临夏回族自治州34302份急诊病历初步分析

目的 初步分析临夏回族自治州医院(简称临夏州医院)急诊科患者的各类疾病特点.方法 对临夏州医院34 302份急诊病案进行回顾性调查分析.结果 外伤和中毒、消化系统疾病、呼吸系统疾病是急诊科的前3位疾病;急诊病人男性多于女性:急诊病人平均年龄34.79岁,其中9类疾病以19～35岁年龄组病人最多,9类疾痛以11岁以下年龄组病人最多.结论 ①高发疾病应做重点预防;②加强男性医疗保健;③急诊疾病具有年龄特点.     

上海市西南地区急诊患者的流行病学调查分析

目的研究上海市西南地区急诊患者的流行病学特点.方法对2004年1月1日～2004年12月31日本院急诊患者的性别、年龄、就诊科别、月分布、就诊时间、初复诊比例、急诊诊断或主诉等进行统计分析.结果全年急诊病人中男女比例为11.21.76232人次中,高发年龄组为20～29岁(17.04%)、30～39岁(13.25%)、40～49岁(14.99%)、50～59岁(14.27%)四个组.7、8、9月份就诊患者最多.全年每天就诊高峰时间为1830～2300(49.28%).报告了除外伤、发热外20种急诊诊断或主诉.结论重视中老年人的健康问题,加强预防保健为主的观念.重视男性健康和安全防范教育.根据急诊患者就诊密度,科学合理地安排急诊工作,为急诊科医护人员的培训和配备提供依据.     

综合性医院急诊收住院患者流行病学研究

目的研究综合性医院急诊收住院患者流行病学特点.方法采用前瞻性资料收集的方法,对2003年1月1日至2003年12月31日间我院急诊并收住院患者的性别、年龄、收住院时间、就诊方式、住院科别或系统、急诊诊断或主诉等项目进行调查统计分析.结果全年有10 221例急诊收住院患者,占全年急诊科实际来诊患者的17.39%.收入院患者中男女比例为1.63:1.高发年龄组为20～29岁、30～39岁2个组.每天11:00～14:00、19:00～23:00两个时间段出现急诊收住院高峰,分别占全天急诊收住院病人的20.65%、23.38%.利用出租车或小车来诊者占49.61%,利用市"120'"急救中心或医院救护车来诊者占38.83%.收住院者以外科系统最多,其次为内科系统,第三为儿科.创伤、消化系统疾病、心血管系统疾病、神经系统疾病是急诊收住院病人的前4位系统或大类疾病.前5位具体疾病谱为四肢或身体未特指部位损伤、颅脑损伤、冠心病心绞痛或心梗、脑梗塞、高血压病或高血压急症.创伤占外科急诊收住院病人的81.13%.由其他医院转诊的占29.27%.结论急诊病人是医院住院病人的主要来源;要加强对男性的健康宣教和医疗保健工作,提高医疗质量;要根据急诊收住院病人高峰时间科学合理安排病房和急诊科工作;要重视院前急救与转运工作;系统大类疾病和疾病谱的排序对医院各学科建设有重要参考价值.     

教学医院急诊日夜就诊病例分析

目的探讨急诊就诊患者在不同时段的就诊规律,为急诊科管理提供依据。方法收集门急诊就诊信息系统2009年10月1日-2010年4月30日急诊病例资料。采用多阶段随机抽样方法,共抽取7634份急诊病例资料。结果急诊患者中男性多于女性,急诊儿科中位年龄3岁,急诊内科、急诊外科中位年龄32岁。就诊科别以急诊儿科患者占多数。费用类别以自费患者为主。16：00-〈0HD：00时上夜班为就诊高峰时段,在高峰时段．急诊儿科、医疗保险患者增加较明显,但疾病轻重分级以4级及5级轻症病例为主。结论在就诊高峰时段,要相应调整排班．加强导诊和分诊．可缓解急诊科拥挤现象。学科建设中要加强急诊儿科医师的培养。     

3707例急诊收住院患者的疾病分类特点

目的了解延边大学附属医院急诊收住院患者的疾病分类特点,为医疗工作提供依据。方法采用回顾性调查方法,对医院急诊住院患者的性别、年龄、民族、收住时间、急诊诊断或主诉等项目进行统计分析。结果全年急诊收住患者3707人次,占全部急诊病人的3.89%,占全年总住院人数的18.98%;收住患者中男女性别构成差异有显著性,朝汉民族构成差异无显著性;平均年龄38.77±17.53岁,以≤10岁、21～30岁、41～50岁三个年龄组段最多;全天收住时间以4:00～6:00最少,9:00～11:00出现高峰。系统或大类疾病中,以损伤和中毒为最多,其次为消化系统疾病,神经系统疾病占第3位;前5位的疾病谱为肢体或身体未特指部位损伤、急性化脓性坏疽性阑尾炎、脑出血、颅脑损伤、脑梗死。结论以疾病大类作为参考,结合实际,确立各科室的学科建设发展方向,既要不断提高专科常见病、多发病的诊治水平,又要调整、明确主攻方向,不断创新,做到科有特色、人有专长;加强对少数民族地区的健康宣教和医疗保健工作,提高医疗质量;根据急诊病人的就诊高峰时间,科学合理安排急诊及病区工作。     

