Predisposing, Enabling, And Reinforcing Factors That Influence Full Basic Immunization Coverage In Bangkalan District, Madura Island In 2017

@#The cases of morbidity and mortality of babies and toddlers are continue to occur because of negligence of the mothers in providing complete basic immunization to their babies. This study is a cross-sectional study that was conducted to identify the predisposing, enabling, and reinforcing factors that influence full basic immunization coverage. The study was performed on mothers who had 9-12 months old child spread in 22 villages, purposively selected through from 22 community health centers in Bangkalan District, Madura Island. 200 mothers were selected as the study's respondents. The data were collected through questionnaires and from the book of "Kesehatan Ibu dan Anak" (KIA). The result of the study was obtained using logistic regression statistical test and it showed that the factors that influenced of full basic immunization coverage in Bangkalan District, Madura Island, were family income as predisposing factor (OR=2.26; 95% CI= 1.14 to 4.51; p= 0.020); health facility as enabling factor (OR=3.03; 95% CI= 1.59 to 5.80; p= 0.001); and community leader support as reinforcing factor (OR=2.56; 95% CI= 1.33 to 4.92; p= 0.005).

Factors Affecting Contact Dermatitis On Palm Oil Plantation Workers Of Pt. X In Semitau Sub-District

@#The prevalence of occupational skin diseases reaches 20% up to 70% around the world. Occupational contact dermatitis cases reached 1.3-8.1 per 10,000 full-time workers per year in two decades. This research aims to identify the relationship between predisposing factors, enabling factors, and reinforcing factors on the contact dermatitis cases on palm oil plantation workers of PT. X in Semitau Subdistrict. This study design was a cross-sectional involving 72 samples. The independent variables covered age, gender, level of knowledge, use of Personal Protective Equipment (PPE), tenure, chemical contact, personal hygiene, history of occupational dermatitis, occupational history, and Occupational Safety and Health Management System (SMK3). Then, the dependent variable was occupational dermatitis cases. A total of 54.2% of respondent suffered from occupational dermatitis. Some respondent were elderly (43.1%) and most of the subject were female (62.5%). The respondents had a good level of knowledge (37.5%), good personal hygiene (52.8%), and use complete PPE (25%). A total of 51.4% of respondent did not have chemical contacts and those who have <2 years of tenure reached 45.8%. Most of the subjects did not have an occupational history (81.9%) and occupational dermatitis history (75%). Half of the subjects had a good level of application of SMK3. Chi-Square Test results showed significant values of personal hygiene, use of PPE, and a history of the disease (<0.05) with p values of <0.05. There is a strong relationship between personal hygiene, the use of PPE, and the history of occupational dermatitis on palm oil plantation workers of PT. X in Semitau Subdistrict.

A clinical study of urinary tract infections in diabetics and non-diabetics patients

Background: The main aim of the present study is to investigate the differences in clinical, microbiological, characteristics of Urinary tract infection between diabetic and non-diabetic patients and influence of diabetes on the spectrum of URO pathogens and the antimicrobial resistance in patients with urinary tract infections.Methods: The present study is conducted from February 2018-April 2019 in Narayana general hospital. A total of 181 diabetics and 124 non-diabetics are included. A thorough history examination investigations done. The final data was analysed using statistical package SPSS. The percentages in different categories were compared using chi square test and means were compared using student ‘t’ test.Results: The mean age among diabetic and non-diabetic patients was 60.2+/-13.79 years and 53.47+/-18.56 years. Fever is the most common presenting symptom. BPH was the most common predisposing factor in both diabetes and non-diabetes followed by indwelling catherization but there was no statistically significant difference. Diabetics with UTI majority (87.14%) had glyco HBA1C >6.5% with p<0.001. The prevalence of recurrent UTI is higher in diabetics compared to non-diabetics however difference was not statistically significant. Recurrent UTI is higher in females in both diabetics and non-diabetics. The presence of E coli is significantly higher in diabetics compared to non- diabetics. The antimicrobial resistance pattern was similar in both diabetic and no-diabetic subjects in E coli with maximum sensitivity to meropenem and least to ampicillin and there is no statistically significant difference.Conclusion: The host factors found to be associated with UTI are female sex, presence of diabetes, poor glycemic control, presence of fever. No correlation was noted with age, duration of diabetes and type of treatment for diabetes. An elevated HBA1C correlates with occurrence of UTI. Escherichia coli (E. coli) was the most frequent uropathogen. The resistance of uropathogens to antibiotics are similar in patients with and without diabetes and non-diabetes.

