Travelling with cystic fibrosis: Recommendations for patients and care team members

There are no European Guidelines on issues specifically related to travel for people with cystic fibrosis (CF). The contributors to these recommendations included 30 members of the ECORN-CF project. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Executive Agency of Health and Consumers of the European Union and the Christiane Herzog Foundation.The main goal of this paper is to provide patient-oriented advice that complements medical aspects by offering practical suggestions for all aspects involved in planning and taking a trip. The report consists of three main sections, preparation for travel, important considerations during travel and at the destination, and issues specific to immunocompromised travellers. People with CF should be encouraged to consult with their CF centre prior to travel to another country. The CF centre can advise on the necessary preparation for travel, the need for vaccinations, essential medications that should be brought on the trip and also provide information relating to CF care in the region and plan of action in case of an emergency.     

Effect of different neuroleptics in tardive dyskinesia and parkinsonism

Participating centers: ¹Sct. Hans Hospital, Dept. 2, Roskilde, Denmark; ²Vordingborg Amtshospital, Denmark; ³Nickby Sjukhus, Finland; ⁴Hesperia Sjukhus, Finland; ⁵Ek»sen Sjukhus, Finland; ⁶Dikemark Sykehus, Norway; ⁷Lillhagen Sjukhus, Gothenborg, Sweden Participating clinicians: J. Gerlach¹, U.G. Ahlfors⁴, K.F. Amthor⁶, S.J. Dencker⁷, A. Gravem⁶, B. Gunby⁶, U. Hagert³, S. Korsgaard¹, L. Lunding⁷, U. Noring¹, K. Ojannen⁵, T. Pitkonen⁴, U.J. Polvsen¹, T. Rossel⁷, E. Tolvanen³, J. Wæhrens² Participating tape raters: J. Gerlach¹, S. Korsgaard¹, U.J. Povlsen¹ Coordination and data collection: K. Elgen, L. Lang-Jensen, H. Lundbeck A/S, Copenhagen, Denmark Statistical analyses: O. Aaskoven, H. Lundbeck A/S, Copenhagen, Denmark Secretary: L. Gustavsen¹ Offprint requests to: J. Gerlach, Sct. Hans Hospital, Dept. 2, DK-4000 Roskilde, DenmarkThirty-three chronic psychiatric patients with tardive dyskinesia (TD) were included in a video-controlled multicenter study of the effect of chlorprothixene, perphenazine, haloperidol and haloperidol + biperiden in TD and parkinsonism. The drugs were given in a cross-over design in randomized order in dosages equipotent to the earlier neuroleptic treatment and administered for periods of 6 months with 6-week placebo periods before and after. A total of 55 treatment periods were completed; only seven patients were able to go through all three treatment phases (=96 weeks). Perphenazine (20.5 mg/day), haloperidol (5.5 mg/day), and haloperidol (11 mg/day) + biperiden (7 mg/day) induced a moderate suppression of TD and at the same time produced a corresponding aggravation in parkinsonism. Chlorprothixene (142 mg/day) had only a slight TD reducing effect and did not change parkinsonism. Thus the TD suppressing effect was inversely related to the parkinsonian-inducing effect of the neuroleptics. Following withdrawal of the drugs, TD increased in some cases and decreased in others compared to the pretreatment level. No significant correlation was found between the intensity of the withdrawal TD and either drugs or preceding parkinsonism or TD suppression. Only in a subgroup of seven patients who consecutively received all three neuroleptics, perphenazine, but not haloperidol and chlorprothixene, produced a post-treatment aggravation which was correlated to the parkinsonsim and TD suppression during treatment. Independent of the neuroleptic given, the TD intensity increased significantly from the first to the third placebo period. This suggests that drug holidays are inappropriate to prevent TD induction/aggravation.The Nordic Dyskincsia Study Group consists of the following:     

Mortality Spike at New Year but not Christmas in North East England

Mortality in the USA has been shown to spike on Christmas and New Year’s Day. No comparable analyses are available for European data despite recognised seasonal mortality variations. Deaths for 1986–2000 were analysed by date for Newcastle and North Tyneside (NNT) to examine the Christmas period and the weeks surrounding Easter. A spike in mortality attributable to increases in cardiac and respiratory deaths was seen on New Year’s Day but not on Christmas Day. No disturbance of trend was seen at Easter. The causes of the ‘holiday phenomenon’ are not understood, but absence of a Christmas spike in NNT may indicate that it is preventable.     

风险管理对提高法定节假日护理安全的作用

目的：探讨风险管理对提高法定节假日护理安全的作用。方法将2013年1-12月节日管理设为风险管理组,2012年1-12月节日管理设为传统管理组。两组均由值班护士长在法定节日期间,依据5项质量考核标准对病区各班次进行考核,24 h综合评价后将8个病区的护理质量记录在考核表上。比较两组高频缺陷发生率和质量控制结果。结果风险管理组护士素质、基础护理、特一级护理、护理文书、核心制度落实总均分分别为（99．35±0．26）,（96．67±1．94）,（99．66±0．18）,（96．27±1．58）,（98．02±2．01）分,均优于传统管理组的（97．70±1．29）,（90．65±1．83）,（98．04±0．45）,（90．08±1．74）,（93．30±4．86）分,差异有统计学意义（ t值分别为2．50,8．86,6．67,6．12,3．11;P＜0．05）;风险管理组患者发生跌倒3例,错服药2例,高频缺陷发生例数少于传统管理组。结论在法定节假日实施风险管理是提高护理安全的有效手段。     

