可调节携便式镇痛泵

现有的镇痛泵是用于手术后,为患者解除或者减轻患者的疼痛而设计的。一个特殊的原因,为使镇痛泵能用于长期受疼痛折磨的患者,为适应这类患者要自由活动和长期使用的需要,在现有镇痛泵的基础上,经过研究、改造,成功的研制出可调节携便式镇痛泵,经临床使用获得良好的效果,并获得国家实用新型专利(专利号:200420059087.1)。     

可调节携便式镇痛泵

现有的镇痛泵是用于手术后，为患者解除或者减轻患者的疼痛而设计的。一个特殊的原因,为使镇痛泵能用于长期受疼痛折磨的患者．为适应这类患者要自由括动和长期使用的需要,在现有镇痛泵的基础上．经过研究、改造，成功的研制出可调节携便式镇痛泵，经临床使用获得良好的效果，并获得国家实用新型专利（专利号：200420059087．1）。     

硬膜外麻醉剖宫产术后留置镇痛泵的观察及护理

为了探讨硬膜外麻醉剖宫产术后留置自控镇痛泵的最佳护理,观察剖宫产术后病人使用自控镇痛泵的效果,总结护理经验。通过站内39例剖宫产妇临床患者仔细观察,收集资料,综合分析,得出术前术后护理措施要点及注意事项。发现硬膜外麻醉剖宫产术后留置自控镇痛泵能有效解决病人术后的疼痛问题,降低患者不良反应,有助于病人全面快速康复和提高生活质量,减少或杜绝术后并发症,效果良好。     

静脉自控镇痛泵在全膝关节置换术后的应用和护理体会

目的:总结全膝关节置换术后使用静脉自控镇痛泵的的护理体会.方法:对35例全膝关节置换术后患者使用静脉自控镇痛泵的临床观察和护理.结果:静脉自控镇痛泵能有效缓解患者疼痛,促进患者早期功能锻炼,而且并发症少.结论:全膝关节置换术后患者应用镇痛泵是安全的,能有效减少患者疼痛,促进患者早日功能锻炼,提高生活质量.     

药泵镇痛显身手

现代医学有责任帮助病人消除疾病,摆脱疼痛的折磨。近年来,临床疼痛治疗的进展之一是临床给药方案由医护人员转向由病人自行给予,即病人利用药泵自控镇痛术(PCA)的使用,这是现代科技造福于疼痛病人的新举措。 PCA的镇痛泵结构并不复杂,与临床常见的静脉点滴方法差不多:由麻醉医师依病人的疼痛情况,将适当浓度的复方药液充填进“药泵”内,将镇痛药泵放置并固定于体壁,通过静脉等途径与病人连接,当感到疼痛或要求镇痛时,病人可自行轻触药泵的按键,泵里的镇痛药便可注入体内而获得镇痛效果。镇痛药泵体积小,便于携带,这种由病人自行决定的镇痛方法,既方便了病人,又充分体现了镇痛用药的个体性。其优点是对疼痛的解除有显著效果,提高了病人的生活质量和生存质量,许多晚期癌疼痛患者使用后觉得消除了那种“痛不欲生”的感觉,重新建立信心配合     

硬膜外镇痛泵的术后应用与护理体会

术后镇痛的方法有很多，但目前最常用的是硬膜外镇痛（PCEA），通过临床证实，PCEA不仅适用于接受硬膜外麻醉，如胸部、腹部、颈部、上肢、盆腔、会阴、下肢等部位实施手术的患者。还能适用于耐受硬膜外麻醉且无禁忌症的其他疼痛患者，如癌性疼痛、心绞痛、无痛分娩、烧伤疼痛、骨折疼痛等。     

麻醉镇痛泵对异位妊娠患者术后疼痛程度及不良事件的影响

目的:以异位妊娠者为研究对象,探究麻醉镇痛泵应用对其术后疼痛程度和不良事件的影响.方法:选取2018年1月～2020年1月本院接收的异位妊娠者72例为对象,以数字单双号形式随机分成2组,即对照组、研究组,每组所占例数36例.予以对照组患者硬膜外麻醉镇痛,予以研究组患者麻醉镇痛泵镇痛.观察两组患者术后疼痛感,镇痛效果,不...     

右美托咪定联合0.2%罗哌卡因髋关节囊周围神经阻滞用于髋部骨折麻醉前体位摆放时的效果

目的 本研究探讨右美托咪定联合0.2%罗哌卡因髋关节囊周围神经阻滞用于髋部骨折麻醉前体位摆放时的效果。方法 选择2019年10月-2021年10月在佛山市南海区第七人民医院行单侧髋部骨折手术患者60例,随机分为A组和B组,每组30例。两组患者均采用腰硬联合麻醉,术毕行静脉自控镇痛。A组患者在实施腰硬联合麻醉前进行超声引导髋关节囊周围神经阻滞,注射0.2%罗哌卡因20mL,在神经阻滞后静脉泵注右美托咪定0.2μg/kg。B组患者仅静脉泵注等剂量右美托咪定,不进行神经阻滞。记录两组患者入室时、摆放体位时、体位摆放后即刻疼痛VAS评分;记录麻醉医生对两组患者体位摆放情况满意度;记录两组患者首次按压镇痛泵时间、镇痛泵按压次数;记录两组患者麻醉镇痛不良反应发生情况。结果 A组患者摆放体位时、体位摆放后即刻疼痛VAS评分明显低于B组(P<0.05),两组患者入室时疼痛VAS评分比较无明显差异(P>0.05);A组患者体位摆放情况满意度明显高于B组(P<0.05),A组患者首次按压镇痛泵时间明显高于B组(P<0.05),A组患者镇痛泵按压次数明显低于B组(P<0.05)...     

麻醉镇痛泵应用于剖宫产术后300例患者的护理

随着第一台病人自控镇痛泵的问世，患者在接受手术之后疼痛的护理难度大大降低了，但是不同性质的手术患者所使用的镇痛泵性质是不同的，为此在镇痛泵使用的方法上也存在着差异。今天笔者研究的就是剖宫产手术之后镇痛泵的护理，其主要的目的提高疼痛护理的效果，避免自控镇痛泵带来的并发症，促进患者手术之后早日康复。     

镇痛泵在剖宫产术后镇痛的临床应用

目前,患者对于术后镇痛的要求与日俱增,缓解患者术后疼痛,是临床不容忽视的问题。近来,我们对剖宫产术后镇痛泵持续滴注取得良好的镇痛效果,报告如下。 一、临床资料 选择我院2000年10月～2002年11月间在硬膜外麻醉下行剖宫产术患者170例,随机分为两组,用镇痛泵者(A组)100例,使用哌替啶者(B组)70例,两组年龄、娩次、手术情况等类似,无统计学差异。     

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.