Principales factores de riesgo en la aparición del cáncer cervicouterino / Main risk factors in the emergence of cervical cancer

Se realizó un estudio descriptivo y transversal de 125 pacientes, atendidas en la Consulta de Patología de Cuello, perteneciente al área de salud del Policlínico Universitario Municipal de Santiago de Cuba, durante el 2016, con vistas a describir los principales factores que propiciaron la aparición del cáncer cervicouterino. En la serie predominaron la neoplasia intracervical de grado I, la cervicitis crónica y las mujeres que comenzaron sus relaciones sexuales a los 15-19 años de edad (68,8 por ciento). Resultó significativa la presencia de leucorrea, sangrado poscoital y el virus del papiloma humano como antecedente de infección de transmisión sexual. Se destacó el papel negativo del cambio frecuente de pareja. Quedó demostrada la necesidad de que los profesionales de la salud consoliden sus conocimientos teóricos y prácticos sobre el cáncer cervicouterino, con énfasis en la educación sexual y reproductiva de las féminas, a través de la promoción y prevención de salud en la atención primaria

A descriptive and cross-sectional study of 125 patients, assisted in the Neck Pathology Service, belonging to the health area of the Municipal University Polyclinic in Santiago de Cuba, was carried out during 2016, aimed at describing the main factors that favored the emergence of cervical cancer. In the series there was a prevalence of grade I intracervical neoplasm, chronic cervicitis and women whose sexual relationships began at 15-19 years (68.8 percent). The presence of leukorrhea, postcoital bledding and human papilloma virus as history of sexual transmitted infection was significant. The necessity that health professionals consolidate their theoretical and practical knowledge on cervical cancer, with emphasis in the sexual and reproductive education of women, through the promotion and health prevention in primary care was demonstrated

Fungal infections of the central nervous system in critically ill children / 中国小儿急救医学

Fungal infections of the central nervous system are still devastating and difficult to treat. A greater understanding of host characteristics, diagnostic criteria, and therapeutic options about the severe central nervous system fungal infection,has led to important advances in the diagnosis and management,and resulting in improved outcomes.

Predisposing Hemodynamic Factors Associated with a Failed Apnea Test during Brain Death Determination / 대한구급학회지

BACKGROUND: The apnea test is an essential component in the clinical determination of brain death, however it may incur a significant risk of complications such as hypotension, hypoxia and even cardiac arrest. We analyzed the risk factors associated with a failed apnea test during brain death assessment in order to predict and avoid these adverse events. METHODS: Medical records on apnea tests performed for brain-dead donors at our institution between January 2009 and January 2016 were retrospectively reviewed. Age, gender, etiology of brain death, use of catecholamines and results of arterial blood gas analysis (ABGA), systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure and central venous pressure prior to apnea test initiation were collected as variables. A-a gradient and P(aO2)/F(iO2) were calculated for more precise assessment of the respiratory system. In total, 267 cases were divided into two groups based on those who completed the apnea test and those who failed the test. RESULTS: 13 cases failed the apnea test. Among them, seven cases failed due to severe hypotension (SBP < 60 mmHg) and the others failed due to refractory hypoxia. In terms of hemodynamic state, SBP was significantly higher in the completed test group than the failed group (126.5 ± 23.9 vs. 103 ± 15.2, respectively; p = 0.001). In ABGA, the completed test group showed significantly higher P(aO2)/F(iO2) (313.6 ± 229.8 vs. 141.5 ± 131.0, respectively; p = 0.008) and a lower A-a gradient (278.2 ± 209.5 vs. 506.2 ± 173.1, respectively; p = 0.000). In multivariable analysis, low SBP (p = 0.003) and high A-a gradient (p = 0.044) were independent risk factors associated with a failed apnea test. CONCLUSIONS: Although the unexpected adverse events during the apnea test for brain death determination do not occur frequently, they can be fatal. If a brain-dead patient has low SBP and a high A-a gradient, clinicians should pay more attention and prepare for potential complications prior to the apnea test.

