ABSTRACT
To explore the clinical distribution and drug resistance characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP), in order to provide reference for the prevention and treatment of CRKP infection. Retrospective analysis was performed on 510 clinical isolates of CRKP from January 2017 to December 2021, and strain identification and drug sensitivity tests were conducted by MALDI-TOF mass spectrometer and VITEK-2 Compact microbial drug sensitivity analyzer. The carbapenemase phenotype of CRKP strain was detected by carbapenemase inhibitor enhancement test. The CRKP strain was further categorized by immunochromogenic method and polymerase chain reaction (PCR) was used for gene detection. The results showed that 302 strains (59.2%) were derived from sputum, 127 strains (24.9%) from urine and 47 strains (9.2%) from blood. 231 (45.3%) were mainly distributed in intensive care, followed by 108 (21.2%) in respiratory medicine and 79 (15.5%) in neurosurgery. Drug susceptibility test result shows that the resistant rate of tigecycline increased from 1.0% in 2017 to 10.1% in 2021, the difference was statistically significant (χ2=14.444,P<0.05). The results of carbapenemase inhibitor enhancement test showed that 461 carbapenemase strains (90.4%) of 510 CRKP strains, including 450 serinase strains (88.2%), 9 metalloenzyme strains (1.8%), and 2 strains (0.4%) produced both serine and metalloenzyme. 49 strains (9.6%) did not produce enzymes. Further typing by immunochromogenic assay showed that 461 CRKP strains were KPC 450 (97.6%) and IMP 2 (0.4%). 7 NDM (1.5%); 2 strains of KPC+NDM (0.4%); PCR results were as follows: 450 strains of blaKPC (97.6%), 2 strains of blaIMP (0.4%), 7 strains of blaNDM (1.5%), and 2 strains of blaKPC+NDM (0.4%). In conclusion, CRKP strains mainly originated from sputum specimens and distributed in intensive care department, and the drug resistance characteristics were mainly KPC type in carbapenemase production. Clinical microbiology laboratory should strengthen the monitoring of CRKP strains, so as to provide reference for preventing CRKP infection and reducing the production of bacterial drug resistance.
Subject(s)
Anti-Bacterial Agents/pharmacology , Carbapenems/pharmacology , Klebsiella pneumoniae/genetics , Hospital Distribution Systems , Retrospective Studies , Microbial Sensitivity Tests , beta-Lactamases/genetics , Bacterial Proteins/genetics , Drug Resistance, Bacterial/geneticsSubject(s)
Humans , Hospitals, Voluntary/supply & distribution , Economics, Hospital/ethics , Materials Management, Hospital/methods , Personnel, Hospital/psychology , Hospitals, Voluntary/organization & administration , Health Personnel/psychology , Coronavirus Infections/economics , Equity in the Resource Allocation , Harm Reduction , Consensus , Patient Care/ethics , Hospital Distribution Systems/economicsABSTRACT
BACKGROUND: The causative agents of leprosy are the well-known Mycobacterium leprae and the newly discovered Mycobacterium lepromatosis. This agent was found in 2008, and it was found to be the cause of diffuse lepromatous leprosy in two Mexican patients. OBJECTIVE: The objective of this work was to determine if M. leprae and M. lepromatosis were present in formalin-fixed and paraffin-embedded skin samples from cases from different regions in Mexico. METHODS: A total of 41 skin samples were obtained from 11 states of Mexico. All patients' samples were diagnosed by clinical and histopathological analyses. Total DNA was isolated using a Qiagen-DNeasy blood and tissue kit and molecular identification was achieved by two semi-nested polymerase chain reactions. RESULTS: The 41 patient included 33 samples from men and 8 samples from women; 29 samples were polymerase chain reaction (PCR)-positive to Mycobacterium and 12 samples were PCR-negative. From those 29 samples, 13 were PCR-positive to M. leprae, 8 to M. lepromatosis and 8 were positive to both species. The histopathological diagnosis included; Nodular lepromatous leprosy (NLL); Diffuse lepromatous leprosy (DLL); and Borderline leprosy (BL). The 29 PCR-positive samples were classified as follow: 14 NLL, 4 DLL, and 11 BL. In the 12 samples negative to Mycobacterium, 7 showed the NLL, 2 DLL and 3 BL. CONCLUSION: These findings add evidence to the M. leprae and M. lepromatous distribution, clinical forms and participation of dual infections in Mexico.
