International Maritime Health最新文献

Background: Diabetic foot ulcers (DFU) are a common and severe disease with vascular and/or neurological complications, affecting the patient's health and quality of life. Hyperbaric oxygen (HBO) is a non-drug treatment method that has anti-inflammatory effects, reduces edema, increases neovascularization, increases the synthesis of collagen fibers, and accelerates the wound healing process. This study aims to evaluate the results of treating patients with diabetic foot ulcers with HBO.

Material and methods: A randomized controlled study was conducted. A total of 94 patients was diagnosed with diabetic foot ulcers, and treated at the Institute of Maritime Medicine from January 2021 to December 2023. Study subjects were divided into 2 groups: the study group included 43 patients treated with HBO combined with intravenous antibiotics, wound care, and control of underlying disease; the reference group included 51 patients who were not treated with HBO, but were treated with intravenous antibiotics, wound care, and control of underlying disease.

Results: The infection status and level of granulation tissue growth of the study group were better than the reference group (p < 0.001); the depth and diameter of the ulcer in the study group decreased compared to the reference group (p < 0.05). Treatment time and amputation rate in the study group were reduced in comparison with the reference group: 10.1 ± 4.6 days, 15.1 ± 7.8 days and 4.6%, 11.7%.

Conclusions: Hyperbaric oxygens a good method for treating diabetic foot ulcers, helps with anti-inflammation, stimulates the growth of granulation tissue, quickly heals ulcers, reduces treatment time, and reduces amputation rates.

Background: Central African Republic (CAR) is one of the poorest countries in the world with nearly 65% of its inhabitants living in extreme poverty, and 87% lacking access to safely managed sanitation facilities. Poor sanitation and limited access to healthcare contribute to high transmission of intestinal parasitoses. The present study aimed to assess the occurrence of intestinal parasitic infections (IPIs) in two separate ethnic groups inhabiting the rainforests in the Lobaye Prefecture in the southern parts of the CAR: the nomadic BaAka Pygmies and the sedentary Bantu people. In addition, the results obtained from the examination of the Pygmy people were compared to the results of the 2021 study on the occurrence of IPIs in a Pygmy community inhabiting the Sangha-Mbaéré Prefecture in the CAR, in the context of the effectiveness of mass deworming actions among the population living in the forest ecosystem.

Materials and methods: Stool samples for parasitological examination were collected from 170 patients (145 Bantu people and 25 BaAka Pygmies) in September 2024 at a healthcare facility in Bagandou, the Lobaye Prefecture, CAR. The exclusion criterion was taking antiparasitic drugs within four weeks before collecting the biological material for testing. The collected biological material was fixed in SAF fixative, and next it was transported to the Department of Epidemiology and Tropical Medicine at the Military Institute of Medicine - the National Research Institute in Poland, where it was examined by light microscopy; the specimens were prepared for examination using three different methods (a direct smear in Lugol's solution, decantation with distilled water, the Fülleborn's flotation method).

Results: A total of 38.2% of the study participants were found to be infected with at least one clinically significant parasitic species. Apart from potentially pathogenic Blastocystis spp. and non-pathogenic protozoa, hookworm, Giardia intestinalis and Ascaris lumbricoides were found to be the most prevalent parasitic species in the study participants. More than 60% of the participants were found to be co-infected with at least two different parasitic species. The occurrence of IPIs was significantly higher in BaAka Pygmies compared to the sedentary Bantu people. It also demonstrated that the infection rate was lower in older age groups.

Conclusions: The study demonstrated a high occurrence of intestinal parasitic infections both among BaAka Pygmies and in the Bantu people inhabiting the Lobaye Prefecture. Mass deworming campaigns conducted by catholic missionaries, as well as non-governmental organisations, are not effective in reducing the number of STH cases in the local communities. Continuous exposure to risk factors and the unique lifestyle of the local residents put them at risk of permanent reinfections.

Background: Fishermen face multiple occupational health risks including drowning, traumatic injuries, asphyxia, and skin allergies. Additionally, their exposure to high intensities of engine noise during fishing puts them at risk of noise-induced hearing loss (NIHL). Inadequate use of ear protective devices and lack of awareness further contribute to the prevalence of NIHL among fishermen. This study aims to measure the engine noise level of fiber motor boats and develop an audiological profile of fishermen in Puducherry.

Materials and methods: Thirty fishermen between the ages of 20 to 45 years, who operate fiber motor boats were tested using pure-tone and speech audiometry, high-frequency audiometry, immittance audiometry, single and multifrequency tympanometry, and distortion product oto-acoustic emissions (DPOAEs). Additionally, the engine noise level of fiber motor boats was measured using a sound level meter.

Results: The engine noise levels ranged from 92 dB(A) to 115 dB(A) and 81 dB(A) to 106 dB(A) at 3 feet and 6 feet distance respectively, which exceeds the permissible 90 dB(A) limit in accordance to Occupational Safety and Health Administration (OSHA) standards for 8 hours. Audiological test results indicated hearing loss primarily at 4 kHz and at higher frequencies. Single and multifrequency tympanometry results were atypical. Although Pure Tone Audiometry (PTA) at standard frequencies was normal, DPOAEs were affected.

Conclusion: It is crucial to educate fishermen about ear care and the use of ear protection to prevent hearing loss due to harmful noise levels. In addition, the importance of using.

Introduction: Jellyfish poisonings are frequent in coastal areas of temperate latitudes. In Spain, the most frequent and dangerous jellyfish is the Portuguese man-of-war or Physalia physalis. Although the clinical manifestations of P. physalis envenomation are known, the acute management and complications are controversial, with varying criteria about proper treatment.

