宫颈癌根治术后医院感染病原菌及影响因素分析

目的宫颈癌根治术后医院感染病原菌及影响因素分析,为宫颈癌根治术患者术后医院感染的预防提供依据。方法回顾性分析2008年1月-2016年1月医院行宫颈癌根治术的152例宫颈癌患者临床资料,调查患者术后医院感染率,并采用单因素分析及多因素Logistic回归分析探讨宫颈癌根治术术后医院感染病原菌及影响因素。结果 152例患者术后医院感染31例,感染率为20.39%;感染部位主要以泌尿道感染和手术切口感染为主,分别占32.26%、25.81%,31例医院感染患者,共检出病原菌39株,其中革兰阴性菌25株,占64.10%,革兰阳性菌11株,占28.21%,真菌3株,占7.69%;单因素分析以及多因素Logistic回归分析显示,尿管留置时间、年龄、化疗、住院时间以及糖尿病为影响宫颈癌患者术后医院感染的重要因素。结论宫颈癌根治术患者术后医院感染率较高,医院感染的相关因素较多,应引起临床工作者的重视。     

宫颈癌患者根治手术后医院感染相关因素分析

目的结合宫颈癌患者临床资料,对其术后发生医院感染的相关因素进行分析,为预防和控制宫颈癌根治术后感染提供科学依据。方法回顾性分析医院2014年1-12月实施宫颈癌根治手术的348例患者临床资料,调查术后感染率,并采用SPSS17.0软件对其进行单因素分析和多因素logistic回归分析。结果 348例患者术后发生感染52例,感染率为14.94%,且泌尿道和手术部位感染率较高,分别为28.85%和23.08%;高龄、贫血、接受化疗、手术时间及住院时间为术后引发感染的独立危险因素(P<0.01)。结论宫颈癌患者根治手术后感染率较高,引发感染的危险因素较多,高龄、贫血、接受化疗、手术时间和住院时间是导致患者发生术后感染的独立危险因素,应引起重视。     

宫颈癌患者根治术后医院感染的病原菌分布及影响因素分析

目的分析宫颈癌患者根治术后发生医院感染的病原菌分布及引起医院感染的影响因素,为宫颈癌根治术后防治感染提供相关临床依据。方法选取2016年3月-2017年7月医院收治的162例宫颈癌根治术患者,观察和记录患者医院感染率、感染部位分布、病原菌分布等结果,并进行单因素及多因素Logistics回归分析患者术后发生医院感染的影响因素。结果 162例患者术后发生医院感染35例,感染发生率为21.60%,感染部位以手术切口感染为主;35例感染患者共检出病原菌42株,其中革兰阴性菌21株占50.00%;多因素Logistics回归分析结果显示,患者年龄≥60岁、合并糖尿病、住院时间≥14d、引流管放置时间≥7d、导尿管留置时间≥14d、手术路径为开腹手术、接受化疗以及合并贫血状态为宫颈癌患者根治术后发生医院感染的独立影响因素。结论宫颈癌患者根治术后发生医院感染较为常见,感染病原菌以革兰阴性菌为主,引发感染的影响因素较多,要重视并采取针对性措施加强术后感染的防治。     

宫颈癌根治术患者医院感染因素分析

目的分析宫颈癌根治术患者医院感染相关因素及预防对策。方法对2010年5月-2013年5月行宫颈癌根治术的130例患者术后感染进行调查,分析感染的相关因素和预防对策。结果 130例宫颈癌根治术患者中45例发生医院感染,感染率为34.6%;感染部位以深部切口和浅表切口为主,分别占28.8%、26.7%;共检出病原菌28株,其中真菌15株、大肠埃希菌10株、肠球菌属3株;大肠埃希菌对哌拉西林、头孢唑林、头孢呋辛的耐药率分别高达100.0%、100.0%、88.9%,对亚胺培南的耐药率最低为0;术后导尿次数≥2次、并发糖尿病、尿管留置时间≥14d、引流管放置时间≥8d的患者医院感染率较其他组高,并是术后发生医院感染的危险因素,差异有统计学意义(P<0.05)。结论为减少医院感染发生,除了要严格进行无菌操作和加强术后切口引流之外,护士遵医嘱合理正确应用抗菌药物、各项护理操作严格执行手卫生、防止医源性感染是预防患者医院感染的一个重要环节。     

胃癌根治术后腹腔淋巴漏合并腹腔感染的影响因素

目的探讨影响胃癌根治术后腹腔淋巴漏并腹腔感染的相关因素,并探讨护理方法,以降低感染的发生。方法采用回顾性方法对医院2011年2月-2012年2月280例胃癌根治术患者的临床资料进行分析,其中感染12例,为感染组,另268例未感染者为对照组,对两组患者进行对比分析;采取SPSS18.0软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验,因素的相关性采取logistic回归分析。结果 280例胃癌根治手术患者术后发生腹腔淋巴漏并腹腔感染12例,感染率为4.3%;相关因素分析显示,贫血、低蛋白血症和临床分期与手术方式均为影响胃癌根治术后腹腔淋巴漏并腹腔感染的相关因素(P<0.05),经多因素logistic回归分析,临床分期和手术方式均为胃癌根治术后腹腔淋巴漏并腹腔感染的独立危险因素。结论胃癌根治术后发生腹腔淋巴漏并腹腔感染的原因较多,临床中应合理选取手术方法,并加强针对性的护理,降低感染的发生。     

