Calidad de higiene en salas de cirugía por luminometría de adenosín trifosfato / Quality of Cleaning on Surgery Room by Adenosin Triphosfate Luminometry / Qualidade de higiene em salas de cirurgia por luminometria de adenosina trifosfato

Objetivo: evaluar la calidad del proceso de desinfección, medido en unidades relativas de luz (URL) en superficies ambientales de salas de cirugía, instrumentos reutilizables y de reuso mediante el equipo luminómetro 3M Clean Trace. Materiales: con un punto de corte en 250 URL, para definir adecuada calidad de la desinfección, se evaluó una muestra por conveniencia de 39 elementos: seis críticos de reuso, seis superficies ambientales y veintisiete de reutilización de difícil limpieza. Resultados: se encontró mala calidad en la mayoría de elementos evaluados. El gancho monopolar (reuso), la cánula de Frazzier (reutilización) y la mesa de medicamentos (superficie ambiental) fueron los elementos con niveles más elevados en cada grupo. Conclusiones: es necesario mejorar la calidad de limpieza y desinfección en salas de cirugía; el lu-minómetro demostró ser un instrumento útil en el control de calidad de este proceso; se requieren estudios adicionales para proponer puntos de corte más apropiados.

Objective: To assess the quality of the disinfection process, measured in relative light units (URL) on environmental surfaces in operating rooms, reusable and disposable instruments through the luminometer equipment 3M Clean Trace. Materials: With a cut-off point on 250 URL to define the adequate quality of disinfection, we evaluated a convenience sample of 39 elements, six disposable instruments of critical importance, six environmental surfaces and twenty-seven reusable that are difficult to clean. Results: Bad quality was found on most of the evaluated elements. The monopolar hook (disposable), the Frazzier cannula (reusable) and the medicine counter (environmental surface) were the elements with the highest levels in each group. Conclusions: It is necessary to improve the quality of cleaning and disinfection in operating rooms. The luminometer proved to be a useful instrument in the quality control of this process. Additional studies are required to propose more appropriate cut-off points.

Objetivo: avaliar a qualidade do processo de desinfecáo, medido em unidades relativas de luz (URL), em superficies ambientais de salas de cirurgia, instrumentos reutilizáveis e de reuso mediante a equipe luminómetro 3M Clean Trace. Materiais: com um ponto de corte em 250 URL, para definir adequada qualidade da desinfecáo, foi avaliada amostra por conveniencia de 39 elementos: seis críticos de reuso, sies superficies ambientais e vinte e sete de reutilizacáo de difícil limpeza. Resultados: Encontrou-se má qualidade na maioria de elementos avaliados. O gancho monopolar (reuso), a cánula de Frazzier (reutilizacao) e a mesa de medicamentos (superficie ambiental) foram os elementos com níveis mais elevados em cada grupo. Conclusoes: é preciso melhorar a qualidade de limpa e desinfeção em salas de cirurgia; o luminómetro demonstrou ser instrumento útil no controle de qualidade deste processo; requerem-se estudos adicionais para propor pontos de corte mais apropriados.

Preoperative sleep quality of inpatients and its influencing factors / 现代临床护理

Objective To evaluate the preoperative sleep quality of inpatients and analyze its influencing factors.Methods A self-designed questionnaire,Pittsburgh sleep quality index(PSQI)and self-rating anxiety scale(SAS)were used to investigate the sleep quality and anxiety of 114 inpatients before operation.The two groups were compared in terms of sleep quality and anxiety.The factors influencing the sleep quality were analyzed.Results Of the 114 preoperative inpatients,72.81%(83 cases)had poor sleep quality.The PSQI scores of preoperative inpatients were significantly higher than that in the healthy individuals,but significantly lower than that in the patients with insomnia(P<0.01).The main factors affecting the quality of sleep were fear of surgery,pain and discomfort,feeling strange with the ward settings,and worry about prognosis,totally causing 89.47%of the sleep disorders. Inpatients with poor sleep quality,37.3%was found suffering from anxiety.The rate was significantly higher than that of patients with good sleep quality(P<0.01).Conclusions The incidence of poor sleep quality is relatively high among the preoperative inpatients, mainly caused by fear of surgery,pain and discomfort.In order to improve the sleep quality,it is necessary to perform psychological and comfort intervention according to the sleep status of the patients.

