泌尿系肿瘤患者留置尿管感染的临床观察

目的:探究泌尿系肿瘤患者留置尿管感染的临床特点,并采取合理干预措施以降低感染发生率.方法:选取2016年12月至2017年12月我院收治的泌尿系肿瘤留置尿管患者254例,总结分析其临床资料及相关治疗情况,探究留置尿管感染相关危险因素及致病菌.结果:女性、年龄≥70岁、留置导尿时间长、给予膀胱冲洗、合并糖尿病、未使用抗菌药物是泌尿系肿瘤患者留置尿管感染的危险因素,本研究中致病病原菌株共108株,其中革兰阳性菌55株,占比50.93%,革兰阴性菌26株,占比24.07%,粪肠球菌7株,占比6.48%.结论:造成泌尿系肿瘤患者留置尿管感染的因素繁多,临床掌握其感染危险因素和致病菌株,并采取积极有效地感染预防策略和控制策略极为必要.     

康复病房患者导尿管相关泌尿系感染分析

目的探讨康复病房患者导尿管相关泌尿系感染的危险因素,提出预防措施。方法通过回顾性调查方法对2010年1月-2012年9月,90例康复病房住院期间接受过留置导尿患者泌尿道感染发生情况进行调查。结果 90例患者在尿管留置期间共有42例患者发生泌尿道感染,总发生率为46.7%,泌尿系感染的发生率与留置导管的时间有关,留置导管的时间越长越容易发生尿路感染,女性泌尿系感染患者明显多于男性。结论康复病房患者留置导尿管是应该严格掌握适应症,留置尿管期间严格进行无菌操作及护理,尤其是对女性患者,尽量缩短留置时间可有效控制泌尿系感染。     

泌尿系肿瘤患者留置尿管感染的临床分析

目的探讨泌尿系肿瘤患者留置尿管感染的临床特点和相应的干预措施,以减少泌尿系肿瘤患者留置尿管导致感染。方法选取2007年3月-2013年5月泌尿系肿瘤行留置尿管患者2 237例,对患者的临床资料、治疗情况进行回顾性分析,并记录感染患者的致病菌。结果 2 237例患者共发生医院感染134例,感染率为5.99%;女性、年龄≥70岁、合并糖尿病、留置导尿管时间较长、进行膀胱冲洗、未预防性应用抗菌药物是泌尿系肿瘤患者发生感染的危险因素(P<0.05);共分离病原菌134株,其中革兰阳性菌78株占58.21%,以粪肠球菌、屎肠球菌为主,革兰阴性菌51株占38.06%,以大肠埃希菌为主,真菌5株占3.73%,以白色假丝酵母菌为主。结论泌尿系肿瘤患者留置尿管造成感染与多种因素有关,在临床工作中应积极预防,一旦发生感染,应选择敏感抗菌药物进行针对性治疗。     

重症患者留置尿管致泌尿系感染的相关因素与干预

目的探讨重症患者留置尿管致泌尿系感染发生率及危险因素。方法对380例留置尿管的重症患者采用查阅病历、微生物监测等方法进行回顾性调查。结果 380例中发生泌尿系感染181例,感染率为47.6%;尿管留置持续时间、基础疾病、无菌操作是主要危险因素。结论切实做好医院感染的控制工作,加强无菌技术操作管理,严格掌握留置尿管的适应证,缩短尿管留置时间,合理应用抗菌药物,是有效降低泌尿系感染的重要方法。     

住院患者留置尿管目标性监测与分析

目的了解留置尿管患者的医院感染发生率、危险因素,积极采取预防措施,防止泌尿系感染。方法制定住院患者留置尿管的监测方案,采用病房查房查阅病历、微生物监测和回顾性调查相结合的方法,监测、分析2004年1~12月份留置尿管患者617例次。结果发生泌尿系感染病例89例,感染例次106次,感染率为14.42%,占医院感染的62.72%,位于医院感染的第1位;院内泌尿系感染主要危险因素是插尿管、留置尿管持续时间长及无菌操作不严格、抗菌药物使用不合理。结论严格掌握插尿管的适应证,缩短留置尿管的时间,严格导尿管的无菌管理,合理应用抗菌药物,是降低泌尿系感染的有效措施。     

肾移植术后患者医院感染目标性监测及危险因素分析

目的 探讨肾移植术后患者发生医院感染的情况及其危险因素,并提出相关的预防控制措施,降低肾移植患者术后医院感染的发生率.方法 对2008年1月-2011年12月医院器官移植病房进行同种异体肾移植手术患者的医院感染情况,进行前瞻性监测并填写统一的“肾移植患者医院感染目标性监测登记表”.结果 共监测肾移植患者329例,发生医院感染125例,感染率为38.00％;感染部位以泌尿系最多,占60.13％,其次为下呼吸道占26.80％;留置尿管时间越长,泌尿系感染发生率越高(P＜0.05);医院感染危险因素中,住院时间长是肾移植患者术后医院感染的危险因素,差异有统计学意义(P＜0.05).结论 针对肾移植患者术后医院感染危险因素,采取相关有效的防范措施,降低肾移植患者术后感染率,提高患者生存质量.     

