神经内科老年患者医院感染目标监测及危险因素分析

目的寻找神经内科老年患者发生医院感染的独立危险因素,以期为神经内科老年患者医院感染的预防控制提供参考。方法调查2014年1月1日~2014年12月31日在解放军305医院神经内科住院的年龄≥60岁且住院天数≥2d的所有患者,共计692例次,收集年龄、性别、住院时间、是否使用泌尿道插管、是否使用鼻胃管等资料,通过非条件单因素和多因素Logistic回归分析研究医院感染的危险因素。结果医院感染64例次,医院感染例次患病率9.2%,医院感染例次千日患病率4.60‰。住院天数(OR=1.048;95%CI为1.030~1.068)和使用胃管(OR=3.455;95%CI为1.831~6.519)是老年患者发生医院感染的独立危险因素。结论延长住院天数以及使用鼻胃管会增加神经内科老年患者的医院感染风险。     

综合性医院产科医院感染危险因素及防控措施探讨

目的：探讨综合性医院产科医院感染发生状况。方法回顾性分析2010年2月-2012年1月我院产科收治出院病人1000例进行院内感染的调查、统计和分析。结果2010年2月-2012年1月我院产科收治出院病人1000例，发生院内感染共81例，感染率为0．81％。产科1000例出院病人平均住院天数为4．82d，81例医院感染病例的平均住院天数为7．6d（5-13d），所有感染病例均大于平均住院天数。结论严格执行无菌操作，加强病房管理、基础护理和健康教育，缩短留置尿管时间和住院天数，以降低产科的医院感染。     

某医院肿瘤病区医院感染分析

医院感染在肿瘤患者中发生率高 ,成为肿瘤患者死亡的主要原因之一。我院介入、放疗科收住患者均为接受化疗、放疗的晚期肿瘤病人 ,更是医院感染的高发病区。为探讨晚期肿瘤患者医院感染的特点和预防措施 ,对我院2 0 0 0～ 2 0 0 1年介入放疗科 98例医院感染病例进行回顾性调查分析。材料与方法2 0 0 0～ 2 0 0 1年共出院 970例 ,发生医院感染 98例、 10 2例次 ,发生率为 10 1%、例次感染率 10 5 %。其中肺部肿瘤 5 3例 ,其余肿瘤 4 5例。材料齐全 80例 ,其诊断均符合我国卫生部颁发的医院感染诊断标准 ,所有资料均采用回顾性调查方法 ,并…     

出血性脑卒中手术患者医院感染直接经济负担分析

目的调查出血性脑卒中手术患者医院感染直接经济负担。方法对2016年1月1日-2018年12月31日收治在齐鲁医院的出血性脑卒中手术患者开展医院感染目标性监测,收集整理患者的人口学资料、临床病程、医院感染相关信息、住院费用等资料。同时,按照是否发生医院感染作为分组依据,对感染组患者和非感染组患者进行1∶1病例对照匹配,运用秩和检验比较两组患者的住院费用和住院天数。结果本研究共纳入符合条件的出血性脑卒中手术患者531例,187例患者发生医院感染,医院感染率为35.22%。感染组患者住院总费用中位数为125 793.42元,对照组患者住院总费用中位数为80 020.38元,因医院感染所致患者经济负担为45 773.04元(Z=-5.695,P<0.001)。在住院时间上,医院感染组患者住院时间中位数是19.00 d,非医院感染组患者住院时间中位数为12.00 d,患者由于医院感染延长的住院天数为7.00 d,感染组和非感染组住院天数比较,差异具有统计学意义(P<0.001)。结论医院感染会增加出血性脑卒中患者医疗费用,延长住院时间,加重患者经济负担。     

精神病患者医院感染及危险因素分析

目的 应用STAT5．0软件对精神病患者医院感染进行Logistic多因素分析。方法 对我院3年间收治的3169例精神病患者的医院感染及其危险因素进行回顾性分析。结果 精神病患者并发各种感染350例，感染发生率为11．04％以上、呼吸道、下呼吸道感染最为多见，其次为胃肠道感染、皮肤感染、眼结膜感染、泌尿道感染等。结论 单因素分析发现8项因素与感染有关，多因素分析结果表明：实验室检查异常，住院天数＞60d，住院次数＞3次为精神病患者并发医院感染的危险因素。     