全方位无缝隙应对模式在提高手术室节假日创伤急救质量中的应用

目的:探讨全方位无缝隙应对模式在提高手术室节假日创伤急救质量中的应用。方法:对275例节假日期间收治的患者进行急救,其中将2010年1～12月121例患者纳入对照组,将2011年1～12月154例患者纳入观察组。对照组进行常规急救人员配备,按照常规急救流程实施急救;观察组应用全方位无缝隙应对模式进行急救手术护理。观察两组创伤急救手术抢救效率和医患满意度。结果:观察组平均手术准备时间、平均手术时间、术后平均送患者入病房时间均短于对照组,抢救成功率、抢救记录合格率、手术间物品准备合格率、医患满意度均高于对照组(P<0.05)。结论:实施全方位无缝隙化急救应对模式有利于提高节假日手术室创伤急救护理质量及医患满意度。     

Influence of Valentine's Day and Halloween on birth timing

It is known that cultural representations, in the form of stereotypes, can influence functional health. We predicted that the influence of cultural representations, in the form of salient holidays, would extend to birth timing. On Valentine's Day, which conveys positive symbolism, there was a 3.6% increase in spontaneous births and a 12.1% increase in cesarean births. Whereas, on Halloween, which conveys negative symbolism, there was a 5.3% decrease in spontaneous births and a 16.9% decrease in cesarean births. These effects reached significance at p < .0001, after adjusting for year and day of the week. The sample was based on birth-certificate information for all births in the United States within one week on either side of each holiday across 11 years. The Valentine's-Day window included 1,676,217 births and the Halloween window included 1,809,304 births. Our findings raise the possibility that pregnant women may be able to control the timing of spontaneous births, in contrast to the traditional assumption, and that scheduled births are also influenced by the cultural representations of the two holidays.     

Firework injuries at a major trauma and burn center: A five-year prospective study

Background and objective

In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007–2011.

Methods

Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition.

Result

From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136–150). The mean age of the patients was 26 ± 15.3 years (range, 1–95 years). Of the 734 patients, the highest proportion of injuries were the 5–14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment.

Conclusion

The private use of fireworks during the Spring Festival Holidays is associated with a considerable number of injuries to various parts of the body. We can minimize the number and severity of accidents by raising awareness of safety practices, encouraging professional displays only and motivating manufacturers to adhere to strict quality control.     

Variation in deliberate self-harm around Christmas and New Year

Seasonal and temporal variations in suicide by patient and demographic groups, though important, have been investigated infrequently. This study examined patterns of non-fatal deliberate self-harm (DSH) during Christmas and New Year (from December 16th to January 6th) by specific patient and demographic group. The sample comprised 19,346 people who presented with 31,369 episodes of DSH to a general hospital Emergency Department in Oxford, UK. Autoregression analysis of all episodes from 1976 to 2003 (controlling for day of the week, month and year) revealed significant reductions (-30% to -40%) in the occurrence of DSH compared with expected numbers on each day from December 19th to 26th (except the 23rd), though no significant increase was found on any of the subsequent 11 days. When analysed separately, young people aged under 25 years showed decreases (-60%) in the occurrence of DSH on several days throughout Christmas (p<0.001) and New Year (p<0.01). Patients with partner relationship problems showed a decrease 3 days before Christmas Day (-80%, p<0.001) and an increase on New Year's Day (+100%, p<0.01). Patients with family relationship problems showed decreases before Christmas and after New Year (-60%, p<0.01). Patients with social isolation problems, or a previous history of DSH showed decreases (-60%, p<0.01) before Christmas only. Patients who used alcohol at the time of DSH or in the 6h beforehand, but did not chronically misuse alcohol, showed an increase (+250%, p<0.01) on New Year's Day. There was no significant variation in the occurrence of DSH for patient groups with either low/medium or high suicide intent. The findings elucidate how social and individual factors may interact in contributing to DSH. They are of theoretical interest, and have important clinical implications regarding identification of patient groups especially susceptible to DSH at New Year.     

Programa de entrenamiento vacacional en investigación: una propuesta de estudiantes de medicina colombianos

Introduction

Research has become a priority in academic training among medical undergraduate students, and it has been associated with positivism, motivation, and critical thinking. Scientific associations also play a role in the research training for undergraduate students. The objective of this study was to describe the results of a research program during holiday periods proposed by Colombian medical students and to evaluate the importance of promoting them in Latin America.

某市三级甲等医院重大节假日急诊就诊情况分析

[目的]对某市重大节假日急诊就诊情况进行分析,为有关部门决策提供科学依据. [方法]通过对2000～2005年重大节假日期间急诊就诊登记的22014例资料进行分析,揭示发病的年龄、性别和昼夜时间的分布规律以及疾病构成梯次.[结果]急诊就诊的男性病例普遍多于女性,并且10岁以下年龄组就诊人数居多;其中.发热、外伤及腹痛是最为常见的就诊原因;每日的午后至凌晨存在"驼峰型"分布的就诊高峰期. [结论]探讨重大节假日期间急诊就诊情况,有助干急诊工作的改进,合理调配卫生资源.