Asociación entre el bajo nivel de vitamina B12 y deterioro cognitivo en adultos mayores del centro médico naval del Perú

Introducción: Los adultos mayores son suscepctibles a la malnutrición y el déficit de vitaminas. Objetivo: Determinar la asociación entre el bajo nivel de vitamina B12 y el deterioro cognitivo en adultos mayores del centro médico naval, ubicado en Lima-Perú, en el periodo 2010-2015. Métodos : Se realizó un estudio transversal analítico, a partir de un análisis secundario de la base de datos Texas-Cemena UTMB 2010-2015 del centro de investigación del envejecimiento (CIEN) de la Universidad De San Martín De Porres. Para la cuantificación de la variable de deterioro cognitivo se utilizó el MiniMental test. Para analizar la asociación, se realizó la prueba de chi cuadrado y la regresión de Poisson. Resultados : El 57,6% de los pacientes fueron de sexo masculino y la edad promedio fue de 78 ± 8,4. El 41,2% presentó deterioro cognitivo y el 9,5% de los pacientes presentó déficit de vitamina b12. Los factores independientemente asociados al deterioro cognitivo fueron el antecedente de enfermedad cerebro vascular (RP= 1,38 IC 95% [1,24-1,53]), depresión (RP = 1,88 IC 95% [1,80-1,97]),) y déficit de vitamina B12 (RP = 1,10 ic 95% [1,01-1,20]),). Conclusiones : En el presente estudio se encontró asociación entre un bajo nivel de vitamina B12 y el deterioro cognitivo en adultos mayores.

Introduction: Older adults are susceptible to malnutrition and vitamin deficiency. Objective: To determine the association between the low level of vitamin B12 and cognitive deterioration in older adults from the Naval Medical Center, located in Lima-Peru, in the period 2010-2015. Methods: An analytical cross-sectional study was carried out, based on a secondary analysis of the Texas-Cemena UTMB 2010-2015 database of the center for research on aging (cien) of The University Of San Martín De Porres. To quantify the cognitive impairment variable, the mini mental test was used. To analyze the association, the chi-square test and poisson regression were performed. Results: 57.6% of the patients were male and the mean age was 78 ± 8.4. 41.2% presented cognitive deterioration and 9.5% of the patients presented vitamin B12 deficiency. The factors independently associated with cognitive impairment were a history of cerebrovascular disease (pr= 1.38 95% ci [1.24-1.53]), depression (pr= 1.88 95% ci [1.80-1 .97]) and vitamin B12 deficiency (pr = 1.10 95% ci [1.01-1.20]). Conclusions: In the present study, an association was found between a low level of vitamin B12 and cognitive deterioration in older adults.

Mental health of Chinese naval officers and soldiers: 2009-2019 / 第二军医大学学报

In recent years, mental health of naval officers and soldiers has attracted wide attention. The present research reviewed literatures on the mental health of naval officers and soldiers from 2009 to 2019, and summarized the characteristics, influencing factors and mental health intervention. The common psychological problems of naval officers and soldiers were depression, anxiety and sleeping problems; the comparative research of mental health level between naval personnel and other military services was still controversial; the branch of the navy, long-term and long-distance navigation as well as personal factors (personality, coping style and life events) influenced their mental health; and only few researches focused on mental health intervention of naval officers and soldiers. The present problems in mental health researches of naval personnel included small scale, inconsistent results, single research method and lack of experimental research. Future studies are needed to expand the sample size and diversity of naval branches, explore the promotion effect of psychological intervention on the mental health, and emphasize to the impact of various military stress factors on the mental health of naval officers and soldiers.

Survey of on-spot first-aid training status of primary naval healthcare personnels / 第二军医大学学报

[Abstract] Objective To known about the status of first-aid techniques among naval primary healthcare personnels, providing reference for improving the related first-aid training. Methods A self-made questionnaire was created based on the naval training activities of mass war wound rescue and the requirements of new guidelines and assessment standards. The questionnaire was used to investigate 172 primary naval healthcare personnels. The first aid techniques were divided in well-mastered, mastered, unskilled and un-mastered. And our analysis focused on the first-aid training of war wound and the mastery of first-aid techniques. Results The naval primary healthcare personnel well mastered the six traditional first-aid techniques, including hemostasis, ventilation, bandaging, fixation, handling, and cardiopulmonary resuscitation. Techniques such as infusion via bone, advanced airway management were not well-mastered, or even hard to master. Conclusion To improve war wound rescue capability of primary naval healthcare personnels, we should continue the training activities of mass war wound rescue, improve the related theory, strengthen the related training, and establish a practical war wound rescue training and evaluation system.