Materials and methods: This paper presents a systematic review of those studies that have collected clinical aspects of the sting of P. physalis, as well as an experimental study that evaluates the discharge capacity of nematocysts under different conditions (heated seawater at 50°C, 4°C seawater, distilled water, 25% commercial vinegar, distilled water, 25% commercial vinegar in seawater) as a proxy for envenomation potential including in sea lice. Also, discharged and undischarged nematocyst count was performed in air-dried tentacles at different times after specimen collection.

Results: Acetic acid does not produce nematocyst discharge when diluted in seawater and warm seawater is an optimal rinsing agent that dissolves the jellyfish mesoglea. Furthermore, the nematocysts detached from the jellyfish body maintain toxic capacity for at least 120 days after the stranding of the organism.

Conclusions: Most controversy regarding the treatment of P. physalis envenomation is related to the lack of proper species stratification or identification. In our sample, acetic acid does not elicit nematocyst discharge by itself, but depending on the solvent. Both vinegar and hot seawater rinses are the best first-aid treatments. A first aid protocol is proposed based on data from the review and the experimental study.

Hyperbaric oxygen therapy (HBOT) is used as a treatment for acute and chronic diseases. The therapy is conducted in hyperbaric chambers. Hyperbaric medicine centers' use of multiplace chambers assures the patients' safety and comfort due to attendant's presence during each session. Among the patients and in the group of medical attendants the most common side effect of HBOT is middle ear disorder. However, inert gas narcosis occurring during compression to over 2 ATA (10 meters' of sea water equivalent) can be manifested in temporary cognitive function impairment, mostly due to nitrogen narcosis. One easily accessible and non-invasive method to assess cognitive functions is critical flicker fusion frequency test (CFFF). In our study, medical attendants were asked to perform CFFF with one and two diodes during separate HBOT sessions. No correlation was found between CFFF scores and the number of flickering lights. However, we observed a relationship between the CFFF results and the different times of day the task was performed. The fusion threshold decreased with age.

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Background: Health literacy (HL) is the ability to access, process and understand information about health. It has been established that HL mediates health-related decisions and behaviours. In the naval environment, sailors are expected to responsively address their healthcare needs and maintain a holistic state of physical and psychological wellbeing to meet the operational demands of their work. While studies of HL in military populations have been undertaken, none of these have explicitly examined active-duty naval personnel. The aim of this study was to examine the levels of HL amongst a sample of active-duty sailors in the South African Navy (SAN) and determine to what extent HL predicted health behaviours.

Materials and methods: A total of 977 active-duty sailors completed a demographic questionnaire and the Health Literacy Questionnaire (HLQ) during their annual health screening. The HLQ is 44-item questionnaire with Likert scale response options that assesses several domains of health literacy across nine subscales. The HLQ data was paired with several health indicators. The following health information was recorded; blood pressure readings (diastolic and systolic), body mass index, hip, and waist measurements, as well as if diabetes and/or hypertension had been diagnosed. Descriptive statistics were used to analyse the data along with a regression analysis to determine the nature and predictability of HL and the health indicators.

Results: The findings supported high levels of HL across all nine subscales with the active management subscale significantly predicting several health outcomes including reduced blood pressure; body mass index and waist and hip measurement.

Conclusions: The HLQ was used to assess HL amongst SAN sailors. Results indicate that SAN personnel have above average HL knowledge and skills which may be attributed to the accessibility of health support information and services as well as mandatory health screenings and evaluations.

Background: Burns, especially heat-related ones, are common injuries at work as well as in daily life. If there is no proper treatment, burns will leave a lot of sequelae, affecting daily activities, working ability, aesthetic and psychology of patients. Hyperbaric oxygen therapy is a new treatment, supporting pain relief, accelerating wound healing process, and reducing hospital stay.

Aim: To describe the clinical characteristics of thermal burn patients right at the time of admission and initial results of hyperbaric oxygen therapy.

Material and methods: Prospective and retrospective case series report. This study comprised of thermal burn patients, who came to the Vietnam National Institute of Maritime Medicine (VINIMAM) for treatment via hyperbaric oxygen therapy from 2018-2022. Patients were first treated by VINIMAM 1, 2 and 3 regimens, then monitored and periodically assessed for some clinical features demonstrating the effect of this treating method.

Results: The mean age of 82 patients was 48.4 ± 19.5; 74.4% of patients were burned by boiling water; 51.2% of them had 3rd degree burns; percentage of patients with < 10% of total body surface area (TBSA) burned was 80.5%; the mean length of stay was 8.9 ± 3.0 days, which was significantly lower than the expected figures.

Conclusions: Hyperbaric oxygen therapy is an effective treatment for thermal burn patients, with a variety of positive effects on burned tissues, therefore it should be scaled up, especially in facilities specialized in burn treatment.

Cardiovascular diseases are the leading cause of death globally. Studies indicate a higher prevalence of cardiovascular risk factors such as obesity, smoking, diabetes, hyperuricaemia, and lipid metabolism disorders among seafarers. The presented literature review highlights a significant gap in current data regarding the prevalence, clinical course, and prognosis of numerous cardiological conditions in this occupational group. The study focused primarily on coronary artery disease, heart failure, atrial fibrillation, and arterial hypertension among seafarers. Recently, there has been a growing emphasis on the intensification of preventive measures as well as early diagnosis of cardiovascular diseases. Seafarers represent an occupational group that may significantly benefit from individualized diagnostic and therapeutic strategies. The use of modern technologies - such as advanced echocardiographic techniques for risk stratification and mobile devices for arrhythmia detection - may significantly improve the effectiveness of identifying diseases before the onset of complications, particularly in situations where access to medical supervision is limited both during work and free time on the ship due to specific conditions at sea.