Strengthening research in prevention and treatment strategies for hypertension in children and adolescents / 中国学校卫生

Abstract@#In recent years, the blood pressure levels and the prevalence of hypertension and among Chinese children and adolescents have shown a rising trend, and the elevated blood pressure is associated with target organ damage and increases the risk of developing cardiovascular and cerebrovascular diseases in adulthood. The article analyzes the current epidemic situation and main risk factors of hypertension in children and adolescents in China, and proposes comprehensive prevention and control measures that can be implemented by government, medical institutions, schools, and families as part of a joint effort to target hypertension in youth, thereby providing evidence for preventing the occurrence of hypertension in this population.

The incidence of artificial stone-related silicosis among interior decoration workers in different countries / 中华劳动卫生职业病杂志

In this paper, 177 cases of artificial stone-related silicosis in interior decoration workers from Israel, Spain, USA, Italy and Australia were analyzed. Interior decoration workers were from small businesses (or workshops), engaged in kitchen and/or bathroom artificial stone countertops cutting, grinding, polishing and other reprocessing. In the working environment, the content of crystalline silica in artificial stone was more than 70%, and the concentration of silica dust exceeded the relevant standards. Most workplaces used dry cutting without ventilation and dust removal and other dust-proof measures, and most workers did not wear qualified respiratory protective equipment. Taking comprehensive measures such as wet operation, ventilation and dust removal, and individual protection can effectively prevent the occurrence of artificial stone-related silicosis.

Compensación dentro de la Evaluación Ambiental en la Secretaría Técnica Nacional Ambiental (SETENA), Costa Rica

Introducción: La ley Orgánica del Ambiente 7554, señala a la Secretaría Técnica Nacional Ambiental (SETENA) como la institución encargada de evaluar y dar seguimiento a las medidas de compensación ambiental en Costa Rica. Objetivo: Exponer el marco jurídico y legislación que rige y aplica la SETENA en el tema de compensación ambiental. Métodos: Se describe brevemente un caso de estudio sobre como la compensación ha sido implementada en el país. Resultados: SETENA interpreta la compensación ambiental como un conjunto de medidas y acciones generadoras de beneficios ambientales que: 1) son proporcionales a impactos o perjuicios ambientales causados por el desarrollo de los proyectos siempre que no se puedan adoptar medidas de prevención, corrección o mitigación; y 2) constituyen una herramienta a utilizar durante la etapa de gestión ambiental, en la fase constructiva u operativa, cuando se evidencien incumplimientos a los compromisos ambientales adquiridos, faltas a la normativa ambiental, o daños ambientales identificados después de obtener la licencia ambiental para el proyecto. Conclusión: SETENA define los Planes de Compensación Ambiental como un procedimiento que sirve de guía para establecer la toma de acciones. Las medidas de compensación se establecen de acuerdo con el tipo de proyecto y hallazgos encontrados durante el monitoreo, por lo que no hay una estandarización para estos planes de compensación.

Introduction: The Organic Law of the Environment No. 7554 designates the National Environmental Technical Secretary (Spanish Acronym - SETENA) as the institution in charge of evaluating and following up on environmental compensation measures in Costa Rica. Objective: To expose the legal framework and legislation that governs and applies SETENA about environmental compensation in this country. Methods: A case study on how compensation has been implemented in the country is briefly described. Results: SETENA interprets environmental compensation as a set of measures and actions that generate environmental benefits that: 1) are proportional to the environmental impacts or damages caused by the development projects, provided that prevention, correction, or mitigation measures cannot be adopted; and 2) is a tool to be used during the environmental management stage, in the construction or operational phase, when there is evidence of non-compliance with the acquired environmental commitments, lack of environmental regulations, or environmental damage identified after reaching environmental approval for the project. Conclusion: SETENA defines the Environmental Compensation Plan as a procedure that serves as a guide to establish the actions to take. The compensation measures are dictated concerning the type of project and the findings encountered during its monitoring, which is why there is no standardization of these compensation plans.

