56例临床输血不良反应原因分析

目的:分析临床输血过程中发生输血不良反应的原因,探讨有效的预防措施。方法:回顾2012—2014年输注由我站提供的血液制品后发生输血不良反应患者56例,分析输血不良反应发生的原因。结果:21615人次输血中,发生不良反应56例,发生率为0.3%,其中非溶血性发热反应为32例,占57.1%,过敏反应为24例,占42.9%,未发现其他输血不良反应。结论:临床上应加强对输血全过程的监管,遵循合理科学用血原则,采用新的输血技术,大力提倡自身输血,确保临床输血的安全性。     

Evaluation of the National Prevention Program in Iran, 2007–2009: the Accomplishments and Challenges with Reflections on the Path Ahead

β-Thalassemia major (β-TM) is an inherited disease and efforts have been made in several countries to reduce the number of affected births. In the present study, we aimed to evaluate the Iranian thalassemia prevention program, considered to be an important program in the region. The time period of the present study ranges from 2007–2009, during which new thalassemic births and the relevant causes were evaluated throughout the country. A cross-sectional analytical study was conducted at the Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. A questionnaire was forwarded to all blood centers of the IBTO so as to obtain information about the new cases of thalassemia and the causes of these thalassemic births. Provincial thalassemia societies also received the questionnaires so that screening and prenatal diagnosis (PND) errors would be recorded. The results showed that 755 new thalassemia cases were born during 2007–2009 with the average fall in affected thalassemia births of 80.82%. The main cause of the new births was attributed to unregistered “timeless religious marriages” based on the conventions of the Sunni community which accounted for 43.17% of all new cases mainly having occurred in Sistan & Baluchestan Province. Not using PND was evaluated to be another main cause. Although the prevention program has led to a great reduction in thalassemic births, new measures are required, including research on how to make the program compatible with social and economic conventions and norms of Sistan & Baluchestan Province. The province of Kohgiluyeh Boyer Ahmad also needs to be revisited in terms of the program efficacy.     

住院精神病患者暴力行为原因分析及护理对策

目的研究住院精神病患者暴力行为发生的原因,采取相应的护理对策,尽量降低暴力行为发生率。方法对65例发生暴力行为的住院精神病患者临床资料进行回顾分析,找到暴力行为发生的主要原因,并提出相应的护理对策;然后再统计对策实施后的精神病患者暴力行为发生情况,以检验实施效果。结果发生暴力行为疾病多见于精神分裂症和双相情感障碍。在采取针对性防范措施后,暴力攻击行为发生率由2.6%下降到1.0%,差异有统计学意义(P0.05)。两组暴力攻击率、精神分裂、双向情感等,拳击、脚踢等比较差异有统计学意义(P0.05),抓伤无统计学意义(P0.05)。结论多数暴力攻击行为由精神症状所致,尽早对精神病患者的症状进行控制,并采取对新入院患者予暴力风险评估、加强医护沟通、加强对患者的宣教、提升护士的防暴能力培训和建立良好的护患关系等措施,可有效降低暴力行为发生率。     

传统疝修补术与无张力腹股沟疝修补术后慢性疼痛原因分析及治疗

目的探讨传统疝修补术与无张力疝修补术后慢性疼痛的原因及治疗。方法对我院自2002年2月至2010年9月426例实施传统疝修补术与无张力疝修补术患者的临床资料进行回顾性地分析。结果所有患者根据手术方式分为两组：传统疝修补术组（n=210）和无张力疝修补术组（n=216）。术后疼痛发生率,传统疝修补术组为9.0%（19/210）,无张力疝修补术组为4.2%（9/216）,两者差异有统计学意义（P〈0.05）。结论聚丙烯平片无张力疝修补术可减少腹股沟疝修补术后慢性疼痛的发生,传统疝修补术与无张力疝修补术后慢性疼痛引起的原因不同治疗方法基本相同。     

急诊护患纠纷发生的主要原因及防范措施

探讨如何防范护患纠纷,并减少纠纷的发生。通过对急诊科常见护患纠纷产生的原因进行分析,并制定相应的防范措施,预防和减少了护患纠纷的发生。增强责任意识和服务意识,改善服务态度,提升服务质量,加强业务素质培训及法律知识培训,对减少护患纠纷的发生具有重要的临床意义。     

Pattern of in-hospital pediatric mortality over a 3-year period at University teaching hospitals in Iran

Introduction:

Causes of death are different and very important for policy makers in different regions. This study was designed to analyze the data for our in-patient children mortality.

Materials and Methods:

In this cross-sectional study from March 2011 to March 2013, all patients from 2 months to 18 years who died in pediatric intensive care unit, emergency room or medical pediatric wards in the teaching hospitals were studied.