Subject(s)
Female , Humans , Male , Diagnosis , DNA , Hospital Distribution Systems , Leprosy , Leprosy, Borderline , Leprosy, Lepromatous , Mexico , Mycobacterium leprae , Mycobacterium , Polymerase Chain Reaction , SkinABSTRACT
OBJECTIVE: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea.METHODS: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps.RESULTS: Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000).CONCLUSION: Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.
Subject(s)
Geographic Mapping , Health Workforce , Health Services Accessibility , Hospital Distribution Systems , Korea , Neurosurgeons , Neurosurgery , Resource AllocationABSTRACT
OBJECTIVE: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea. METHODS: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps. RESULTS: Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000). CONCLUSION: Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.
Subject(s)
Geographic Mapping , Health Workforce , Health Services Accessibility , Hospital Distribution Systems , Korea , Neurosurgeons , Neurosurgery , Resource AllocationABSTRACT
Fanconi's anemia is a rare autosomal recessive genetic disorder characterized by congenital abnormalities and anaplastic anemia. Patients with this disorder has predisposition for leukemia, specifically acute myeloid leukemia. Risk for head and neck solid tumors are also increased. Head and neck cancers in patients with Fanconi's anemia are significantly different from those in patients without Fanconi's anemia in frequency, distribution, clinical course, and treatment. Therefore, we report a case of 23-year-old male with Fanconi's anemia, who presented with an oral tongue cancer treated with radical excision, bilateral neck dissection and careful postoperative radiation therapy.
Subject(s)
Humans , Male , Young Adult , Anemia , Congenital Abnormalities , Fanconi Anemia , Head , Hospital Distribution Systems , Leukemia , Leukemia, Myeloid, Acute , Neck , Neck Dissection , Tongue Neoplasms , TongueABSTRACT
Recentemente noticiou-se a difusão do uso da substância fosfoetanolamina sintética, conhecida como a pílula do câncer, entre portadores de neoplasia maligna. Ocorre que a substância, além de não contar com registro na Agência Nacional de Vigilância Sanitária, sequer havia concluído os estudos clínicos necessários à garantia de sua eficácia e segurança. Não obstante, o governo federal editou a Lei n. 13.269/2016, que autorizava o fornecimento pelo Sistema Único de Saúde sob determinadas condições, e diversas liminares foram concedidas obrigando o Estado a fornecê-la. A questão foi apreciada pelo Supremo Tribunal Federal em dois rumorosos julgamentos, em que a Corte suspendeu todas as liminares concedidas e suspendeu a eficácia da referida lei por indícios de inconstitucionalidade. Neste artigo analisamos os fundamentos das citadas decisões no contexto de posicionamentos anteriores da Corte e das orientações estabelecidas no julgamento do Agravo Regimental na Suspensão de Tutela Antecipada 175
Widespread use of the synthetic substance phosphoethanolamine, known as the cancer pill, was recently reported among patients with malignant neoplasm. However, the substance was not registered in the Brazilian National Health Surveillance Agency and the clinical studies necessary to guarantee its effectiveness and safety had not even been completed. Nevertheless, the federal government enacted Law number 13.269/2016, authorizing provision by the Brazilian National Public Health System under certain conditions, and various injunctions were granted that forced the state to provide it. The question was considered by the Supreme Court in two important judgments in which the Court suspended all injunctions granted and suspended the effectiveness of the law based on evidence of unconstitutionality. In this article, we analyze the legal grounds of the decisions in the context of previous positions of the Court and the guidelines established in judgment of STA 175-AgR/CE
Subject(s)
Humans , Male , Female , Drug Evaluation , Efficacy , Hospital Distribution Systems , Judicial Decisions , Jurisprudence , Neoplasms , Right to Health , Therapeutics , Clinical Study , Health Surveillance , Unified Health SystemABSTRACT
Cross-sectional descriptive study with a quantitative approach, whose objectives were to identify those responsible for the care of sterilized healthcare products after their distribution to inpatient units, structural and material resources available for transportation and storage, and to describe the care given to transport and storage of sterilized healthcare products in inpatient units, and the occurrence of events related to these products. Data were collected by checklist in a large teaching hospital from July to September 2012, completed by direct observation and interviews with nursing managers. After descriptive analysis, none of the 11 units met all recommendations concerning the structure, material resources or work processes for the transport and storage of sterilized healthcare products. Events related revealed lack of care of the healthcare teams in the units, and consequent risk to maintaining product sterility and patient safety.
