Although the care of inpatients is an important aspect of radiation oncology practice in many countries, it has never been studied in detail. The goal of this study was to describe the admissions to a radiation oncology inpatient service over a 1-year period with respect to patient characteristics, primary malignancies, common nonmalignant diagnoses, use of radiotherapy and outcome of admission.
Using computerized hospital databases, we analysed the utilization of 11 radiation oncology beds in a 424-bed teaching hospital from March 31, 1991, to April 1, 1992.
There were 342 admissions of 277 patients. The median age was 66.5 years; the male:female ratio was 1:1. The commonest primary neoplastic diagnoses were lung (42%), gynecological (15%), genitourinary (14%) and breast (8%) cancers. Only 17% of the patients had cancer as the sole diagnosis; most patients had multiple medical diagnoses. Infections (22%), neurological (20%), cardiovascular (13%) and endocrine (9%) conditions were the commonest. Mean length of stay was 11.25 days. Most of the admissions (71%) resulted in discharge to the patient's home; few patients (15%) died. Only half of admissions involved radiotherapy, indicating that the focus of patient care was the medical treatment of cancer complications or other active medical problems.
These data show that radiation oncology inpatients have complicated medical problems, and they support the training of radiation oncologists in the comprehensive medical care of patients.
A significant progress in the management of controllable infections achieved by the early XXI century made it possible eliminate poliomyelitis across the nation, and practically eliminate measeles by vaccinating 96-99% of the children without raising the complication rate. The list of counterindications was shortened significantly, the Calendar of immunoprophylaxis was supplemented by inoculations against hepatitis B, rubella, flu, and type b Haemophilis influenzae infections. Morbidity of controllable infections in Russia decreased substantially compared with that in the 1990s. Nevertheless, the public health services are faced with the necessity of speedy application of new vaccines (including combined ones) allowing the inoculation impact on the child to be reduced. A rationale for the use of vaccines against pneumococcal and meningococcal infections, hepatitis A, varicella and for scaling up anti-pertussis vaccination coverage is proposed. Equally important is more extensive vaccination against papillomavirus infection as a means of cervical cancer prevention and introduction of the rotavirus vaccine to control most viral diarrheas.
Mass destructions of the social infrastructure and household systems under stressors in the areas of emergency situations involve marked sanitary-and-epidemiological problems in a region's population, which in turn give rise to the activation of routes of transmission and formation of infectious and parasitic diseases. The most important lines of activities of supervising the sanitary-and-epidemiological situation under emergencies are to timely assess the sanitary-and-epidemiological situation, to predict, to organize, and to correct sanitary-and-antiepidemic measures.
The objective of this paper was to develop an agent-based modeling framework in order to simulate the spread of influenza virus infection on a layout based on a representative hospital emergency department in Winnipeg, Canada. In doing so, the study complements mathematical modeling techniques for disease spread, as well as modeling applications focused on the spread of antibiotic-resistant nosocomial infections in hospitals. Twenty different emergency department scenarios were simulated, with further simulation of four infection control strategies. The agent-based modeling approach represents systems modeling, in which the emergency department was modeled as a collection of agents (patients and healthcare workers) and their individual characteristics, behaviors, and interactions. The framework was coded in C++ using Qt4 libraries running under the Linux operating system. A simple ordinary least squares (OLS) regression was used to analyze the data, in which the percentage of patients that became infected in one day within the simulation was the dependent variable. The results suggest that within the given instance context, patient-oriented infection control policies (alternate treatment streams, masking symptomatic patients) tend to have a larger effect than policies that target healthcare workers. The agent-based modeling framework is a flexible tool that can be made to reflect any given environment; it is also a decision support tool for practitioners and policymakers to assess the relative impact of infection control strategies. The framework illuminates scenarios worthy of further investigation, as well as counterintuitive findings.