Conception and design of a global naval medical geographic information database / 第二军医大学学报

Medical geographic information plays an important role in prevention, treatment, rescue and delivery of the wounded, prevention and control of diseases, and supplement and use of medicines and equipment. We collected and collated the natural geography, social geography, medical geography and military geographic information of 181 coastal countries and regions in the world, and constructed a global naval medical geographic information database. This database can provide fast and efficient information support and decision support, and contribute to implementing naval medical support timely and effectively and promoting the comprehensive development of China’s naval health services.

Insomnia of soldiers in Chinese navy escort fleets in Aden Gulf: Status and influencing factor analysis / 第二军医大学学报

Objective To explore the insomnia status and the influencing factors of navy soldiers during escort in Aden Gulf. Methods Totally 476 soldiers were collected by random cluster sampling method. The mental health status of the soldiers was assessed by Eysenck personality questionnaire-revised, short scale for Chinese (EPQ-RSC) and symptom check list-90 (SCL-90) at 1 week before the escort. At 2 months after the long voyage, the insomnia status and general situation were assessed using the insomnia severity index (ISI) scale and the general situation questionnaire, respectively. The multivariate linear regression analysis was conducted to analyze the influencing factors of insomnia. Results A total of 474 valid questionnaires were collected. During the escort, 44.1% (209/474) of the soldiers suffered from insomnia of different extents, with 28.1% (136/474) subthreshold insomnia, 13.5% (64/474) moderate insomnia and 1.9% (9/474) severe insomnia. The multivariate linear regression analysis showed that the times of escort, night duties and the frequency of oral ulcer were the influencing factors of insomnia (R2=0.68; standardized regression coefficients were -0.101, 0.111 and 0.172, respectively; all P<0.05). Meantime, emotional stability also influenced insomnia to a small extent (R2=0.03, standardized regression coefficient=0.173, P<0.05). Conclusion The sleep quality of the soldiers during long-time escort is severely influenced, with high prevalence of insomnia. The main influencing factors include the times of escort, night duties and the frequency of oral ulcer, and emotional stability may also be an influencing factor.

Naval military medical geographic information system based on ArcGIS / 第二军医大学学报

Focusing on the diversified training environment of the Chinese navy and the peculiar injuries of the soldiers, we created a navy military medical geography information system based on ArcGIS two-dimensional development platform by using the large sample survey data of a certain naval medical support unit. This established system can link the naval injury data, civilian and military health resources and spatial geographic data, contributing to the monitoring and early warning of the navy injury, information management of medical resources, and decision-making in medical support.

Thinking on ultrasonography practice in overseas medical service on hospital ship during “Mission Harmony-2017” task / 第二军医大学学报

“Ark Peace” is a modern hospital ship for marine medical rescue, and is taken as “the tertiary academic hospital floating on the sea”. It plays an important role in the ocean-going medical support and military diplomacy of the Chinese Navy. Ultrasound diagnosis, as an indispensable part of hospital ship, provides a solid guarantee for medical services. We summarized our experience on the equipment configuration, staff preparation, reporting system improvement, quality control management and introduction of new technologies on hospital ship during “Mission Harmony-2017” task, and put forward some suggestions for improving the comprehensive diagnosis and medical treatment ability and carrying out diversified military tasks in the future.

Sleep quality, fatigue and mental health status of students during first long distance voyage of Qi Ji-guang Warship / 第二军医大学学报