Estudio descriptivo transversal, con abordaje cuantitativo cuyos objetivos eran identificar los responsables de los cuidados requeridos por Productos Sanitarios después de su distribución en unidades de hospitalización, y los aspectos estructurales y recursos materiales disponibles para su transporte y almacenamiento; describir cuidados entregados en el transporte y almacenamiento de Productos Sanitarios en unidades de hospitalización, eincidencia de eventos relacionados con esos productos. Los datos fueron recolectados en un hospital clínico de gran tamaño, entre julio y septiembre de 2012, a través de un checklist, llenado con observación directa y entrevistas a los gerentes de enfermería. Después de un análisis descriptivo, ninguna de las 11 unidades observó todas las recomendaciones referentes a estructura, recursos materiales y procesos de trabajo para el transporte y almacenamiento de los productos. Los eventos relacionados observados revelaron descuidos por parte del equipo de salud en unidades, y el consiguiente riesgo en la mantención de la esterilidad de productos y seguridad del usuario.
Estudo transversal, descritivo com abordagem quantitativa, cujos objetivos foram identificar os responsáveis pelos cuidados com os produtos para saúde, após a sua distribuição nas unidades de internação, e os aspectos estruturais e recursos materiais disponíveis para o seu transporte e armazenamento; descrever os cuidados dispensados com o transporte e armazenamento de produtos para saúde, nas unidades de internação e a ocorrência de eventos relacionados com esses produtos. Os dados foram coletados em um hospital de ensino de grande porte, de julho a setembro de 2012, por um checklist, preenchido por observação direta e uma entrevista com os gerentes de enfermagem. Após análise descritiva, nenhuma das 11 unidades atendia a todas as recomendações referentes à estrutura, recursos materiais e processos de trabalho para o transporte e armazenamento dos produtos. Os eventos relacionados observados revelaram descuidado da equipe de saúde nas unidades e consequente risco para a manutenção da esterilidade dos produtos e segurança do usuário.
Subject(s)
Humans , Perioperative Nursing , Sterilization , Hospital Distribution Systems , Materials Management, HospitalABSTRACT
Modelo do Estudo: Estudo de Caso. Objetivo do Estudo: O presente trabalho visou estudar o processo de compras e programação de materiais de um hospital público de ensino de nível terciário e analisar os perfis de itens de materiais de consumo faltantes em determinado período, com a finalidade de identificar como ferramentas de gestão de materiais podem ajudar na definição de políticas de compras e estoque. Metodologia: O estudo foi elaborado com base em análises qualitativas e quantitativas. As primeiras foram feitas por meio de coleta de dados relativos ao entendimento dos processos e estrutura interna da Divisão de Materiais do Hospital através de observação e entrevistas semi estruturadas entre o período de setembro a novembro de 2013. A relação dos itens faltantes em 2012 e 2013 foi obtida através do sistema de informação da instituição e a partir destes dados foram feitas as análises quantitativas dos perfis destes itens segundo as classificações ABC e VEN (ou XYZ). Resultado: Os resultados apontam que dos 8.595 itens de materiais de consumo do Hospital apenas 5% em quantidade são classificados como A na curva ABC, no entanto tais itens correspondem a 42% em valores. Já os itens vitais representam 49% do valor e 46% em termos de quantidade. Quando analisadas em conjunto, as duas curvas apontam que a maioria das quantidades de materiais de consumo do Hospital são classificados como vitais da curva C (36,35%) e os itens não essenciais da curva A representam tanto em valor como em quantidade a menor parcela de materiais. O perfil dos itens faltantes em 2012 e 2013 são semelhantes,o maior índice de faltas está nos itens vitais da curva C e a menor nos itens não essenciais da curva...
