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995 Chang, H. J. et al.: An epidemic of Malassezia pachydermatis in an intensive care nursery associated with colonisation of health care workers’ pet dogs. New England Journal of Medicine

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service, and indemnity insurance], International Statistical Classification of Diseases and Related Health Problems codes (i.e., ICD-9-CM codes), health-care services and pharmaceuticals provided in all health-care settings in MA, service dates, provider

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European Journal of Microbiology and Immunology
Authors: Volker Micheel, Benedikt Hogan, Rivo Rakotoarivelo, Raphael Rakotozandrindrainy, Fetra Razafimanatsoa, Tsiriniaina Razafindrabe, Jean Rakotondrainiarivelo, Sabine Crusius, Sven Poppert, Norbert Schwarz, Jürgen May, Hagen Frickmann, and Ralf Hagen

This study assesses the nasal occurrence of β-lactamase-producing Enterobacteriaceae both in patients in a hospital department of infectious diseases at admission and in healthy Madagascan students and health care workers.Nasal swabs from 681 students, 824 health care workers, and 169 patients were obtained in Antananarivo, Madagascar, and transferred to Germany. Screening for β-lactamase (ESBL, ampC) producing Enterobacteriaceae was performed by cultural and molecular approaches, comprising Brilliance ESBL agar, E-testing, ABCD-testing, and commercial hyplex ESBL and SuperBug ID PCR.Regarding ESBL-positive strains and strains with resistance against at least three out of the four tested bactericidal antibiotic drugs, 0.3% (five out of 1541) of the students and health care workers group showed nasal colonization, whereas colonization was observed in 7.1% (12 out of 169) of the hospitalized patients at admission. No appreciably reduced detection rates after sample storage and intercontinental transport were observed.A considerable proportion of nasal colonization with cephalosporin-resistant Enterobacteriaceae was demonstrated in Madagascan hospital patients at admission, posing a risk of developing future endogenous infections. The nasal colonization of healthy individuals was negligible. Good storage and transport stability of Enterobacteriaceae will allow for future studies even in areas difficult to access.

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—37. Pásztor, K. (2006). Az egészségügyi dolgozók orvoshoz-fordulási szokásai. Nővér, 19 (3), 3—9. Pikó, B. (2006). Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: A questionnaire

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Az egészségügy jelenlegi helyzetében a finanszírozás annyira bonyolulttá vált, hogy a gyógyító orvosnak nem elegendő a szakmáját ismernie, hanem tekintettel kell lennie a különböző jogszabályok, szabálykönyvek előírásaira is. Az orvosi munka ma már nem végezhető úgy, hogy a szakorvos csupán szakmája akár művészi gyakorlója. Hiába minden orvosi praktika, diagnosztikai képesség, intuíció, empátia (és még sok minden más), ha valaki nincs tisztában az elszámolás alapjaival, a legjobb szándékkal is akár csődbe viheti az intézményt. Ez az írás a finanszírozás egy kis szeletét, a teljesítményvolumen-korlátot (TVK) próbálja más aspektusból megközelíteni. Az általános közgazdasági és gazdálkodási alapelvek alapján egy elméletileg ideális kórház és adatainak tükrében kívánja bemutatni a teljesítményvolumen-korlát gyakorlati alkalmazásának nehézségeit. A tanulmány rávilágít, hogy a TVK meghatározásakor figyelembe kellene venni a kórház üzembezárási pontját, és ennek ismeretében lehetne a kórház működését nem ellehetetlenítő teljesítménykorlátot megállapítani.