Objective To investigate the physiological and psychological status of students during the first long distance voyage of Qi Ji-guang Warship and to explore their correlation. Methods From Sep. 17 to Dec. 7, 2017, Qi Ji-guang Warship was on the first long distance voyage mission. On the 60th day during the voyage, the questionnaire survey was conducted on the students aboard Qi Ji-guang Warship. In all, 150 questionnaires were distributed randomly to respondents. The general information of the students was included in the questionnaire, and the physiological status and psychological status were assessed using Pittsburgh sleep quality index (PSQI) scale, Epworth sleeping scale (ESS), fatigue severity scale (FSS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Results A total of 138 valid questionnaires were returned (response rate 92.0%). Forty-two first voyage students (30.4%) complained of health problems. The proportions of the students with poor sleep quality, moderate or excessive daytime sleepiness, high fatigue levels, anxiety and depression were 11.6% (16/138), 45.7% (63/138), 40.6% (56/138), 18.1% (25/138) and 21.0% (29/138), respectively. The PSQI, ESS and FSS scores of the students with anxiety were significantly higher than those of the students without anxiety (8.40±2.93 vs 6.34±3.10, 11.12±5.03 vs 8.70±4.53 and 38.84±12.41 vs 31.55±11.20, all P<0.05). The SAS score was positively correlated with PSQI, ESS and FSS scores (r=0.301, 0.242 and 0.274, all P<0.01). SDS score was positively correlated with PSQI and FSS scores (r=0.256 and 0.209, both P<0.05). Conclusion During long distance voyage, the students aboard have probabilities of poor sleep quality, sleepiness, fatigue, anxiety or depression. Mental status (anxiety and depression) is closely related to physiological status (sleep quality, sleepiness and fatigue), and exerts certain effect on physiological status. Psychological behavior training should be carried out to improve the tolerance, work efficiency and combat ability of students.

Asistencia médica a bordo de los buques en altamar basada en la telemedicina / Medical assistance via telemedicine on ships at sea

Introduction: Statistical study about the health care provided to seafarers on board their ships by the Spanish Radio Medical Center of the Marine Social Institute (Ministry of Employment and Social Security). Material and results: In 2015, 1658 calls were received requesting medical assistance and 1014 patients were attended (average: 1.64 calls / case). The use of satellite communication was the most common means of communication used (92.2%). The mean age of the patients was 44.51 (standard deviation = 9.892). The average age of Spanish and European Union crew members is higher than those of other origin (p < 0.01). Trawlers account for the 76.4% of the calls asking for medical assistance, merchant ships the 13.2%, travelling ships 1%, yachts 0.5% and others 8.8%. No significant differences were found between the pathology seen and the type of vessel (p> 0.1). 25% of medical consultations were due to trauma conditions and 75% to other diseases. In trauma patients, the affected body regions were: the upper limbs (40.2%), the head (10.8%), the lower limbs (16.7%) and the trunk (12.7%). Isolated eye traumas represented the 11.2% of cases. 81.6% of all the cases were treated on board until port destination. In the 18.4% of the cases, rescue was required (3.2% per helicopter). In the trauma cases, only 61.26% were able to remain on board. Rescue was more frequent in the event of trauma (p < 0.01). Conclusions: Assistances due to diseases are more frequent than those due to trauma. Most patients could be assisted on board. It was observed that seafarer population is becoming older.

Introducción: Estudio estadístico de la atención sanitaria prestada por el Centro Radio Médico Español del Instituto Social de la Marina a los marinos a bordo de sus buques. Material y resultados: Durante un año, se asistieron 1014 pacientes y se recibieron 1658 llamadas demandando consulta médica (media: 1.64 llamadas/caso). El satélite es el medio de comunicación más empleado para la consulta (92.2%). La media de edad de los pacientes fue de 44.51 (desviación estándar = 9.892). La media de edad de los tripulantes españoles y de la Unión Europea es mayor que el resto (p = 0,00). Los pesqueros representan un 76.4% de las asistencias; los mercantes, 13.2%; pasaje, 1%; buques de recreo, 0.5%, y otros, 8.8%. No se han encontrado diferencias significativas entre la afección consultada y el tipo de buque (p > 0.1). El 25% de las atenciones se debieron a accidentes y el 75% a enfermedades. En los accidentes, las regiones corporales afectadas fuern: miembros superiores (10%), cabeza (5.5%), miembros inferiores (4.1%) y tronco (3.2%). Los ojos representan el 2.8% de los casos. El 81.6% de todos los casos fue atendido a bordo hasta la siguiente llegada a puerto. En el 18.4% fue necesaria la evacuación (3.2% por helicóptero). En el caso de los accidentados, sólo el 6.26% pudo permanecer a bordo. La evacuación es más frecuente en caso de accidente (p = 0.00). Conclusiones: Son más frecuentes las asistencias por enfermedad que por accidente. La mayoría de los pacientes pueden permanecer a bordo. Se observa un envejecimiento de la población embarcada.