Model Study: Case Study. Purpose of the Study: This study aims to explore the purchasing materials process in a tertiary teaching hospital and analyze the missing items profiles in a given period in order to identify how materials management tools can help optimizing purchasing and inventory policies. Methodology: The study was based on qualitative and quantitative analyses. The first was made by means of collecting data to understand both processes and internal structure of the Materials Division through observation and semi-structured interviews between September-November 2013. A list of missing items in 2012 and 2013 was obtained from system information in order to analyze the profiles of these items according to the ABC and VEN (or XYZ) ratings. Results: The results show that out of 8,595 items of consumable materials, only 5 % in volume are classified as A in ABC curve, however such items correspond to 42 % in value. On the other hand, vital items represent 49 % on value and 46 % in terms of quantity. When analyzed together, the two curves show that most quantities of consumables materials are classified as vital from the C curve (36.35%) where as non-essential items from the A curve represent both in value and in volume the smallest amount portion of materials. The missing items profile in 2012 and 2013 were similar, the highest rate of faults is from vital and C curve materials and the smaller, of nonessentials of the A curve...
Subject(s)
Humans , Materials Management, Hospital , Health Services Administration , Hospitals, Teaching , Purchasing, Hospital , Hospital Distribution SystemsABSTRACT
El presente trabajo tiene la finalidad reflexionar sobre el uso de las teorías de Enfermería en la prßctica. A pesar de los esfuerzos de los profesionales de Enfermería en construir conocimiento a través de las teorías y modelos y del alto nivel alcanzado en la formación de Enfermería, aún no se evidencia en la prßctica la implementación de las teorías y odelos que fundamenten la misma. Por el contrario se ha considerado que la prßctica de Enfermería se ha basado en la técnica y el cumplimiento de las Leyes vigentes sobre los procedimientos rutinarios Se utilizó un abordaje Cuali-Cuantitativo-Descriptivo, interpretativo, estratificado por servicio, de corte transversal, en un universo de 165 enfermeros del Hospital Interzonal San Juan Bautista de la Provincia de Catamarca, cuya muestra seleccionada fue de 41 enfermeros de los servicios de Clínica, Terapia y Cirugía, seleccionada en forma estratificada por servicio en forma aleatoria...
The present work aims to reflect on the use of nursing theories in practice. Despite the efforts of professionals from nursing to build knowledge through the theories and models and the high level achieved in the training of nursing, still not evident in practice implementation of the theories and models that support the same. On the other hand has been considerednursing practice is based on the technique and the enforcement of existing laws on procedures routine was used an approach qualitative-quantitative-descriptive, interpretive, stratified by service, cross section, in a universe of 165 nurses of the Hospital Interzonal San Juan Bautista of the province of Catamarca, whose sample was 41 nursing of clinic services Therapy and surgery, selected as stratified by randomly service...