留置尿管患者尿路感染的相关因素及预防对策

目的 分析留置尿管患者尿路感染的相关因素,并探讨预防对策,以降低尿路感染发生率.方法 运用回顾性调查方法对23例留置尿管发生尿路感染患者进行原因分析;观察不同留置尿管时间尿路感染的发生率.结果 随着留置尿管时间的增加,发生尿路感染例数显著增加,留置尿管10、20、30、＞30 d患者发生尿路感染分别占8.70％、17.39％、30.43％、43.48％ ;23例感染患者中有16例行尿培养检查,送检率为69.57％,培养结果均为阳性,分离出的病原菌以革兰阴性杆菌为主,占52.17％,其中主要为大肠埃希菌、肺炎克雷伯菌,分别占30.43％、21.74％,革兰阳性球菌占26.09％,以屎肠球菌为主,占17.39％,除此之外真菌感染增加,以白色假丝酵母菌为主,占21.74％.结论 留置尿管时间、集尿系统密闭性不良等原因是造成尿路感染的主要危险因素,针对各种危险因素,采取有效的预防措施,可降低尿路感染的发生.     

神经内科患者留置尿管相关泌尿道感染目标性监测

目的研究神经内科患者留置尿管相关泌尿道感染的危险因素,积极采取措施,降低其感染率。方法制定住院患者留置尿管相关泌尿道感染的监测表格,采用病房查房、查阅病历、微生物监测和回顾性调查相结合的方法,对2012年1-12月905例患者进行调查,其中145例留置尿管患者进行目标性监测。结果 905例神经内科患者中发生泌尿道感染10例,感染率1.1%,留置尿管患者感染率4.8%,明显高于未留置尿管患者感染率0.4%;留置尿管<3周患者泌尿道感染与留置尿管时间成正相关;夏季留置尿管患者感染率13.8%,远高于其他季节留置尿管患者感染率2.6%,差异有统计学意义(P<0.05);女性患者留置尿管泌尿道感染率8.9%,高于男性患者的5.6%,但差异无统计学意义。结论留置尿管是泌尿道感染最主要的因素,夏季也是泌尿道感染多发季节,对留置尿管相关泌尿道感染进行目标性监测并根据监测结果持续改进护理措施,减少患者尿管留置时间,可以有效降低泌尿道感染的发生。     

留置导尿管致泌尿系感染的预防及护理

目的通过对留置尿管发生泌尿系感染这一问题,从各个方面对易感因素及感染途径进行分析,采取适当的护理措施,有效降低留置尿管所致泌尿系感染的发生。方法对留置尿管患者从直接原因、患者本身个人原因、护士在实时操作过程中的无菌技术观念、导尿管使用及保留的情况、抗菌药物的合理使用等方面进行分析,临床采取了加强护理人员无菌观念,保持导尿管的完好、通畅,提高护理人员护理操作技能,增强患者抵抗力和免疫机能以及缩短长期留置导尿管的带管时间等措施。结果通过对留置尿管患者采取相应的护理措施,减少了留置尿管的时间,有效降低留置导尿管所致的泌尿系感染的发生,减少了患者痛苦。结论留置尿管是导致泌尿系感染的主要原因,采取恰当有效的护理措施,能有效预防减少泌尿系感染的发生。     

脑卒中患者留置尿管致尿路感染调查分析

目的 调查脑卒中患者留置尿管致尿路感染(CAUTI)的相关因素,以便积极采取有效的预防措施,减少CAUTI的发生.方法 对73例脑卒中患者留置尿管后致尿路感染进行调查分析.结果 109例留置尿管患者中有73例发生尿路感染,感染率为66.97％;其中女性患者明显高于男性,留置尿管时间＜5、5～8、≥8d的感染率分别为41.67％、45.28％、100.00％;糖尿病病程＞10年、HbA1c≥7.5％者、年龄＞60岁、神志不清醒者感染率均明显增加,差异均有统计学意义(P＜0.05).结论 脑卒中患者年龄大、留置尿管时间久CAUTI发生率高,并且合并2型糖尿病者感染率明显增加,应采取有效措施降低其发生率.     

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.     

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.     

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.     

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.     

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.