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Sever MS, Luyckx V, Tonelli M, Kazancioglu R, Rodgers D, Gallego D, Tuglular S, Vanholder R. Disasters and kidney care: pitfalls and solutions. Nat Rev Nephrol 2023; 19:672-686. [PMID: 37479903 DOI: 10.1038/s41581-023-00743-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 07/23/2023]
Abstract
Patients with kidney disease, especially those with kidney failure, are particularly susceptible to the adverse effects of disasters because their survival depends on functional infrastructure, advanced technology, the availability of specific drugs and well-trained medical personnel. The risk of poor outcomes across the entire spectrum of patients with kidney diseases (acute kidney injury, chronic kidney disease and kidney failure on dialysis or with a functioning transplant) increases as a result of disaster-related logistical challenges. Patients who are displaced face even more complex problems owing to additional threats that arise during travel and after reaching their new location. Overall, risks may be mitigated by pre-disaster preparedness and training. Emergency kidney disaster responses depend on the type and severity of the disaster and include medical and/or surgical treatment of injuries, treatment of mental health conditions, appropriate diet and logistical interventions. After a disaster, patients should be evaluated for problems that were not detected during the event, including those that may have developed as a result of the disaster. A retrospective review of the disaster response is vital to prevent future mistakes. Important ethical concerns include fair distribution of limited resources and limiting harm. Patients with kidney disease, their care-givers, health-care providers and authorities should be trained to respond to the medical and logistical problems that occur during disasters to improve outcomes.
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Affiliation(s)
- Mehmet Sukru Sever
- Istanbul University, Istanbul School of Medicine, Department of Nephrology, Istanbul, Turkey.
| | - Valerie Luyckx
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Renal Division, Brigham and Women's Hospital, Harvard, Medical School, Boston, MA, USA
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Rumeyza Kazancioglu
- Division of Nephrology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Darlene Rodgers
- Independent Nurse Consultant, American Society of Nephrology, Washington, DC, USA
| | - Dani Gallego
- European Kidney Health Alliance, Brussels, Belgium
- European Kidney Patient Federation, Wien, Austria
| | - Serhan Tuglular
- Marmara University, School of Medicine, Department of Nephrology, Istanbul, Turkey
| | - Raymond Vanholder
- European Kidney Health Alliance, Brussels, Belgium
- Nephrology Section, Department of Internal Medicine and Paediatrics, University Hospital Ghent, Ghent, Belgium
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Arao K, Yoshikawa T, Isogai T, Imori Y, Mochizuki H, Sakata K, Takaoka Y, Yamaguchi T, Nagao K, Yamamoto T, Takayama M. A study of takotsubo syndrome over 9 years at the Tokyo Cardiovascular Care Unit Network Registry. J Cardiol 2023; 82:93-99. [PMID: 36640906 DOI: 10.1016/j.jjcc.2022.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/04/2022] [Accepted: 12/17/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Takotsubo syndrome (TTS) is an acute cardiovascular disease with clinical manifestations similar to those of acute myocardial infarction (AMI), and TTS sometimes occurs just after catastrophes. Large-scale studies of TTS in Japan are scarce, so we examined data over 9 years from Tokyo metropolitan acute cardiovascular care hospital network registry. METHODS A total of 1626 patients were diagnosed with TTS between 2010 and 2018 at Tokyo Cardiovascular Care Unit Network facilities, and data from all these patients were analyzed. We investigated annual and monthly captured incidence of TTS, temporal trend of the captured incidence proportion of TTS versus AMI, the occurrence of TTS on the day of the great earthquake, and we elucidated the prognostic factors for in-hospital death. RESULTS The annual incidence proportion of TTS versus AMI increased from 2.3 % to 4.5 % (p < 0.001) over 9 years. The mean TTS patient age was 74.4 years: the peak incidence of TTS was at 80 to 84 years of age for both male and female; females accounted for 78.5 % of patients. The monthly variation of the incidence of TTS was found (p = 0.009). In 2011, a total of 137 cases of TTS occurred, with as many as 6 occurring on March 11, the day of the Great East Japan Earthquake. There was a definable trigger for TTS in 64 % (physical: 36 %; emotional: 27 %; others: 2 %). All-cause in-hospital mortality was 5.3 % and was higher in males than in females (10.3 % vs 3.9 %; p < 0.001). Non-cardiac causes accounted for 62 % of in-hospital mortality. Factors at presentation that were associated with in-hospital all-cause mortality were male sex, low body mass index, and a high C-reactive protein level. CONCLUSIONS This study elucidated the clinical features, in-hospital outcomes, and their attributed factors in patients with TTS in real-world clinical practice in Japan.
