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Laleishmaniasis cutánea (LC) es una zoonosis endémica y un problema de salud pública en el Ecuador. En los últimos años, Manabí, es la provincia más incidente de Leishmania como consecuencia de los desastres naturales ocurridos y la migración de locales a las áreas rurales.El objetivo del estudio es determinarlos aspectos clínicos yepidemiológicosde la Leishmania.El estudio de casos de datos secundarios, reclutó 4 pacientes registrados en el hospital regional de Portoviejo en Manabí, en el 2017. La determinación clínica (características de las lesiones) y epidemiológica de la leishmaniasis, así como el diagnóstico complementario de las muestras (polo benigno) con frotis directo fueron evaluados. La determinación taxonómica de Leishmaniano se prescribe en entidades públicas gubernamentales.El análisis descriptivo se realizó en M. Excel, determinándose la LC en el 100% (N=4) de las mujeres, de entre 1 a 43 años, 3 (75%) de ellas <16 años. Solo 1 (25%) paciente acudió a la consulta hospitalaria por las lesiones dérmicas mientras que el resto [n=3 (75%)], fueron determinadas como un hallazgo fortuito durante la hospitalización por otras entidades clínicas emergentes. El 25% (n=1) de ellas, recibió tratamiento hospitalario con glucantime, mientras que el 75% (n=3) de ellas fueron derivados a hospitales de segundo nivel. La necesidad urgente de capitación del equipo médico de la atención primaria es inherente para la identificación oportuna de Leishmaniasis comunitaria para mejorar la supervisión epidemiológica de la zoonosis. Aún existen reportes clínicos diagnósticos erróneos sobre las lesiones dérmicas, sin considerar los aspectos epidemiológicos y de laboratorio que pueden ayudar a determinarLC.
The cutaneous leishmaniasis (CL) is an endemic zoonosis and a public health problem in Ecuador. In recent years, Manabí is the most incident province with Leishmania as a result of recent natural disasters and the migration of locals to rural areas. The Aim of this study is to determine the clinical and epidemiological aspects of Leishmania. The case study used secondary data cases and recruited 4 patients, registered at a tertiary hospital in Portoviejo, Manabí, in 2017. The clinical (characteristics of the lesions) and epidemiological determination of CL, as well as the complementary diagnosis of skin samples (benign pole) with direct smear were evaluated. The taxonomic determination of Leishmania is not prescribed in public health institutions. The descriptive analysis was performed in M. Excel. The CL was determined in 100% (N=4) of women between 1 to 43 years, 3 (75%) of them <16 years. Only 1 (25%) patient attended the hospital checking out for skin lesions while the rest [n=3 (75%)] were determined as a fortuitous finding during hospitalization by other emerging clinical entities. Only 25% (n=1) of them received treatment with glucantime at hospital, while 75% (n=3) of them were referred to second level hospitals. The urgent need for training of health workers at primary care level is inherent to the timely identification of community leishmaniasis, to improve epidemiological surveillance upon the zoonoses. Some mistakes in diagnosis of skin lesions, without considering the epidemiological and laboratory aspects, in order to determine cutaneous leishmaniasis, have been reported.
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Humans , Leishmaniasis , Zoonoses , Leishmaniasis, Cutaneous , Disasters , Rural Population , Therapeutics , Wounds and Injuries , DiagnosisABSTRACT
Objective To understand and analyze the effect and impact on Hospital-level Young Scholar Scientific Research Program in personal training and project promoting.Methods To review and analyze the archived documents and data materials of total 402 Young Scholar Scientific Research Program involving 339 young fellows from 2003 to 2013,compared the research input and output with general hospital level,including getting new fund,publications,Awards and patent.Results Output on researchers with Young Scholar Scientific Research Program is much higher than the general hospital level,but showing unbalanced distribution in medical disciplines.Conclusions To establishment of Young Scholar Scientific Research Program has achieved very good effect in promoting research in tertiary public hospital as well as has empowered the young fellows for conducting scientific research independently.It is proposed to go on strength the scientific management and optimize the system construction of research input,further establishing academic communication platform for young fellows.