Investigation on prevention knowledge level of brucellosis among permanent residents in the agricultural area of Hulunbuir City, Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To understand the prevention knowledge of brucellosis among permanent residents in the agricultural area of Hulunbuir City, Inner Mongolia Autonomous Region, and to provide a scientific basis for formulating brucellosis prevention strategies and measures.Methods:From May to December 2018, Daur Autonomous Banner of Morin Dawa and Arun Banner in the agricultural area of Hulunbuir City were selected as the survey sites. Three townships were selected from each banner, and one administrative village from each township was selected as the survey village. The permanent residents aged ≥14 who had lived in the survey village for at least one year were selected as the survey subjects. Serum was separated by the examiner and the rose-bengal plate agglutination test (RBPT) was conducted. The positive sera were further tested by tube agglutination test (SAT).Questionnaires were conducted by investigators in the form of face-to-face case interview, including general demographic information, family information, brucellosis prevention knowledge awareness status, epidemiological contact history, prevention status, general behavior, etc., to calculate the awareness rate of brucellosis prevention knowledge.Results:A total of 880 sera were isolated, of which 185 were positive for RBPT. Further examination of SAT showed that the positive rate of SAT was 17.27% (152/880). The overall awareness rate of brucellosis prevention knowledge was 46.73% (16 450/35 200). The awareness rates of males and females were 47.82% (8 473/17 720) and 45.64% (7 977/17 480), respectively. The 21 - 40 years old group had the highest awareness rate [60.94% (3 705/6 080)]. The awareness rates of primary school and below, junior high school, senior high school and above were 45.96% (11 969/26 040), 48.79% (3 962/8 120) and 49.90% (519/1 040), respectively. The awareness rate of people with livestock raising behavior in the year before the survey was 47.35% (8 011/16 920), while the awareness rate of people without such behavior was 46.17% (8 439/18 280).Conclusions:The overall awareness rate of brucellosis prevention knowledge among permanent residents in the agricultural area of Hulunbuir City is low. It is necessary to strengthen the training of relevant knowledge and strengthen the publicity and education of people with low awareness rate.

Adesão aos protocolos de atendimento para a não infecção de sítio cirúrgico de coluna / Adherence to care protocols for non-infection of the surgical site of the spine / Cumplimiento de los protocolos de atención para la no infección del sitio quirúrgico de la columna vertebral

Objetivo: avaliar a adesão aos protocolos de atendimento para a não infecção de sítio cirúrgico (NISC) de coluna e os fatores associados. Método: estudo transversal realizado por meio da revisão de 60 prontuários de pacientes submetidos à cirurgia de coluna de 2015 a 2019, seu desfecho de não infecção e as condições relacionadas. O estudo foi executado no primeiro semestre de 2020. Resultados: algumas variáveis relacionadas para NISC foram: profilaxia antimicrobiana de 30 a 60 min antes da cirurgia (RR= 0,97; p=0,026), normotermia (RR= 0,80; p=0,050), internação pós cirúrgica em Unidade de Terapia Intensiva (até 3 dias) (RR=2,00; p=0,040). A frequência de NISC foi de 83,3% (50/60) p= 0,728). Conclusão: apenas a normotermia foi fator associado a não infecção para NISC na regressão linear. Ressalta-se que a adesão aos processos de trabalho é primordial para a proteção das infecções, reduzir eventos adversos e garantir a segurança.

Objective: to evaluate adherence to treatment protocols for non-surgical site infection (NISC) of the spine and associated factors. Method: cross-sectional study conducted through the review of 60 medical records of patients undergoing spinal surgery from 2015 to 2019, its non-infection outcome and related conditions. The study was carried out in the first half of 2020. Results: some variables related to NISC were: antimicrobial prophylaxis from 30 to 60 min before surgery (RR= 0.97; p=0.026), normothermia (RR= 0.80; p =0.050), post-surgical hospitalization in the Intensive Care Unit (up to 3 days) (RR=2.00; p=0.040). The frequency of NISC was 83.3% (50/60) p= 0.728). Conclusion: only normothermia was a factor associated with non-infection for NISC in linear regression. It is noteworthy that adherence to work processes is essential to protect against infections, reduce adverse events and ensure safety.

