Obesity correlates with a higher risk of fractures in some sites as vertebras, upper arm, and legs. This is a narrative mini-review focused on several key points that link obesity with osteoporosis. Waist circumference may a better predictor of fractures than body mass index (BMI) in obese females. Even obese menopausal women have an extra source of estrogens in fat tissue this actually is not enough to offer a complete protection against osteoporotic fractures. Low levels of testosterone in males induce a higher risk of fall dependent or independent of sarcopenia (which is more evident in elderly). High BMI is correlated with vitamin D deficiency. Obesity is a contributor to muscle damage and decline due to fat accumulation and inefficient fuel utilisation by the muscle, namely sarcopenic obesity, regardless the age. Associated type 2 diabetes mellitus involves bone damage and fracture risk due to glycated proteins of the matrix, the changes of adipokines, increased cortical porosity, high risk of fall because of blood pressure and glycaemia anomalies, visual disturbances, renal and peripheral nerves diabetes-associated conditions etc. The fracture risk is also augmented via fat derived cytokines and chronic inflammation. Even it seems logical that the weight correction though bariatric surgery reduces the fracture risk in obesity, actually data from longitudinal studies pointed that, despite the procedure is life saving, it does not actually protect against osteoporosis which is regarded as a potential long-term complication. A high fracture burden in obesity should increase the level of awareness for practitioners of different medical areas due to multiple levels of complications and to the epidemiological impact of obesity.
Purpose: Cancers are one of the main causes of mortality in the world. The incidence of cancers in the world and mainly in developing countries is increasing. Due to the importance of this issue, the purpose of the current study was to assess the trend of incidence and death of Bladder Cancer among Iranian Military Community (MC) from 2007 to 2019. Methods: This is a cross-sectional study using time series data. All registered bladder cancer in Iranian Military community from March 2007 to February 2017 entered in this study. The future trend predicted using ARIMA (p,d,q) model. All analyzes were performed using ITSM and Excel (2010) software. Results: According to ARIMA (2, 2, 1) model, the bladder cancer among the Iranian military community had an increasing trend. The AR (12, 2, 0) model showed an increasing trend of this cancer among males but it seems the trend of bladder cancer among females will have a constant trend AR (12, 2, 1). The death due to bladder cancer was showed a decreasing trend using AR (14, 2, 1) model. Conclusion: In spite of decreasing trend in death due to bladder cancer, the trend of incidence of the Bladder cancer among the Iranian Military Community was increasing. However, it is necessary to adjust the effect of many factors that may have an important role in this trend.
Evidenced-based medicine drives best practices. The Lessons Learned (LL) process in clinical medicine for deployed and military support services drive the NATO Military Medical Center of Excellence (MILMED COE). This review article focuses on the Lessons Learned process and its use in NATO and partner countries medical services. Organizational learning drives development and progress; capturing lessons from mistakes, colleagues’ interactions and institutional experience can be lost without an organized lesson learned process. Therefore, in 2014, NATO institutions and Centers of Excellence across disciplines began to focus on the quality management, information sharing and evidence-based practices to maximize outcomes. Since this inception, NATO has implemented the Lessons Learned process and expanded the impact across the alliance in order to save life and prevent illness. The Lessons Learned process and sharing of experience is also a way to improve the quality of care in the military medicine, from preventive, epidemiological, trauma related, casualty evacuation and forward surgical care, among many others, to the medical standardization and organization of military medical services. The Lessons Learned process is an undertaking and an instrument that can also be used to achieve better international and civil-military cooperation. Finally, we deal with the current situation and use of the information obtained from the areas of military health care.