Evaluation of the effects of evidence- based nursing on improving the quality of life of surgical patients / 中国实用护理杂志

ObjectiveTo study the effects of evidence-based nursing in improving the quality of life of surgical patients.Methods120 surgical patients in our hospital from October 2009 to October 2010 were selected as research object,and they were randomly divided into the control group (the routine nursing group)and the observation group (the evidence-based nursing group)with 60 cases in each group, then the HAMA,HAMD and SF-36 score of two groups before and after the nursing were analyzed and compared.ResultsThe HAMA and HAMD, SF-36 score of both groups ameliorated after nursing, but the amelioration of the observation group was better than those of the control group.ConclusionsThe effects of evidence-based nursing in improving the quality of life of surgical patients are better,and it is worthy of popularization and application in department of surgery.

Biliary Cystadenoma and Cystadenocarcinoma

Biliary cystadenomas are rare cystic neoplasms of the biliary ductal system. Cystadenomas have a tendency to recur, particularly following their incomplete excision, with the potential for malignant transformation. Cystadenocarcinomas are very rare and; despite complete resection, can recur in a short time. A cystadenoma cannot be easily differentiated from a cystadenocarcinoma preoperatively or intraoperatively; therefore, complete surgical resection should be always considered. Four biliary cystadenoma and one biliary cystadenocarcinoma cases, treated at the Kyung Hee Medical Center, between 1998 and 2003, are reported. The patients were comprised of one man and four women, with a mean age of 45 years. Four patients presented with abdominal pain or jaundice, and the other was asymptomatic, with an incidentally discovered liver tumor. Preoperative CT scans demonstrated a multilocular cyst in four patients and a choledochal cyst-like appearance in the other. All patients underwent complete excision. One cystadenoma arose in the extrahepatic bile duct and the other four appeared in the liver. A histological examination revealed a mesenchymal stroma, which resembling ovary, in two cystadenomas. None of the four patients with a cystadenoma developed a recurrence. However, the patient with a cystadenocarcinoma underwent two pulmonary wedge resections for pulmonary metastases 14 and 21 months after the liver resection.

A Nosocomial Infection Point-Prevalence Survey in Departments of Internal Medicine and Surgery:Results and Analysis / 中华医院感染学杂志

0.05).The most prevalent infections found were different between internal medicine department and surgical department(representing 30.7% and 23.1%,respectively);the main pathogens were G bacteria;surgical department had higher percent of antibiotic usage than that of internal medicine department(51.1% vs 42.9%,P

Differences in Serum CEA Level between Colon and Rectal Cancer

We investigated whether there is differences in serum level of carcinoembryonic antigen (CEA) between patients with colon and rectal cancer. Preoperative serum levels of CEA was determined in 65 patients with colon cancer and in 88 patients with rectal cancer. Cut-off value recommended by manufacturers is 5 ng/ml for CEA. At the recommended cut-off levels for CEA, overall sensitivity of CEA was 43.1 percent for colon and 42.0 percent for rectal cancer. In colon cancer CEA was elevated in 38.4, 46.2, 60 percent of patients with Dukes Stages B, C, and D, respectively. In rectal cancer CEA was elevated in 12.5, 31.6, 44.8, 84.6 percent of patients with Dukes Stages A, B, C, and D, respectively. In Stages B, and C, sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. In Stages D, sensitivity of CEA was higher in rectal cancer than in colon cancer, but the difference was not significant. In overall stages sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. The difference was not significant either in overall or in different stages of colon and rectal cancer.