Direct medical costs of adverse events in Dutch hospitals

Background  

Up to now, costs attributable to adverse events (AEs) and preventable AEs in the Netherlands were unknown. We assessed the total direct medical costs associated with AEs and preventable AEs in Dutch hospitals to gain insight in opportunities for cost savings.     

Histopathological changes in the oesophageal mucosa in Egyptian children with corrosive strictures: A single-centre vast experience

BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus.AIM To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture.METHODS This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia.RESULTS The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance(potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessionswas 37.2 ± 14.9. Histopathological examination of the specimens showed that 85%of patients had evidence of chronic oesophagitis(group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia(group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients(2%)had mild squamous dysplasia(group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine.CONCLUSION The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of postcorrosive oesophageal stricture.     

FC04.6Characterisation of dendritic cell responses to ascaridol, an autoxidation product of tea tree oil

A large number of monoterpenes and their degradation products are likely skin sensitizing agents (Hausen et al., 1999). Terpenes are very common e.g., as constituents of cosmetics, food and other daily used products.
We investigated responses to the endoperoxide 1,4‐epidioxy‐2‐p‐menthen (ascaridol), an autoxidation product of tea tree oil, using monocyte derived dendritic cells (MDDC). Therefore, we isolated peripheral blood mononuclear cells (PBMC) from 9 healthy donors by the standard Ficoll‐Paque gradient centrifugation.
Monocytes were isolated by adherence and incubated in media (RPMI 1640) containing GM‐CSF (800 units/ml), IL‐4 (1000 units/ml) and 10% autologous serum. The immature MDDC (day 6) were characterized by flow cytometry (CD1a+, CD14−, CD40, CD45, CD80, CD83, CD86, HLA‐DR and CCR‐7) and incubated with various concentrations of ascaridol (1–70 μg/ml). After one hour incubation time LPS was added (1 μg/ml) for 23 h. Cell culture supernatants were collected after 24 h for cytokine analysis.
IL‐12p40, IL‐12p70 and prostaglandin E2 were measured by ELISA, TNF‐alpha and IL‐2 were measured by flow cytometry (FACS). Methods of the quantification of steady state mRNA levels were established for IL‐12 and CCR7 (real‐time RT‐PCR). Ascaridol enhanced significantly IL‐12p70 production (120% up to 396%) by MDDC as well as mRNA levels for IL‐12 and CCR7. Moreover, we detected a distinct increase of TNF‐alpha (110% up to 146%) secretion, IL‐2 (135%) and PGE2 (102% up to 155%).
Totally, these results suggest that ascaridol may be a potent modulator of maturation and antigen presenting function of dendritic cells, and we performing further experiments to verify this hypothesis.
This study was supported by the Deutsche Forschungsgemeinschaft.     

Ethmoid sinus disease: CT evaluation in 400 cases. Part II. Postoperative findings

Clinical, pathologic, and computed tomographic (CT) findings were reviewed in 400 patients with ethmoid sinus disease, including 272 who had undergone surgery. The postoperative appearance of ethmoid sinuses on CT scans is a highly neglected subject in radiologic literature. The unique ethmoid anatomy permits a variety of surgical approaches, and radiologists must be familiar with the postoperative appearances if they are to recognize the effects of prior surgery and detect, when possible, the recurrence of disease. It is often difficult to evaluate the clinical significance of soft-tissue disease, despite good clinical correlation.     

The emerging dental workforce: why dentistry? A quantitative study of final year dental students' views on their professional career

Background  

Dental graduates are joining a profession experiencing changes in systems of care, funding and skill mix. Research into the motivation and expectations of the emerging workforce is vital to inform professional and policy decisions. The objective of this research was to investigate final year dental students' perceived motivation for their choice of career in relation to sex, ethnicity and mode of entry.     

Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy,after total knee arthroplasty

Background  

Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty.     

体液中29种中枢神经系统药物的高效毛细管电泳系统分析方法

建立了高效毛细管电泳系统分析法,分析体液样品中29种CNS药物,作为CNS药物中毒的快速的初筛方法。血、尿样品用有机溶剂萃取,胃液直接进样。用酸、弱碱和中性3组缓冲液体系进行电泳分离。以组分与电渗流迁移时间之比的相对迁移时间和紫外吸收光谱为定性指标。最低检测浓度0.5～5μg·mL^-1。在此法基础上可增加分析品种。通用的提取方法可避免漏检,广谱分离条件便于分类,专一分离条件便于定性。本法用于实际中毒样品分析,证实所建方法操作简便、分析时间短、杂质干扰小。     

A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff

BACKGROUND: A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self- service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. STUDY DESIGN AND METHODS: Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. RESULTS: Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. CONCLUSION: The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.     

老年人平衡能力特点及评估

学术背景:平衡能力是人体的一项重要生理机能,在人类生活中有非常重要的意义.特别是老年人平衡能力下降,直接影响老年人独立生活能力,严重的会引起老年人跌倒,诱发其他疾病.目的:总结老年人平衡能力的国内外研究现状,并展望未来老年人平衡能力研究的发展方向.检索策略:应用计算机检索PubMed数据库1990-12/2007-06有关老年人平衡能力方面的文章,检索词“elderly,balance“,限定文章语言种类为English,共检索到208篇文章.同时应用计算机检索中国期刊全文数据库、万方数据库1997-12/2007-06的相关文章,检索词“老年人、平衡能力“,限定文章语言种类为中文,共检索到85篇文章.对资料进行初审,选取符合研究要求的有关文章找全文.纳入标准:①平衡能力的研究.②老年人平衡特征.③平衡能力评价.④运动干预对平衡能力的研究.排除理由:①较陈旧的文献.②重复研究.文献评价:共19个研究满足全部纳入标准,予以纳入.其中6篇为老年人平衡特征的文献、8篇平衡评价的文献、5篇运动干预老年人平衡影响的文献.资料综合:①平衡能力是人体相关系统功能的集中表现,研究影响平衡能力的前庭系统、视觉系统、躯体感觉、神经系统及肌肉-骨骼等系统功能增龄性的变化趋势,探究导致平衡能力增龄性变化的主要因素是待解决的问题.②平衡测试是定量评定平衡能力的前提,针对老年群体的特殊性,逐步寻求安全、简捷能全面反映其平衡能力的测试方法.③国内专业人员日益提高了对平衡的关注,发表的论文也较多,但由于平衡评定方法不统一,对中国人民平衡能力增龄性变化的研究没有继承性,研究国民的平衡能力增龄性变化是必要的.④众多研究表明,体育锻炼可以延缓平衡能力的衰退.但研究比较分散,运动项目比较单一,探究利于干预的运动项目以及最佳时机是待解决的热点课题.结论:建立一整套适合中国国民平衡能力评价体系,研究国民的平衡能力增龄性变化是十分有必要的,为全民健身活动中的老年人科学地进行健身提供依据.