Objetivo: Evaluar la adherencia a los protocolos de tratamiento de la infección del sitio no quirúrgico (NISC) de la columna y los factores asociados. Método: estudio transversal realizado mediante la revisión de 60 historias clínicas de pacientes sometidos a cirugía de columna entre 2015 y 2019, su desenlace no infeccioso y afecciones relacionadas. El estudio se realizó en el primer semestre de 2020. Resultados: Algunas variables relacionadas con NISC fueron: profilaxis antimicrobiana de 30 a 60 min antes de la cirugía (RR = 0,97; p = 0,026), normotermia (RR = 0,80; p = 0,050), internación posquirúrgica en la Unidad de Cuidados Intensivos (hasta 3 días) (RR = 2,00; p = 0,040). La frecuencia de NISC fue del 83,3% (50/60) p = 0,728). Conclusión: solo la normotermia fue un factor asociado a la no infección por NISC en regresión lineal. Es de destacar que la adherencia a los procesos de trabajo es fundamental para proteger contra infecciones, reducir los eventos adversos y garantizar la seguridad.

Percepción del equipo de salud sobre los beneficios del calostro como factor protector de enterocolitis necrotizante en recién nacidos prematuros / Health professionals perception about the use of human colostrum, as preventive measure for necrotizing enterocolitis in preterm newborns

INTRODUCCIÓN: La incidencia de enterocolitis necrotizante (ECN), en Chile es de 0,3 a 2,4 por mil recién nacidos vi vos, siendo principalmente afectados los neonatos prematuros, y de 8 a 12 por ciento en prematuros menores a 1.500 gramos. OBJETIVO: Describir la percepción de profesionales de salud sobre el uso de calostro en recién nacidos prematuros, como factor protector de enterocolitis necrotizante. SUJETOS Y MÉTODO: Estudio cualitativo, mediante entrevista semiestructurada a 18 profesionales de la salud en tres hospitales públicos de la región de Valparaíso. La pauta de entrevista incluyó 3 temas: Conocimientos, percepción del suministro temprano de calostro y opinión acerca de la extensión de la medida, y 6 subtemas, 2 para cada tema respectivamente: Autopercepción del nivel de conocimiento y fuentes de información; Experiencia: aspectos positivos/eventos adversos y opinión del calostro como factor protector de enterocolitis; aspectos facilitadores u obstaculizadores y opinión acerca de la medida como política nacional. Procesamiento de datos mediante análisis de contenido cualitativo, temático. RESULTADOS: El uso de calostro en prematuros se da de modo protocolizado en dos de las tres unidades de alta complejidad neonatal de la región de Valparaíso. Los participantes opinan positivamente acerca de los resultados preventivos de esta medida. Aun cuando en un tercer estable cimiento no se aplique, hay una percepción favorable acerca de su potencial beneficio y su bajo costo de implementación. Se señala, no obstante, que ésta requiere de mayor evidencia y de un protocolo de aplicación. Otras limitantes serían la insuficiente dotación y formación del personal, y la necesidad de adquirir equipamiento e insumos. CONCLUSIONES: Profesionales que han aplicado un protocolo de administración de calostro en neonatos prematuros en la Región de Valparaíso, reportan buenos resultados de salud, y promueven la motivación del equipo hacia esta praxis. Sin embargo, se considera relevante la difusión y discusión de protocolos nacionales e internacionales, así como el desarrollo de investigación local. Dadas las experiencias en curso en Chile, y el debate internacional, se considera oportuno que el tema sea abordado y discutido en la comunidad sanitaria nacional.

