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1.
目的 分析大连市瓦房店地区在2016—2019年公共场所公共用具卫生状况,为卫生监督管理提供依据。方法 按照国家双随机抽检要求,2016—2019年在大连市瓦房店地区内抽查公共场所共计352家,进行微生物指标监测和分析。结果 2016—2019年共抽检公共用品用具1 057份,微生物指标合格率92.62%(978/1 057),四年间合格率差异有统计学意义(χ2=7.98,P=0.046),以2018年最高,为94.61%(158/167);不同种类公共用品用具微生物指标合格率差异有统计学意义(χ2=18.55,P<0.001),其中毛巾最低,为87.34%(276/316);不同公共场所微生物指标合格率差异有统计学意义(χ2=10.42,P=0.003),以沐浴场所微生物指标合格率最低,为50.00(3/6)。结论 大连市瓦房店地区公共场所公共用品用具的卫生状况整体良好,沐浴场所以及毛巾类样品超标严重,需要加强消毒管理。  相似文献   
2.
BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.  相似文献   
3.
BackgroundPolypharmacy is commonly related to poor drug adherence, decreased quality of life and inappropriate prescribing in eldery. Furthermore, this condition also leads to a higher utilization of health services resources, due to the increased risk of adverse drug events, length of stays in hospitals and readmissions rates after discharge.ObjectiveThis Systematic Review aimed to synthesize the current evidence that evaluates pharmaceutical services on polymedicated patients, from an economic perspective.MethodsSystematic searches were conducted in MEDLINE, SCOPUS and Cochrane Library databases to identify studies that were published until January 2021. Experimental and observational studies were included in this review, using strict inclusion/exclusion criteria and were assessed for quality using the following tools: RoB and ROBINS-I. Two independent reviewers selected the articles and extracted the data.Results3,662 articles were retrieved from the databases. After the screening, 18 studies were included: 9 experimental and 9 observational studies. The studies reported that the integration of the pharmacist as a member of the healthcare team provides an optimized use of pharmacotherapy to polymedicated patients and contributes to health promotion, providing reduction of spending on medication, reduction of expenses related to emergency care and hospitalizations and other medical expenses. The ECRs made cost-effectiveness or cost-benefit analysis, and most of the Non Randomized studies had statistically significant cost savings even considering the expenses of pharmaceutical assistance. Experimental studies reported a cost reduction varying between US$ 193 to US$ 4,966 per patient per year. Furthermore, observational studies estimated a cost reduction of varying from US$ 3 to US$ 2,505 per patient per year. The cost savings are related to decrease in emergency visits and hospitalizations, through pharmacist intervention (medication review and pharmacotherapy follow-up).ConclusionsConsidering the set of studies included, pharmaceutical care services directed to polymedicated patients may cooperate to save financial resources. Most of the interventions showed positive economic trends and also contributed to improving clinical parameters and quality of life. However, due to the majority of the studies having exploratory or qualitative methodology, it is essential to carry out more robust studies, based on full economic evaluation.  相似文献   
4.
探索重大突发公共卫生事件中以亚定点医院为代表的医疗管理模式。从上海新国际博览中心W1亚定点医院的实际运行情况出发,对其医疗供需、收治标准、运行效果、存在问题等逐一分析,结合本医疗队的经验,提出新的工作模式和管理思路。亚定点医院为普通型和有基础疾病的新冠病毒阳性感染者提供及时有效的救治,缓解了定点医院的运行压力,但也暴露出人员配置、信息化支撑、院感防控等方面的问题。采取“两级缓冲、双向转诊”的工作模式和“三个快、三个准、三个稳、三个全”的管理方案,可为患者提供及时、有效、适宜的医疗服务,缓解定点医院运行压力。  相似文献   
5.
Since its creation, the Psychiatric Guidance and Reception Centre (CPOA) has received and cared for patients aged 16 to 18. Among them, the rate of Unaccompanied Minor Refugees (UMR) has steadily increased, from 10% in 2016 to 12% in 2018. Meeting UMR patients most often occurs at the peak of their crisis, when their personal resources are overwhelmed and when they experience a severe state of psychological suffering. Our objective was to understand who UMR are concerning the particularities and the similarities they could share at clinical and therapeutic levels with other adolescents. We conducted a retrospective and observational cohort study of the 52 UMR received at the CPOA in 2018 in order to draw a portrait of them, to identify the specificities of their care, their guidance and their access to care, and to compare them with other young non UMR patients. UMR we met at CPOA in 2018 were most often boys aged 16 to 17, with limited resources and in great psychological distress. UMR had more suicidal behaviors (19%) than other minor patients (13%), and our results showed more prolonged consultations for UMR than non UMR at the CPOA (44% versus 41%), indicating that the isolated situation of UMRs complicates their ambulatory support. This study also allowed us to question the existence of emergency care specially dedicated to UMR. Although there are few recommendations to date, it seems important to reintroduce time into their care, in order to recreate a unit, which has sufficient place and time for these young patients whose lives are marked by many breakdowns.  相似文献   
6.