Subject(s)
Humans , Male , Female , Equity in the Resource Allocation , Nursing/statistics & numerical data , Hospital Distribution Systems , Legislation, Nursing , Practice Patterns, Nurses'/statistics & numerical data , Nursing Staff/statistics & numerical data , /legislation & jurisprudence , /organization & administration , ArgentinaABSTRACT
BACKGROUND AND PURPOSE: Symptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known. METHODS: We retrospectively identified 3,451 patients hospitalized because of ischemic stroke within 24 hours of symptom onset at 9 stroke centers in South Korea. Patients who did not undergo magnetic resonance imaging were excluded. SYSO was defined as stenosis or occlusion of cerebral arteries with relevant ischemic lesions in the corresponding arterial territory. The number, location, and severity of SYSOs and their effects on functional outcome were analyzed. RESULTS: In total, 1,929 of 3,057 subjects (63.1%) had SYSO. The most frequently affected vessels were the middle cerebral artery (34.6%), extracranial internal carotid artery (14%), vertebral artery (12.4%), and basilar artery (8.7%). SYSO predicted poor outcome on the modified Rankin Scale 3-6 (odds ratio, 1.77; 95% confidence interval, 1.46-2.15) with adjustments. Involvement of 2 or more vessels was observed in 30.6% of patients with SYSO and independently increased the risk of poor outcome (odds ratio, 2.76; 95% confidence interval, 2.12-3.59). The severity of SYSO was associated with outcome and showed a significant dose-response trend (P<0.001). The effect of SYSO on outcome did not significantly differ by individual arterial location (P for contrast=0.21). CONCLUSIONS: Approximately 60% of patients with acute ischemic stroke had SYSO, and the severity and number were inversely correlated with outcome. The results suggest that SYSO could predict stroke outcome.
Subject(s)
Humans , Basilar Artery , Carotid Artery, Internal , Cerebral Arteries , Cerebral Infarction , Cerebrovascular Disorders , Constriction, Pathologic , Hospital Distribution Systems , Magnetic Resonance Imaging , Middle Cerebral Artery , Prevalence , Prognosis , Republic of Korea , Retrospective Studies , Stroke , Vertebral ArteryABSTRACT
<p><b>OBJECTIVE</b>To explore the modern hospital and regional medical consumable reagents logistics system management.</p><p><b>METHODS</b>The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down.</p><p><b>RESULTS</b>Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution.</p><p><b>CONCLUSIONS</b>Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.</p>
Subject(s)
Hospital Distribution Systems , Indicators and Reagents , Quality ControlABSTRACT
With various increasing health sector's demand of medical materials, monitoring and tracking medical materials lot number has become the most important thing of hospital's medical materials management. This paper discussed and researched deeply the actual operation problem through data analysis and charts comparison, put forward realizing barcodes wireless scanning, and synchronizing information in local area network, so to improve the barcode input accuracy. Achieve the ultimate goal of completing medical materials lot number traceability.
Subject(s)
Hospital Distribution Systems , Materials Management, Hospital , Quality ControlABSTRACT
PURPOSE: In Korean society, extra-large hospitals are congested with the majority of patients. Because of the congestions, the urgent patients need to wait anywhere from as short as a month to around three months. These concentrations of the patients on the extra-large hospitals causes not only the economic problem in terms of loss of opportunity cost and resources of other medium and large hospitals but also the fear and the consequential stress of the patients and the families of the patients who are waiting for the surgeries. The phenomenon of the concentrations derived due to the insufficient information to the medical consumers. If the information on medical treatment services such as surgery schedule is provided before the selection of hospital, we expect that the selection of hospital for the patients and their family will differ, resulting in redistribution of concentration phenomenon. In this paper, we propose and verify the effective distribution system for the concentration on the extra-large hospitals. METHODS: Web simulation survey was conducted. A total 100 respondents were divided into 4 groups of 25 respondents and the different information was provided to each group. RESULTS: Through multiple comparisons among groups, only group which was provided with both information about 'the difference of surgical results' and 'the waiting time for surgery', had difference in significance. CONCLUSION: By providing two sets of information to patients, reckless selection of extra-large hospitals can be spread to more appropriate hospitals and therefore achieve effective distribution of the population concentration on extra-large hospital.
Subject(s)
Humans , Appointments and Schedules , Decision Theory , Estrogens, Conjugated (USP) , Hospital Distribution Systems , Patient Self-Determination Act , Surveys and QuestionnairesABSTRACT
Subject(s)
Humans , Male , Dentigerous Cyst , Hospital Distribution Systems , Radicular Cyst , Recurrence , Retrospective Studies , Surgery, OralABSTRACT
Herpes zoster is characterized by multiple groups of vesicles on an erythematous base located within the distribution of a single spinal or cranial sensory ganglion. Classically, herpes zoster occurs in elderly patients, distributed unilaterally within one dermatomal area. The response to antiviral treatment is usually good, with rare recurrence. Herein we report 5 cases of atypical herpes zoster, which showed non-ordinary clinical features of the onset age, location and distribution, clinical course and treatment response. Moreover, since herpes zoster is a viral disorder in dermatologic clinics, different treatment protocols according to various underlying conditions are crucial. Therefore, we reviewed pertinent remedies under such uncommon circumstances.