INTRODUCTION: In Chile, necrotizing enterocolitis (NEC) mainly affects preterm infants, with an incidence of 0.3 to 2.4 per 1,000 live births, and 8 to 12% in preterm infants weighing less than 1,500 grams. OBJECTIVE: To describe health professionals perceptions on the use of human colostrum as a preventive measu re against necrotizing enterocolitis in preterm newborns. SUBJECTS AND METHOD: Qualitative study, using 18 semi-structured individual interviews of health professionals in three public hospitals of the Valparaíso Region. The interview included 3 topics: Knowledge, Perception of early colostrum supply and Opinion about the extent of the measure, and 6 subtopics, 2 for each topic respectively: Self-perception of knowledge level and Sources of information; Experience: positive aspects/adverse events and Opinion of colostrum as a protective factor for enterocolitis; Facilitating or hindering aspects and Opinion about the measure as national policy. Data were processed through qualitative content analysis. RESULTS: Two of the three high-complexity neonatal units of the Valparaíso Re gion have a protocol for administrating colostrum in premature infants. Participants have a positive opinion about the preventive results of this measure. Even in the third hospital where there is no protocol, they have a favorable perception of its potential benefit and its low cost of implementa tion. However, we observed that this procedure requires more evidence and an application protocol. Other limitations would be the lack of staffing and training and the need for equipment and supplies. CONCLUSIONS: Professionals who have applied a colostrum administration protocol in preterm infants in the Valparaíso Region report good health outcomes and promote team motivation towards this practice. However, it is relevant to the dissemination and discussion of national and international protocols, as well as the development of local research. Given the ongoing experiences in Chile and the international debate, we considered appropriate to address and discuss the topic within the na tional health community.

Nivel de conocimiento sobre los factores de riesgo y las medidas preventivas del cáncer de mama en estudiantes de ciencias de la salud / estudiantes de ciencias de la salud Level Of Knowledge On Risk Factors And Preventive Measures For Breast Cancer In Health Science Students

Introducción: El cáncer de mama es uno de los cánceres más comunes a nivel mundial y en el Perú, por ello es importante que los estudiantes en salud conozcan las medidas preventivas y factores de riesgo. Objetivo: Evaluar el nivel de conocimiento sobre los factores de riesgo y medidas de prevención para el cáncer de mama en estudiantes de la escuela de medicina de una universidad privada, 2019. Métodos: Estudio cuantitativo, descriptivo de corte transversal, se contó con una muestra de 319 estudiantes de la Facultad de Medicina de la Universidad Católica Santo Toribio de Mogrovejo en el año 2019,que hayan estado matriculados en alguna de las escuelas profesionales. Se utilizó un cuestionario que constó de 18 preguntas, 5 ítems que abordaron datos sociodemográficos y 13 midieron el nivel de conocimiento sobre los factores de riesgo y medidas de preventivas del cáncer de mama. Se usó estadística descriptiva. Resultados: Después de la exclusión, se contó con 292 estudiantes, 72% fueron mujeres. La media de edad fue 20,5. 23,6 % fueron de segundo ciclo. Los factores de riesgo menos conocidos fueron beber alcohol, tener más de 45 años, menarquia antes de los 12 años y menopausia después de los 55 años, asimismo, las medidas de prevención menos conocidas fueron: edad correcta para realizar mamografía 71% y frecuencia para realizar autoexamen 63% en mayor porcentaje. Conclusión: El conocimiento sobre factores de riesgo y medidas de prevención de cáncer de mama fue adecuado.

Introduction: breast cancer is one of the most common cancers worldwide and in Peru. Health studentsneed to know preventive measures and risk factors. Objective: to assess the level of knowledge aboutrisk factors and prevention measures for breast cancer in students of the private medical school, 2019.Methods: a quantitative, descriptive cross-sectional study was conducted with a sample of 319 studentsfrom the Faculty of Medicine of the Universidad Católica Santo Toribio de Mogrovejo in 2019, who havebeen enrolled in one of the professional schools. We used a questionnaire consisting of 18 questions, 5items that addressed sociodemographic data, and 13 measured the level of knowledge about risk factorsand preventive measures of breast cancer. Descriptive statistics were used. Results: After exclusion,there were 292 students, 72% were women. The mean age was 20.5, 23.6% were from the second year.The least known risk factors were drinking alcohol, being over 45 years of age, menarche before 12years of age, and menopause after 55 years of age, and the least known prevention measures were:correct age for mammography 71% and frequency for self-examination 63% in a higher percentage.Conclusion: knowledge about risk factors and breast cancer prevention measures was adequate.