Analysis of global trends in military medicine research / 军事医学

Objective To explore the trends of global research on military medicine,such as publication trends,research priorities,research topics,research routes and sources of publication.Methods The data was from the Web of Science core collection of Thomson Reuters Technology,Inc.,and the retrieval time was up to September 2016.The retrieval involved related disciplines of military medical papers published from WOS.Trends,research priorities,research programs,research routes and published sources were analyzed statistically by using Web of Science classification standards.Results A total of 42 986 articles were retrieved,and there were 257 research priorities according to this classification.In terms of the trends of military medicine related papers,the number of papers began to increase considerably in the late twentieth century after the two wave crests of two world wars.Over the past 5 years,more than 2000 papers have been published in this field.As for the spheres of research,the related papers involved 199 fields of research,155 of which had more than ten papers published.According to the analysis of hot spots of research,the range of high-frequency words involved was very extensive,including the type of disease (posttraumatic stress disorder,depression,and traumatic brain injury),the type of patients (veterans,female,and adult),regional distribution (the United States,Iraq,and Afghanistan),relevant parameters (prevalence,risk factors and mortality) and the related medical technology and means (nursing,exercise,prevention,modeling).There were 3132 periodicals involved in related papers,and there were 635 periodicals that published more than 10 papers.The number of military medical conference papers was relatively small(a total of 2914),involving 1771 meetings.The top 20 journals included Military Medicine,Aviation Space and Environmental Medicine,British Medical Journal,The Lancet,The Journal of the American Medical Association.Conclusion Through the retrieval research of main factors,we can see the basic developments of military medicine abroad.

Analysis of the casualties aboard warships attacked by anti-ship missiles / 军事医学

In the future,anti-ship missiles(ASM) will be major weapons in the sea war.It is very important to handle the profile of the casualties aboard warships attacked by ASM for development of naval health service.The statistical result shows there is a greater chance of casualties but less chance of warships being sunken by ASM.Besides,medical staffs should pay more attention to the first aid for victims due to blast,burn,smoke inhalation and penetration while the danger of the sea water immersion should not be ignored.

Analysis of mental health status and its influencing factors of navy crews during long-term sailing / 第二军医大学学报

Objective To analyze the mental health status and its influencing factors of navy crews during long-term sailing. Methods Totally 172 crews with long-term sailing were collected by random sampling method. The mental health status of the crews was assessed by Eysenck Personality Questionnaire (EPQ) and Symptom Checklist-90 (SCL-90) at 1 week before the long-term sailing (first assessment). The psychological measurement and investigation of crews was conducted by SCL-90, Fatigue Scale-14 (FS-14) and Assens Insomnia Scale (AIS) after 4-month long-term sailing (second assessment). The differences in the total score of SCL-90 and each factor scores of crews between the first assessment, the second assessment and the military norm were analyzed to determine the influence of long-term sailing on the mental health status of crews. The relationship between the total score of SCL-90 and each factor scores (second assessment) and AIS, FS-14, and EPQ were used to analyze the correlation of the mental health status of crew with sleep, fatigue and personality traits. The major factors influencing the mental health status of crews during long-time sailing were explored by multivariate linear regression analysis with the SCL-90 score as the dependent variable. Results The mental health status of crews after 4-month long-term sailing was significantly lower than that before the sailing, with significant difference in SCL-90 scores (P0.4, P<0.01). Multivariate linear regression analysis showed that neuroticism, seasickness, total score of sleep, total score of fatigue, working pressure, mental quality and ship adaptability were the major factors influencing the total score of SCL-90. Conclusion The long-time sailing on the sea has a bad influence on the mental health of navy crews. The seasickness, personality traits, working pressure, sleep, fatigue, and ship adaptability are the major factors influencing the mental health of crews.

A preliminary study of emergency blood collection during a long-distance voyage / 军事医学

Objective To study the method of emergency blood collection during a long-distance voyage to ensure blood transfusion treatment.Methods Ten voluntary blood donors were recruited, a base unit of blood was collected and preserved.Reactions of the blood donors were observed, and the blood quality was tested.Results The success rate of blood collection was 90% and the qualification rate was 100%.Conclusion Emergency blood collection during a long-distance voyage is feasible,which can help ensure blood supply in peace time or war time.