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Affiliation(s)
- Kenshiro Arao
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan; Division of Cardiovascular Medicine, Nerima-Hikarigaoka Hospital, Tokyo, Japan.
| | - Tsutomu Yoshikawa
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Toshiaki Isogai
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Yoichi Imori
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Hiroki Mochizuki
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Konomi Sakata
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Yoshimitsu Takaoka
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Tetsuo Yamaguchi
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Ken Nagao
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Takeshi Yamamoto
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
| | - Morimasa Takayama
- Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan
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Impact of Flood Due to Typhoon Hagibis on Cardiovascular and Cerebrovascular Events in the Disaster Area of Nagano City: A Sub-Analysis Using Data From the SAVE Trial. Disaster Med Public Health Prep 2022; 17:e113. [PMID: 35287780 DOI: 10.1017/dmp.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to examine the effects of flooding due to Typhoon Hagibis on the incidence of cardiovascular/cerebrovascular events in Nagano City. METHODS The SAVE trial retrospectively enrolled 2426 patients hospitalized for cardiovascular/cerebrovascular disease in 5 hospitals in Nagano City from October 1 to December 31 in 2017 and 2018 (pre-disaster period) and in 2019 (post-disaster period). From these, 280 patients who were hospitalized in a district flooded in 2019 were recruited for the same period (October 12 to December 31) over the 3 years. The baseline characteristics of and the incidence of cardiovascular/cerebrovascular disease in cases from the flooded district in 2019 were compared with those of cases in the flooded district in 2017 and 2018. RESULTS The total number of patients with acute myocardial infarction did not differ significantly between the post- and pre-disaster periods. The incidence of unstable angina pectoris was significantly higher in 2019 (n = 4, 5.1%) than in 2017 and 2018 (n = 0, 0.0%) (P = 0.001). CONCLUSIONS This study did not prove the impact of flood due to a typhoon on the incidence of cardiovascular/cerebrovascular events.
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Sunohara D, Miura T, Komatsu T, Hashizume N, Momose T, Kono T, Motoki H, Mochidome T, Kasai T, Kuwahara K, Ikeda U. Relationship between the flood disaster caused by the Reiwa first year east Japan typhoon and cardiovascular and cerebrovascular events in Nagano City: The SAVE trial. J Cardiol 2021; 78:447-455. [PMID: 34183228 DOI: 10.1016/j.jjcc.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/15/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Reiwa First Year East Japan Typhoon of 2019 caused a torrential flood in Japan. In Nagano City, a large area was flooded due to the collapse of the Chikuma River embankment. After large-scale disasters, an increase in cardiovascular and cerebrovascular events has been reported on account of the stressful conditions. However, few reports of disaster-related diseases associated with flood damage have been described. Thus, our aim was to elucidate the effect of floods on the incidences of cardiovascular and cerebrovascular diseases in Nagano City. METHODS The Shinshu Assessment of Flood Disaster Cardiovascular Events (SAVE) trial enrolled 2,426 patients admitted for cardiovascular or cerebrovascular diseases at all five hospitals with an emergency department in Nagano City from October 1 to December 31 in the years 2017, 2018, and 2019. The occurrence of these diseases was calculated in every 2 weeks and the findings of 2019 (year of the flood) were compared with those of 2017 and 2018. RESULTS Cardiovascular and cerebrovascular diseases significantly increased during the 2 weeks immediately after the flood disaster (149 in 2019 vs average of 116.5 in the previous 2 years, p < 0.05). Unstable angina cases significantly increased 1.5-2 months after the flood disaster, and cerebral hemorrhage cases significantly increased in the 2 weeks after the flood disaster. CONCLUSIONS Cardiovascular and cerebrovascular events increased significantly during the 2 weeks immediately after the large-scale flood disaster caused by the Reiwa First Year East Japan typhoon. Because of the increasing frequency of flood disasters, it is necessary to predict the occurrences of cardiovascular and cerebrovascular diseases and to implement guidelines for their appropriate and timely management.