安阳市32 457例急诊成年病例流行病学特征及转归分析

目的 探讨急诊成年病例流行病学特征及转归情况。方法 采用回顾性分析方法对2016年1月1日至2020年12月31日安阳市某医院急诊科接诊的成年病历资料。结果 2016年1月1日至2020年12月31日安阳市某医院急诊科共接诊32 457例成年患者,2016年6 785例,2017年6 854例,2018年6 866例,2019年6 521例,2020年5 431例,2016—2019年的病例数大致平稳,2020年病例数较少。男性17 195例,占52.98%,女性15 263例,占47.03 %。60~74岁患者比例最高,占36.95%。就诊病例中冬季就诊例数最多,占30.34%,18：00~23：59就诊病例比例最高,占30.86%,就诊成年病例中脑血管疾病、心血管疾病、呼吸系统疾病、消化系统疾病及泌尿系统疾病是排列前5位的疾病,就诊病例中有79.16%的患者在急诊滞留<6 h妥善安排,95.27%的患者在急诊滞留<24 h妥善安排。结论 安阳地区近5年的急诊成年病例男性比例高于女性,且多以60岁以上的老年患者为主,冬秋季、晚上是急诊接诊的高峰阶段,心脑血管疾病就诊的患者比例最高,仍有部分患者急诊滞留时间过长。因此仍需合理安排人力、物力资源,提高急诊医疗水平。     

急诊患者在不同季节中的病种的分析研究

目的 探讨急诊患者在不同季节病种构成及分布规律.方法 对我院急诊科2009年至2010年就诊的5201例病例进行回顾性分析.结果 4个季度的就诊率中第一季度占比例最高;其中就诊最高的病种是外伤和中毒,占33.88%,其次是呼吸系统疾病,消化系统疾病位于第3位.结论 根据不同季节疾病的分布特点,急诊科医务工作者要做好合理的安排和准备,以提高急诊诊断的准确卒和抢救的成功率.     

电子分诊叫号系统在急诊分诊中的应用

目的为了改善医院急诊科的就医环境,提高急诊护士的分诊工作效率和病人的满意度。方法在急诊科应用电子分诊叫号系统为急诊护士分诊病人提供帮助。结果使急诊病人候诊秩序得到改善,实现了在挂号时设置专科的诊别状态,将病人的分诊等级、隶属专科资料信息对应到相应的诊室,这样可以在诊室由专科医生直接呼叫病人就诊,又可以在分诊台护士呼叫病人就诊,同时还在候诊区域设置大的显示屏幕显示候诊病人数、播放背景音乐,急诊病人在候诊时能一目了然、舒缓情绪。结论改变了原有的急诊分诊工作模式,减轻了护士工作压力,提高了护理工作效率及质量,提高了医院的服务质量,缩短了急诊病人的候诊时间,改善了就诊环境及就诊秩序,提高了病人满意度,受到医、护、患三方的欢迎。     

电子分诊叫号系统在急诊分诊中的应用

目的为了改善医院急诊科的就医环境,提高急诊护士的分诊工作效率和病人的满意度。方法在急诊科应用电子分诊叫号系统为急诊护士分诊病人提供帮助。结果使急诊病人候诊秩序得到改善,实现了在挂号时设置专科的诊别状态．将病人的分诊等级、隶属专科资料信息对应到相应的诊室,这样可以在诊室由专科医生直接呼叫病人就诊,又可以在分诊台护士呼叫病人就诊,同时还在候诊区域设置大的显示屏幕显示候诊病人数、播放背景音乐,急诊病人在候诊时能一目了然、舒缓情绪。结论改变了原有的急诊分诊工作模式,减轻了护士工作压力,提高了护理工作效率及质量,提高了医院的服务质量,缩短了急诊病人的候诊时间,改善了就诊环境及就诊秩序,提高了病人满意度。受到医、护、患三方的欢迎。     

10 506例次急诊发热患者流行病学调查研究

目的 研究综合性医院急诊发热患者流行病学特点.方法 采用前瞻性资料收集2003年度到医院急诊体温≥38℃发热患者的性别、年龄、就诊时间、急诊诊断、去向等进行调查统计分析.结果 共收到10 506份调查表,男女比例为1.23∶1,年龄(15.20±17.18)岁,高发年龄组为0～9岁组,SARS期间患者最多,每天1800-2200为来诊高峰时间,前3位疾病是上呼吸道感染、支气管炎、咽喉炎、扁桃体炎;住院和急诊留观率12.2%.结论 急诊科和发热门诊是防控传染病和医院感染管理的重点科室,是发热监测的重要窗口,要有疫情应急预案.     

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.