Predisposing Hemodynamic Factors Associated with a Failed Apnea Test during Brain Death Determination / 대한중환자의학회지

BACKGROUND: The apnea test is an essential component in the clinical determination of brain death, however it may incur a significant risk of complications such as hypotension, hypoxia and even cardiac arrest. We analyzed the risk factors associated with a failed apnea test during brain death assessment in order to predict and avoid these adverse events. METHODS: Medical records on apnea tests performed for brain-dead donors at our institution between January 2009 and January 2016 were retrospectively reviewed. Age, gender, etiology of brain death, use of catecholamines and results of arterial blood gas analysis (ABGA), systolic/diastolic blood pressure (SBP/DBP), mean arterial pressure and central venous pressure prior to apnea test initiation were collected as variables. A-a gradient and P(aO2)/F(iO2) were calculated for more precise assessment of the respiratory system. In total, 267 cases were divided into two groups based on those who completed the apnea test and those who failed the test. RESULTS: 13 cases failed the apnea test. Among them, seven cases failed due to severe hypotension (SBP < 60 mmHg) and the others failed due to refractory hypoxia. In terms of hemodynamic state, SBP was significantly higher in the completed test group than the failed group (126.5 ± 23.9 vs. 103 ± 15.2, respectively; p = 0.001). In ABGA, the completed test group showed significantly higher P(aO2)/F(iO2) (313.6 ± 229.8 vs. 141.5 ± 131.0, respectively; p = 0.008) and a lower A-a gradient (278.2 ± 209.5 vs. 506.2 ± 173.1, respectively; p = 0.000). In multivariable analysis, low SBP (p = 0.003) and high A-a gradient (p = 0.044) were independent risk factors associated with a failed apnea test. CONCLUSIONS: Although the unexpected adverse events during the apnea test for brain death determination do not occur frequently, they can be fatal. If a brain-dead patient has low SBP and a high A-a gradient, clinicians should pay more attention and prepare for potential complications prior to the apnea test.

Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals / 소아과

PURPOSE: Information on the clinical features of lung abscess, which is uncommon in children, at hospitalizationis helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. METHODS: The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. RESULTS: Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. CONCLUSION: The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.

Relations of Whole Grain Consumption with Predisposing, Reinforcing, and Enabling Factors among Korean Adults

This study compared levels of whole grain consumption-related predisposing, reinforcing, and enabling factors according to socio-demographic variables, and examined how these factors are associated with whole grain consumption frequency among Korean adults. A survey questionnaire was administered to a convenience sample of adult males and females aged 20~59 years (n=300). The questionnaire included questions on predisposing, reinforcing, and enabling factors in relation to whole grain consumption as well as a brief whole grain food frequency questionnaire. Female subjects showed a significantly higher level of negative beliefs on health.nutrition.taste.texture while showing a significantly lower level of social support compared to that of males. The age group of 40~59 years showed a significantly higher social support level than the age group of 20~39 years. Results from multivariate regression analyses showed that different combinations of predisposing, reinforcing, and enabling variables were significant in predicting whole grain consumption frequency according to sex and age. The study findings can be used for developing specific target-oriented nutrition intervention programs for promotion of whole grain intake among Korean adults.

Incidencia del síndrome metabólico en una comunidad del municipio de II Frente oriental "Frank País García" / Incidence of the metabolic syndrome in a community of II Frente Oriental "Frank País García" municipality

Se efectuó un estudio descriptivo y transversal de 73 personas, pertenecientes la comunidad de Mícara en el municipio de II Frente de la provincia de Santiago de Cuba, durante el 2011, a fin de determinar la incidencia del síndrome metabólico en la misma y su relación con variables seleccionadas. El diagnóstico de la citada afección se basó en los criterios de la Organización Mundial de la Salud. Se utilizaron la proporción y el porcentaje como medidas de resumen. En la serie, el síndrome metabólico tuvo una incidencia de 19,1 % y predominó en el sexo masculino, los mayores de 30 años, la categoría de directivos, así como aquellos con excesivo consumo energético y actividad física ligera. Se recomendó realizar actividades de intervención educativa para modificar los estilos de vida, eliminar los factores predisponentes a la enfermedad y mejorar la calidad de vida de los afectados.