Association of Complications in Retained Ureteral Stents

Introduction: One of the most frequent complicationof ureteral stent and difficult case management is stentencrustations resulting in morbidity and financial burdento patient. The primary aim of this study is to evaluatethe complications incidence associated to patients andunderstanding different management techniques and otherfactors includes stent insitu duration, patient literacy level andsocioeconomic level.Material and methods: In this study, there are 48 patientspresented with retained DJ stents to Urology Department,Sri Venkateswara Institute of Medical Sciences (SVIMS),Tirupati, Andhra Pradesh, India between August 2009 andJanuary 2016 were included.Results: The mean age of the patients in the cohort is 42.46years and with highest percentage (37.5%) of the patientsin age group of 40 to 50 years. Most of the patients in thecohort are from poor socio-economic status (66.7%) andilliterate (54.2%). Most of the patients (58.3%) are not awareof stent placement in their body and majority of the patients(83.3%) are unilateral cases. In this study, 31.2% of patientsexperienced multisite encrustations. Stents are placed mostcommonly for ureteric stones following the ureteroscopiclithotripsy and percutaneous nephrolithotomy proceduresin our study. Stone composition revealed predominantlyCalcium oxalate.Conclusion: Retained DJ stents results in morbidity andcomplications like encrustation and stone formation whichcan be treated using combined endo urological procedures.Our study stress the prominence of regular follow up, andexplaining patient about complications, prompt and timelystent removal and change of stent and proper documentation.Maintenance of stent register, is another important measure toavoid potential complications.

Pathogen profile and risk factors of infected diabetic foot ulcers / 中国感染与化疗杂志

Objective To explore and analyze the pathogen proifle and risk factors of infected diabetic foot ulcers, and propose appropriate prevention and intervention measures for early recovery of patients.Methods The data of 120 patients with diabetic foot ulcers treated in our hospital from February 2012 to May 2014 were retrospectively analyzed. These patients were classified into infection group (38 patients) and non-infection group (82 patients) based on whether their ulcer was infected or not. The pathogens and risk factors of infection in diabetic foot ulcer were analyzed.Results In this study, 43 strains of pathogenic bacteria were isolated from 38 cases of infection, of which gram positive bacteria accounted for 51.2 %, gram negative bacteria 41.9 %, and fungi 7.0 %.Staphylococcus aureus,Pseudomonas aeruginosa and Enterobacter cloacae were the top three pathogens, accounting for 16.3 % each. Univariate analysis showed that diabetic vascular complication, retinopathy, more than 2 foci of ulcer, osteomyelitis, and diabetic nephropathy were closely associated with infection (P<0.05). Multivariate logistic regression analysis showed that HDL-C, albumin, diabetic vascular complication, number of ulcers, osteomyelitis were independent risk factors for infection in patients with diabetic foot ulcer. Conclusions HDL-C, red blood cell, hemoglobin, diabetic complications, white blood cell, triglyceride, albumin, diabetic vascular complication and smoking are the risk factors for infection in patients with diabetic foot ulcer. These factors should be prevented and controlled to reduce the incidence of infection in diabetic foot ulcer.

Pressure ulcer prevalence and its related measures of hospitalized patients:a multicenter survey in Guangdong province / 中国实用护理杂志

Objective To ascertain the pressure ulcer prevalence among secondary and tertiary general hospitals in different areas of Guangdong Province, and describe pressure ulcer related nursing measures in hospitalized patients. Methods A cross-sectional descriptive design was used in the present study. 5 secondary and tertiary general hospitals including 25164 hospitalized patients from different regions in Guangdong Province were recruited. There were 267 pressure ulcer patients among them. Minimum Data Set (MDS) was used to measure prevention measures of hospitalized patients. Pressure ulcer patients′questionnaire was used to measure medical treatment of pressure ulcer patients. Results The overall prevalence rates of pressure ulcers in the 25 hospitals range from 0 to 3.49%, with an average of 1.26%. The prevalence rate in the secondary general hospitals was 1.8%(41/2266), which was significant higher than that of in the tertiary general hospitals(1.0%, 226/22998), χ2=13.48, P<0.01. For the hospitalized patients at risk, 42.0%(1408/3353) of patients didn′t use any systemic support surface, 45.8%(1537/3353) of patients didn′t use any local support surface. In the pressure ulcer patients, 35.2%(94/267) of patients didn′t use any systemic support surface, 14.2% (38/267)of patients didn′t use any local support surface, and 61.4%(164/267) of pressure ulcer patients didn′t use any skin care products. Conclusion The prevention measures of pressure ulcer in Guangdong province were not effective, further improvements are still required.

