老年心血管疾病并发肺部感染的特点分析

目的探讨分析老年心血管并发肺部感染的特点及干预措施,以更好地为患者提供护理服务。方法 2010年1月-2012年12月医院治疗的老年心血管疾病并发肺部感染患者200例,将其分为观察组和对照组各为100例;对照组采用常规护理方法,观察组在常规护理基础上有针对性地制定护理干预措施,并严格执行;比较两组患者肺部感染体征出现时间和持续天数以及平均住院日和护理满意度;采用SPSS16.0统计软件对所得数据进行分析。结果平均住院日观察组(14.3±1.6)d,对照组(22.6±1.2)d,两组比较,差异有统计学意义(P<0.05);患者满意度观察组(97.42±6.29)%,对照组(80.32±5.42)%,两组比较,差异有统计学意义(P<0.05);观察组出现肺部感染体征的时间(6.51±5.78)d,感染持续时间(6.01±3.31)d,对照组分别为(2.41±1.35)d、(17.57±7.10)d,两组比较差异有统计学意义(P<0.05)。结论制定详细的护理干预措施有效预防了肺部感染的发生,提高了患者的满意度,缩短了住院日。     

护理干预对神经内科医院感染患者影响的研究

目的 探讨特定的护理干预对神经内科住院患者医院感染发生率的影响,关注负性情绪的差异,以期为临床工作提供理论帮助.方法 选取在神经内科住院治疗的患者,共702例,依患者入院的顺序分为观察组与对照组,观察组共352例,应用特定的护理干预措施,对照组共350例,应用常规护理干预措施,观察两组患者医院感染的发生率、负性情绪以及满意度的差异.结果 医院感染率观察组为10.80％,明显低于对照组的20.00％;医院感染的菌种观察组有两种,对照组有8种;患者的焦虑评分观察组为(38.43±3.25)分,对照组为(43.43±4.27)分;抑郁情绪评分观察组为(37.64±3.72)分,对照组为(42.35±3.96)分,观察组明显低于对照组;患者对治疗的满意度观察组为94.74％,高于对照组的80.00％.结论 特定的护理干预能减少神经内科住院患者医院感染的发生率,提高患者的满意度.     

舒适护理干预在老年慢性心力衰竭中的应用效果

目的:探讨在老年慢性心力衰竭治疗中应用舒适护理干预的临床效果.方法:选取我院收治的老年慢性心力衰竭患者120例,随机分为对照组(60例)和观察组(60例).对照组给予常规护理干预,观察组在对照组的基础上给予舒适护理干预.记录两组患者平均气喘缓解时间、水肿消退时间以及心率恢复时间,比较两组患者的临床疗效和护理满意度.结果:观察组患者平均气喘缓解时间、水肿消退时间以及心率恢复时间均显著低于对照组,护理满意度评分均显著高于对照组,差异具有统计学意义(P＜0.01);观察组治疗总有效率显著高于对照组,差异具有统计学意义(P＜0.05).结论:在老年慢性心力衰竭治疗中应用舒适护理干预能提高临床疗效,满足护理需求,值得临床推广应用.     

慢性乙型肝炎患者医院感染危险因素分析

目的 探讨慢性乙型肝炎患者医院感染发生的特点及相关因素,寻求有效地控制措施.方法 以2010年1月-2011年12月医院传染科收治的150例慢性乙型肝炎患者为调查对象,对其医院感染发生及相关因素进行调查分析.结果 150例慢性乙型肝炎患者发生医院感染36例,感染率为24.0％,感染部位以腹腔为主占49.0％,其次为呼吸道占28.6％;感染患者平均年龄(55.3±6.8)岁、平均住院日(39.4±4.9)d;非感染患者平均年龄(42.5±8.9)岁、平均住院日(29.2±5.6)d,两者差异有统计学意义(P＜0.05);慢性乙型肝炎合并肝硬化患者医院感染发生率为28.7％,明显高于未合并肝硬化患者的11.9％,差异有统计学意义(P＜0.05);感染患者血清白蛋白水平(33.2±3.60)g/L,低于非感染患者的(38.9±2.30)g/L,差异有统计学意义(P＜0.05).结论 年龄大、住院时间长的重度慢性乙型肝炎患者医院感染的发生率较高,必须采取有效地控制措施降低慢性乙型肝炎患者医院感染的发生率,提高医疗质量,确保医疗安全.     

老年直肠癌根治术后肺部感染的危险因素分析

目的 分析老年直肠癌经腹会阴直肠癌根治术(Mile's)术后肺部感染的预防及康复护理方法,以提高直肠癌患者术后的生存质量.方法 将行Mile's术的老年直肠癌患者86例随机分为干预组和对照组,每组各43例,对照组采用常规护理,干预组同时给予术前禁烟、控制呼吸道感染及深呼吸训练,术后加强心肺功能监护和呼吸道护理、药物促进排痰、营养支持及早期下床活动等康复护理,比较两组患者肺部感染率、低氧血症发生率、平均住院时间及患者对护理服务的满意度.结果 干预组肺部感染率为4.7％,显著低于对照组20.9％ (P＜0.05);干预组平均住院时间(28.54±2.82)d,明显低于对照组的(35.48±3.39)d,低氧血症发生率明显降低(P＜0.05);干预组护理服务满意率为90.7％,显著高于对照组的72.9％,差异有统计学意义(P＜0.05).结论 针对性的康复护理可有效降低老年直肠癌Mile's术后肺部感染的发生率,提高患者及家属满意度,改善护患关系.     

