A cross sectional study of maternal iron status of Korean women during pregnancy

The purpose of this study was to determine the iron status of Korean women during pregnancy and to assess the relationship between maternal iron status and the outcome of their newborns. A total of eighty-one pregnant women living in Gwangju, Korea, participated in the study: 26 women were in the first trimester, 23 in the second trimester, and 32 in the third trimester. Maternal red blood cell (RBC) number, hemoglobin (Hb) concentration, and serum iron and ferritin levels were reduced significantly in the last trimester (p < 0.05) compared to the findings both in the first and second trimesters. On the other hand, total iron binding capacity (TIBC), transferrin level, and the ratio of sTfR to ferritin in the third trimester were higher (p < 0.05) than those both in the first and second trimesters. Dietary intake of iron in the three trimesters was 9.7 ± 2.3, 13.3 ± 4.3, and 10.6 ± 2.5 mg/day, respectively. All were far below the Korean Recommended Dietary Allowances (RDA) of iron for pregnant women. Approximately, ninety percent of the subjects consumed iron supplements after the 20th week of their pregnancies until delivery. The supplemental iron intake in the second and third trimesters was 40 ± 12 and 46 ± 11 mg/day, respectively. There was a significant correlation between the maternal Hb level in the third trimester and the birth weight of infants. In conclusion, maternal iron status deteriorated during pregnancy, although most subjects consumed more than the RDA of iron by taking iron supplements after the 20th week of pregnancy. The results confirm that maternal iron deficiency during pregnancy negatively affects the outcome of newborns.     

重症监护病房中耐甲氧西林金葡菌的流行

目的调查耐甲氧西林金黄色葡萄球菌（ＭＲＳＡ）在重症监护病房（ＩＣＵ）的流行情况。方法将临床分离２８株ＭＲＳＡ包埋于琼脂块中，原位溶解细菌，ＳｍａⅠ消化染色体ＤＮＡ，经脉冲场凝胶电泳（ＰＦＧＥ）分离，比较染色体限制性内切酶图谱，确定菌株的亲缘关系。结果２８株ＭＲＳＡ的ＰＦＧＥ图谱有Ｋ、Ｍ、Ｌ、Ｎ４型，以Ｋ型为主（１８株）。ＩＣＵ本次流行期间的ＭＲＳＡ分离株均为Ｋ１亚型（１４株），与前次流行株Ａ１亚型完全不同。采集２０位ＩＣＵ医护人员鼻拭子，分离到２株ＭＲＳＡ，阳性率１０％，其ＰＦＧＥ图谱与流行株一致。结论ＭＲＳＡ在ＩＣＵ流行情况十分严重，及时采取有效措施控制这种流行及播散是至关重要的     

Comparison of the sensitivity of NAT using pooled donor samples for HBV and that of a serologic HBsAg assay

BACKGROUND: Studies were conducted using samples from early and late-stage HBV-infected persons to determine the pool size at which PCR had better sensitivity than a sensitive HBsAg chemoluminescence immunoassay (CLIA-HBsAg). STUDY DESIGN AND METHODS: HBV seroconversion panels were tested for HBsAg by CLIA and for HBV DNA by nested PCR (95% hit rate: 100 copies/mL); PCR was carried out at various dilutions. HBV serologically positive samples that were detected from the simultaneous screening of 540,161 routine whole-blood donations using CLIA-HBsAg and agglutination assays were also characterized for additional markers of HBV infection. RESULTS: In 9 of 10 HBV seroconversion panels, PCR had better sensitivity than CLIA-HBsAg at dilutions of 1-in-25 or lower. Of 65 CLIA-only confirmed-positive donor samples (agglutination assay-negative), 8 represented early infection, 2 of which were PCR positive at a 1-in-50 dilution but negative at a 1-in-100 dilution. Only 2 of 47 samples from probable late-stage HBV infection that were positive on CLIA only were PCR positive with 0.1-mL sample volume and the S-region primer; the remaining 45 samples required a 1.0-mL sample input and C-region primer for increased PCR positivity. The remaining 10 CLIA-only confirmed-positive donor samples were from HBV vaccine recipients. None of the 12 CLIA- and HBsAg-negative donor samples that were strongly anti-HBc reactive could be detected by PCR at any dilution; all 12 were PCR positive when undiluted, but 4 required a 1.0-mL input volume for PCR positivity. CONCLUSION: For the detection of samples representing early-stage HBV infection, PCR at dilutions of 1-in-25 or lower (equivalent to a pool of < or =25 members) had greater sensitivity than CLIA-HBsAg. In contrast, samples from late-stage HBV infection were detected by PCR only with undiluted samples (0.1-mL or 1.0-mL input volumes), regardless of CLIA-HBsAg reactivity. Therefore, although NAT using minipools of 25 donations or less may be effective for the detection of early-stage HBV infection, it may not be effective for the detection of persistent HBV infection.     