A descriptive and cross-sectional study of 73 persons, belonging to the community of Mícara in II Frente municipality from Santiago de Cuba province was carried out during 2011, in order to determine the incidence of the metabolic syndrome in it, and its relation to selected variables. The diagnosis of the mentioned disorder was based on the criteria of the World Health Organization. Proportion and percentage were used as summary measures. In the series, the metabolic syndrome had an incidence of 19.1% and it prevailed in the male sex, those older than 30 years, the category of managers, as well as those with excessive energy consumption and poor physical activity. It was recommended to carry out educational intervention activities to modify the lifestyles, to eliminate the predisposing factors for the disease and to improve the life quality of the affected persons.

A Case of Oral Myiasis Caused by Lucilia sericata (Diptera: Calliphoridae) in Korea

We report here a case of oral myiasis in the Republic of Korea. The patient was a 37-year-old man with a 30-year history of Becker's muscular dystrophy. He was intubated due to dyspnea 8 days prior to admission to an intensive care unit (ICU). A few hours after the ICU admission, 43 fly larvae were found during suction of the oral cavity. All maggots were identified as the third instars of Lucilia sericata (Diptera: Calliphoridae) by morphology. We discussed on the characteristics of myiasis acquired in Korea, including the infection risk and predisposing factors.

Factores asociados al uso de servicios de atención primaria por adultos mayores de Cartagena, Colombia / Factors associated with senior citizens using primary healthcare services in Cartagena, Colombia

RESUMEN Objetivo Establecer los factores asociados al uso de los servicios de salud por los adultos mayores de Cartagena-Colombia. Métodos Estudio transversal. Con una población de 66 795 adultos mayores, se estimó una muestra de 656. Muestreo estratificado. Se aplicó el cuestionario "uso de los servicios de salud". Se utilizó estadística descriptiva y regresión logística para modelar la probabilidad de ser usuario del servicio. Resultados Participaron del estudio 656 adultos mayores, con un promedio de edad de 67,9 años. Consultaron por enfermedad, en el último mes, 407 participantes (62,0 %) de los cuales 376 (92,4 %) consultó 1 o 2 veces. Residir en estrato socio-económico 4, 5 y 6) (chi² 4,14 p=0,043), tener una enfermedad diagnosticada (chi² 3,82 p=0,051), enfermedad crónica (chi² 7,0 p=0,008) o esperar 30 minutos o menos para ser atendidos (chi² 3,17 p=0,075), son factores asociados al uso de los servicios de atención primaria en salud por parte de los adultos mayores en Cartagena. En el modelo de regresión las variables tener enfermedad diagnosticada (chi²3, 59 p=0,0581) y esperar 30 minutos o menos para ser atendido (chi² 3,02 p=0,0818), fueron variables explicativas del uso de los servicios. Conclusión El uso de los servicios de atención primaria por parte de los adultos mayores en Cartagena está influido por múltiples dimensiones como residir en estrato socio-económico medio, tener enfermedad diagnosticada, padecer enfermedad crónica y esperar 30 minutos o menos para ser atendidos.

Objective Establishing the factors associated with using healthcare services for the aged in Cartagena, Colombia. Methods This was a cross-sectional study. A 656 sample-size was estimated for a population of 66,795 senior citizens; stratified sampling was used. A questionnaire entitled "Using healthcare services" (Uso de los servicios de salud) was used; descriptive statistics and logistical regression were then used for modeling the probability of being a healthcare service user. Results 656 senior citizens participated in the study; average age was 67.9 years old. 407 of the participants had consulted for disease during the last month (62.0 %); 376 of them (92.4 %) had consulted once or twice. Living in socio-economicstrata4, 5 and/or 6 (Chi² 4.14; p=0.043), having a diagnosed disease (Chi² 3.82 p=0,051), suffering from a chronic disease (Chi² 7.0; p=0.008) or waiting for 30 minutes or less to be seen (Chi² 3.17; p=0.075) were factors associated with using primary healthcare services by senior citizens in Cartagena. Having a diagnosed disease (Chi² 3.59; p=0.0581) and waiting for 30 minutes or less to be seen (Chi² 3.02; p=0.0818) were the regression model variables explaining healthcare service use. Conclusion A senior citizen using primary healthcare services in Cartagena was influenced by variables such as residing in mid-level socio-economic strata, having a diagnosed disease, suffering from a chronic disease and waiting for 30 minutes or less to be seen.