非小细胞肺癌脑转移患者手术治疗医院感染相关因素分析

目的探讨非小细胞肺癌脑转移患者手术治疗术后医院感染相关危险因素,为降低医院感染率提供依据。方法回顾性分析2010年1月-2014年6月收治的635例非小细胞肺癌脑转移患者临床资料,并分析患者术后感染相关因素与医院感染的相关性。结果 635例非小细胞肺癌脑转移患者发生医院感染80例,感染率为12.60%;感染部位主要以颅内、呼吸道、皮下、泌尿系统为主,其中最易感染部位为颅内感染,占45.00%,其次为呼吸道感染占26.25%、皮下感染占10.00%及泌尿系统占18.75%;后颅窝手术、手术时间、开放性颅脑损伤、拔管时间、置入植入物、脑脊液漏是非小细胞肺癌脑转移手术治疗患者发生医院感染的危险因素(P<0.05);logistic回归分析发现,后颅窝手术、开放性颅脑损伤、脑脊液漏等因素是发生医院感染的独立危险因素(P<0.05)。结论影响非小细胞肺癌脑转移手术治疗患者术后医院感染因素较多,应根据相关危险因素采取对应措施,预防与降低脑部术后感染率。     

胃癌根治术后淋巴漏并腹腔感染的相关因素分析

目的分析胃癌根治术后淋巴漏并腹腔感染的发生、相关危险因素,并探讨临床预防治疗术后淋巴漏并腹腔感染的措施。方法回顾性分析2009年1月-2013年8月行胃癌根治术的637例患者临床资料,将患者分为淋巴漏组38例和非淋巴漏组599例,组间一般资料差异比较采用t、χ2检验,术后淋巴漏并腹腔感染的相关危险因素采用多因素logistic回归分析。结果 637例患者中发生淋巴漏并腹腔感染38例,感染率为5.97%;淋巴漏组与非淋巴漏组TNM分期、手术方式、手术时间比较,差异均有统计学意义(P<0.05),多因素logistic分析显示,TNM分期(OR=2.371)、手术方式(OR=4.167)是胃癌根治术后腹腔淋巴漏并腹腔感染的独立危险因素;35例淋巴漏并腹腔感染患者经保守治疗后治愈,1例死于重症感染。结论胃癌根治术后腹腔淋巴漏并腹腔感染与肿瘤TNM分期及手术方式密切相关,应在术中注意预防;术后充分引流和保守治疗效果良好。     

股骨头坏死关节置换术后医院感染的临床特征分析

目的探究股骨头坏死关节置换术后医院感染的临床特点。方法选择2013年8月-2017年6月在医院治疗的单侧股骨头坏死患者473例,对股骨头坏死关节置换术后医院感染患者的标本进行细菌培养分离。分别给予单因素和多因素Logistic回归模型分析。结果 473例股骨头坏死关节置换术后发生23例次感染,例次感染率占4.86%。下呼吸道感染,占47.83%,为主要感染部位;共培养分离出49株病原菌,以革兰阳性菌为主导,33株,占67.35%,革兰阴性菌14株,占28.57%;相关基础疾病≥3种、既往手术史、手术时间>3h、抗菌药物使用≥3种及住院时间≥7d是导致股骨头坏死关节置换术后患者发生医院感染的相关独立影响因素(P<0.05)。结论股骨头坏死关节置换术的患者术后医院感染率相对较高,要依据患者医院感染的病原菌特点及导致感染的危险因素,给予患者合理的预防措施。     

宫颈癌根治术患者医院感染相关因素分析

目的 分析宫颈癌根治术后患者医院感染的状况、特点、病原菌分布及其耐药性,探究其预防措施.方法 对2009年10月-2010年9月在医院行宫颈癌根治术患者120例进行医院感染相关因素调查分析.结果 120例宫颈癌根治术患者发生医院感染40例次,例次感染率为33.3％;手术部位感染最多见,占52.5％,其次为消化道感染,占27.5％;检出病原菌24株,以真菌(12株)占首位,其次为大肠埃希菌(9株);大肠埃希菌对亚胺培南的耐药率为0,对头孢他啶、头孢吡肟、阿米卡星耐药率分别为12.5％、12.5％、12.5％.结论 为减少医院感染的发生,除应严格无菌技术操作及加强术后切口的引流外,合理使用抗菌药物是预防医院感染的重要环节.     

全麻术后患者呼吸系统医院感染临床特点及影响因素分析

目的探讨气管插管全麻手术后患者呼吸系统医院感染临床特点及影响因素,为降低感染提供依据。方法收集2011年6月-2014年6月行气管插管全麻手术的1 200例患者临床资料,记录患者医院感染率,并对病原菌种类、影响感染的危险因素进行分析。结果 1 200例气管插管全麻手术患者术后发生呼吸系统感染42例,感染率3.50%;其中上呼吸道感染13例占30.95%、下呼吸道感染29例占69.05%;共检出病原菌58株,其中革兰阳性菌34株占58.63%、革兰阴性菌19株占32.75%、真菌5株占8.62%;单因素分析显示,年龄大、全麻时间长、术后导管留置时间长、具有吸烟史、无手术镇痛以及神经系统手术患者呼吸系统医院感染率越高,差异有统计学意义(P<0.05);多因素分析结果显示,无术后镇痛患者医院感染率显著升高,全麻时间长、导管留置时间长、年龄大,发生呼吸系统医院感染的风险越高,差异有统计学意义(P<0.05)。结论气管插管全麻患者呼吸系统医院感染的主要病原菌为革兰阳性菌,无术后镇痛、全麻时间长、导管留置时间长、年龄大是导致感染的独立危险因素。     

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.