医院内尿路感染原因探讨和预防

为探讨医院内尿路感染的规律 ,采取有效预防措施 ,对我院 1998年 1月～ 2 0 0 1年 12月间的 16 2例尿路感染患者进行调查分析。1　资料与方法1.1　临床资料　 16 2例患者 ,男 5 2例 ,女 110例 ,年龄 15～ 89岁 ,平均年龄 6 1.30± 17.6岁 ,其中≥ 6 0岁者 112例 ,占 6 9.14 %。住院时间 12～ 10 5 0天 ,平均 5 6 .0 1天。1.2　方法　采用回顾性调查 16 2例医院内尿路感染患者的年龄、性别、住院天数、是否插管、插管天数、基础疾病等。1.3　诊断标准　依据卫生部医政司医院感染监控协调组修订的医院感染诊断标准[1] 其中的泌尿系统感染诊断…     

肝癌介入化疗患者医院感染风险因素分析与防控对策研究

目的回顾性分析肝癌介入化疗患者医院感染风险因素并研究防控对策。方法选取2013年1月-2016年1月942例肝癌介入化疗患者,回顾性调查一般资料、介入手术情况、医院感染、抗菌药物使用时间、住院时间等,引入多因素Logistic回归模型分析肝癌介入化疗者医院感染风险因素,总结防控对策。结果 942例患者,发生医院感染50例,感染率为5.30%;多因素Logistic回归模型分析,年龄>60岁、糖尿病、白细胞计数<2.5×109/L、白蛋白水平≤30g/L、皮肤或黏膜溃损、侵入性操作、介入手术时间>180min、抗菌药物使用时间≥7天、术中出血量≥500ml、伤口疼痛明显和住院时间≥21天是肝癌介入化疗者医院感染的独立风险因素,差异有统计学意义(P<0.05)。结论不断加强肝癌介入化疗者医院感染风险因素回顾性调查,明确风险,早期改进防控对策能最大程度控制医院感染,提升医院感染管理质量。     

急性心肌梗死急诊冠脉介入术后住院患者医院感染的临床特征

目的探讨急性心肌梗死急诊冠脉介入术后住院患者医院感染的临床特征。方法回顾性调查分析2007年1月-2009年12月225例急性心肌梗死急诊冠脉介入术后住院患者的临床资料。结果急诊冠脉介入术后心肌梗死住院患者感染率为28.44%,感染部位以呼吸道感染多见,占74.99%,其次为消化道,占9.38%,泌尿道感染占9.38%;年龄、住院天数、合并糖尿病、慢性支气管炎、心功能不全(3~4级)、广泛前壁心肌梗死、多支病变是医院感染发生的相关危险因素。结论急性心肌梗死急诊冠脉介入术后住院患者医院感染有一定的发生率,有其临床特征,临床需引起注意,及时预防及治疗医院感染的发生。     

新生儿病房135例医院感染因素分析

目的　了解新生儿病房医院感染的特点及危险因素 ,为医院感染工作提供控制措施。方法　对 2 0 0 2年 1月 1日～ 2 0 0 3年 11月 30日 2 713例新生儿住院患者进行回顾性分析。结果　 2 713例病历中发生医院感染 135例 ,感染率为 4 98% ,感染部位以呼吸道感染为第一位。结论　发生医院感染的因素与患者的住院天数、重症新生儿、使用侵入性操作有关。     

胸心外科住院患者医院感染调查分析

目的　调查某院胸心外科医院感染发病率及相关因素。方法　回顾性分析 1 998年 5月 1日～ 2 0 0 3年4月 30日胸心外科住院的 1 82 3例病例的临床资料。结果　该科 5年医院感染率为 5 .87% ;感染部位以呼吸道和胃肠道为主。年龄≥ 6 0岁 ,住院时间 >3周 ,恶性疾病患者医院感染率明显升高 (P <0 .0 0 5 ) ;手术组与非手术组医院感染率差异无显著性。结论　患者年龄、疾病类型、住院时间等与医院感染的发生密切相关 ,应有针对性地进行重点监控。     

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.     

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.