Care related pain in hospitalized patients: A cross‐sectional study

Context: Care‐related pain includes pain occurring during transportation, movement, diagnostic imaging, physical examination, or treatment. Its prevalence has never been assessed in a large adult inpatient population. Objective: To identify the procedures likely to induce or increase pain in hospital patients, attempting to separate the most painful from those reported as most frequently inducing pain. Design: A single‐day cross‐sectional survey conducted in two large French teaching hospitals, including all hospitalized patients, free of communication problems. One third was randomly selected and interviewed about the painful episodes that had occurred or were associated with the procedures performed during the previous two weeks. Patients were interviewed using a structured questionnaire. Results: Six‐hundred‐eighty‐four patients were randomly selected. Six‐hundred‐seventy‐one painful events were reported in 55% of the patients, with an average of 1.8events/patient. Fifty‐two percent of the painful events were associated with procedures performed by non‐medical staff; 38% of the painful episodes occurred during procedures involving vascular puncture and 24% during patients’ mobilization. In 57% of painful procedures, pain was rated as severe or extremely severe. The most painful procedures were invasive procedures, other than vascular and non vascular punctures (74% of severe and extremely severe painful episodes). Maximum pain intensity was rated higher for procedures that were repeated than for those experienced only once (62% versus 53%, p=0.02). Conclusion: This survey gives new insight into our daily practice. Proper management of care‐related pain should be a major concern of all hospital staff to improve the quality of our health care.     

Association between time to surgery and 90-day mortality after hip fracture: A retrospective cohort study of 1734 cases

Background

It remains unclear whether early surgical intervention can reduce mortality after surgery in hip fracture patients. The aim of this study was to investigate the association between time from injury to surgery and mortality rate within 90 days after hip fracture surgery.

我院呼吸内科真菌性医院感染的调查与耐药性分析

目的探讨呼吸内科真菌性医院感染的分布、基础疾病、危险因素和耐药性。方法对142例病例进行回顾性调查分析并统计资料。结果呼吸内科真菌性医院感染以白色念珠菌为主，慢性阻塞性肺病、支气管扩张、肺癌占基础疾病的前3位，患者抵抗力下降和侵入性诊疗措施是其主要的危险因素，真菌的耐药性也逐渐增多。结论临床上应重视呼吸内科患者的真菌性医院感染，改善患者的基础状况，合理诊疗，减少真菌耐药性的发生，有效地预防和治疗呼吸内科真菌性医院感染.     

连续5年医院感染动态分析

摘 要：目的 分析近5年来我院医院感染发病现状及发病规律，为合理制定医院感染防控措施、降低医院感染发病率提供依据。方法 对我院2002～2006年的全部出院病例进行回顾性流性病学调查，分析各年度医院感染发病率、医院感染发病部位构成比、科室医院感染发病率、医院感染漏报率的变化趋势。结果 近5年来，我院医院感染发病率有上升趋势。医院感染高发部位为上、下呼吸道感染。重症监护病房的医院感染率上升明显。结论 降低医院感染发病率，需采取综合性预防措施，加强医院感染控制，尤其要加强重症监护病房的医院感染控制。     

90岁以上老年人眼部状况及疾病分析

目的　调查 90岁及以上长寿老年人的视力状况和眼部疾病情况。　方法　对 135例90岁以上老年人常规检测视力 ,外眼、眼前节、眼底及眼压。对合作者进行验光 ,矫正屈光不正。　结果　 135例老年人右眼视力平均 0 4 6± 0 5 0 ,左眼 0 4 9± 0 5 0。盲和低视力分别为 7(5 9% )例和14 (10 3% )例。 4 3例 (81 1% )老年人验光后视力提高 1～ 5行 (平均 3行 ) ,验光前、后视力改善差异有统计学意义 (P <0 0 1)。所有老年人均有眼睑下垂、角膜类脂环、眼底动脉硬化、老视等老年性眼部变化。平均每位老人患有 2 4 (2～ 7)种眼病和 7 6 (3～ 12 )种全身主要脏器病变。对视力产生普遍影响的因素是屈光不正 ,诸多眼病中白内障居首位 ,严重影响视力的眼病是黄斑病变和各种原因的视神经萎缩。　结论　 90岁以上老年人盲和低视力的发生率高 ,其原因既有衰老退化因素 ,又有老年人常见眼病和屈光不正的影响。