口腔医护人员职业危险因素分析

职业危险自从18世纪职业医学之父Bernadio Ramazini提出这个概念之后[1],职业危险就愈来愈受到人们的重视和关注。口腔医护人员由于职业的特殊性,每天不得不直接或间接地接触患者的血液、唾液及化学材料等,在操作设备的噪声、粉尘环境中工作,并易受到针刺和锐器的机械性损伤。因此,口腔医护人员工作具有较高的职业危险。经济发达国家十分重视口腔医护人员的职业危险问题,已展开广泛的研究。在我国,这方面的研究较少,但人们已意识到职业危险所造成的后果并开始得到重视。为了有效地避免或减少职业危险,必须首先明确与职业危险的相关因素,具…     

医护人员职业安全危险因素及防护对策

大家知道，医院是个具有多种潜在危险因素的工作环境，如生物性、感染性、物理性及化学性因素等，而医护人员常常暴露于各种危险因素中，尤其是临床的医护人员，如2003年的SARS，医护人员的全人口发病率是一般人群的平均发病率的38倍，医护人员的职业危险因素严重威胁着他们的身心健康，成为日前函待解决的问题。因此，医护人员的职业安全防护已引起医院管理者及卫生行政部门的关注。现将国内外医护人员职业危险因素及职业防护的最新进展综述如下：     

肿瘤护理人员职业危险因素及防范措施

职业危险自从18世纪医学之父Bernadio Ramazini提出这个概念之后，职业危险就愈来愈受到人们的重视和关注。肿瘤科职业的特殊性，每天不得不直接或间接地接触患者的血液、唾液及化学药物等，并易受到针刺和锐器的机械性损伤，护理管理者应及时发现危险因素，主动采取防范措施，控制或减少危险因素，加强对医护人员的防护。     

手术室护士的职业危险和自身防护

现代手术室存在着许多威胁医护人员健康的危险因素，如经常暴露在易被病人血液感染的环境、吸收放射线、挥发性麻醉气体等，有关手术室护士的职业卫生现象已成为不可忽视的问题。因此，充分地重视手术室护士的职业防护，有效的做好日常工作的职业防护，保护护士的身心健康，是一项十分重要和有益的工作。     

手术室护士职业危险相关因素分析及防护

职业危险是职业医学之父Bernadio Ramazini在18世纪提出的[1].职业危险越来越受到人们的重视和关注,特别是医疗卫生机构.手术室护士由于职业的特殊性,是职业暴露风险较大的群体.对手术室护士来说,需要频繁接触病人的血液、体液、分泌物等[2],还会经常接触一些有毒的化学物质,如戊二醛、甲醛、乙醚等物质[3],且易被锐利器械刺伤[4].有研究表明,手术室护士通过针刺伤或者是其他经皮方式,暴露于乙型肝炎病毒、丙型肝炎病毒、人类免疫缺陷病毒,它们的感染率分别为6.0%～30.0%,3.0%～10.0%,0.2%～0.5%[5].因此,手术室护理工作的职业危险受到了高度重视.为了有效避免或减少职业危险,必须首先明确与职业危险相关的因素,具有十分重要的意义.     

手术室护士的职业危险因素分析

职业危险因素自18世纪医学之父Bernadio Ramazini提出这个概念后，越来越受到人们的关注。手术室是一个特殊的工作环境，是集手术、治疗、检查或抢救于一体的重要场所，由于工作的特殊性，每天直接或间接接触患者的血液、唾液及各种化学消毒剂、麻醉废气、X线、传染性手术等。因此手术室护士具有较高的职业危险。为了有效地避免或减少职业危险因素，必须首先明确职业危险因素的相关因素，才能更好地采取相应措施。     

口腔医护人员职业暴露现状与防护对策

口腔科是医院感染管理的重点部门，预防和控制口腔医护人员发生医院内感染是口腔医疗领域长期探讨的重要问题。根据美国职业安全局统计显示，卫生部门相关人员在工作期间通过血源性途径感染人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）等的人数有逐年上升趋势，特别指出职业暴露是导致感染的最主要危险因素。已有大量文献报道口腔医护人员因职业暴露导致自身感染的病例。为减少我院口腔职业危害，针对口腔医护人员职业暴露现状，提出相应管理对策，以避免口腔职业危害的发生。现介绍如下。     