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From two perspectives of doctors and patients, we selected two microscopic angles of the hospital level and communication mode to carry out a parallel research and analyzed the effect of different levels of hospitals and doctor - patient communication mode on the trust between doctor and patient. The study found that both doctors and patients tended to trust each other, and in the process of medical treatment, the trust degree of patients that medical staffs believed was lower than that of the doctors that patients believed; both doctors and patients tended to consider that the hospital levels had great influence on doctor - patient trust, and their evaluation to doctor - patient trust in different levels of hospitals was discrepant; and both the doctors and patients tended to consider that the communication mode had great influence on the doctor - patient trust, in which the patients thought that doctors' appearance, detailed asking about disease and communication channels existed differences of effect in different lev-els of hospital.
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Introducción: la resistencia de las bacterias a las drogas antimicrobianas es un fenómeno natural que se ha convertido en un problema mundial emergente. La Organización Mundial de la Salud ha declarado la resistencia a los antimicrobianos como una enfermedad. En la categoría de antibacterianos existe un tercer grupo, los agentes antibacterianos de reserva, los medicamentos de este grupo no tienen alternativas terapéuticas y su uso se limita a reducir el riesgo de aparición de resistencia. Objetivo: se realizó un estudio descriptivo, transversal sobre el uso de antibacterianos de reserva y la resistencia. Materiales y Métodos: se realizó un estudio descriptivo, transversal, durante el período enero a diciembre de 2015 a partir de los criterios normados en el Manual de Políticas de Antibióticos de la institución. La población de estudio estuvo constituida por todas las historias clínicas obtenidas del registro de uso de antibacterianos de reserva. Se incluyó en el estudio los microorganismos aislados en el periodo de estudio y la susceptibilidad /resistencia de los mismos a los antimicrobianos de reserva. Resultados: se puso en evidencia que los microorganismos con más frecuencia aislados fueron el estafilococo aureus y la echerichia coli. Conclusiones: se encontró en la amoxicilina+sulbactam los mayores patrones de resistencia, siendo más llamativo frente a la echerichia coli y en menor medida frente al estafilococo aureus. El cefepime mostró alta resistencia a ambos microorganismos. El uso de antibióticos de reserva puede ser considerado adecuado en la institución donde se realizó el trabajo (AU).
Introduction: bacteria resistance toward antimicrobial drugs is a natural phenomenon that has become an emergent problem around the world. The World Health Organization has declared the resistance toward antimicrobials a disease. There is a third group in the category of antibacterials: the reserve antibacterial agents. The medicines of this group do not have therapeutic alternatives and their usage is limited to reducing the risk of resistance emergence. Objective: to carry out a cross-sectional, descriptive study on the usage of reserve antibacterials and resistance. Materials and Methods: a cross-sectional, descriptive study was carried out in the period from January to December 2015, taking into account the criteria standardized in the Handbook of Antibiotics Policy of the institution. The studied population was formed by all the clinical records obtained from the reports of the reserve antibacterials usage. The microorganisms isolated in the studied period and their susceptibility/resistance toward the reserve antimicrobials was also included. Results: it was evidenced that the most frequently isolated microorganisms were Staphylococcus aureus and Escherichia coli. Conclusions: the higher resistance patterns were found in the amoxicillin + sulbactam, being more suggestive toward the Escherichia coli and less important toward the Staphylococcus aureus. Recepime showed high resistance toward both microorganisms. The reserve antibiotics use may be considered satisfactory in the institution where the study was carried out (AU).
