Disabling neurological syndromes: prevalence amongst hospitalized neurological patients

Neurological patient populations are usually described by diagnosis or in terms of functional disability measures but rarely by their clinical syndromes. A point-prevalence study was conducted assessing 349 neurological inpatients to determine the frequency and co-occurrence of disabling neurological syndromes, considering a wider spectrum including pain, emotional, neuropsychological, vegetative and sensorimotor syndromes. Of the study patients, 61% ( n  = 224) had sensorimotor syndromes, 53% ( n  = 185) had neuropsychological disorders, 40% ( n  = 139) of the patients suffered from pain, emotional disorders were found in 36% ( n  = 122) and vegetative disorders in 33% ( n  = 113). Although frequency varied by neurological diagnosis, these disabling conditions were found across all inpatient groups of diagnosis. Similarly, disorders outside the motor domains grouped according to their Barthel Index showed a striking frequency in patients considered as activities of daily living independent, reflecting a wider spectrum of disability that functional measures are not able to capture. Of the study population, 68% ( n  = 237) suffered from co-occurring disorders from different categories (pain, emotional, neuropsychological, vegetative and sensorimotor syndromes). There is a high prevalence and co-occurrence of disabling syndromes in neurological inpatients. These proportions reflect the neurological workload in a patient population and should be considered in future rehabilitation research and allocation of resources.     

Effects of cognitive remediation therapy versus other interventions on cognitive functioning in schizophrenia inpatients

Computerised cognitive remediation therapy (CCRT) has been shown to improve cognitive function in individuals with schizophrenia beyond effects of other forms of therapy. However, results vary between studies, and most are aimed at individuals who are living in the community. Very few studies have investigated its efficacy in psychiatric wards in order to assess whether or not this is a suitable site to start the therapy. This study evaluated CCRT efficacy among schizophrenia inpatients who received a broad range of therapeutic interventions in a psychiatric ward. A randomised controlled trial of CCRT versus an active control in 66 young inpatients with a diagnosis of schizophrenia was conducted. The intervention lasted for 6 weeks and its efficacy was assessed with the composite score of the MATRICS Consensus Cognitive Battery. Both groups improved similarly in cognitive function and psychopathological symptoms. However, the CCRT group improved more than the controls in negative symptoms. This result shows that providing a drill and practice cognitive remediation to inpatients does not produce benefits for cognitive functioning substantially greater than other forms of therapy provided in a ward, but it is more efficient in reduction of negative symptoms. Our results suggest that CRT might be considered as a promising intervention for reducing negative symptoms in schizophrenia individuals.     

某院住院病人抗微生物药物应用分析

【目的】了解本院住院病人抗微生物药物应用情况,分析用药的合理性,为临床合理用药提供参考。【方法】从本院药品管理系统提取2008年度住院病人用药信息数据,应用限定日剂量法分析抗微生物药物的使用情况,采用Excel进行统计分析。【结果】本院住院病人抗微生物药物的应用中,注射剂品种占到近50％;医保药品品种占到87．91％;最常用的抗微生物药物分别是头孢菌素类、大环内酯类、青霉素类、喹诺酮类。【结论】本院住院病人抗微生物药物用药结构相对合理,并逐步规范化,但仍存在问题,应进一步规范抗菌药物的应用,使用药更加安全、有效、经济。     

Traumatic visual loss of inpatients in Yazd, Iran from 2005 to 2006

AIM: To investigate the conditions of traumatic visual loss of inpatients in Yazd, Iran from 2005 to 2006, and to explore the possible causes and preventive methods. METHODS: We retrospectively analyzed data on all patients with eye injuries (70 cases) hospitalized at Shahid Sadoughi Hospital between August 2005 and August 2006, including age, gender, causes, type of injury, time of initial treatment, visual acuity during admission and discharge, surgical procedures, and final outcome. Furthermore, standardized international classification of ocular trauma (Birmingham Eye Trauma Terminology) was used for eye injury categorization. · RESULTS: A total of 70 inpatients with ocular injuries were selected by simple approach. The male/female ratio was 2.8 to 1. The most frequent causes of eye injury were metallic objects (34.3%) especially in age group of ≤10 and ≥30 years old, accidents (22.8%) and assaults (17.2%). Waiting time to initial treatment was 6-24 hours in most cases (51.4%). Trauma was blunt in 38.6% and penetrating in 61.4%. The most and the least final visual acuity in blunt and penetrating trauma was LP (51.8%, 41.8%) and HM (7.5%, 4.7%) respectively. Surgery outcome was globe saving with acceptable visual acuity in 72.9% and enucleation in 24.2%. CONCLUSION: With regard to the high incidence of ocular trauma and consequent severe visual loss, parents' attention, eye safety protection and early treatment should be considered as final preserving globe in most accidents.     

