ABSTRACT
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common and preventable infections in mechanically ventilated patients. It is associated with a high mortality rate. To prevent VAP, various strategies address this issue using "VAP-bundles", which are implemented in many intensive care units. The risk of acquiring VAP starts with the induction of anesthesia, strictly speaking at the time of intubation. This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years). Procedures beyond standard hygienic precautions for VAP prevention are reviewed. METHODS: A literature search in different databases (PubMed, Cochrane, Ovid und CINAHL) over the last five years. RESULTS: Beyond standard hygienic precautions, microaspiration should be avoided to prevent VAP. During mechanical ventilation at least 5 cm H2O PEEP is advised. Continuous monitoring and adjustment of cuff pressure is necessary. All patients mechanically ventilated after general anesthesia for more than 24 h should be intubated with an ETT with a port for subglottic suctioning.
Subject(s)
Anesthesia , Pneumonia, Ventilator-Associated/prevention & control , Humans , Hygiene , Infection Control , Pneumonia, Ventilator-Associated/epidemiology , Pneumonia, Ventilator-Associated/microbiology , Respiration, Artificial/adverse effects , Respiration, Artificial/methodsSubject(s)
Hospitals, Teaching/organization & administration , Pathology Department, Hospital/organization & administration , Planning Techniques , Hospital Bed Capacity, 500 and over , Hospitals, Urban/organization & administration , Management Audit , Process Assessment, Health Care , Professional Staff Committees , Social Responsibility , VirginiaABSTRACT
We used magnetic resonance imaging in 41 patients with shoulder pain. Magnetic resonance was found useful in depicting the spectrum of rotator cuff abnormalities associated with mechanical impingement including both large and small rotator cuff tears as well as tendinitis. Abnormalities of the capsular mechanism, osseous tumors, osteonecrosis, and injuries to the supporting musculature are also well depicted.
Subject(s)
Magnetic Resonance Imaging , Pain/etiology , Shoulder Joint/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Bursitis/diagnosis , Humans , Image Enhancement , Middle Aged , Reference Values , Shoulder Injuries , Shoulder Joint/abnormalities , Tendinopathy/diagnosisSubject(s)
Occupational Medicine , Women, Working , Women , Carcinogens , Chemical Industry , Data Display , Employment , Female , Humans , Pregnancy , Teratogens , WorkSubject(s)
Abnormalities, Drug-Induced/etiology , Air Pollutants, Occupational/adverse effects , Maternal-Fetal Exchange , Chromosome Aberrations/chemically induced , Chromosome Disorders , Female , Germany, West , Humans , Occupational Health Services/legislation & jurisprudence , Occupational Medicine , PregnancySubject(s)
Absenteeism , Disability Evaluation , Occupational Diseases/prevention & control , Work Capacity Evaluation , Adult , Female , Germany, West , HumansABSTRACT
Monoclonal antibodies were used to determine the level of circulating helper and suppressor T cells in 34 infants and adults with severe atopic dermatitis and in normal controls. The percentage of OKT3 (total T lymphocytes) was reduced significantly in all the atopic infants. The percentage of OKT8 (suppressor-cytotoxic T lymphocytes) was reduced significantly in all patients with active lesions. The percentage of T gamma lymphocytes was reduced in all the atopic patients with or without active lesions.
Subject(s)
Antibodies, Monoclonal/analysis , Dermatitis, Atopic/immunology , T-Lymphocytes/immunology , Adolescent , Adult , Child , Child, Preschool , Humans , Immunity, Cellular , Leukocyte Count , Receptors, Fc/analysis , T-Lymphocytes, Helper-Inducer/immunology , T-Lymphocytes, Regulatory/immunologyABSTRACT
Report on women working in the chemical industry. Attention is drawn to the occupational medicine problems: sex-specific physical differences, occupational protection for women, rate of sickness -- absences, accidents, problems regarding health, double amount of stress -- part-time employment, health awareness of the working women, precautional and rehabilitation measures, and measures beneficial to health.