Subject(s)
Humans , Hospitals, Pediatric , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/prevention & control , Observational Studies as Topic , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/pharmacologyABSTRACT
To analyze the potential limitations of hospital-level research projects management by summarizing its performance status from 2008 to 2011,including but not limited to lack of time for conducting research,insufficient financial funds,inadequate funding application,inadequate supervision.Thus,since 2014,our hospital has adopted some new measurements for projects management,including full-time research,hierarchical management,full mobilization,the establishment of reward and punishment measures,which significantly improved the quality of hospital-level research projects,and the rate of longitudinal follow-up project,research enthusiasm of medical staff,and sustainable development of hospital science and technology.
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Objective To analyze the implementation problems of hospital-level research after the reform at a tertiary referral hospital,and provide strategies for further management.Methods Using statistical analysis of the application,funding and implementation of hospital-level research,summarizing the problems in the process of research.Results 55.79％ of the issue can be completed on schedule,the main reason is that the research could not reach the subject mission.The subjects about the management and care progressing better than clinical and medical issues.Conclusions The hospital level research completion should to be increased,the main reasons including that papers published been delayed,the researchers invested too little in the implementation process and research funding could not be effectively use.Recommend hospital to strengthen the system construction of research input and use,not only promoting collaboration and communication between different disciplines,but also building a comprehensive research platform,and then improving the level of scientific research management.
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Starting from the reform result and influence of A County of public hospital reform,the reform experience and forming mechanism are analyzed to provide references for county level public hospital reform.Through taking controlling medical fees as the core,replacing policy break with mechanism break has a realistic meaning and applicable value.But the administrative type of passive controlling fees and squeezing the income of medical workers will produce a negative influence for the long-term development of health industry and for the future interest of local people.
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Objective Investigating and analyzing problems and influencing factors in the process of hospital-level research project management,proposing effective and feasible recommendations,and to prove a reference for hospitals administrative management development.Methods The research analyzed factors including researchers,the departments and implementation.Results Since 2005,the total funding to support research projects in the hospital-level project reached 6.345 million yuan,the pass rate in middle-term examination was 84.94％ and was 71.81％ in final examination,with the majority of them were senior researchers.Conclusions Problems founded in this study includes the participate rate was low inyoung and middle-aged researchers,the quality of hospital-level research is also low,lack of research time,and the research outcome is not satisfied.We suggest strengthen the management of the research process,improve the mechanism of scientific rewards and punishments,integrate the disciplines resources,and improve the quality of hospital-level research project.
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Objective To discuss the efficacy of applying management-by-objectives(MBO) in the hospital-level nursing quality control group.Methods Goals of objective management and assessment details were set by leaders of quality control groups along with the nursing department at the beginning of the year.The nine subordinate groups performed upon the required criteria,completed the quality inspection on time and recorded group activities.At the end of the year,group leaders reported to the hospital-level nursing quality committee and head nurses about their performances,where several major honors were rewarded to the best performing groups.SPSS 17.0 software was used for data statistics.The measurement data were analyzed by paired t test data while enumeration data by chi-square test.Results Scores of assessment items were significantly raised after implementing MBO(P＜0.05).Scores of key items,such as high quality care,emergency management,nursing skill,were increased to (98.1 ± 2.2),(97.7 ±2.7),(99.6±0.6),(96.1 ±2.1)from (93.6 ±2.5)(P=0.009),(93.0 ± 2.6) (P=0.009),(96.2 ± 1.3) (P=0.000) and (89.3 ± 4.5) (P--0.000),respectively.Care complaints were sharply dropped for all inpatient wards while numbers of management innovationand process reengineering were greatly increased (x2=8.884,P=0.031).Condusion Introduction of MBO in the hospital-level nursing quality control group does facilitate the continuous improvement of care quality.
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According to the research demands of the Cancer Hospital of Chinese Academy of Medical Sciences, we adjusted the strategy for project management of the hospital. We prioritized clinical researches, creating favorable atmosphere for the projects and the research talents to develop. We increased program budget, trained applicants, and standadized the management. Meanwhile, it was important to attend to the relationships between the following factors:the quantity of support and the quality of project, the strict regulation criteria and the free research atmosphere, and the short-term goals and the long-term effects.