Subject(s)
Aged , Humans , Age of Onset , Clinical Protocols , Ganglia, Sensory , Herpes Zoster , Hospital Distribution Systems , RecurrenceABSTRACT
Herpes zoster is characterized by multiple groups of vesicles on an erythematous base located within the distribution of a single spinal or cranial sensory ganglion. Classically, herpes zoster occurs in elderly patients, distributed unilaterally within one dermatomal area. The response to antiviral treatment is usually good, with rare recurrence. Herein we report 5 cases of atypical herpes zoster, which showed non-ordinary clinical features of the onset age, location and distribution, clinical course and treatment response. Moreover, since herpes zoster is a viral disorder in dermatologic clinics, different treatment protocols according to various underlying conditions are crucial. Therefore, we reviewed pertinent remedies under such uncommon circumstances.
Subject(s)
Aged , Humans , Age of Onset , Clinical Protocols , Ganglia, Sensory , Herpes Zoster , Hospital Distribution Systems , RecurrenceABSTRACT
BACKGROUND: Molluscum contagiosum is a common cutaneous viral infection of the skin. Although molluscum contagiosum generally affects young children, the incidence in adults is rising. OBJECTIVE: The purpose of our investigation was to describe the clinical characteristics of 28 adults with biopsy-proven molluscum contagiosum. METHODS: We reviewed the medical records and clinical photographs of 28 patients who were diagnosed with molluscum contagiosum from June 2000 to May 2007. Personal and clinical information such as onset, age, gender distribution, clinical manifestations, associated diseases, pathologic characteristics and treatment modalities were investigated. RESULTS: Of the 28 patients, 19 (67.9%) were men and 9 (32.1%) were women. The average age of onset in men and women were 39.4 and 46.4 years, respectively and the overall average age of onset was 41.7 years. The most common clinical finding was a typical umblicated papule in 10 (35.7%) of the 28 cases. The atypical presentations including giant molluscum, chickenpox-like lesions, prurigo-like lesions and verruca-like lesions were also seen. The most common affected site was the genital area, followed by the head and neck, extremities and trunk. Except for the 21 asymptomatic patients, 7 patients complained of pruritus. Seropositive ELISA assays for HIV was found in 1 patient. Five patients were under immunosuppressive conditions such as HIV infection, sarcoidosis, taking immunosuppressant drugs after liver transplantation, chemotherapy for breast cancer and chemotherapy for gastric cancer. Molluscum bodies were confirmed in all patients through histologic findings. Molluscum extraction was mainly used as a treatment of molluscum contagiosum. CONCLUSION: In Korean literature, this is the first clinical study of molluscum contagiosum occurring in adults. Molluscum contagiosum in adults shows atypical clinical features, so it can be misdiagnosed as other diseases. We suggest that dermatologists should perceive clinical findings of molluscum contagiosum in adults and perform proper investigation and management.