Relationship between mother’s knowledge of malaria and preventive measures for children / 国際保健医療

Introduction  This study assessed the level of malaria-related knowledge in Cameroonian mothers and identified the relationship between maternal knowledge and practice of preventive measures in their children.Methods  The study was conducted from August through September 2014. The participants comprised 50 mothers who visited A Health Center for immunization of their biological children under the age of 5 years. They were interviewed using a questionnaire, which was developed by the authors, with a response rate of 100%. The questionnaire was composed of questions regarding maternal malaria-related knowledge, preventive measures for malaria in their children, sources of information on malaria, and attributes of the participants. Analysis of covariance was performed with the items on maternal malaria-related knowledge (four items) as independent variables and preventive measures for malaria in their children (one item) as a dependent variable. Attributes of the participants were entered as covariates in the analysis. Chi square test was conducted between the age of the mother, knowledge related to the causes of malaria, and the use of mosquito nets as a preventive measure against malaria for children.Results  Among the 50 participants, 40 (80.0%) knew “mosquito bite” as the cause of malaria, whereas 10 (20.0%) did not, and 39 (78.0%) cited “healthcare provider at a hospital or clinic” as the source of information on malaria, whereas 26 (52.0%) cited “television.”  Analysis of covariance, which was performed to elucidate the relationship between the four items on malaria-related knowledge and the one item on preventive measures for malaria in their children, showed significant differences in all combinations.   Chi square test was conducted between knowledge related to the causes of malaria and the use of mosquito nets as a preventive measure against malaria for children. The result was a significant trend.Conclusions  This study demonstrated that mothers who had knowledge about the causes, symptoms, preventive measures, and financial burden of malaria took measures to prevent malaria in their children.   These findings suggested the importance of disseminating correct information on malaria, including its causes and the behavior of mosquitoes, for decreasing malarial morbidity and under-five mortality with appropriate preventive measures.

Collective food poisoning characteristics and prevention measures in Shanghai in 2005-2014 / 上海预防医学

Objective To analyze the characteristics of nearly 10 years of collective food poisoning occurring in Shanghai,and evaluate strategies and measures for effective prevention and control of food poisoning in Shanghai.Methods By collecting data on collective poisoning from 2005 to 2014 in Shanghai was made research and analysis on all food poisoning events,classification effect evaluation for the prevention and control measures.Results In the past 10 years,there was a total of 146 cases of food poisoning in Shanghai,with 3 810 poisoned persons.And 76.7% of food poisoning occurred in May-October;86.3% of the food poisoning were caused by catering units;bacterial food poisoning caused by vibrio parahemolyticus accounted for 71.4%;Cross contamination of raw and cooked,personnel pollution and improper storage of cooked food was the major cause of the poisoning.Good achievement has been achieved in sticking to prevention first,risk management,process control,and social work for prevention and control of food poisoning.Conclusion By adopting specific measures for prevention and control of food poisoning,through nearly 10 years of effective curbing food poisoning accident,collective food poisoning has shown a downward trend year by year.

Prevention and control of nosocomial infection from the large number of cataract surgery at Life-line Express / 中国实用护理杂志

Objective To investigate the prevention measure of infections from the large number of cataract surgery at the Life- line Express. Methods From September to November 2013, a total of 1 069 cases (1 070 eyes) completed cataract surgery in Songyuan City of Jilin Province. A series of peri- operative prevention measures for nosocomial infection were established and implemented according to the characteristics of cataract surgery carried out in Life- line Express and local environment. Results The measures to prevent the nosocomial infection were fulfilled quite well, 1 069 patients had received cataract surgery successfully, no case occurred entophthalmia. Conclusions Effective prevention of the nosocomial infection can be achieved through establishing a sound system and measures, which can ensure the effect of surgery.

