Incidence of IDDM during 1988–1992 in Zagreb,Croatia

Summary The objective of this study was to determine the incidence of insulin-dependent diabetes mellitus (IDDM) in the population of Zagreb, Croatia, during 1988–1992. A centralized diabetes registry was the primary source of data, while secondary sources were used to assess ascertainment. A total of 282 new cases of IDDM were diagnosed in the study period, the primary and secondary sources identifying annually 93–100% of the cases. The annual incidence rate ranged from 5.6 per 100,000 to 6.6 per 100,000. Early fatality in persons older than 50 years was the major cause of underascertainment. The incidence peaked in the 10–14 years age group (12.4 per 100,000), and remained stable after age 24 years. Males had a significantly higher incidence in the 5–9 and 24–44 years age groups. In the 45–54 years age group, females had a significantly higher incidence. No seasonality was observed. Despite the war conditions in Croatia, the low overall IDDM incidence rates did not change significantly during the study period.Abbreviations IDDM Insulin-dependent diabetes mellitus - DKA diabetic ketoacidosis     

Electrocardiographic changes in ex-prisoners of war released from detention camps

The aim of the study was to determine whether and to what extent changes in the electrocardiograms occurred in released prisoners of war (POWs) from Serbian detention camps and whether the frequency of occurrence differed from similar changes in a control group. An electrocardiogram was recorded and medical examinations conducted on 182 randomly selected ex-POWs. The subjects were male with a mean age of 35.8 ± 11.0 years, age range 18–65 years and the average length of imprisonment 164.5 ± 87.1 days. The electrocardiograms were analysed according to the Minnesota côde. The following changes were frequently found: postinfarction Q-wave in 3.3%, control 1.1% (not significant), ST-segment depression horizontal or descendent in 14.3% (controls 3.8%, P < 0.01), particularly S-T segment depression of up to 0.5 mm in 12.1% (controls 2.2%, (P < 0.01), total negative T-wave in 7.1% (control group 3.3%, not significant), total arrhythmia 18.1% (controls 7.1%, P < 0.01), particularly ventricular premature beats in 2.2% (controls 0.5%, not significant), incomplete left bundle-branch block 2.2% (not registered in the control group), complete left bundle-branch block in 0.5% (not registered in the control group), sinus tachycardia in 12.1% (controls 6.6%, not significant), sinus bradycardia 3.3% (not registered in the control group) and microvoltage QRS complex in 11.5% (controls 0.5%, P < 0.001). The results of this study confirm that changes in the electrocardiograms of the POWs released from Serbian detention camps were far more frequent than in the controls.     

The Ukraine–Russia War Is Deepening Food Insecurity,Unhealthy Dietary Patterns and the Lack of Dietary Diversity in Lebanon: Prevalence,Correlates and Findings from a National Cross-Sectional Study

Background: Due to Russia and Ukraine’s key roles in supplying cereals and oilseeds, the Russia–Ukraine war intensifies the current food availability and price challenges in Lebanon, which is a major wheat importer. Given these constraints, we conducted this study to assess the prevalence and correlates of food insecurity, low dietary diversity (DD), unhealthy dietary patterns, and the shifts in households’ food-related habits in response to the Russia–Ukraine war among a representative sample of Lebanese household’s members aged 18 years and above (N = 914). Methods: Data were collected between June and July 2022 using self-administered questionnaires; Results: Findings showed that nearly half of the households consume an undiversified diet (46%), and 55.3% ate fewer than two meals per day. The prevalence of food insecurity among Lebanese households was 74%, with one in every four households being severely food insecure. In addition, the majority of households’ members went out shopping and purchased food less than the pre-war period (68.7% and 70.3%, respectively). Furthermore, almost 68.3% of households’ members highlighted price increases for cereal products, which were the least available and most stocked items. Findings obtained through binary logistic regression also showed that food insecurity was two times higher among households with low monthly income, 35% higher among females, and three times higher among married participants; Conclusions: The impact of the Russia–Ukraine conflict on food security in Lebanon requires a systems-thinking approach as well as international effort to understand the challenges and find solutions to minimize the war’s negative effects.     

