Compliance with monitoring standards for anaesthesia in Malaysian hospitals

The Malaysian Society of Anaesthesiologists published a document entitled "Recommendations for Standards of Monitoring during Anaesthesia and Recovery" in 1993. This paper examines the results of two surveys, carried out in 1995 and 1996 respectively; to determine compliance with published Monitoring Standards in Malaysian public and private hospitals. In the private sector, compliance with the recommended standards during anaesthesia varied greatly. Of the 28 government hospitals surveyed in 1996, compliance with monitoring standards during anaesthesia was almost 100%. Standards in recovery areas were less than ideal. The majority of anaesthesiologists thought that the current recommended standards were adequate.     

重症监护病房新生儿死亡病例分析

目的探讨新生儿重症监护病房（NICU）新生儿死亡的危险因素及变迁。方法回顾性分析我院NICU 2004年1月—2009年12月期间死亡的129例患儿的病历资料,筛选死亡危险因素。结果体重〈1.5 kg新生儿年均病死率9.2%;胎龄≤32周早产儿年均病死率为9.4%;死亡新生儿中出生48 h内病死率达34.9%.2004年—2009年新生儿直接死亡原因排序依次为感染性疾病、窒息及其并发症、先天性畸形、其他疾病。结论胎龄小、出生体重低及母亲高龄始终是新生儿死亡的高危因素,死亡高危时段在出生后48 h内。感染性疾病、窒息及其并发症是最主要的直接死因,先天性畸形致死率增高,疾病谱有扩大趋势。     

新生儿围手术期护理体会

新生儿在解剖和生理上的特点与成人及儿童存在较大的差异，新生儿围手术期护理，必须根据新生儿的解剖、生理特点，加强生命体征的监测和护理，维持水、电解质、酸碱平衡，注意安全，加强术前及术后家长心理支持及健康教育，更好地发现患儿病情变化，更及时、有效地施行护理措施，对减少围手术期并发症，降低死亡率，提高治愈率有重要意义。     

新生儿重症监护病房中新生儿真菌败血症的临床特点

目的:探讨新生儿真菌败血症的临床特点,并与新生儿细菌败血症的临床特点进行比较,提高对新生儿真菌败血症的认识.方法:选取2011-2016年北京大学第一医院新生儿重症监护病房中收治的新生儿真菌败血症患儿的临床资料进行回顾性分析,同时选取同期住院的新生儿细菌败血症患儿,对两组患儿的临床特点进行比较.结果:共纳入新生儿真菌败血症患儿15例,真菌败血症发生情况为0.52％,极低出生体重儿为2.5％.临床表现非特异,所有患儿应用肠外营养、广谱抗生素,13例患儿留置外周放置中心静脉导管(peripheral inserted central venous catheter,PICC).病原学分析显示,光滑假丝酵母菌(Candida glabrata)占第一位,对二性霉素B均敏感,一株光滑假丝酵母菌对氟康唑耐药.与同期34例新生儿细菌败血症患儿比较,真菌败血症组的血小板计数明显低于细菌败血症组(61×109/L vs.178×109/L,P=0.004),血小板下降比例明显高于细菌败血症组(80.0％vs.29.4％,P=0.001),留置PICC比例高于细菌败血症组(86.7％vs.55.7％,P=0.037).受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析发现,以血小板计数145×109/L为界值时,预测新生儿真菌败血症的敏感度和特异度分别为61.8％和92.9％.经规范的抗真菌治疗后,真菌败血症患儿均治愈,血小板恢复正常,肝、肾功能未见明显变化.结论:新生儿真菌败血症的临床表现呈非特异性,病原以光滑假丝酵母菌占第一位,给予规范治疗疗效较好,血小板降低和留置PICC可能提示真菌感染.     

Commercial filming of patient care activities in hospitals

Commercial filming of patient care activities is common in hospitalsettings. This article reviews common circumstances in which patients arecommercially filmed, explores the potential positive and negative aspectsof filming, and considers the ethical and legal issues associated with commercialfilming of patients in hospital settings. We examine the competing goals ofcommercial filming and the duties of journalists vs the rights of patientsto privacy. Current standards and recommendations for commercial filming ofpatient care activities are reviewed and additional recommendations are offered.