Classification pattern of overseas medical services at Grenada station during Mission Harmony-2015 / 军事医学

Objective To summarize the characteristics of medical service patterns at Grenada station of Mission Harmony-2015 so as to provide reference for future overseas services in similar island countries .Methods After detailed analysis of actual conditions of the countries visited and efficient communication with host country health organizations , we made an appropriate adjustment of the medical service pattern , which involved multi-site screening of general patients , followed by intensive checkups and treatment aboard the hospital ship .Results The procedure of diagnosis and treatment was streamlined and the efficacy of medical services was significantly enhanced to meet the maximum medical demand of local residents.Grenada became a station with the largest number of patients who received top-quality fee-free healthcare during Mission Harmony-2015 .Conclusion Adjustment of medical service patterns according to the actual conditions could deliver a desired effect during overseas missions .

Afterthoughts on hospital ship during Harmony Mission-2015 oversea medical service / 军事医学

On Sept 7, 2015, Chinese hospital ship Ark Peace left its home-port in Zhoushan, Zhejiang Province, forHarmony Mission-2015, the fifth in a series of annual international humanitarian and free medical assistance endeavors by the PLA Navy.This mission lasted 142 days, involving a visit to Malaysia and participation in Peace Friendship-2015 exercise,before she was dispatched to seven countries (regions) including Australia, Polynesia, USA, Mexico, Barbados, Grenada, Peru and provided a wide range of medical , humanitarian assistance to the last four countries .A total of 12 589 patients were treated on the main platform , 4852 patients by the 29 fore-lying medical corps , 59 surgeries performed , 46 patients hospitalized ,and 7130 CT and DR et al auxiliary examinations conducted during four mission stops .We organized academic exchanges , visits and interviews , get-togethers , dynamic and static exhibitions in each country .The experience from Harmony mission-2015is of great significance for such tasks in the future .

"Joint military exercise""Peace friendship-2015""and""Mission harmony-2015""aboard hospital ship" / 军事医学

During the mission of Peace friendship-2015, between September 2015 and January 2016,the Chinese Navy hospital ship respectively participated in the Harmony-2015joint military exercise in Malaysia and with the local military of Polynesia and Barbados .The article summarized the relevant background of the joint military exercise and the main practices in various stages .This article also suggests that the emergency platform be moved forward , the function of the triage area be expanded, basic life support(BLS),advanced cardiovascular life support (ACLS),and advanced trauma life support(ATLS) training programs be introduced, the training model and the test system be innovated , and realistic traumatic conditions be designed in order to guarantee the success of the joint exercise .

Application of geographic information system in navy medical service support / 第二军医大学学报

As it becomes normal for the PLA navy to sail to the open sea for training and the the multiple kinds of offshore military tasks it will face on the sea, the navy officers and soldiers will face more complicated health care problems, which brings greater challenges to the naval medical service support. In this review, we started from the problems in the medical service support; using the spatial analysis functions of geographic information' system (GIS), and designed a navalmedical service support GIS functional model, which included three functional modules: monitoring of the woundedand diseased, informationmanagement of naval medical service resource, and assistant decision-making for military medical service; and we also discussed the application of GIS in monitoring and early warning of the diseases, analysis and evaluation of risk factors, health resource allocation and decision-making support for health service.

A few considerations on trauma care in a modern naval warfare / 解放军医学杂志

Building a powerful navy is the key to safeguarding China’s maritime rights and interests and developing maritime strategy. Improving the level and capability of trauma care for naval battle is one of the important tasks for safeguarding naval combat capability and keeping up morale. This paper analyzes the characteristics of naval battle and both the key points and difficulties of medical support under the conditions of modern war, and draws lessons from the experiences of United States navy in the construction of medical support mode, force allocation and maritime health platform, and refers to its training mode and evaluation methods by relying on advanced medical equipment to carry out simulated trauma care efficiently. This paper considers and analyzes the mode of maritime health support, the allocation and utilization of mobile medical service force, the research work related to trauma for naval battle and the training of health professionals. The aim of this study was to provide some effective suggestions for improving capacity and efficiency of trauma care for naval battle.

