Diarrhea A to Z: America to Zimbabwe

Purpose: To review international statistics on the morbidity and mortality of diarrhea, pathophysiology, global incidence, and implications for the clinical practice of nurse practitioners (NPs).
Data sources: Selective review of literature.
Conclusions: Because of ever-increasing international travel, immigration, and rising awareness of global health issues, NPs must be current on the prevention, diagnosis, and treatment of diarrhea.
Implications for Practice: Increased awareness of diarrhea as a significant international health issue mandates that NPs counsel clients who travel to high-risk areas about preventive measures to avoid exposure or manage symptoms while traveling. Guidelines for evidence-based treatments of diarrheal illness are widely available and should be followed.     

城市成批伤亡事件医院救护模式的回顾性研究

目的 介绍上海"11.15"特大火灾成批伤员医院内救护模式,分析本模式在城市成批伤救护中的运用效果.方法 回顾性调查承担主要救治任务的某二级甲等医院的医护人负共5名,采用查看病历、问卷调查和半结构访谈等方法,获取医院及伤员基本资料、院内救护展开模式、伤员转归及医护人员评价.结果:该院共接收56例伤员,以吸入性损伤为主.医院采用的是"以急诊科为主组织院内抢救,院领导协调救护资源调配"的救护模式,以及"病房作为急诊的大后方,二三级医院联合救助"的伤员分流模式.伤员预后良好,救护人员整体评价好.结论:本次医院所采取的医院内外协作救护模式值得借鉴,但还需加强应急分队和制度建设、优化流程等措施,以提高医院对于成批伤的救护能力.     

医院护理应急体系的构建与效果

目的探讨医院护理应急体系的构建方法及效果。方法建立护理应急指挥组织、应急救护小组及专家指导小组,建立应急救护信息系统,制订应急救护预案,培训应急救护技能,开展救护技术研究。结果各项应急救护任务高质量完成,危重病人护理质量考核合格率及护士急救技能考核成绩显著提高,差异具有统计学意义（P〈0．05或P〈0．01）。结论建立完善的护理应急体系可有效提高突发事件应急保障能力。     

Traumatic deep vein thrombosis in a soccer player: A case study

A 42 year-old male former semi-professional soccer player sustained a right lower extremity popliteal contusion during a soccer game. He was clinically diagnosed with a possible traumatic deep vein thrombosis (DVT), and sent for confirmatory tests. A duplex doppler ultrasound was positive for DVT, and the patient was admitted to hospital for anticoagulation (unfractionated heparin, warfarin). Upon discharge from hospital the patient continued oral warfarin anticoagulation (six months), and the use of compression stockings (nine months). He followed up with his family doctor at regular intervals for serial coagulation measurements, and ultrasound examinations. The patient's only identified major thrombotic risk factor was the traumatic injury. One year after the initial deep vein thrombosis (DVT) the patient returned to contact sport, however he continued to have intermittent symptoms of right lower leg pain and right knee effusion.     

基层综合医院感染预防控制管理的策略应对

目的 探讨基层综合医院感染预防控制管理的策略应对及临床效果。 方法 选取2014年1月-2015年12月我院医务人员30人及住院患者100例为对照组,选取2016年1月-2017年12月实施医院感染集束化干预后我院医务人员30人及实施期间住院患者100例为观察组,观察干预措施实施前后医院感染管理质量控制指标的效果。 结果 实施医院感染集束化干预后,医务人员院感相关知识知晓率、医务人员手卫生依从率均高于实施前(χ²=5.455,P=0.020;χ²=6.667,P=0.010)。观察组住院患者“三管”(呼吸机、血管导管、尿管)相关千日感染率及手术部位感染率均低于对照组。 结论 基层综合医院实施集束化医院感染管理干预后,规范了医疗行为,促进各项医疗护理核心制度的落实,降低感染风险、降低住院患者感染概率,保障医疗质量与安全。     

Active surveillance in response to the identification of a single carbapenemase-producing Escherichia coli at a Japanese university hospital

This report described the experience of active surveillance culture implemented in response to the identification of a single carbapenemase-producing Escherichia coli in a Japanese university hospital. It revealed a horizontal transmission event and an additional asymptomatic carrier of carbapenemase-producing Escherichia coli with unique drug susceptibility and resistance gene profiles. Early implementation of active surveillance culture as a part of multifaceted infection control measures appeared to be useful to control further transmission of carbapenemase-producing Escherichia coli even in the low endemic facility. Further investigations on the timing and usefulness of active surveillance culture in the control of carbapenemase-producing Enterobacteriaceae would be warranted.     

Hypertension in Zimbabwe: A meta-analysis to quantify its burden and policy implications

AIM: To estimate the pooled prevalence of hypertension in Zimbabwe and describe its trend since independence in 1980 using secondary source data. METHODS: MEDLINE, EMBASE and Scopus databases from April 1980 to December 2013 were searched for population and community based studies on the prevalence of hypertension among adults (≥ 18 years) in Zimbabwe. The key words used were “prevalence”, “epidemiologic studies”, “hypertension” or “high blood pressure”, based on the cut-off (≥ 140 mmHg systolic blood pressure and/or ≥ 90 mmHg diastolic blood pressure). We conducted a meta-analysis on the published studies, using the random-effects model to estimate the pooled prevalence. RESULTS: The search retrieved 87 publications, of which four studies met the selection criteria. The four studies had a total of 4829 study participants between 1997 and 2010 across 5 provinces in Zimbabwe. Two studies were in urban areas, while the other two had mixed study settings (urban and rural). The overall pooled prevalence of hypertension was 30% (95%CI: 19%, 42%, I²= 98%, χ² = 164.15, P = 0.00). CONCLUSION: Our results show a high prevalence of hypertension in Zimbabwe, with urban areas having higher prevalence than rural areas.