and 88% at scheduled corrected-age intervals. Mean caregiver stress scores showed favorable observational trends, decreasing from 14.64 to 10.81. Fifty-two referrals to social resources enhanced service accessibility and family support. Conclusions: This multidisciplinary transitional home care program demonstrated high enrollment coverage and sustained follow-up engagement within a tertiary medical center setting. The findings support the feasibility and potential applicability of integrated and family-centered transitional care models in supporting continuity of care and caregiver support for high-risk infants after discharge. Due to the descriptive retrospective design and absence of a control group, causal relationships cannot be established. Full article

Background and Objectives: Falls represent a major public health concern among older adults, contributing substantially to morbidity, mortality, and healthcare burden. This study aimed to analyze trends, demographic characteristics, hospitalization rates, injury patterns, and outcomes of fall-related hospitalizations among individuals aged ≥65 years in Split-Dalmatia County, Croatia, from 2020 to 2024. Materials and Methods: A retrospective epidemiological study was conducted using fall-related hospitalization data from the National Health Information System. Discharges for injury (S00-T98) caused by a fall (W00-W19) were selected using ICD-10. Analyses included individuals aged ≥65 years and were stratified by age group (65–74, 75–84, ≥85 years), sex, and year. Hospitalization rates per 100,000 population were calculated using official population data. Differences were assessed using chi-square and Kruskal–Wallis tests, while Poisson regression was used to estimate rate ratios (RRs) with 95% confidence intervals (CIs) and assess temporal trends. Results: A total of 4737 fall-related hospitalizations were recorded among individuals aged ≥65 years (58.32% of all cases). Hospitalization rates increased markedly with age, with individuals aged ≥85 years having more than a fivefold higher rate compared to those aged 65–74 years (RR = 5.16, 95% CI 4.80–5.56). Women accounted for 69.83% of cases and had higher hospitalization rates than men (RR = 1.74, 95% CI 1.64–1.85). Hip and femur injuries were the most common (50.39%). In-hospital mortality was 3.02% and higher among men. No significant temporal trend was observed (AAPC = −2.18%, p = 0.392). Conclusions: Fall-related hospitalizations are strongly associated with advanced age and female sex, with hip fractures predominating. Although rates remained stable over time, ongoing population ageing is likely to increase the future burden. Targeted, age- and sex-specific prevention strategies should be prioritized. Full article