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Affiliation(s)
| | - Takashi Miura
- Cardiology, Nagano Municipal Hospital, Nagano, Japan; Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | | | | | - Tomoyasu Momose
- Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan
| | | | - Hirohiko Motoki
- Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | | | - Toshio Kasai
- Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Koichiro Kuwahara
- Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Uichi Ikeda
- Cardiology, Nagano Municipal Hospital, Nagano, Japan; Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
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Song H, Zhang M, Wang Y, Yang L, Wang Y, Li Y. The impact of resilience on anxiety and depression among grass-roots civil servants in China. BMC Public Health 2021; 21:710. [PMID: 33849497 PMCID: PMC8042932 DOI: 10.1186/s12889-021-10710-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/25/2021] [Indexed: 01/10/2023] Open
Abstract
Background The grass-roots civil servants are the final implementers and executors of a series of government policies and the fundamental force for social stability and harmonious development. However, the mental health problems of grass-roots civil servants have not got full attention. This study aimed to assess the impact of resilience on anxiety and depression among grass-roots civil servants in China. Method From Oct to Dec 2019, 302 civil servants completed a series of questionnaires. The Civil Servants Stress Scale (CSSS) was used to assess the stress of civil servants. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) were used to evaluate the depression and anxiety of participants, respectively. The resilience of civil servants evaluates by the Connor-Davidson Resilience Scale (CD-RSCI). We conducted the moderating and mediating analysis on the impact of resilience on depression and anxiety in grass-roots civil servants. Results There were significant differences in gender, education, position, relationship with coworkers, physical exercise, and monthly income for stress in grass-roots civil servants (P < 0.05). Resilience can negatively regulate the stress of grass-roots civil servants, and an effective mediator and moderator in the relationship between stress and anxiety and depression and the mediating effect ratios of 7.77 and 22.79%. Conclusion Resilience has moderating and mediating effects on the relationship between stress and depression, and anxiety. The negative effects of stress on depression and anxiety of grass-roots civil servants can be buffered by resilience as a dynamic moderator directly and indirectly. These findings contribute to society and government better understand the mental health status of grass-roots civil servants and provide references and guidance for the formulation of corresponding management and prevention measures.
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Affiliation(s)
- Huiling Song
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, 100 Kexue Road, Zhengzhou, 450000, Henan, China
| | - Mengjie Zhang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, 100 Kexue Road, Zhengzhou, 450000, Henan, China
| | - Yanjie Wang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, 100 Kexue Road, Zhengzhou, 450000, Henan, China
| | - Liying Yang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, 100 Kexue Road, Zhengzhou, 450000, Henan, China
| | - Yanyu Wang
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, 24 Jinghua Road, Luoyang, 4571003, Henan, China
| | - Yan Li
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, 100 Kexue Road, Zhengzhou, 450000, Henan, China. .,School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, China.
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Zarei S, Nasimi F, Abedi H, Sadeghi N. A survey on personnel awareness of the factors affecting accurate blood pressure measurement in the medical centres of Jahrom County. Nurs Open 2020; 7:928-934. [PMID: 32587710 PMCID: PMC7308673 DOI: 10.1002/nop2.403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/03/2019] [Indexed: 12/04/2022] Open
Abstract
Aims and objectives The main purpose of this study was to determine the clinical skill of the medical personnel on level of awareness of standard methods used during blood pressure measurement. Background Blood pressure measurement is one of the vital clinical proficiencies the hospital personnel must be equipped with. Results from different surveys highlight the importance of awareness amongst medical personnel in controlling blood pressure. Design Descriptive cross-sectional study. Methods Using standardized questionnaires devised by the researcher, data were collected from 302 participants working in healthcare centres in Jahrom. The extracted data were analysed using SPSS. Results Observations showed that 10-20% of the participants had wide knowledge of influential factors affecting blood pressure measurement. Moreover, there was a meaningful relation between holding higher degrees and accurate blood pressure measurement (p < .05). Nevertheless, besides the personnel holding lower degrees, those holding higher educational degrees also had dearth of knowledge of factors affecting blood pressure measurement. Conclusions The overall findings of this study indicate that the knowledge among the hospital personnel in determining factors affecting blood pressure measurement was inadequate.