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[Hungarian] 2 Hungarian Medical Chamber. [Magyar Orvosi Kamara.] http://www.mok.hu/info.aspx?sp=65 [Hungarian] 3 Chamber of Hungarian Health Care

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Orvosi Hetilap
Authors: András Lorx, Dóra Bartusek, György Losonczy, and János Gál

A légzési elégtelen betegek akut és krónikus ellátása továbbra is nagy terhet ró az egészségügyi ellátórendszerre. A légzési elégtelen betegek magas dependenciájú osztályon való kezelése a költséghatékonyságon túl jobb túlélést, gyorsabb gyógyulást, rövidebb kórházi tartózkodást és alacsonyabb intubációs rátát biztosít. A hazai gyakorlatban ezen betegeket mégis az általános osztályok látják el mindaddig, amíg teljes légzési elégtelenség alakul ki, és ekkor kerülnek a betegek az intenzív osztályokra. A szerzők a Semmelweis Egyetemen hazánkban elsőként létrehozott nem invazív légzési osztály elsőéves tapasztalatait, működését és a hazai rendszerbe történő integrációját mutatják be. Orv. Hetil., 2012, 153, 918–921.

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Acta Microbiologica et Immunologica Hungarica
Authors: Márta Patyi, István Sejben, Gábor Cserni, Beáta Sántha, Zoltán Gaál, Júlia Pongrácz, and Ferenc Oberna

In polymorbid or anaemic patients who receive preoperative radiotherapy or undergo long duration surgery involving potentially infectious sites, perioperative antibiotic prophylaxis (PAP) that is effective against normal oral bacterial flora is mandatory and plays an important role in preventing postoperative infection. In a four-year retrospective analysis, the incidence, outcome, and the efficacy of PAP were evaluated in patients treated at the Department of Oral and Maxillofacial Surgery and Otorhinolaryngology at Kecskemét Hospital. The results were compared with data from the literature to determine if the use of PAP was adequate at the Department.During the study period (between 01/09/2007 and 31/01/2011) 108 patients were evaluated. The mean duration of prophylactic antibiotic treatment was 8.3 ± 5.2 days, with cefotaxime+metronidazole being the most commonly used combination. Surgical site infection occurred in 8 patients (7.5%) in the clean-contaminated category.Our results showed that the perioperative antibiotic prophylaxis administered at our Department was efficient and effective against the oral bacterial flora of patients. Its use is recommended in head and neck microsurgery. To avoid development of antibiotic resistance and to reduce costs, it seems that the duration of antibiotic regimen for primary surgery can be reduced from 8.3 ± 5.2 days to 3 days.

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Hungarian Medical Journal
Authors: Yousif Asiri, Abdlatif Al-Dhawailie, Saleh Alqasoumi, Mohammed Al-Yahya, and Syed Rafatullah

From prehistoric times, herbal medicine has been used by various communities and civilizations throughout the world. This trend continues to the present day. For the past several decades, herbal medicines have been increasingly consumed by people without prescription. They are traditionally considered as harmless since they belong to natural sources. Herbal formulations which have reached widespread acceptability as therapeutic agents are such as antidiabetics, anti-arthritics, aphrodisiacs, hepatoprotectives, cough remedies, memory enhancers and adoptogens. However, with a more efficient case reporting of adverse drug reactions, the hazards of herbal medicines as self prescriptions have been well recorded. In this regard the World Health Organization (WHO) has set specific guidelines for the assessment of the safety, efficacy and quality of herbal medicines. The purpose of pharmacovigilance is to detect, assess and understand, and to prevent the adverse effects or any other possible drug-related problems, which is not only confined to chemical drugs, but extended to herbal, traditional and complementary medicines, biologicals, vaccines, blood products and medical devices. Herbal pharmacovigilance should be implemented and authorities should record apart from existing information on various aspects of the single herb and/or compound herbal formulations on concomitant use with chemical drugs, adverse drug reaction, delayed or acute toxic effects, allergies etc. Most over-the-counter herbal products like ginseng have drawn great public attention but there are several case reports mentioned in the literature of adverse drug reactions of herbal drugs which are generally considered safe. In this paper, we have succinctly reviewed the various aspects associated with the pharmacovigilance of herbal medicines ranging from the pathophysiology to the various clinical elements of adverse drug reactions associated with herbal medicine.

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