Investigation on Hospitalization of Cervical Spondylosis among Military Pilots, 2010 - 2019

ObjectiveTo investigate and analyze the situation of hospitalization and medical appraisal of cervical spondylosis in military pilots. MethodsA single-center retrospective study was conducted on the active military pilots hospitalized for cervical spondylosis in our center from January 2010 to December 2019.After inclusion and exclusion criteria, descriptive statistics and analysis were made on age, sex, flight type, flight time, disease type, diagnosis and treatment and medical identification results of the included subjects.ResultsDuring January 2010 to December 2019, 166 military pilots with cervical spondylosis were admitted to our center, accounting for 17.61% of the total orthopaedic diseases, ranking the second place.The hospitalization rate of military pilots with cervical spondylosis in orthopedics department decreased from 2015 to 2019, but the hospitalization rate (193 person-times) was in an increasing trend compared with that in 2010-2014 (148 person-times) (P < 0.05).The average age of the pilots with cervical spondylosis was 37.37±7.37 years old, and there was no significant difference in the age of the pilots of different aircraft types. Compared with the age of other active servicemen in the same period (39.72±8.98 years), the incidence of the pilots tended to be younger (P < 0.05).The average incidence of cervical spondylosis in flight crew was 2597.09±1954.50h, and fighter pilots were more likely to have cervical spondylosis in early flight than those who flew helicopter, transport aircraft and trainer aircraft (P < 0.05).4 cases (2.41%) received surgical treatment, which was significantly lower than that of non-aircrew members (12.09%) (P < 0.05).Among the 166 cases, 87 cases (52.41%) were qualified and returned to work,53 cases of military pilots temporary unqualified flight, 26 cases of military pilots unqualified flight, unable to continue to fly.ConclusionCervical spondylosis of pilots account for the forefront of orthopedic disease spectrum, and the onset age is younger, the treatment is relatively simple, and the qualified rate of flight after treatment is low.

Определение ведущей руки в судебно-медицинской практике с помощью стоматологического индекса КПУ

In current forensic medicine practice, the need for the development of new, scientifically based approaches and methods of forensic medical identification is still very important. The number of left-handed people in the world varies from 5 to 30 %, and it can be useful in forensic practice. The possibility of establishing a dominating hand based on the intensity of dental caries (CFE - CARIES-FILLIN-EXTRACTION index) was studied. Taking into consideration the intensity of caries damage to the teeth on the right and left sides of right-handed, left-handed and ambidextras people, we offered and calculated the CFE difference index: «CFE on the right – CFE on the left». Significant differences in the CFE indexes can help to determine what hand has been predominant and it might be useful for forensic specialists.

2 PDSA Audit Improves Identification and Management of Urinary Incontinence In Post Stroke Patients

Introduction Urinary incontinence is a prognostic indicator of mortality and functional recovery in stroke. There is a small evidence base that early intervention within the first three months may improve continence status and subsequent physical and psychological consequences. Methods Utilising a proforma and PDSA, data was collected on the identification and assessment of urinary continence status for patients admitted to a stroke unit. Five agreed standards from NICE (2012) and RCP (2016) guidelines formed the basis of audit. Three cycles of prospective data for a total of 66 patients was collected over four months, implementing quality improvement measures after each cycle. Results 22 participants per cycle. Cycle one demonstrated continence status was identified by the nursing team (100%), and the medical team (41%). However, standards regarding further care planning and assessment (22%), MDT input (11%) and subsequent behavioural and practical interventions (11%) was low. Change strategy, i) awareness training, ii) development of MDT prompt sheet. Cycle two, medical identification (82%), MDT discussion (100%), and continence specific interventions (66%), care planning decreased from 22% to 0%. Change strategy, incontinent patients receive an individualised assessment within 7 days by the advanced nurse practitioner, this assessment should consider all available evidence-based interventions, with the aim of reducing urinary incontinence within the early phases of stroke. Cycle three showed an overwhelming improvement to all five standards, nursing and medical identification (100%, 91. Conclusions PDSA style audit led to quality improvement. The identification of urinary continence status post stroke was high, but due to multifactorial elements often did not progress to assessment or intervention from the MDT. Utilising the existing role of the trainee advanced practitioner patients received evidence-based continence reviews in a timely manner, with no additional cost impact to the service.