对住院老年高血压患者实施健康教育路径的效果观察

目的 探讨健康教育路径在住院老年高血压患者中的实施效果.方法 随机将200例住院老年高血压患者分为观察组和对照组各100例,对照组采用一般常规宣教,对观察组患者根据健康教育路径图实施健康教育.并对两组患者进行书面测试、自我护理操作考核、服药依从性、血压的控制等方面的比较.结果 观察组患者书面测试、自我护理操作考核及护理满意度得分明显高于对照组,差异有显著性(P<0.001);观察组患者服药依从性、血压的控制率及健康教育达标率明显高于对照组,差异有显著性(P<0.005).结论 实施健康教育路径能够提高患者对高血压健康教育知识及服药依从性,从而使患者的血压得到有效的控制,减少患者的并发症,同时促进了护患沟通,提高了患者及家属对护理工作的满意度,获得良好的护理效果.     

精神科住院患者HBV感染状况调查

为探讨精神科住院患者乙肝病毒(HBV)感染状况,为防治HBV的院内感染提供参考依据,采用酶联免疫吸附试验(ELISA)对1295例住院精神病患者进行血清HBV标志物检测。结果,血清HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc五顶HBV标志物阳性率分别为8.80％、30.81％、2.78％、21.54％、15.29％,HBV总感染率为43.63％,565例阳性标本检出HBV感染模式15种,HBsAg( )、抗-HBs(-)、HBeAg(-)、抗-HBe( )、抗-HBc( )(小三阳)占12.21％,HBsAg( )、抗-HBsAg( )、抗-HBe(-)、抗HBc( )(大三阳)占5.84％。提示,精神科住院患者中存在HBV传染源,病区应加强监测、隔离、消毒等综合性措施,预防住院患者HBV的院内感染。     

原发性肝癌患者1838例预后因素分析

摘 要：［目的］ 探讨影响肝癌患者预后的相关因素,为临床治疗和肝癌预防提供参考依据。［方法］ 选择1989年11月至2007年1月我院的1838例肝癌住院病例的临床及随访资料进行分析,分析筛选影响患者生存期的相关因素。［结果］ 肝癌住院患者1、3、5、10年生存率分别为52%、26%、17%和8%,中位生存期14个月,最长生存期190个月。Cox比例风险回归模型进行多因素分析显示性别、AFP、临床分期、大体分类、组织学分型、治疗方法不同的肝癌病例的生存率差异均有统计学意义(P<0.05)。 ［结论］ 性别、术前AFP量、临床分期、大体分类、组织学分型以及治疗方法对肝癌的预后生存期有显著性影响。     

老年住院病人健康知识掌握程度与生活质量的相关性

目的了解内科老年住院病人健康知识掌握程度对生活质量的影响,为做好内科老年住院病人的护理工作和提高他们的生活质量,提供科学合理的指导方法。方法青州市人民医院2008年1月—2009年3月期间因心血管疾病住院的、意识清晰、具有良好口头表达能力、且愿意接受问卷调查的156位老年人为研究对象,用健康知识掌握程度问卷和李凌江与杨德森[1]编制的生活质量综合评定问卷对本组病人进行问卷调查,采集数据,进行统计学处理。结果健康知识掌握程度与性别、年龄、婚姻状况无关,与受教育程度高低呈正相关(r=0.206,P0.05);健康知识掌握程度与生活质量呈显著正相关(r=0.215,P0.05)。结论健康知识的掌握程度影响老年内科住院病人的生活质量。根据现有的护理现状,应采用多种方式相结合的健康指导形式,提高病人对健康知识的掌握程度,提高老人的生活质量。