《Vaccine》2022,40(15):2292-2298
IntroductionChildhood vaccination rates have decreased significantly during the COVID-19 pandemic. The Brazilian immunization program, Programa Nacional de Imunização (PNI), is a model effort, achieving immunization rates comparable to high-income countries. This study aimed to evaluate the impact of the COVID-19 pandemic in pediatric vaccinations administered by the PNI, as a proxy of adherence to vaccinations during 2020.MethodsData on the number of vaccines administered to children under 10 years of age nationally and in each of Brazil’s five regions were extracted from Brazil’s federal health delivery database. Population adjusted monthly vaccination rates from 2015 through 2019 were determined, and autoregressive integrated moving average (ARIMA) models were used to forecast expected vaccinated rates in 2020. We compared the forecasts to reported vaccine administrations to assess adequacy of pediatric vaccine delivery during the COVID-19 pandemic.ResultsFrom January 2015 to February 2020, the average rate of vaccine administration to children was 53.4 per 100,000. After February 2020, this rate decreased to 50.4, a 9.4% drop compared to 2019 and fell outside of forecasted ranges in December 2020. In Brazil's poorest region, the North, vaccine delivery fell outside of the forecasted ranges earlier in 2020 but subsequently rebounded, meeting expected targets by the end of 2020. However, in Brazil's wealthiest South and Southeast regions, initial vaccine delivery fell and remained well below forecasted rates through the end of 2020.ConclusionIn Brazil, despite a model national pediatric vaccination program with an over 95% national coverage, vaccination rates decreased during the COVID-19 pandemic. Coordinated governmental efforts have ameliorated some of the decrease, but more efforts are needed to ensure continued protection from preventable communicable diseases for children globally.  相似文献   
7.
ObjectiveTo assess whether long-term cancer survivors (≥5 years after diagnosis) are at an increased risk of experiencing an opioid-related emergency department (ED) visit or hospitalization compared with persons without cancer.MethodsA 1:1 matched retrospective cohort study was performed using the Surveillance, Epidemiology, and End Results–Medicare linked data sets. The analysis was conducted from October 2020 to December 2020 in persons who lived 5 years or more after a breast, colorectal, lung, or prostate cancer diagnosis matched to noncancer controls on the basis of age, sex, race, pain conditions, and previous opioid use. Fine-Gray regression models were used to assess the relationship between cancer survivorship status and opioid-related ED visit or hospitalization.ResultsThe incidence of opioid-related ED visits and hospitalizations was 51.2 (95% CI, 43.5 to 59.8) and 62.2 (95% CI, 53.4 to 72.1) per 100,000 person-years among cancer survivors and matched noncancer controls, respectively. No significant association was observed between survivorship and opioid-related adverse event among opioid naive (hazard ratio, 0.79; 95% CI, 0.61 to 1.02) and non-naive (hazard ratio, 1.26; 95% CI, 0.84 to 1.89) cohorts.ConclusionCancer survivors and noncancer controls had a similar risk of an ED visit or inpatient admission. Guidelines and policies should promote nonopioid pain management approaches especially to opioid non-naive older adults, a population at high risk for an opioid-related ED visit or hospitalization.  相似文献   
8.
9.
BackgroundThe Coronavirus Disease 2019 pandemic provided a natural experiment to study the effect of social distancing on the risk of developing Hirschsprung's Associated Enterocolitis (HAEC).MethodsUsing the Pediatric Health Information System (PHIS), a retrospective cohort study of children (<18 years) with Hirschsprung's Disease (HSCR) across 47 United States children's hospitals was performed. The primary outcome was HAEC admissions per 10,000 patient-days. The exposure (COVID-19) was defined as April 2020–December 2021. The unexposed (historical control) period was April 2018–December 2019. Secondary outcomes included sepsis, bowel perforation, intensive care unit (ICU) admission, mortality, and length of stay.ResultsOverall, we included 5707 patients with HSCR during the study period. There were 984 and 834 HAEC admissions during the pre-pandemic and pandemic periods, respectively (2.6 vs. 1.9 HAEC admissions per 10,000 patient-days, incident rate ratio [95% confidence interval]: 0.74 [0.67, 0.81], p < 0.001). Compared to pre-pandemic, those with HAEC during the pandemic were younger (median [IQR]: 566 [162, 1430] days pandemic vs. 746 [259, 1609] days pre-pandemic, p < 0.001) and more likely to live in the lowest quartile of median household income zip codes (24% pandemic vs. 19% pre-pandemic, p = 0.02). There were no significant differences in rates of sepsis (6.1% pandemic vs. 6.1% pre-pandemic, p > 0.9), bowel perforation (1.3% pandemic vs. 1.2% pre-pandemic, p = 0.8), ICU admissions (9.6% pandemic vs. 12% pre-pandemic, p = 0.2), mortality (0.5% pandemic vs. 0.6% pre-pandemic, p = 0.8), or length of stay (median [interquartile range]: 4 [(Pastor et al., 2009; Gosain and Brinkman, 2015) 2,112,11 days pandemic vs. 5 [(Pastor et al., 2009; Tang et al., 2020) 2,102,10 days pre-pandemic, p = 0.4).ConclusionsThe COVID-19 pandemic was associated with significantly decreased incidence of HAEC admissions across US children's hospitals. Possible etiologies such as social distancing should be explored.Level of evidenceII.  相似文献   
10.
IntroductionAs of 30 April 2020, 203.715 SARS-CoV-2 infections had been reported in Spain, 54.486 in Madrid, 21.4% were health care workers. Our objective is to determine seroprevalence of COVID-19 among workers in a monographic pediatric hospital.MethodsBetween April13th and 30th, 1.523 health workers were recruited to be tested for SARS-CoV-2 serology screening (All Test®) and they answered a questionnaire with demographic, epidemiological and clinical information and previous exposure to COVID-19.FindingsOne thousand two hundred ninety two (84.8%) were tested. Positive serology (IgM and/or IgG) to SARS-CoV-2 was found in 17.2% (222/1.292), in 15.5% (201/1.292) if only IgG was considered. Median age was 44±13 years, 73% were female. The 33.8% (75/222) were asymptomatic. Eighty one had a previous positive rRT-PCR. The 14% (32/222) referred a family contact.ConclusionSerology prevalence for SARS-CoV-2 in workers of a pediatric hospital was higher than in general population. Many of them had an unnoticed infection.  相似文献   
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