RESUMEN
The capacity of absorbent beads in BacT/ALERT® FA Plus and BACTEC® Aerobic/F Plus blood culture bottles to bind and neutralize antibiotics was compared. Binding was established using reverse-phase HPLC, and inactivation was based on the recovery of susceptible test stains from simulated blood cultures. The FA Plus medium demonstrated more rapid and better overall binding kinetics for each drug tested, resulting in significantly better overall recovery rates. Differences in time to detection favored the FA Plus medium for three drug/organism combinations and Aerobic/F Plus for two.
Asunto(s)
Adsorción , Antibacterianos/aislamiento & purificación , Cultivo de Sangre/métodos , Medios de Cultivo/química , Manejo de Especímenes/métodos , Antibacterianos/análisis , Cromatografía Líquida de Alta Presión , Humanos , Cinética , Factores de TiempoRESUMEN
Twenty-five workers, five currently and 20 formerly involved in the manufacture of hybrid microcircuits, underwent clinical evaluations at the request of a management-union committee concerned about chronic solvent exposures in a research and development laboratory. A battery of neurobehavioral tests was administered to compare the solvent-exposed group with 32 age-, gender-, ethnicity-, and education-matched controls. The tests included: MMPI-I, hand grip strength, tactile sensitivity, dexterity, color discrimination, visual acuity and contrast sensitivity, and tests selected from the computerized Neurobehavioral Evaluation System (NES2). Clinical narratives and retrospective exposure assessments in the study group suggested chronic low-level exposure to solvents, with intermittent acute excursions. Work-related diagnoses included upper respiratory mucosal irritation and sinusitis (44%), lower respiratory reactive airway disease (12%), and dermatitis (5%). Three workers (12%) had findings consistent with a solvent-induced encephalopathy. Significant differences (after Bonferroni correction) were found between the two groups on 5 of 11 NES subtests: symptom scale, mood scale, finger tapping, simple reaction time, and symbol-digit substitution. Differences also reached significance for overall vibration sensitivity thresholds, visual contrast sensitivity, and grip strength. The MMPI average clinical scale elevation was significantly higher in the exposed group than controls. These results support an association between chronic low-dose solvent exposure and measurable neurobehavioral changes.
Asunto(s)
Electrónica , Enfermedades del Sistema Nervioso/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Solventes/efectos adversos , Adulto , Análisis de Varianza , Femenino , Humanos , MMPI , Masculino , Análisis por Apareamiento , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/fisiopatología , Pruebas Neuropsicológicas , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/fisiopatología , Enfermedades Respiratorias/etiología , Medición de Riesgo , Sensibilidad y Especificidad , Lugar de TrabajoRESUMEN
As the success rate of earlier diagnosis and more effective cancer therapy increases, more individuals are finding that they are living with a cancer diagnosis. Cancer, as a chronic illness, requires that all health care professionals view the patient from a perspective of functional abilities rather than from a disease process. Rehabilitation is a dynamic process and is generally goal-directed. The goal of rehabilitation is to help the individual to function at his maximum level within the limitations and constraints of the disease and treatment protocols (Dudas, 1984). The physical, mental, emotional, social, sexual, and economic potential of the individual are the broad areas involved in the assessment, plan, implementation, and evaluation of rehabilitation programs. The rehabilitation team consists of the oncologist, surgeon, nurse, social worker, physical therapist, occupational therapist, nutritionist, and others depending on the special needs of the individual. The most important members of the team are the patient and family. The patient involved on the team can help to identify specific needs throughout the trajectory of the cancer diagnosis and treatment. The spouse and friends of the patient with cancer are important support systems and assist the patient in exploring feelings and needs (Frank-Stomborg and Wright, 1984). Dietz (1980) described four rehabilitation stages for cancer programs: preventive, restorative, supportive, and palliative. During each phase of rehabilitation the physical, mental, emotional, social, sexual, and economic needs of the patient must be considered. This report identifies specific areas of concern for the patient and family during the four stages of rehabilitation and to identify potential action plans for individual patients.
Asunto(s)
Neoplasias Urogenitales/rehabilitación , Consejo , Familia , Femenino , Humanos , Masculino , Cuidados Paliativos , Grupo de Atención al Paciente , Rol del Médico , Apoyo Social , Derivación Urinaria , Neoplasias Urogenitales/terapiaRESUMEN
The primary goal of skin care for the person with a stoma is prevention of skin breakdown. The first step is careful maintenance of the skin from the time of surgery forward. The patient and family should be taught every step of protecting the skin and recognizing early signs and symptoms of potential breakdown. The loss of peristomal skin integrity affects the person's entire well-being. Pouches will not adhere as well and accidental leaks occur. The impact on psychologic well-being is difficult to measure, but can be assumed to be significant. A circular effect can begin in which the skin irritation leads to accidents, which further compromise the skin integrity. Time may be lost from work or school. Damaged skin is also painful. The cost of treating peristomal skin breakdown can be high. The products used in ostomy care are relatively expensive. A single skin barrier may range from $3 to $5. Frequent changes will be necessary to assess and treat the lesions adding to the cost. Prevention is in the realm of effective nursing care and will include assessment of the skin, selection and application of appropriate pouches and skin barriers, patient and family teaching programs, and follow-up evaluations after hospitalization.