Cancer trends and burden among Armed Forces personnel,veterans and their families: Cancer registry data analysis from tertiary care hospital

BackgroundCancer incidence is rising across the globe. The incidence and patterns of various cancers among Armed Forces Personnel and Veterans is not known. We did the analysis of registry data maintained at our hospital.MethodsA retrospective analysis was performed of all patients registered at our hospital cancer registry between 01st January 2017 and 31st December 2019. Patients were registered with unique identification number. Baseline demographics and cancer subtype data were retrieved. Patients with histopathologically proven diagnosis and age ≥18 years were studied. Armed Forces Personnel (AFP) were defined as those who are in active service, and Veterans as those who had retired from service at the time of registration. Patients with Acute and Chronic Leukemias were excluded.ResultsNew cases registered were 2023, 2856 and 3057 in year 2017, 2018, 2019 respectively. AFP, Veterans and dependents among them were 9.6%, 17.8%, and 72.6% respectively. Haryana, Uttar Pradesh and Rajasthan represented 55% of all cases with male to female ratio 1.14:1 and median age was 59 years. The median age among AFP was 39 years. Among AFP as well as veterans, Head and Neck cancer was the most common malignancy. Cancer incidence was significantly higher in adults >40 years as compared to <40 years.ConclusionSeven percent rise per year of new cases in this cohort is alarming. Tobacco-related cancers were the most common. There is an unmet need to establish a prospective centralized Cancer Registry to better understand the risk factors, outcomes of treatment and strengthen the policy matters.     

Misdiagnosis: Burnout,moral injury,and implications for the electronic health record

Burnout is a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. Burnout in clinicians is receiving significant attention. Some have proposed that clinicians are experiencing symptoms of moral injury, defined as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Current efforts to improve the electronic health record (EHR) have focused on improving the user experience to reduce burden that has been identified as a contributing factor to provider burnout. However, if EHRs are contributing to moral injury, improvements to user experience will not eliminate the effects on providers. Current research has not evaluated the risk for moral injury resulting from the use of EHRs. This Perspective reviews the differences between burnout and moral injury, discusses the implications for clinicians using EHRs, and highlights the need for research to better define the problem.     

脑弥漫性轴索损伤致伤装置的研制和应用

研制和应用脑弥漫轴索损伤致务装置。方法：自行设计制作头颅旋转致伤装置，保证其可使动物头颅于瞬间旋转特定角度，仅以大鼠为对象进行力学，行为及病理效应评价。结果；１．力学参数测定，旋转角速度为８０１．２７ｒｄ／ｓ，角加速度２．０４４×１０＾４ａｄ／ｓ＾２，用时约２ｍｓ；角速度及角加速度均大于Ｍａｒｇｕｌｉｅｓ提出和ＤＡＩ的外力阈值；２．行为及病理观察表明旋转后大鼠符合ＤＡＩ特征。