护理干预措施对神经内科重症监护患者院内感染控制的影响

目的探讨护理干预措施对神经内科重症监护患者院内感染控制的影响。方法选择本院神经内科重症监护患者144例,分为干预组69例和对照组75例,对照组给予常规护理,观察组在此基础上给予综合护理干预,比较两组院内感染发生率。结果干预组患者发生院内感染12例,感染率16.00%,对照组患者发生院内感染37例,感染率53.62%,两组比较差异有统计学意义（P〈0.01）。两组患者下呼吸道、上呼吸道、泌尿道、颅内及皮肤院内感染发生率比较,差异有统计学意义（P〈0.01）。结论强化综合护理干预措施对预防和控制神经内科重症监护患者院内感染的发生作用显著。     

老年住院患者医院感染率调查及护理对策

目的调查老年住院患者医院感染率并提出护理对策,以减少老年患者医院感染率的发生。方法对医院2008年1~6月年龄≥65岁住院老年患者149例进行回顾性调查。结果老年患者医院感染率与年龄差异无统计学意义;但与住院时间延长相关,住院时间60 d患者医院感染发生率高于住院时间30 d(P0.05);感染部位以呼吸道(63.6%)和泌尿道(13.6%)为主;病原菌以铜绿假单胞菌(31.8%),鲍氏不动杆菌(18.1%)、大肠埃希菌(15.9%)和金黄色葡萄球菌(11.4%)为主。结论在预防与控制医院感染发生中加强护理质量监控和培训不容忽视。     

老年非霍奇金淋巴瘤医院内感染临床分析

目的了解老年非霍奇金淋巴瘤（NHL）患者的医院内感染情况。方法对126例次住院老年NHL患者中发生医院感染的51例次患者进行回顾分析,并与同期非老年组进行比较。结果老年组发生医院感染率为40．5％,高于同期非老年组的12．6％（P〈0．05）。感染部位以呼吸道为主;病原菌以革兰阴性杆菌为主,占43．7％;革兰阳性菌占34．4％;真菌占21．9％。外周血白细胞、化疗疗程、住院天数都是影响院内感染发生的重要因素。结论老年NHL患者医院感染发生率高,应引起重视,加强防护。     

儿童患者EB病毒感染状况分析

目的了解爱泼斯坦巴尔病毒（EB病毒）在住院患者感染及引起的临床症状。方法从2004年10月-2006年4月,对医院儿科住院患者,取咽拭子,用实时荧光定量PCR法检测咽拭中EB病毒-DNA。结果总共检测了3429例,有738例为阳性,阳性率为21.5%;EB病毒感染率随年龄增大而升高,在≤3、4～7、8～11、12～15岁年龄组的感染率分别为18.8%、26.5%、29.0%、31.7%,差异有统计学意义（P〈0.01）;在EB病毒感染的病例中,主要以呼吸道感染为主,急性上呼吸道感染（41.2%）、肺炎（15.3%）、支气管炎（12.6%）等。结论EB病毒是儿科住院感染的重要病原体,主要感染病例为急性上呼吸道感染、肺炎、支气管炎等,而随着年龄的增长,由EB病毒感染所引起比例越大。     

精神科老年住院患者感染情况调查与分析

目的 为了了解精神科老年住院患者的院内感染情况,探寻感染发生的原因,以期降低感染率.方法 采用回顾性的方法,对2009年我院住院老年精神障碍患者(男≥60岁、女≥55岁)中发生医院感染的病历进行统计分析.结果 331例住院老年患者发生感染113例,医院感染率34.1%,以下呼吸道感染为主(52.2%),获感染的患者中老年痴呆例数多(55.75%),医院感染率及感染部位分别与性别具有较显著性差异(P<0.05),男性较女性更易感染,呼吸道感染男性比例高,泌尿道感染女性比例高,感染部位与年龄无显著性差异.结论 老年痴呆症患者是老年精神障碍患者中最易感染的群体,预防呼吸道及泌尿道感染是降低精神科老年患者感染率的关键.     

浦东新区远郊社区卫生服务中心院内感染调查分析

目的了解浦东新区远郊社区卫生服务中心院内感染发生现状,有效预防和控制医院内感染的发生和流行。方法对泥城社区卫生服务中心2012年1月—2014年6月全部病历进行调查,对院内感染情况进行回顾性调查分析。结果院内感染发生率为7.07%,院内感染的发生与患者年龄、疾病和住院时间等都有统计学意义(P<0.01)。年龄越大,发生率越高,90岁以上年龄组感染率为9.03%,75~89岁年龄组感染率为8.45%,60~74岁为5.82%;住院时间越长,发生率越高,住院10天以下的感染率为1.42%,大于60天的入院感染率为48.57%;在所有院内感染病例中,以呼吸系统感染最多,占58.67%;11月、1月和2月是院内感染的高发季节,分别为22.9%、11.1%和11.04%。结论我中心院内感染率高于全国发生的一般水平,社区卫生服务中心应根据院感发生的易感因素,结合服务中心的自身特点,采取有效的干预措施,控制院内感染的发生和流行。     

