International Maritime Health最新文献

This paper presents a case of a 77-year-old patient diagnosed with type 2 cardio-renal syndrome, who has undergone a Transcatheter Aortic Valve Implantation surgery due to aortic stenosis associated with permanent atrial fibrillation and type 2 diabetes. This patient, despite their multi-morbidity, undertook family travels to Egypt. Despite disease symptoms and plethora of medication, the patient did not seek medical advice on preventative measures or potential health risks prior to the departure. During the stay in Egypt, the patient sustained a lower limb injury, which resulted in pretibial hematoma requiring a 2-week stay in a local hospital. The patient's condition was systematically deteriorating and after returning to Poland a continued multi-specialist treatment in the field of surgery, nephrology and cardiology was required. The medical history of the described patient and the severity of heart failure and chronic kidney disease were clear contraindications to long-distance travels. Despite those risks, the patient did not seek pre-travel medical advice from specialists and did not undertake any preventative measures. As a result of an accident during travel, an elderly patient with multiple diseases suffered serious health complications that significantly and permanently worsened his general health condition. Due to the aging population and the increasing amounts of elderly patients traveling internationally, proper preparation of seniors before departure is one of the key aspects of modern travel medicine.

Most hyperbaric medicine reports concentrate on the patient and his morbidities. In addition to the well-known indications for hyperbaric oxygen therapy (HBOT), we cannot discount possible side effects. Among medical staff regularly exposed to hyperbaric conditions the best described so far is decompression sickness. A non-invasive and easily available way to assess cognitive functioning involves the use of the critical flicker fusion frequency (CFFF) test. In the current study, the flicker test was performed several times on 21 subjects, both under normobaric and hyperbaric conditions. The test was conducted using the device that flickering was programmed according to the method of limits. While in the hyperbaric chamber, 15 of the participants breathed oxygen to reduce the risk of decompression sickness. Flicker and fusion frequencies differed from each other in both normo- and hyperbaric conditions (p < 0.01). CFFF results were dependent on oxygen breathing during decompression.

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Myiasis, an infestation caused by dipteran larvae, commonly known as maggots, is one of the most common parasitic skin disorders in the tropical regions. Authors report a case of cutaneous myiasis caused by Dermatobia hominis (Diptera: Oestridae) in a Polish traveller returning from a self-organized trip to South America. Species biology, prophylaxis, and medical implications of this tropical parasitosis are discussed.

Background: First, this analysis was conducted to study a coronavirus disease 2019 (COVID-19) cluster dynamic on a cruise ship in order to allow the ship physician to anticipate the duration and importance of the contaminations. Secondly, the author tries to find out if the closed environment on board allows specific conclusions about epidemic dynamics and preventative measures.

Materials and methods: From a personal epidemiological compendium done by himself on board the author analysed different epidemic curves identified on board other ships and compared them to the epidemiologic data from the different COVID-19 contamination waves in France since 2020. All crew members were submitted to polymerase chain reaction tests on D2, D5, D8 and D15 and symptomatic cases were tested on on-board devices in the meantime. An excel file called "Log Covid" allowed for daily reporting to the ship-owner on the epidemic dynamics and the prospects on the end of crises in order to anticipate the resumption of the business in the best conditions. The jobs on board, age and geographic origin of the contaminated people were analysed, as well as their vaccination status.

Results: Out of a total of 118 crew members, 61 (52%) sailors were contaminated in 8 days. The symptoms were benign (pharyngitis, headaches, feverish state); no serious form of illness were reported. The passengers were repatriated to France at the earliest stage. The epidemic phase occurred in a 15-day window. The first 8 days corresponded to the ascending phase, then a faster phase of epidemic decrease of 7 days. Similarities emerged between the epidemic dynamics of this virus and other contaminations on cruise ships and epidemic phases on land in spite of important differences in numbers.

Conclusions: This study can allow a ship's doctor to better understand the viral dynamics in case of a COVID- 19 cluster and to anticipate the exit of the crisis. Repeated tests during the active phase of the epidemic are necessary in case of a large cluster to know where to place oneself on a typical epidemic curve. Isolation and barrier measures advised by the ship's doctor remain the only weapons that can limit its magnitude.