Epidemiología: [revisión] / Epidemiology: [review]

Las enfermedades diarreícas, constituyen un problema mundial, con altas tasas de morbilidad y mortalidad, especialmente en países en vías de desarrollo. Venezuela presentó, en el año 2008, 1.768.509 casos de diarrea, con un 40 por ciento en menores de 5 años. El total de muertes en menores de 5 años en el período 2000-2007 fue de 9311, siendo la tercera causa en este grupo de edad. Entre las bacterias, el género Salmonella, es el más frecuentemente aislado en brotes epidémicos. En niños menores de 6 años. E.coli enteropatógena fue el agente principal, seguido por E.coli enteroinvasiva, Aeromonas sp., salmonella sp y Shigella. Campylobacter es una de las bacterias más frecuentemente en las heces de los lactantes y niños en países en desarrollo. En algunos países, tener en cuenta al Vibrium Cholera y en diarreas nosocomiales al Clostridium difficile. En lactantes y preescolares la etiología viral es la más frecuente y el rotavirus el agente más común, causando aproximadamente 15000 muertes anuales en la región de las Américas. Otros virus causantes de diarreas , son los calicivirus y los adenovirus. Los factores de riesgo están relacionados con el medio ambiente, estilos de vida, factores dependientes de la biología humana y de los sistemas de servicios de salud. Las medidas de prevención y control epidemiológico más importantes son la promoción de la lactancia materna, hábitos adecuados de higiene y saneamiento ambiental, uso adecuado de antibióticos, terapia de rehabilitación oral e intravenosa, inmunizaciones, mejoría de las condiciones socio sanitarias y sistemas eficientes de vigilancia epidemiológica.

Diarrheal diseases constitute a global problem, with high rates of morbidity and mortality, particulary in developing countries. Venezuela, for 2008, presented 1.768.509 cases of diarrhea, with 40% in children under 5 years. The total number of dealths in children under years of age in the period 2000-2007 was 9311, being the third learding cause in this age group. Among causing bacterias, Salmonella in the most isolated in outbreaks. In children under 6 years, E.Coli was the principal agent, followed by E.coli., enteroinvasive, Aeromonas sp., Salmonella sp, and Shigella. Campylobacter is one of the most common bacterial in the feces of infants and children in developing countries. In some countries, Vibrium Cholera and Clostridium difficile should be considered. In infants and preshool children, viral etiology is the most frequent and rotavirus the most common agent, causing about 15000 deaths annually in the region of the Americas. Other viruses that cause diarrhea are the calciviruses and adenoviruses. Risk factors are related to the environment, lifestyles, factors dependent on human biology and health care systems. The most important prevention and control measures are the promotion of breastfeeding, proper habits of hygiene and sanitation, proper use of antibiotics, oral and intravenous rehydration therapies, immunization, improvement of sanitary conditions and efficient surveillance systems.

Hospital Onset of Lower Respiratory Tract Infection:Investigation Analysis and Countermeasures / 中华医院感染学杂志

OBJECTIVE To learn the condition of nosocomial infection of lower respiratory tract,so as to take effective measures to prevent and control it. METHODS A total of 10351 inpatients of our hospital from Mar 2007 to Mar 2008 were monitored prospectively and investigated retrospectively. RESULTS Of 234 nosocomial infection events,the lower respiratory tract infection occupied 80 events which the infection rate was the highest (34.19%) and mainly happened in internal medicine (33.75%) and neurosurgery (25.0%) departments. The pathogenic bacteria of hospital infection were mainly G-bacteria (50.94%). CONCLUSIONS The primary affection should be actively treated with strictly aseptic manipulation,reasonable application of antibiotics and strengthening disinfection and management of wards. All the measures are effective,to prevent the lower respiratory tract infection.