急诊护士职业性损伤的危险因素与防护对策

医院的工作环境存在潜在的职业危险，医护人员常常暴露于多种职业危险因素中，特别是急诊室医护人员，常在患者未完全明确诊断前即投入对患者的处置和抢救，因此，急诊护士职业性损伤的潜在危险性大。急诊护士的自身防护问题应引起重视。本文对急诊护士职业性损伤的危险因素进行了探讨，并提出相应的防护对策。     

口腔内科门诊护士潜在职业相关危险因素及其防护

由于口腔科门诊特定的工作性质，受病毒感染的机会较多，国内外的研究结果均表明，口腔医护工作者属于HBV、HCV等病毒的高危感染人群；也由于口腔内科治疗的特殊要求，存在特定的危险因素，容易造成医护人员职业性损伤，严重威胁着医护人员的身心健康，是目前亟待解决的课题。本文结合本单位临床工作实际，讨论口腔内科门诊护士微生物、物理及化学性职业相关危险因素及防护对策。     

急诊科护理人员常见的职业危险因素分析与防护

在医院的工作过程中，医护人员，特别是急诊室工作人员，常常暴露于多种职业危险因素中问，对未明确诊断的患者进行处置和抢救，职业性损伤的潜在危险非常大。对护理工作者来说，身边有许多的危险因素威胁着他们的身心健康，可能使其受到很大的困扰，影响他们的工作和生活。目前，在我国，护理人员的职业危害问题依旧很严峻。如何做好自我防护已成为医院以及护理工作者密切关注的问题。笔者在学习前辈经验的基础上，     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Erythropoietin and uremic platelet aggregation in vivo and in vitro

Erythropoietin treatment is known to correct anemia and to improve hemostasis. Since platelets may contribute to thromboembolic complications, we assessed platelet aggregation in whole blood and platelet-rich plasma from chronically hemodialyzed patients treated with erythropoietin and evaluated in vitro effects of this drug on aggregatory responses of uremic and normal platelets. Recombinant human erythropoietin was given to uremic patients at a dose of 2.000 IU subcutaneously three times a week. Platelet aggregation in whole blood and platelet-rich plasma was induced by collagen, ADP, arachidonic acid, and ristocetin. In uremic patients, erythropoietin therapy resulted in an enhancement of platelet sensitivity to various agonists, particularly in platelet-rich plasma, reaching values comparable to those of healthy volunteers. In vitro studies we were unable to show any direct effect of erythropoietin, used at concentrations that occurred post intravenous administration, on platelet aggregation both in whole blood and in platelet-rich plasma.     

Responses in extracellular and intracellular calcium and magnesium in aldosteronism

We hypothesized the hypercalciuria and hypermagnesuria that accompany aldosteronism could be pharmacologically attenuated to prevent shifts in extracellular and intracellular levels of these divalent cations and the adverse outcomes associated with them. Accordingly, rats administered aldosterone/salt treatment (ALDOST) were cotreated with either hydrochlorothiazide (Hctz), to selectively reabsorb urinary Ca2+, or with Hctz plus spironolactone (Hctz+Spi), where Spi retards the excretion of these cations in both urine and feces. We monitored urinary excretion and responses in extracellular and intracellular Ca2+ and Mg2+, together with indices of oxi/nitrosative stress in plasma and ventricular tissue. At 4 weeks ALDOST we found the following: (1) hypercalciuria was reduced by Hctz and normalized by Hctz+Spi, and this combination, unlike Hctz alone, also rescued hypermagnesuria; (2) the decrease in plasma-ionized [Ca2+]o was not seen with Hctz or Hctz+Spi, whereas Spi cotreatment protected against a decline in [Mg2+]o; (3) the Ca2+ loading of peripheral blood mononuclear cells and cardiac tissue was not seen with Hctz+Spi; and (4) the induction of oxi/nitrosative stress, expressed as reduced plasma alpha1-antiproteinase activity and activation of gp91(phox) subunit of NADPH oxidase in inflammatory cells invading intramural coronary arteries of the right and left ventricles, together with vascular fibrosis, was completely prevented by Spi cotreatment. In rats with aldosteronism, cotreatment with Hctz+Spi more effectively (vis-à-vis Hctz alone) protects against adverse iterations in extracellular and intracellular concentrations of Ca2+ and Mg2+, as well as the appearance of oxi/nitrosative stress to prevent the proinflammatory vascular phenotype.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.