Community acquired Listeria monocytogenes meningitis in adults / 中华急诊医学杂志

Objective To study risk factors associated with predisposition to Lm -ABM in adult patients and to evaluate the clinical features,management and out in this cohort of patients because Listeria monocytogenes (Lm) is the third most common cause of acute community acquired bacterial meningitis (Ac-ABM),after Streptococcus pneumoniae and Neisseria meningitides aetiologies.Methods A descriptive,prospective study carried out in a tertiary grade medical center emergency department in Beijing over a 10 -year period.During the study period,15 patients of Lm- ABM were included.Comparison of episodes of Lm - ABM versus other aetiologies was made.Results Fifteen episodes of Lm - ABM were identified in327 adult Ac - ABM patients.Three cohorts of individuals were vulnerable to Lm - ABM:the elderly ( RR=3.14; 95％ CI 1.84-5.35),the immunocompromised (RR =3.34; 95％ CI2.08-5.38),and pregnant women ( RR 12.48 ; 95％ CI 3.29 ～ 47.39 ).The classic triad of fever,neck stiffness,and altered mental status was present in 40％ (6 of 15) Lm - ABM patients.Similarly,40％ patients had at least one of cerebrospinal fluid (CSF) samples with features met the criteria of typical bacterial meningitis.The coverage of empirical antimicrobial therapy was microbiologically inadequate for 13 ( 86.7％ ) patients.The mortality rate was 33.3％ (5 of 15),and 7 (46.7％ ) of 15 patients led to an unfavorable outcome ( GOS ＜ 4),both of which were significantly higher than those in other aetiologies of Ac - ABM ( P =0.015P =0.009 respectively). Conclusions Our study showed the elderly,the immunocompromised patients,and pregnant women predisposed to Ac - ABM most likely to be Listeria monocytogenes aetiology.In contrast with similar previous reports, the current study showed that patients with meningitis due to Listeria monocytogenes did not present with atypical clinical features.A high proportion of patients received empirical antimicrobial therapy that did not cover Listeria monocytogenes.Lm - ABM is still a serious disease that leads to high morbidity and mortality rates.With these important caveats in mind,our findings have implications for clinical practice and food safety policy makers.

Research progress in epidemiology of microbial keratitis / 中华实验眼科杂志

Microbial keratitis is one of major causes of vision loss and blindness worldwide today,especially in developing countries in Asia and Africa.Population-based annual incidence of microbial keratitis is 0.36/10000 to 79.9 /104.The epidemiological features and predisposing factors for microbial keratitis varies significantly from country to country,even from region to region within the same country.The progress of research on describing epidemiological characteristics demographiccharacteristics andpredisposing factors of microbialkeratitiswere reviewed in this paper.

Predisposing Factors Associated With Chronic and Recurrent Rhinosinusitis in Childhood

PURPOSE: There is currently no information regarding predisposing factors for chronic and recurrent rhinosinusitis (RS), although these are considered to be multifactorial in origin, and allergic diseases contribute to their pathogenesis. We evaluated the predisposing factors that may be associated with chronic and recurrent RS. METHODS: In this prospective study, we examined patients with RS younger than 13 years of age, diagnosed with RS at six tertiary referral hospitals in Korea between October and December, 2006. Demographic and clinical data related to RS were recorded and analyzed. RESULTS: In total, 296 patients were recruited. Acute RS was the most frequent type: 56.4% of the patients had acute RS. The prevalences of other types of RS, in descending order, were chronic RS (18.9%), subacute RS (13.2%), and recurrent RS (11.5%). Factors associated with recurrent RS were similar to those of chronic RS. Patients with chronic and recurrent RS were significantly older than those with acute and subacute RS. The prevalences of allergic rhinitis, atopy, and asthma were significantly higher in patients with chronic and recurrent RS than those with acute and subacute RS. CONCLUSIONS: An association between atopy and chronic/recurrent RS, compared to acute and subacute RS, suggests a possible causal link.

