Absenteeism and associated factors: a study addressing the workers from a footwear manufacturer.

Objectives: To characterize absenteeism among the workers of a footwear manufacturer and analyze associated factors.

Method: This quantitative and cross-sectional study addressed 572 workers from a footwear company located in southern Brazil, totaling 1,902 sick leaves in 2017. Analyses considered absolute and relative frequencies, and univariate and multivariate Poisson regression models were performed.

Continuous Physiological Monitoring Improves Patient Outcomes.

Background: General patient acuity is increasing in the United States, with more patients having multiple comorbidities and acute-on-chronic conditions. Hospitalizations may also be complicated by serious adverse events, often unrelated to the admitting medical diagnosis. In our facility, the late detection of patient deterioration on general medical units often resulted in increased length of stay (LOS) in the ICU and poor patient outcomes.

Occupational health nurses: interdisciplinary experience in occupational health.

Objective:: to analyze the relationship of occupational health nurses with the other members of the Specialized Service in Safety Engineering and Occupational Medicine (SESMT) and characterize joint actions of these professionals in occupational health.

Method:: qualitative, exploratory, and descriptive study with 34 professionals of seven companies from the South Macroregion of the state of Rio Grande do Sul. Interviews and observations were conducted for content analysis of Bardin.

[Hypercapnic failure in patients with COPD under 4 weeks non-invasive, home mechanical ventilation].

Background: In patients with severe COPD, ventilatory pump failure is a separate pathophysiological factor. Non-invasive ventilatory support has been introduced in COPD with acute-on-chronic respiratory failure according to evidence-based medicine, but the benefit of long-term ventilation is still not proven. The purpose of this investigation was to evaluate the feasibility of carbon dioxide-reducing, non-invasive, home mechanical ventilation in patients with chronic hypercapnic respiratory failure due to stable COPD.

Effectiveness of a hospital-wide selective screening programme for methicillin-resistant Staphylococcus aureus (MRSA) carriers at hospital admission to prevent hospital-acquired MRSA infections.

Screening of potential MRSA-positive patients at hospital admission is recommended in German and international guidelines. This policy has been shown to be effective in reducing the frequency of nosocomial MRSA transmissions in the event of an outbreak, but the influence of screening on reducing hospital-acquired MRSA infections in a hospital setting where MRSA is endemic is not yet well-documented. This study describes the effect of hospital-wide screening of defined risk groups in a 700-bed acute care hospital during a period of 19 months.

Reduced tolerance of simulated altitude (4200 m) in young men with borderline hypertension.

Background: Primary hypertensives who are acutely exposed to hypoxic hypoxia show an enhanced reactivity of arterial chemoreceptors as well as an exaggerated response of the sympathetic nervous system. Since these phenomena could influence their ability to tolerate sustained hypoxic hypoxia, this study was performed to determine whether persons predisposed to hypertension have a normal tolerance of simulated high altitude.

Methods: Subjects were 18 young men with a family history of hypertension (sons of hypertensives, SOHT) whose BP values were in the upper normal or borderline hypertensive range.

Long-term effects of asthma education for physicians on patient satisfaction and use of health services.

This randomized clinical trial evaluated the long-term impact of an interactive seminar for physicians based on principles of self-regulation on clinician behaviour, children's use of health services for asthma, and parent's views of physician performance. Seventy-four general practice paediatricians, and 637 of their asthma patients aged 1-12 yrs, were randomized to treatment or control. Children and parents were blind to physicians' participation.

Extracorporeal life support: the University of Michigan experience.

The University of Michigan experience with extracorporeal life support (ECLS) in 1000 consecutive patients between 1980 and 1998 is the largest series at one institution in the world. Among this patient population, survival to hospital discharge in moribund patients with respiratory failure was 88% in 586 neonates, 70% in 132 children, and 56% in 146 adults. Survival in moribund patients with cardiac failure was 48% in 105 children and 33% in 31 adults.

Parental report of pediatric tracheostomy care.

Objective: There are little data on the actual care given pediatric tracheostomy patients in their homes. Information on the use of supplies and on techniques and frequency of care is valuable for a better understanding of the needs of this population.

Design: Questionnaires were distributed by mail or at clinic visits from May 1995 to June 1996 to a convenience sample of tracheotomized patients at the University of Michigan Pediatric Physical Medicine and Rehabilitation clinic.

Impact of education for physicians on patient outcomes.

Objectives: This study was conducted to assess the impact of an interactive seminar based on self-regulation theory on 1) the treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' parents.

Methods: A total of 74 general practice pediatricians were assigned to either a program or a control group in a randomized controlled study. Data were collected from physicians at baseline, and 69 (93%) provided follow-up data 5 months after the program.

