Evaluación de las actividades de control mediante la lógica difusa compensatoria en una entidad hospitalaria / Evaluation of control activities through diffuse Compensatory Logic in a hospital entity

RESUMEN Fundamento: el control es fundamental para que un hospital logre alcanzar sus objetivos y metas trazadas, de lo contrario sería imposible que se puedan definir las medidas que se deben adoptar para alcanzarlos. Objetivo: evaluar las actividades de control como componente interno en una entidad hospitalaria cubana, mostrando la mejor dirección a seguir a la hora de la toma de las decisiones, con un bajo nivel de incertidumbres en los resultados. Métodos: se diseñó un modelo a través de la lógica difusa compensatoria, compuesto por los elementos fundamentales de la norma actividades de control. Resultados: las actividades de control en el hospital se encuentran en una categoría deficiente de algo verdadero, al influir de manera negativa la rotación del personal y los indicadores de rendimiento en el desempeño. Conclusiones: se obtuvo el índice de la gestión del control, al evidenciar que existen deficiencias notables en la implementación del mismo. Lo que permite al hospital establecer una estrategia de mejora, basadas en un plan de acción.

ABSTRACT Background: the control is essential for a hospital to achieve its objectives and goals, otherwise it would be impossible to define the measures to be taken to achieve them. Objective: to evaluate control activities as a component of internal control in a Cuban hospital entity, showing the best direction to follow when making decisions, with a low level of uncertainty in the results. Methods: a model was designed through Diffuse Compensatory Logic, composed of the fundamental elements of the control activities standard. Results: the control activities in the hospital are in a deficient category of something true, negatively influencing staff turnover and performance indicators. Conclusions: the control management index was obtained, showing that there are notable deficiencies in its implementation. Allowing the hospital to establish an improvement strategy based on an action plan.

Efficacy comparison of two administration methods of fluconazole in the treatment of intractable vulvovaginal candidiasis / 局解手术学杂志

Objective To discuss the efficacy comparison of two administration methods of fluconazole in the treatment of intractable vulvovaginal candidiasis( VVC) . Methods 200 patients with intractable VVC were selected in our hospital from January 2014 to January 2017;according to the random number table,all patients were divided into single-dose group and consolidation group,each with 100 cases;the single-dose group was orally administered a single dose of 150mg fluconazole,while the consolidation group was orally administered 150mg o-ral fluconazole(1 time/d, continuous treatment for 3d, and administering it 1 time after next menstruation);the clinical symptom remission time,curative effect,adverse reaction and recurrence were compared in two groups. Results The vaginal itching,abdomen pain,vaginal se-cretion,mucosal hyperemia,edema remission time and the treatment efficiency rate,adverse reaction rate of single group and consolidation group were basically the same;and the difference was not statistically significant (P>0. 05). During the 12-month follow-up,the recurrence rate of consolidated group was significantly lower than that of single-dose group,the difference was statistically significant(P<0. 05). Con-clusion Compared with the single dose,the fluconazole consolidation therapy also has the good therapeutic efficacy and safety in the treat-ment of intractable VVC,and it can effectively reduce the recurrence of patients,so it is worth further clinical promotion.

Incidence of Osteoporosis in Patients with COPD According to Different Methods of Glucocorticoid Administration / 결핵

BACKGROUND: There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. METHODS: A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. RESULTS: The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). CONCLUSION: The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.