Frequency and Predictive Factors of Lymph Node Metastasis in Mucosal Cancer

PURPOSE: The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. MATERIALS AND METHODS: A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. RESULTS: Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. CONCLUSIONS: The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.

Frequency and Predictive Factors of Lymph Node Metastasis in Mucosal Cancer

PURPOSE: The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. MATERIALS AND METHODS: A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. RESULTS: Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. CONCLUSIONS: The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.

Nosocomial Infection and Risk Factors in Our Cancer Center 2006-2007 / 中华医院感染学杂志

OBJECTIVE To study the incidence rate of nosocomial infection and risk factors in our Cancer Center during 2006-2007.METHODS All the reported cases of nosocomial infection from 2006 to 2007 in our Center were analyzed retrospectively.RESULTS From the 50011 hospitalized patients,952 were infected.The infection rate of the hospital was 1.9%,with the case infection rate of 2.12%.Infection usually occurred at the respiratory tract,gastrointestinal tract and oral cavity,with the constituent ratio of 48.6%,34.12% and 13.22%,respectively.Cancer,chemotherapy,radiotherapy and surgery were the leading predisposing factors.CONCLUSIONS The main infected site is respiratory tract.Cancer and the clinical therapies may lead to infection,so we should pay more attention to the nosocomial infection in the cancer therapy.

Distribution and Clinical Characteristics of FungalSpecies Isolated from Blood Cultures over a 7-yearPeriod at a Tertiary-care Hospital / 대한임상미생물학회지

BACKGROUND: Fungemia has increased over the past decade and is an important cause of significant morbidity and mortality. Since 1980, there has been an increase in the worldwide studies of nosocomial bloodstream fungal infections. We analyzed the distribution and the clinical characteristics of fungemia at a tertiary care hospital, Kyung Hee University hospital. METHODS: We retrospectively reviewed medical records and laboratory findings of 139 patients who had fungemia from January 2000 to December 2006. We investigated the incidence of each fungal species, yearly occurrence, underlying diseases, hospitalized units, predisposing factors, use of the antifungal agents, mortality, and the characteristics of the expired group. RESULTS: The most common species isolated was C. albicans (40.3%), followed by C. tropicalis (24.5%). Overall, fungemia occurrence showed an increasing trend during the study period, except for the year 2004. Common predisposing factors were previous antimicrobial therapy (89.2%), central venous catheter (78.4%), and ICU admission state at diagnosis (59.7%). among the 139 patients, 98 (70.5%) were treated. Primary choice of antifungal agents included fluconazole (70.4%) and amphotericin B (29.0%). Overall mortality was 38.9% with the highest rate (47.1%) in patients with C. tropicalis and the lowest one (22.2%) in patients with C. parapsilosis. Predisposing factors for mortality due to fungemia in the univariate analysis included only mechanical ventilation (P=0.008). CONCLUSION: Fungemia in the tertiary care hospital was caused predominantly by C. albicans and followed by C. tropicalis. The mortality rate was high and interspecies differences existed.

Results of Recurrent Patellar Instability after Trauma According to Anatomical Predisposing Factors

PURPOSE: We analyzed the results of lateral retinacular release(LRR) and proximal realignment for recurrent patellar instability after trauma according to the anatomical predisposing factors. MATERIALS AND METHODS: Twelve patients of fifteen cases of recurrent patellar instability had been evaluated. Clinical assessment were performed by Q-angle, apprehension test, passive patellar tilt test and general joint laxity. The anatomical predisposing factors assessed by plain radiographs included patella alta, sulcus angle, femoral trochlear dysplasia, genu valgum and patellar dysplasia. Clinical results were assessed by Kujala scoring system. Radiographic results were assessed by congruence angle. The results were analyzed according to the predisposing factors. RESULTS: Patella alta was observed in eight, increased sulcus angle in six, trochlear dysplasia in twelve, genu valgum in five and patella dysplasia in four cases. The result of treatment (Kujala score / congruence angle) was 85.8 / 9.7degrees in group A(predisposing factors > or = 3) and 91.4 / -5.3degrees in group B (predisposing factors<3)(p=0.036). We had 4 cases of recurrence after operation and genu valgum was related with recurrence rate. CONCLUSION: The clinical results of LRR and proximal realignment for recurrent patellar instability developed after trauma were worse in cases with more anatomical predisposing factors.