Antibiotic-Associated Diarrhea in COPD Patients:Analysis of 82 Cases / 中国药房

OBJECTIVE:To probe into the incidence,latency,clinical features and prevention of the antibiotic-associated diarrhea (AAD). METHODS:968 patients with chronic obstructive pulmonary diseases (COPD) treated with antibiotics in the respiratory department of our hospital were prospectively followed for 30 days immediately after administration of antibiotics. RESULTS:The incidence of AAD was 8.47% (82/968) and the latency of AAD was (8.35?5.19) days. 84.15%(69/82)of the AAD cases manifested as simple diarrhea. The AAD was chiefly induced by cephalosporins (42.68%) and penicillins (23.17%). The incidence of AAD increased markedly if the length of the antibiotic treatment was ≥7 days or if at least 3 kinds of the antibiotics were used concomitantly. After discontinuation or alteration of the antibiotics or administration of microbial ecological agents,metronidazole or vancomycin,71(86.59%) of the total 82 AAD cases were cured,10(12.20%) improved and 1 (1.21%) showed no response. CONCLUSION:AAD is a frequent complication of antibiotic therapy. A powerful measure to prevent AAD is rational use of antibiotics.

Prevention of Ventilator-associated Pneumonia / 中华医院感染学杂志

OBJECTIVE To explore the systemic prevention messures of ventilator-associated pneumonia(VAP).METHODS Mesures were taken to 54 patients to prevent infection in 54 from 2006 to 2008 and 52 patients with similar symptoms at the same interval time were chosed as control.RESULTS In the test group VAP occurred in 14.81%,with(11.11%) of mortality.In control group VAP accounted for 42.31%,with(26.92%) of mortality.CONCLUSIONS Systemic prevention messures can decrease VAP occurrance.

Bacteriological Investigation of Drainage Tube after Modified Radical Mastectomy and Counter measures / 中华医院感染学杂志

OBJECTIVE To evaluate the present condition of bacteriological infection caused by drainage tube after modified radical mastectomy(MRM) and the prevention measure.METHODS Atotal of152 patients with drainage tube after MRM during 2005-2007 were analyzed,bacteria culture of drainage fluid from breast wound or axillary wound were taken in 24 hours after operation.The bacteria or fungi were identified with ATB bacterial analysis apparatus.RESULTS Seventy specimens from 52 patients were positive(positive rate 34.2%).Of 70 strains,40 were Gram-positive cocci,24 were Gram-negative bacilli and the other 6 were fungi.The reasons of infection included subsided immunity defense system,drainage tube application,incorrect aseptic processing or disinfection procedure,and obstruction of drainage tube.CONCLUSIONS The important prevention measures of bacteria infection through drainage tube after MRM include maintenance of aseptic environment in operating room,strict aseptic processing,fluent drainage,and proper indwelling time of drainage tube.

Investigation and Preventive Measures of Nosocomial Infection in Cancer Patients Undergoing Chemotherapy / 中华医院感染学杂志

OBJECTIVE To discuss the relevant factors and preventive measures of nosocomial infection Cancer patients undergoing chemotherapy. METHODS The clinical data of 957 malignant tumor patient′s were retrospectively analyzed. RESULTS 62 patient′s occurred nosocomial infection after Chemotherapy and the rate of infection was 6.48%. The infection site in the respiratory tract accounted for 45.16%; the most commons lung cancer accounted for 33.87%. The patient′s age, length of stay, decreased total number of white blood; long-term use of broad-spectrum antibiotics was the risk factor of nosocomial infection. CONCLUSIONS The imunity of the patients reduced after chemotherapy and nosocomial infection rate increas. We must take some effective prevention measures for the risk factors to reduce nosocomial infection.

Observed Data from Hospital-acquired Infection in Different Time / 中华医院感染学杂志

OBJECTIVE To compare two different observed data from Nov 2003 to Apr 2004 and from Jan 2005 to Dec 2005 on hospital-acquired infection in our hospital and put forward the counterned measures.METHODS The bacteria samples from clinic were cultured.RESULTS The Pseudomonas aerugonosa,Acinetobacter baumannii and Escherichia coli were common strains of bacteria according to the two years data in our hospital.They were 30.35%,18.41% and 8.46% vs 19.74%,17.11% and 14.04%,respectively.The P.aerugonosa infective constituent ratio was decreased(30.35% vs 19.74%,P