Application of humanistic care to the reengineering of nursing process at maternity hospital

目的 从流程管理入手,探讨保证护理服务与人文关怀有机融合的有效途径.方法 依据卓越护理流程设计的原则、华生人文关怀理论、患者需求、患者权利,对所有直接服务于患者的护理项目中的人文关怀措施进行个性化设计,对设计后的流程试运行3个月,并在实施过程中不断征求患者的意见,定稿后进行培训和执行.结果 流程再造实施后患者对护理服务11项指标评价及舒适达标、护理质量、安全评价显著优于实施前(均P＜0.01).结论 将人文关怀融入各项护理流程再造中,有利于提高护理服务质量和患者满意度.     

俯卧位用于患儿催吐洗胃效果观察

目的 探讨俯卧位催吐在口服中毒患儿洗胃中的应用价值.方法 将30例误服药物患儿随机分为观察组和对照组各15例.观察组采用俯卧位进行反复催吐洗胃,对照组采用常规坐位反复催吐.比较两组催吐成功率、药物残留率、洗胃并发症发生率以及患儿合作情况.结果 除药物残留项外,另3项观察组显著优于对照组(均P＜0.01).结论 俯卧位催吐应用于患儿洗胃效果好,安全,易于被家长及患儿接受.     

Clinical value of Hysteroscopy in the diagnosis of postmenopausal uterine bleeding

目的 研究宫腔镜检查在绝经后子宫出血中的诊断价值.方法 选取2009年1月至2011年2月于本院进行检查的63例绝经后阴道出血患者为研究对象,对其分别采用阴道超声和宫腔镜进行检查,并将检查结果与手术病理确诊结果进行对比.结果 经与最终手术病理检查结果对比发现,宫腔镜检查在各种情况中的确诊率均明显高于经阴道超声检查,差异均有统计学意义(P＜0.05).结论 宫腔镜检查在绝经后子宫出血中的诊断价值较高,优于阴道超声检查,可作为绝经后子宫出血补充诊断方法.     

Evaluación del sistema VIDAS para estudio de marcadores serológicos de infección por el virus Epstein Barr

Enzyme linked fluorescent assays (VIDAS EBV VCA IgM, VIDAS EBV VCA/EA IgG and VIDAS EBV EBNA IgG (Biomérieux, France) were evaluated to determine markers for infection of Epstein Barr virus, as well as to establish antibody profiles, compared with immunofluorescence assays as reference. The assays evaluated showed good values for sensitivity, specificity and agreement, making them useful for their application in clinical laboratories.     

Differences in the causes of death of HIV-positive patients in a cohort study by data sources and coding algorithms

OBJECTIVES:: To compare causes of death (CoDs) from two independent sources: National Basic Death File (NBDF) and deaths reported to the Spanish HIV Research cohort [Cohort de adultos con infección por VIH de la Red de Investigación en SIDA CoRIS)] and compare the two coding algorithms: International Classification of Diseases, 10th revision (ICD-10) and revised version of Coding Causes of Death in HIV (revised CoDe). METHODS:: Between 2004 and 2008, CoDs were obtained from the cohort records (free text, multiple causes) and also from NBDF (ICD-10). CoDs from CoRIS were coded according to ICD-10 and revised CoDe by a panel. Deaths were compared by 13 disease groups: HIV/AIDS, liver diseases, malignancies, infections, cardiovascular, blood disorders, pulmonary, central nervous system, drug use, external, suicide, other causes and ill defined. RESULTS:: There were 160 deaths. Concordance for the 13 groups was observed in 111 (69%) cases for the two sources and in 115 (72%) cases for the two coding algorithms. According to revised CoDe, the commonest CoDs were HIV/AIDS (53%), non-AIDS malignancies (11%) and liver related (9%), these percentages were similar, 57, 10 and 8%, respectively, for NBDF (coded as ICD-10). When using ICD-10 to code deaths in CoRIS, wherein HIV infection was known in everyone, the proportion of non-AIDS malignancies was 13%, liver-related accounted for 3%, while HIV/AIDS reached 70% due to liver-related, infections and ill-defined causes being coded as HIV/AIDS. CONCLUSION:: There is substantial variation in CoDs in HIV-infected persons according to sources and algorithms. ICD-10 in patients known to be HIV-positive overestimates HIV/AIDS-related deaths at the expense of underestimating liver-related diseases, infections and ill defined causes. CoDe seems as the best option for cohort studies.     

Heart Rate Variability in Peritoneal Dialysis Patients: What Is the Role of Residual Renal Function?

Background: The relationship between heart rate variability (HRV) and residual renal function (RRF) has not been elucidated previously. Methods: In this cross-sectional study, HRV was evaluated in 71 peritoneal dialysis patients. Patients were divided into RRF decline group, RRF stable group and anuric group. Results: RRF was negatively correlated with SDNN (r = -0.284, p = 0.017), TP (r = -0.247, p = 0.039), and HF (r = -0.238, p = 0.047). Significant sympathetic nerve activation was found in the RRF decline group (significantly lower SDNN, SDSD, RMSSD, pNN50, LF, HF, TP and higher LF/HF ratio) as compared to the RRF stable and anuric groups. Besides, significantly parasympathetic activation was found in the anuric group (the lowest LF/HF ratio as compared to the other groups (both p < 0.05). Multivariate stepwise regression analysis showed that the status of RRF was an independent factor associated with HRV parameters. Conclusion: This study showed autonomic nervous function in peritoneal dialysis patients was associated with a different status of RRF.     

Novedades en estimulación cardiaca

This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.