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Affiliation(s)
- Safar Zarei
- Department of PhysiologyFaculty of MedicineJahrom University of Medical SciencesJahromIran
| | - Fatemeh Nasimi
- Department of Intensive Neonatal Care NursingFaculty of NursingJahrom University of Medical SciencesJahromIran
| | - Hassanali Abedi
- Research Center for Non‐Communicable DiseasesJahrom University of Medical SciencesJahromIran
| | - Najmeh Sadeghi
- Research Center for Non‐Communicable DiseasesJahrom University of Medical SciencesJahromIran
- Sirjan School of Medical SciencesSirjanIran
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Guan S, Xiaerfuding X, Ning L, Lian Y, Jiang Y, Liu J, Ng TB. Effect of Job Strain on Job Burnout, Mental Fatigue and Chronic Diseases among Civil Servants in the Xinjiang Uygur Autonomous Region of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080872. [PMID: 28771199 PMCID: PMC5580576 DOI: 10.3390/ijerph14080872] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/16/2022]
Abstract
Job strain is a major concern in view of its effects among civil servants associated with job burnout, mental fatigue and chronic diseases. The objective of this study was to assess the job strain level among civil servants and examine the effect of job strain on job burnout, mental fatigue and the resulting chronic diseases. A cross-sectional study with a representative sample consisting of 5000 civil servants was conducted from March to August 2014. Using a structured questionnaire, the job strain level, job burnout and mental fatigue were measured by using the Personal Strain Questionnaire (PSQ), Maslach Burnout Inventory (MBI) and Multidimensional Fatigue Inventory (MFI-20), respectively. Overall, 33.8% of the civil servants were found to be afflicted with high and moderate job strain. The characteristics of most of the civil servants with a higher-job strain level were as follows: female, Uygur, lower educational level and job title rank, shorter working experience, married marital status, and lower income level. Civil servants suffering from chronic disease mainly had hypertension and coronary heart disease, which accounted for 18.5% of the diseases. Civil servants with a high-job strain level exhibited higher rates of burnout, mental fatigue scores and incidence of chronic diseases. There was a multiple linear regression model composed of three predictor variables in job burnout, which accounted for 45.0% of its occurrence: female gender, lower-income level, higher-job strain in civil servants, the greater the rate of job burnout was. Four factors—male gender, lower-job title rank, higher-job strain, shorter-job tenure of civil servants—explained 25.0% of the mental fatigue model. Binary logistic regression showed that intermediate-rank employees (OR = 0.442, 95% CI: 0.028–0.634; p < 0.05), job tenure of 10–20 years (OR = 0.632, 95% CI: 0.359–0.989; p < 0.05), and low-job strain (OR = 0.657, 95% CI: 0.052–0.698; p < 0.05) were all associated with significantly lower odds of chronic disease. The risk of chronic disease was higher in civil servants with high-job burnout scores and mental fatigue scores compared with civil servants with lower scores (OR = 1.139, 95% CI: 1.012–3.198; OR = 1.697, 95% CI: 1.097–2.962). These data provide evidence for the effects of job strain on job burnout, mental fatigue and chronic diseases among civil servants.
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Affiliation(s)
- Suzhen Guan
- Department of Social Medicine, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
- Department of Occupational Health and Environmental Health, College of Public Health, Ningxia Medical University, Yinchuan 750000, China.
| | - Xiadiya Xiaerfuding
- Department of Social Medicine, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Li Ning
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Yulong Lian
- Department of Occupational Health and Environmental Health, College of Public Health, Nantong University, Nantong 226000, China.
| | - Yu Jiang
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Jiwen Liu
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Tzi Bun Ng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Disaster Hypertension: Experience from the Great East Japan Earthquake of 2011. Curr Hypertens Rep 2012; 14:375-81. [DOI: 10.1007/s11906-012-0298-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kario K. [Series: Physicians and disaster medical care; disaster-related cardiovascular disease]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2012; 101:1446-1457. [PMID: 22693871 DOI: 10.2169/naika.101.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Japan
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Abstract
The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan.
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