Activity

lithiasis is a feasible, safe and effective technique with a low complication rate. LTD-CBDE offers another alternative for surgeons to treat patients in similar scenarios. However, additional randomized, controlled studies are needed to demonstrate its efficacy, safety, and impact on CBD stenosis.BACKGROUND Life expectancy acts as a population measure of the performance of healthcare systems. Regional disparities on life expectancy in Indonesia has been persisted and become a public health policy challenge. A systematic clustering of provinces can be a valuable alternative for organizing cooperation that aimed to increase life expectancy and reduce disparities. This study aimed to identify determinants of life expectancy and designate clusters of Indonesian provinces with similar characteristics. This approach can be useful in generating alternative cooperation strategies to improve life expectancy. METHODS We carefully selected variables that have been shown to impact life expectancy and gathered 2015 data from Indonesia’s Ministry of Health. All 34 Indonesian provinces were included as analysis units. We performed structural equation modeling (SEM) to select domains that needed to work on from theoretical models. Based on SEM results, we performed cluster analysis to arrange cooperation groups. RESULTS Life expectancy showed correlations with mean years of schooling, expenditure per capita, health workforce, healthcare facilities, and environment. Expenditure per capita also was the strongest of all constructs. Based on SEM results, we performed cluster analysis to arrange cooperation groups of total 34 provinces and generated five clusters of provinces. CONCLUSIONS Enhancing the economy is the most effective approach for improving life expectancy and other constructs. These clusters can build cooperation that is new, within, and across clusters. These results may be useful in formulating cooperation strategies aimed at increasing life expectancy.BACKGROUND Alzheimer’s disease (AD) is a neurodegenerative disorder featuring the behavioral and psychological symptoms of dementia. Patients with early-onset AD that exhibits first as psychotic symptoms usually lack obvious cognitive impairment, so they may be misdiagnosed with late-onset schizophrenia. CASE PRESENTATION We report a patient who had prominent psychotic symptoms at the age of 60 and was initially diagnosed with very-late-onset-schizophrenia-like psychosis. Psychotic symptoms disappeared rapidly after treatment with olanzapine, and the patient later showed extrapyramidal symptoms and decline in cognitive function. Brain magnetic resonance imaging (MRI) showed frontotemporal atrophy, and positron emission tomography (PET) showed extensive areas of hypometabolism in the frontal cortex and head of the caudate nucleus. selleck chemicals The patient’s SORL1 gene was found to carry a heterozygrous mutation (c.296A > G). The patient was eventually diagnosed with early-onset AD. CONCLUSIONS Our case suggests that clinicians should consider the possibility of early-onset AD in middle-aged or elderly patients whose first symptoms are the behavioral and psychological symptoms of dementia. To distinguish early-onset AD from late-onset schizophrenia, clinicians should evaluate cognitive function, perform MRI and PET, and search for SORL1 mutations.BACKGROUND It is essential for medical treatment that patients and medical staff can communicate about acute complaints, pre-existing conditions, and the treatment procedure. Misunderstandings can have far-reaching consequences, particularly in time-critical emergencies, which require rapid assessments and decision-making and in which interpreters are rarely available. In this study, we aim to develop a digital communication tool that is to help paramedics communicate with patients who speak hardly any or no German, to monitor its implementation, and to investigate its effect on communication between foreign-language patients and staff. Furthermore, a large amount of data on patients that are cared for in emergency medical services in Germany are collected for the first time. METHODS To consider the complex situations of paramedic care and to meet paramedics’ demands, we use an action-oriented research approach to develop the tool. We include the staff of the participating emergency medical service stations aal communication tool to overcome language barriers in emergency medical services and investigating its usability, acceptance, and effect on communication, in short, its usefulness and value for paramedic care. Additonally, we expect to gain comprehensive information on rescue operations. TRIAL REGISTRATION German Clinical Trials Register, DRKS00016719, registered 08 February 2019, World Health Organization Trial Registration Data Set, http//apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00016719.BACKGROUND Pakistan has one of the highest reported incidence of vitamin D deficiency in studies conducted worldwide. However, there has been very limited exploration of vitamin D related knowledge, attitudes and practices among healthy youth in Pakistan. METHODS A cross-sectional survey was conducted among youth (aged > 16 years) from two engineering universities in Pakistan. Participants were asked questions on their concern about vitamin D levels, testing, and supplementation practices. Knowledge was examined using questions about food sources, health benefits and factors affecting vitamin D production within the human body. Of the 900 eligible students invited to participate, 505 (56%) completed the questionnaire and were included in the analysis. RESULTS Only 9% participants were able to identify the correct food sources of vitamin D, 33% were aware of the bone health benefits (bone health and calcium absorption) of vitamin D and 36% identified sunlight exposure as a factor influencing vitamin D productig health-policy recommendations for this vulnerable population group.BACKGROUND The health of forcibly displaced individuals changes along their migration path and estimates of disease burden are essential to develop health care policies and practices adequately corresponding to their health care needs. This study aims to describe the health status and use of medication among Syrian refugees in two different migration phases in a transit setting and in a recipient country. Further, we aim to investigate the associations between migration related exposures and both chronic pain and mental health among Syrian refugees. METHODS This is a cross-sectional study based on survey data collected among 827 adult Syrian refugees in Lebanon and Norway during 2017-2018. The survey instrument included items measuring somatic status (including chronic pain), mental health (using the HSCL-10 and HTQ items), use of medication and migration related exposures. We used descriptive statistics to calculate standardised prevalence proportions and regression analyses to study associations between migration related exposures and health outcomes.