Tuberculosis in female nurses in British Columbia: implications for control programs.

All 57 cases of active tuberculosis in women in nursing and related assisting occupations (henceforth called nurses) notified in British Columbia between 1969 and 1979 were reviewed. This represented a mean annual incidence of active tuberculosis of 2.6/10 000, similar to that in other women, adjusted for age and birthplace. The rate varied according to birthplace: among nurses born in Canada the rate was 2.0, almost twice that of other women born in Canada, and among those born in Asia it was 24.8, less than half that of other women born in Asia. The nurses born in Canada who had received BCG (bacille Calmette-Guérin) during their training were least likely to contract tuberculosis, the incidence rate being comparable to that among other women. Those whose results of tuberculin testing were negative but who were not vaccinated were twice as likely to contract tuberculosis, whereas those whose results were positive at the start of training were four times as likely to contract tuberculosis. The feasibility and implications of a tuberculosis screening and surveillance program are discussed.     

Attitudes of Hungarian students and nurses to physician assisted suicide

In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide (PAS) and euthanasia are punishable criminal acts. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, nurses and social science students in Hungary towards PAS, using a twelve item scale: the total number of participants was 242. Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.     

护生临床实习中存在的问题及对策

本文通过总结近3年来在我院临床实习护生中存在的问题,提出了相应的解决对策,以期提高多轨道、多层次护生在同一环境临床实习的质量,培养适应社会需求的护理人才,从而提高护理教育水平,推动护士队伍整体水平的提高。     

护生临床实习中存在的问题及对策

本文通过总结近3年来在我院；临床实习护生中存在的问题，提出了相应的解决对策，以期提高多轨道、多层次护生在同一环境临床实习的质量，培养适应社会需求的护理人才．从而提高护理教育水平．推动护士队伍整体水平的提高。     

男护士需求与护理本科男生就业取向调查

目的：调查男护士需求与护理本科男生就业取向,为医院及医学院校男护士招收、培养提供依据。方法2013年5月-2014年1月随机抽取川北医学院5家实习医院（川北医学院附属医院、南充市中心医院、绵阳四〇四医院、广安市人民医院、遂宁市人民医院）的医生、护士、患者、患者家属及实习男护生共325名作为研究对象,通过问卷及访谈方式进行调查,一方面调查不同人群对男护士的需求及男护士在护理工作中的优势,另一方面调查男护生的就业去向及影响他们就业取向的因素。结果82%的医生、92%的护士、76%的患者、73%的患者家属认为医院护理工作非常需要和需要男护士加入,且男护士在工作中占有较多优势,发挥着重要的作用,但受到传统观念、社会舆论、工作性质及社会地位等因素的影响,导致不少男护生就业取向受到影响,毕业后不愿选择当护士或从事护理工作。结论男护士在护理行业中发挥着极其重要的作用,加强男护士的培养势在必行。     

支气管结核与肺结核患者临床特征分析

目的总结支气管结核的临床特征,以期提高诊断水平。方法对36例支气管结核患者与30例肺结核患者的发病年龄、性别、临床表现、X线胸片及痰涂片抗酸杆菌结果进行卡方检验。结果2组患者发病年龄≥60岁者差异无统计学意义。支气管结核多见于女性,其主要症状为咳嗽、发热、胸闷。X线胸片特点:片状影多于小斑片影,22.2%的患者胸片正常,病灶部位右肺多于左肺。痰涂片抗酸杆菌均呈阴性,支气管刷检全部为阳性。肺结核主要症状为咯血,胸片均有阴影,以小斑片影为主,病灶部位以左肺多见,痰涂片抗酸杆菌全部呈阳性。36例支气管结核患者镜下显示炎症浸润型占38.9%、干酪坏死型占33.3%、瘢痕狭窄型占19.4%、肉芽增殖型占8.3%。结论支气管结核好发于女性,胸片影像无特征,22.2%的患者胸片无异常,病灶右肺多于左肺。镜下病变以炎症浸润和干酪坏死型为主。支气管镜刷检是诊断支气管结核的最重要方法之一。     

Tuberculosis Drug Resistance and Outcomes among Tuberculosis Inpatients in Lilongwe,Malawi

Setting/Objective

We evaluated clinical characteristics, yield of solid vs. liquid culture, polymerase chain reaction (PCR)-based drug-resistance profiles, and clinical outcomes of tuberculosis (TB) inpatients in Lilongwe, Malawi.

Design

We enrolled adult patients admitted to the Bwaila TB Ward from Jan-Aug/2010. Evaluations included questionnaires, clinical exam, chest radiograph, HIV status, CD4 lymphocyte count, plasma HIVRNA and sputum analysis including Auramine-O stain, Lowenstein-Jensen (LJ) and Mycobacterial Growth Indicator Tube (MGIT) culture, and susceptibility testing using the HAIN GenoType® MTBDRplus.

Results

Eighty-eight patients were enrolled (88% re-treatment, 42% smear positive, 93% pulmonary TB, 74% HIV co-infected). At baseline, 44/88 (50%) MGIT and 28 (32%) LJ cultures were positive with a mean time to positivity of 12.1 (Range 1–42) and 21.5 (Range 7–58) days, respectively. Four percent (3/77) of retreatment patients or 8% of the 38 MGIT+ PCR-confirmed retreatment cases had multi-drug resistant tuberculosis (MDR TB). One MDR TB patient was smear negative and only one MDR patient was identified with LJ. Lower mean hemoglobin at admission was associated with mortality (10.5 vs. 7.5; p<0.01; CI 101 9.8–11.0).

Conclusions

The MDR TB burden among the retreatment population in Lilongwe, Malawi is similar to regional estimates by the WHO (7.7% 95% CI 0–18.1). MDR TB patients are not routinely identified with sputum smear or LJ, suggesting more efficient technology should be adopted.