某妇幼保健院妇科患者HPV亚型感染的研究

目的探讨妇科门诊患者HPV感染率、亚型分布以及不同年龄HPV感染情况,为本地区妇女HPV防制提供基线资料。方法对2009年10月-2011年7月来湘潭市妇幼保健院妇科门诊就诊的9 266例患者进行登记,并采集其阴道、宫颈分泌物作为标本,用导流杂交基因芯片技术进行21种HPV基因型的分型检测。用EXCEl2007和SPSS17.0建立数据库及统计分析,HPV感染率比较采用χ2检验。结果①HPV阳性总检出率为21.07%（1 952/9 266）,高危型别感染率为18.55%（1 719/9 266）,低危型别感染率为2.51%（233/9 266）,单一型别感染率为15.55%（1 441/9 266）,多重型别感染率为5.51%（511/9 266）;②HPV感染数前三位的是HPV52、HPV16、HPV58,且以单一感染和双重感染为主,高危型和低危型感染者在HPV单一及多重感染分布上差异有统计学意义（χ2=68.37,P〈0.01）;③不同年龄检查者的HPV感染率差异有统计学意义（χ2=28.27,P〈0.01）,不同年龄的HPV感染者感染高低亚型的分布上差异有统计学意义（χ2=32.87,P〈0.01）,不同年龄的HPV感染者HPV感染类型的分布上差异有统计学意义（χ2=48.49,P〈0.01）,各年龄均以单一及高危感染为主,但在25岁以下及50岁以上年龄HPV感染者中高低危合并感染、多重感染多于其他年龄段。结论本院妇科门诊患者HPV感染率处于较高水平,HPV感染最常见的亚型为HPV52、16、58。不同年龄患者HPV感染率不同,高低危亚型、单一及多重感染分布在不同的年龄中有差别,在25岁以下及50岁以上年龄患者中高低危合并的多重感染高于25~50岁患者。     

某医院老年患者院内感染因素分析

目的探讨老年患者院内感染的危险因素以及预防对策。方法 调查某医院老年住院患者560例,对60例发生院内感染患者临床资料进行调查,分析院内感染的危险因素。结果某医院院内感染感染发生率为10.71%,阻塞性肺疾病院内感染率最高为12.83%,其次为恶性肿瘤10.58%,糖尿病9.26%,脑血管疾病为6.67%,心血管疾病5.13%。感染部位以呼吸道为主（51.67%）;泌尿道其次（21.67%）。吸氧、静脉留置针、雾化等侵入性操作的院内感染发生率分别为95.00%。、81.67%和43.33%。病原菌培养以革兰阴性杆菌为主（60.94%）。结论 吸氧、静脉留置针、雾化等侵入性操作是院内感染的主要危险,不同基础疾病发生院内感染率不同,严格规范各类侵入性操作,并加强基础性疾病的治疗和合理使用抗生素,预防减少院内感染的发生。     

某医院消化内科住院患者院内感染危险因素分析及相关管控措施探讨

目的分析增加消化内科住院患者发生院内感染风险的危险因素,并据此探讨相应的管理控制（管控）措施,以更加有效防止消化内科住院患者院内感染的发生。方法回顾性分析2011年4月—2013年4月兴隆县人民医院消化内科收治的1 473例住院患者临床资料,根据患者感染与否分为感染组（135例）及非感染组（1 338例）,对患者院内感染危险因素分别进行单因素分析、logistic多因素回归分析,并根据分析结果总结针对性管控措施。结果该组1 473例消化内科住院患者中院内感染135例,感染率为9.16%;单因素分析显示,性别、年龄（≥60岁）、住院时间、合并糖尿病、肿瘤、联合使用抗生素、使用激素、化疗药物、侵入性操作均与患者院内感染相关（均P〈0.05）;logistic多因素回归分析显示年龄、住院时间、合并基础疾病、侵入性操作及抗生素联合使用为导致患者发生院内感染的独立危险因素。结论消化内科住院患者院内感染是多种因素共同作用的结果,针对各因素采用必要合理的管控措施,可有效降低消化内科患者院内感染的发生率,促进患者康复和预后。     

医院感染化脓性眼内炎临床分析

目的探讨医院感染化脓性眼内炎的临床特点,给预防和治疗提供依据。方法对1996-2005年住院患者进行回顾性研究分析。结果医院感染化脓性眼内炎占手术例数的0.024%,91.00%发生在术后3 d内,送检标本培养以革兰阳性球菌为主;晶状体后囊膜破裂与后囊膜未破裂的眼内炎感染率差异有统计学意义（P〈0.05）;年龄≥60岁与〈60岁感染率差异无统计学意义（χ^2=1.50,P〉0.05）。结论医院感染化脓性眼内炎的致病菌以条件致病菌为主要菌属,危险期为术后3 d内,晶体后囊膜破裂是其危险因素,老年人医院感染相对高发的现象不明显。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.