手术后护理在预防消化道手术切口感染中的应用

目的 观察手术后护理在预防消化道手术术后切口感染中的作用效果,为提高护理效果降低术后切口感染提供指导.方法 选取医院2009年2月-2012年2月收治的消化道择期手术患者520例作为研究资料,将其随机均分为两组,对照组采用常规护理,观察组在对照组基础上采用综合护理,观察两组患者切口甲级愈合率、切口感染率及愈合时间.结果 两组患者手术切口情况及满意度比较,观察组260例,切口甲级愈合223例,切口感染15例,感染率5.8％,愈合时间(7.3±2.5)d,患者满意度95.0％；对照组切口甲级愈合182例,切口感染39例,感染率15.0％,愈合时间(9.6±3.6)d,患者满意度80.0％,两组比较,观察组手术切口愈合率及患者满意度均优于对照组,切口感染率低于对照组,差异有统计学意义(P＜0.05).结论 在临床护理过程中,提高患者全身状况、做好肠道准备、合理应用抗菌药物、同时严密护理切口,对减轻患者的不良心理、提高愈合效果、降低术后感染发生有重要作用.     

不同护理干预措施对预防呼吸机相关性肺炎发生的效果分析

目的 探讨应用不同护理干预措施在控制呼吸机相关性肺炎(VAP)中的作用,以降低VAP的发生率.方法 2010年1月-2011年12月选取行机械通气辅助治疗的住院患者共88例,随机分为两组,其中观察组48例,应用临床护理路径进行护理干预;对照组40例,应用传统的常规护理干预措施.结果 观察组VAP发生率为29.17％,对照组为45.00％,两组比较差异有统计学意义(P＜0.05);观察组吸痰间隔时间(4.9±2.7)h,对照组为(2.2±1.9)h,两组比较差异有统计学意义(P＜0.05);出院时护理工作满意率观察组为89.58％,对照组为77.50％,观察组明显高于对照组,差异有统计学意义(P＜0.05).结论 实施临床护理路径能有效地控制气管插管行机械通气患者VAP的发生,有效提高了患者的护理质量满意度,是现代护理发展的方向.     

手术室护理干预在预防胃肠道手术患者切口感染的临床效果分析

目的综合分析手术室护理干预在预防胃肠道手术患者切口感染的临床效果,为治疗胃肠道手术切口感染患者提供科学参考依据。方法选择2013年1月-2014年1月医院102例胃肠道手术患者临床资料,按照不同的护理干预模式随机分为观察组与对照组,每组各51例;观察组应用手术室综合护理干预模式,对照组应用常规干预模式;调查分析两组患者切口愈合率、感染率及护理效果,采用SPSS 17.0软件进行数据统计分析。结果观察组患者发生感染1例感染率为1.96%,对照组患者发生感染6例感染率为11.76%,两组比较差异有统计学意义(P0.05);患者切口甲级愈合观察组占74.51%、对照组占37.25%,两组比较差异有统计学意义(P0.05);观察组患者住院费用及住院时间分别为(1.01±0.25)万元及(9.56±2.69)d,对照组分别为(1.51±0.19)万元及(15.21±3.66)d,两组数据比较差异均有统计学意义(P0.05)。结论在手术室护理干预中采取综合护理的模式比采取常规的护理模式治疗效果更理想,能够有效降低患者切口感染率。     

急诊科预防清创缝合术后感染护理干预探讨

目的 探讨护理干预对急诊科预防清创缝合术后感染的临床效果,为预防感染发生提供参考资料.方法 选取医院急诊科清创缝合并给与护理干预患者196例为观察组,选取同期急诊科清创缝合未给予护理干预患者140例为对照组,将两组患者术后感染及细菌培养结果进行统计分析.结果 清创缝合术后7d,观察组感染9例,感染率4.59％,对照组感染16例,感染率11.43％,两组差异有统计学意义(P＜0.05);经细菌培养,观察组感染主要为金黄色葡萄球菌,占33.33％,表皮葡萄球菌占22.22％,对照组感染主要为金黄色葡萄球菌,占25.00％,表皮葡萄球菌占18.75％,溶血葡萄球菌占18.75％.结论 通过护理干预模式,能有效降低清创缝合术后患者的感染率,改善患者的伤口愈合,提高临床治疗效果.     

综合护理干预与常规护理对慢性心力衰竭患者心功能及生活质量的影响对比分析

目的:比较护理干预与常规护理对慢性心力衰竭患者心功能及生活质量的影响的差异.方法:将70例符合入组标准的慢性心力衰竭患者按随机数字表分为观察组35例和对照组35例,对照组进行常规护理,观察组进行综合护理干预,两组均观察3个月,干预前后比较两组患者治疗依从性与护理满意度,进行心脏彩超检查监测心功能指标(左心室射血分数、左室舒张末径),测定6min步行距离,进行生活质量测评表(QOL)评分.结果:①观察组和对照组治疗依从率与满意率分别为94.29％比77.14％,97.14％比51.43％,差异具有统计学意义,x2=6.917和5.609,均P＜0.05;②观察组与对照组治疗前6min步行距离、左室射血指数、左室舒张末径、QOL总分差异不显著,具有可比性,但两组治疗后均较治疗前明显改善,其中6min步行距离、左室射血指数明显升高,左室舒张末径、QOL总分明显降低;观察组与对照组治疗后6min步行距离、左室射血指数、左室舒张末径、QOL总分分别为542±87 m比475±76m,53.6±8.7％比45.3土7.1％,50.1±3.8 mm比54.3±4.1 mm,60.2±1.8分比92.6±2.4分,差异均具有统计学意义.结论:慢性心力衰竭患者应重视综合护理干预的积极作用,改善护理满意度、治疗依从性、心功能恢复、生活质量提高及治疗预后,值得临床推广使用.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.