Background: Hajj and Umrah mass gatherings (MGs) in the Kingdom of Saudi Arabia amplify the risk of viral respiratory tract infections (RTIs), but there is a lack of comparative data from these two MGs. This study aims to compare pilgrims' hand hygiene knowledge, practices, and rates of RTIs during the peak periods of Umrah and Hajj in 2021.

Materials and methods: The datasets of this comparative study were obtained from two previously conducted studies that used similar study tools and identical syndromic definitions. The binary logistic regression was applied to compare the categorical variables and, a t-test was used to compare the continuous variables.

Results: A total of 510 Hajj pilgrims and 507 Umrah pilgrims were recruited. The majority of Hajj pilgrims (68%) were ≥ 40 years old, while most Umrah pilgrims (63%) were < 40 years old. The mean total knowledge scores of hand hygiene between the Hajj and Umrah pilgrims differed significantly (4.1 vs. 3.7, respectively, p < 0.001) so did their compliance with frequent use of alcohol-based hand rubs (53.0% vs. 36.3%, respectively, p < 0.001) and the rates of RTIs (4.7% vs. 2.2%, respectively, p = 0.05).

Conclusions: These differences could be attributable to the distinctive characteristics of Hajj and Umrah pilgrimages, and the unique differences in risks posed by those MGs.

Background: Several studies have demonstrated the existence of psychological pathologies and psychosocial risks among seafarers, particularly merchant navy officers. To date, there is no study of merchant navy officer cadets. First aims are to assess anxiety and depression disorders, framework, work strain and social support in this population.

Materials and methods: A questionnaire including demographic and sailing data to which we added the Hospital Anxiety and Depression Scale (HAD) and Karasek questionnaire was developed. All students were approached and completed the questionnaire anonymously by electronic means.

Results: One hundred and seventy questionnaires could be included. The population was predominantly male (76.4%), and the average age of the students was 21.7 years. The means of the HAD anxiety and HAD depression were 6.9 and 5.37, respectively. According to Karasek classification, we noted that the "active" class was the most represented with 29.4% of students, followed by the "high strain" and "low strain" classes with 27.6%. The "passive" class was the least represented with 15.3%.

Conclusions: We found a predominance of anxiety disorders but few signs of depression. Signs of "high strain" according to Karasek were found in 27.6% of the population of these young officers. Job demand was linked to mean of anxiety and depression disorders declared in HAD questionnaire. Being a woman was associated with anxiety but not depression symptoms. Prevention programme to decrease the level of job demand and increase decision latitude and social support seems relevant for mental health disorders in merchant officers.

Background: Seafaring is a demanding profession that exposes individuals to unique health risks and challenges. This study investigates risk classification patterns among seafarers who underwent physical and medical examination at the Nordic Medical Clinic, a pre-employment clinic in the Philippines.

Materials and methods: The analysis involved data obtained from medical records, including demographic information, diagnoses, medical risk classification, corresponding management, and occupational details. medical risk classification, based on guidelines from the Philippine Department of Labour and Employment, categorised fit to work seafarers into risk class A, B, or C. Descriptive statistics and statistical tests, with a significance level set at p < 0.05, were utilised for data analysis using R Studio (version 4.2.3).

Results: The study population consisted of 11,831 seafarers seen at the Nordic Medical Clinic between 2018 and 2022. The results revealed a significant proportion of seafarers falling into higher risk classifications, with risk class C being the most prevalent at 48.16%. Pre-employment medical examinations (PEME) to fit to work duration demonstrated a significant association with risk classification, revealing that lower-risk classes had shorter fit-to-work times compared to higher-risk classes. Moreover, risk classification exhibited uneven distribution across specific demographic and occupational characteristics, with older seafarers, males, married individuals, and those in higher-ranking positions having a higher proportion of risk class C.

Conclusions: Our findings highlight the need for comprehensive and customised pre-boarding medical screening standards for seafarers based on factors such as their specific role, vessel type, voyage, contract length, and work location. Moreover, health implementation of health promotion and preventive strategies that are based on the specific occupational and demographic needs of the seafarers are needed.