Results:

From a total of 18,915 admissions during a 2-year-period, 256 deaths occurred with a mean age of 4.3 ± 5 years and mortality 1.35%. An underlying disease was present in 70.7% of the patients and in 88.5% of them the leading causes of death were related to the underlying diseases. The most common underlying diseases were congenital heart disease and cardiomyopathy in 50 (27.6%). The four main causes of deaths were sepsis (14.8%), pneumonia (14.5%), congestive heart failure (9.8%), and hepatic encephalopathy (9.8%).

Conclusion:

We may conclude that after sepsis and pneumonia, congestive heart failure, and hepatic encephalopathy are the leading causes of death. Most patients who died had underlying diseases including malignancies, heart and liver diseases as the most common causes.     

Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions

Cirrhosis causes a heavy global burden. In this review, we summarized up-to-date epidemiological features of cirrhosis and its complications. Recent epidemiological studies reported an increase in the prevalence of cirrhosis in 2017 compared to in 1990 in both men and women, with 5.2 million cases of cirrhosis and chronic liver disease occurring in 2017. Cirrhosis caused 1.48 million deaths in 2019, an increase of 8.1% compared to 2017. Disability-adjusted life-years due to cirrhosis ranked 16th among all diseases and 7th in people aged 50-74 years in 2019. The global burden of hepatitis B virus and hepatitis C virus-associated cirrhosis is decreasing, while the burden of cirrhosis due to alcohol and nonalcoholic fatty liver disease (NAFLD) is increasing rapidly. We described the current epidemiology of the major complications of cirrhosis, including ascites, variceal bleeding, hepatic encephalopathy, renal disorders, and infections. We also summarized the epidemiology of hepatocellular carcinoma in patients with cirrhosis. In the future, NAFLD-related cirrhosis will likely become more common due to the prevalence of metabolic diseases such as obesity and diabetes, and the prevalence of alcohol-induced cirrhosis is increasing. This altered epidemiology should be clinically noted, and relevant interventions should be undertaken.     

Retrospective radiological evaluation to study the prevalence and pattern of maxillofacial fracture among Military personal at Prince Sultan Military Medical City [PSMMC], Riyadh: An institutional study

PurposeThe aim of the present study was to analyze the prevalence, causes, and patterns of maxillofacial fractures retrospectively in patients who were treated at Prince Sultan Military Medical City, Riyadh, Saudi Arabia.MethodsPatients′ medical records were reviewed from 2005 to 2014. Patient′s age, gender, cause, and the pattern of maxillofacial fractures were studied. Associated body injuries were also recorded.ResultsOut of 263 patients, 207 (78.7%) were male and 56 (21.3%) were female. The age range was from 3 to 67 yr with a mean age of 26.21 yr. Road traffic accidents 236 (89.8%) were the most commonly reported cause of maxillofacial fractures, followed by falls 14 (5.3%), assaults 4 (1.5%), gunshot 3 (1.1%), and sport accidents 2 (0.8%). Most of the cases of maxillary fracture were Le Fort II 27 (36.5%), followed by LeFort I 23 (31.1%), LeFort III 20 (27.0%) and palatal fractures 4 (5.4%). Of the mandibular fractures, parasymphysis fractures constituted 61 (27.4%), body 50 (22.4%), condyle 45 (20.2%), angle 40 (17.9%), symphysis 16 (7.2%), ramus 7 (3.1%) and coronoid 4 (1.8%). Zygomatic complex fractures 110 (94.8%) were the most commonly reported fractures in the mid and upper facial region. Other facial fractures included orbital floor 61 (97.0%), naso-orbito-ethmoidal 18 (19.8%), and frontal 12 (13.2%).ConclusionRoad traffic accidents were the most common cause of maxillofacial fractures. Spreading awareness among young drivers regarding road safety regulations is highly recommended.     

Analysis of cases of forensic veterinary opinions produced in a research and teaching unit

The aim of the study was to present the results of necropsies carried out in the years 2000–2014 in the Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Life Sciences in Lublin.The material used for the analysis consisted of expert opinions prepared on the basis of a decision by a judicial body to admit an expert opinion as evidence.An increase was observed in the demand for the services of veterinary forensic experts, beginning in 2006 and persisting through 2014. The response to the growing popularity of veterinary forensic examinations should be systematization of knowledge and exchange of experience, which would enable the further development of this interdisciplinary science.     

某三级甲等医院护理不良事件发生情况分析

目的：通过对护理不良事件的发生时间、类型及原因进行分析,提出改进措施,以预防和减少不良事件的发生。方法对某三级甲等医院2013年上报的210例护理不良事件进行回顾性分析,统计护理不良事件的类型、原因、不良事件高发的时间段等资料。结果不良事件高发的主要时间段集中在7：00—8：59和10：00—10：59,占28.57%;交接班前后、上午班、下午班及晚班是不良事件发生的高峰期。结论护理管理者可调整当前护理排班模式,减少护理人员交接班次数,提高护理人员业务水平熟练程度,以期减少护理不良事件的发生。