Los cuerpos militares como hito social del cuidado para la enfermería naval / Military bodies as a social milestone of care for naval nursing

En las últimas décadas la enfermería en México ha realizado investigaciones que buscan recuperar su identidad disciplinar con base en la historiografía de distintos gremios de enfermeras indagando sobre sus orígenes y antecedentes históricos para definir los elementos ontológico y epistemológicos que les caracterizan. Tal es el caso de la Enfermería Naval que a través de su historia, describe la evolución profesional como gremio, con el objetivo de construir la primera historiografía sobre la formación de enfermeras navales en el medio militarizado, contribuyendo a su vez con el acervo histórico de la enfermería en México. La historia de este gremio se construyó con base en la fenomenología descriptiva e interpretativa, para ello se efectuó análisis de contenido de fuentes históricas documentales, periódicos, fotografías, videos, microfilms, entrevistas a profundidad e inclusive una historia de vida, entre las cuales se categorizaron temas y subtemas definiendo como ejes teóricos: los orígenes de la sanidad en el ejército, la iniciación de la enfermería en la Armada y la evolución de las enfermeras navales al servicio de sus milicias. Los resultados han revelado que los cuidados de enfermería hacia las milicias marítimas en México, datan desde el siglo XVIII principalmente en los puertos de Veracruz y Acapulco; así también, que a lo largo del siglo XX mediante fenómenos sociales como: la profesionalización de los marinos militares, la Segunda Guerra Mundial, el crecimiento económico de la zona marítima mexicana, la proporción de ayuda humanitaria a población en situación de catástrofe natural y el apoyo en los procesos de seguridad nacional, es como la enfermería naval mexicana ha evolucionado su práctica profesional. Se concluye que el gremio de enfermeras navales ha evolucionado en su disciplina, a través de estudiar, adaptar y articular su práctica profesional con su población de estudio que son los cuerpos militares marítimos, incrementando su nivel educativo a partir de la existencia de su escuela y consolidando su reconocimiento en el ámbito militar mediante la adaptación de sus cuidados en cuyo ambiente, representa la parte humana de la Armada de México.

On last decades the nursing in Mexico has done research with the intention of recovering its identity as a discipline based on the historiography of different nurses guilds, inquiring about their origins and historical background in order to define the ontologic and epistemological elements that characterize them. Such is the case of the Naval Nursing that through its history, describes the professional evolution as a guild, with the objective of building the first historiography about the formation of naval nurses inside the military scope, and at the same contributing with the nursing historical heritage of Mexico. The History of this guild was constructed based on the descriptive and interpretative phenomenology, for this was performed an analysis of the content of historical documental sources, newspaper, photographs, videos, microfilms, interviews in depth and even a life story, among which topics and subtopics were categorized, defining as theoretical axis: Origins of health in the army, the beginnings of the nursing in the Army and the evolution of the naval nurses to the services of their militias. The results have revealed that the nursing attentions toward the militias in Mexico dating mainly from the XVIII century in the Veracruz and Acapulco ports; also that along the XX century due to social phenomena as: the professionalization of the marines, the Second World War, the economic growth in the Mexican maritime area, the portion of humanitarian help given to the population at natural disaster and the support on the national security process, is how the Mexican naval nursing has evolved its professional practice. I conclude that the guild of the naval nurses has evolved in its discipline, through knowing, attending and articulating its professional practice with its study population which are the maritime military corps, increasing its educational level since the foundation of its school and consolidating its recognition in the military scope through adapting its care representing the human part of the Mexican Navy. Keywords: Military, naval nursing, care.

New progress in nautical medicine / 解放军医学杂志

Objective To review the research and development of nautical medicine both abroad and at home in the recent five years. Methods The research papers,reviews,reports and books both in Chinese and English concerning the nautical medicine were retrieved and searched,and the progresses,achievements and the development in this field were analyzed. Results The research in nautical medicine developed very rapidly as the improvement of the sailing technologies. Much achievement was made in recent five years in diving physiology and medicine,health services and medical prevention in maritime,search and rescue at sea,psychology of the mariners,and ergonomics in seafaring. Conclusion With much progress is in life saving appartues developments,disaster medicine at sea,research and development of marine drugs,and telemedicine at sea,the nautical medicine in China will support the Chinese Navy better in blue water.