Subject(s)
Adult , Child , Female , Humans , Male , Age of Onset , Breast Neoplasms , Enzyme-Linked Immunosorbent Assay , Extremities , Head , HIV , HIV Infections , Hospital Distribution Systems , Incidence , Liver Transplantation , Medical Records , Molluscum Contagiosum , Neck , Pruritus , Sarcoidosis , Skin , Stomach NeoplasmsABSTRACT
PURPOSE: To evaluate the clinical characteristics and results of outcomes in different types of orbital pseudotumor. METHODS: This study included 62 patients diagnosed with orbital pseudotumor between 2002 and 2007, who were followed-up for more than 6 months. The pseudotumor was classified into anterior, diffuse, apical, myositic, or lacrimal types according to computed tomography (CT) findings. All patients were initially treated with corticosteroids and checked for symptom improvement and response to the corticosteroids. RESULTS: Lacrimal type pseudotumor (61%, 39/62) showed the highest incidence, and lid swelling (97%, 60/62) was the most common symptom. Response rate to corticosteroid treatment was 84%, and the recurrence rate was 29%. CONCLUSIONS: The orbital pseudotumors were localized by computed tomography and classified to compare the symptoms, treatment efficacy and recurrence rates between the different types. The orbital pseudotumor is most commonly diagnosed based on clinical symptomsand radiologic features without biopsy. The orbital pseudotumor showed a good treatment response but also a high recurrence rate. Therefore, when starting treatment, it is important to consider differential diagnosis. It is recommended to carefully examine patients who have lid swelling for a few weeks with computed tomography before using corticosteroid treatment.
Subject(s)
Humans , Adrenal Cortex Hormones , Biopsy , Diagnosis, Differential , Hospital Distribution Systems , Incidence , Orbital Pseudotumor , Recurrence , Treatment OutcomeABSTRACT
O estudo identifica parâmetros de produtividade no Centro de Material e Esterilização, com base em documentos, observação e cronometragem do processamento de duas amostras: caixa de herniorrafia e pacote de curativo. A produção média mensal foi de 30.466,42 artigos, a capacidade de produção, por hora, foi de 10,3 artigos por funcionário. O tempo de processamento do curativo do expurgo ao armazenamento foi, em média, de 295 minutos; o processo manual utilizou 46 minutos e o automatizado, 88 minutos. O tempo da caixa de herniorrafia foi de 329 minutos; o processo manual utilizou 60 minutos e o automatizado, 98 minutos. O processamento manual do curativo utilizou 59,23% horas produtivas no expurgo; 26,31% guarda e distribuição; 10,94% esterilização e 3,28% preparo. Quanto à caixa de herniorrafia: no preparo 16,20%; no expurgo 11,84%; na guarda e distribuição 7,47% e na esterilização 1,89%. Este estudo possibilitou aferir resultados e analisar o processo de trabalho no CME.
This study identifies productivity indicators at a Sterilization Central Supply (CME) through documents, observation and time counting of theprocess for two items selected fromthe sample: a bandage pack and aherniorrhaphy box. The monthly average production was 30,466.42 items, and the production capacity per hour was 10.3 items per employee. The bandage pack averaged 295 minutes from theexpurgation area to storage; the manual process lasted 46 minutes and the automated 88 minutes. For the herniorrhaphy box the average was 329 minutes; the manual process lasted 60 minutes and automated 98 minutes. In the bandage kit, the manual process used up 59.23% of the productivityhours in the expurgation area, 3.28% in the preparation, 10.94% in the sterilization process, and 26.31% in storage and distribution. Figures for the manual process of herniorrhaphy boxwere: expurgation, 11.84%; preparation, 16.20%; storage and distribution, 7.47%; and sterilization,1.89%. The study made possible to assess the results and to analyze the working process at the CME.
El estudio identifica parámetros de productividad del Centro de Material y Esterilización, basados en documentos, observación y cronometraje procesadas en dos muestras: caja de herniorafia yfardo de curativo. El promedio de producción mensual fue de 30.466,42 artículos y el promedio de la capacidad de producción por hora fue 10,3 artículos por empleado. El tiempo de procesamiento del curativo del expurgoal almacenamiento fue en un promedio de 295 minutos; su proceso manual utilizó 46 minutos y lo automatizó en 88minutos. El tiempo de la caja de herniorafia fue 329 minutos; su proceso manual utilizó 60 minutos y lo automatizó en 98 minutos. El procesamiento manual del curativo fue: 59,23% horas productivas encima delexpurgo; 26,31% guarda y distribución; 10,94% esterilización y 3,28% preparo. Cuanto a la caja de herniorafia: en supreparo 16,20%; en el expurgo 11,84%; en la custodia y asignación 7,47% y en la esterilización 1,89%. El estudio posibilitó contrastar resultados y analizar el proceso de trabajo del CME.