战伤分类编码系统研究

战场卫勤信息化建设和平时军队医院的信息化建设一样,需要遵守“统一规范、统一代码、统一接口”的原则。统一的战伤代码是战场卫勤信息化建设的基础。本研究探讨了战伤分类编码标准和方法,构建符合战场卫勤信息化建设的战伤编码系统,为卫勤信息化建设提供了统一的战伤分类标准和代码,并开发了相应的计算机软件系统。     

军队采供血机构血液储备应关注的问题

战备血液储备与常规的血液储备,在储备的形式、管理的方式、动用的权限等方面存在一定的差异,军队采供血机构在战备血液储备工作中应当关注：物资准备、人员培训、信息管理、动用权限、保密等问题。     

How the war on drugs impacts social determinants of health beyond the criminal legal system

There is a growing recognition in the fields of public health and medicine that social determinants of health (SDOH) play a key role in driving health inequities and disparities among various groups, such that a focus upon individual-level medical interventions will have limited effects without the consideration of the macro-level factors that dictate how effectively individuals can manage their health. While the health impacts of mass incarceration have been explored, less attention has been paid to how the “war on drugs” in the United States exacerbates many of the factors that negatively impact health and wellbeing, disproportionately impacting low-income communities and people of colour who already experience structural challenges including discrimination, disinvestment, and racism. The U.S. war on drugs has subjected millions to criminalisation, incarceration, and lifelong criminal records, disrupting or altogether eliminating their access to adequate resources and supports to live healthy lives. This paper examines the ways that “drug war logic” has become embedded in key SDOH and systems, such as employment, education, housing, public benefits, family regulation (commonly referred to as the child welfare system), the drug treatment system, and the healthcare system. Rather than supporting the health and wellbeing of individuals, families, and communities, the U.S. drug war has exacerbated harm in these systems through practices such as drug testing, mandatory reporting, zero-tolerance policies, and coerced treatment. We argue that, because the drug war has become embedded in these systems, medical practitioners can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and by becoming engaged in policy reform efforts.

KEY MESSAGES

• A drug war logic that prioritises and justifies drug prohibition, criminalisation, and punishment has fuelled the expansion of drug surveillance and control mechanisms in numerous facets of everyday life in the United States negatively impacting key social determinants of health, including housing, education, income, and employment.
• The U.S. drug war’s frontline enforcers are no longer police alone but now include physicians, nurses, teachers, neighbours, social workers, employers, landlords, and others.
• Physicians and healthcare providers can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and engaging in policy reform.

     

间接腹内压监测在基层部队腹部战创伤救治中的应用

目的探讨间接腹内压(intra-abdominal pressure,IAP)监测技术在基层部队腹部战创伤救治中的应用。方法 2015年1-9月,便利抽样法选取解放军第303医院所属基层部队收治的腹部损伤患者78例为研究对象,以是否存在腹内高压(intra-abdominal hypertension,IAH)将患者分为IAH组(n=46)和非IAH组(n=32)。动态观察两组患者IAP变化趋势,比较其入住监护病房时间、总住院时间、输血量、手术探查率、并发症发生率和病死率,并将腹腔内积血量与IAP的关系进行直线回归分析。结果IAH组和非IAH组患者入住监护病房时间分别为(6.28±4.5)d和(3.1±1.94)d,总住院时间分别为(48.3±25.9)d和(32.3±17.4)d,输血量分别为(3304.3±985.2)ml和(618.75±220.3)ml,手术探查率分别为93.5%和75.0%,差异均有统计学意义(均P0.05)。IAP随腹腔内出血量的增多而增高(R2=0.786,P0.05)。结论间接IAP测定准确、及时,能反映伤员腹部创伤病情变化,具有操作简单、无创和动态监测的优点,适合在基层部队腹部战创伤救护中的应用。     

Flow cytometric determination of glucocorticoid receptor (GCR) expression in lymphocyte subpopulations: lower quantity of GCR in patients with post-traumatic stress disorder (PTSD)

Assessment of the intracellular glucocorticoid receptor (GCR) level may be useful in monitoring functional disturbances of the hypothalamic-pituitary-adrenocortical axis or effects of prolonged steroid therapy. Cytosolic ligand binding assays have recently been supplemented by flow cytometric determination of receptor expression in individual cells. A method based on multiparametric analysis of whole blood by simultaneous labelling of intracellular GCRs and surface markers of lymphocyte subsets is described. We examined 25 healthy male volunteers and 35 age- and sex-matched post-traumatic stress disorder (PTSD) patients within 8 years from traumatic event. PTSD patients had a lower relative quantity of GCR in all lymphocyte populations tested as compared with healthy volunteers. NK cells of both groups showed higher expression of GCR than other lymphocyte subsets. In PTSD patients, the expression of GCR in B lymphocytes was also higher than in T cell. Although serum cortisol level was lower in PTSD patients, there was no correlation between cortisol level and GCR expression. Multiparameter flow cytometric determination of GCR expression in lymphocyte subpopulations may provide a useful tool for monitoring immunoregulatory action of glucocorticoids.