A scale for Assessing Health Care Providers' Teaching and Communication Behavior regarding asthma.

Partnership between health care providers and patients is important for controlling illness. A limited number of studies show how to assess health professionals' communication and partnering behavior. The relationship between these aspects of professional behavior and enhanced management of disease by patients has received little empirical study.

Ventricular volume elasticity: a component of cardiovascular control?

According to Koepchen, stimulation of different receptors within a complex network produces typical patterns of effector responses. We investigated whether the dynamical volume elasticity of the heart chamber is an independent component of cardiovascular control. The measurement of the dynamical volume elasticity was calculated by changes of the eigenfrequency of a modified catheter transducer system.

The effect of bronchopulmonary dysplasia on growth at school age.

Objective: To determine the effect of bronchopulmonary dysplasia (BPD) on growth at school age.

Design: A prospective cohort study.

Methods: The sample included 406 children selected from a reconstructed cohort of infants of very low birth weight previously enrolled in a multisite, randomized, controlled clinical trial.

Chronic respiratory failure in limb-girdle muscular dystrophy: successful long-term therapy with nasal bilevel positive airway pressure.

Chronic respiratory failure is a major factor contributing to mortality in progressive neuromuscular disorders. Among the muscular dystrophies, respiratory failure most commonly occurs with Duchenne dystrophy, while in Becker, limb-girdle, and facioscapulo-humeral dystrophies, respiratory failure is infrequent and generally occurs in the more severe cases that have progressed to a nonambulatory, advanced functional stage. We report two brothers with a myopathic disease in which the distribution of weakness, initial clinical course, heredity, and muscle pathology most closely resembled a limb-girdle type of dystrophy.

Routine administration of phenobarbital for the prevention of intraventricular hemorrhage in premature infants: five years' experience.

After it was reported in 1981 that phenobarbital reduced the incidence of intraventricular hemorrhage from 46.7% in control infants to 13.3% in treated premature infants, routine phenobarbital prophylaxis (loading dose, 20 mg/kg; maintenance, 5 mg/kg per day for 5 days) was introduced at the hospital of the original trial for all premature infants with birth weights of < or = 1800 gm.

Extracorporeal membrane oxygenation in term newborns. A prospective cost-benefit analysis.

Clinicians reserve ECMO for neonates at > 80% predicted mortality risk. The authors hypothesized that ECMO instituted at lower (50%) mortality risk would result in fewer intensive care unit days and a lower hospital cost compared with conventional therapy (including ECMO at high mortality risk). This was a randomized control trial, cost-benefit analysis in an academic newborn intensive care unit.

Follow-up of infants treated with extracorporeal membrane oxygenation for newborn respiratory failure.

Follow-up studies were conducted to assess the medical and developmental outcome of 92 infants treated with extracorporeal membrane oxygenation at the University of Michigan. Of 118 near-term (greater than 34 weeks' gestation) infants who received extracorporeal membrane oxygenation, 103 (87%) were surviving and available for follow-up at between 1 and 7 years of age. Ninety-two of these children were seen on at least one occasion.

[Gas gangrene in childhood--a review].

Although gas gangrene in childhood is not mentioned in the paediatric literature, paediatric surgery textbooks included, this toxic wound infection also occurs in children. Prognosis totally depends on the early detection of the disease. Having checked over 2000 relevant literature sources, in which 110 cases of gas gangrene are mentioned, of which 24 are described in detail, this paper points to constellations paving the way for developing or favouring the infection.

[Prerequisites for the transfer of patients with gas gangrene to a specialized facility].

According to the cases reported in the GDR as well as in the FRG, 1-2 persons contract a gas gangrene infection per week. The lethality is alarmingly high. In the GDR more than two thirds of the patients die.

Sleep disorders and airway obstruction in newborns and infants.

For most infants with a disorder of breathing control or airway obstruction, cause and management can be defined with a careful history and a few simple diagnostic tests. Pneumograms and multichannel studies can identify patterns of apnea and associated hypoxemia and can be used to assess therapeutic efficacy. For the majority of infants with disordered breathing, the outcome is favorable and conservative management is appropriate.

The volume elasticity of the heart: a method for its evaluation under closed chest conditions.

A method is described for measuring the volume elasticity of the heart under closed chest conditions by simply inserting a catheter in the left ventricle. The heart as a system capable of oscillations detunes an external oscillating system. The shift in resonance frequency is a measure of the volume elasticity.

Inborn/outborn status and neonatal survival: a meta-analysis of non-randomized studies.

We have applied meta-analysis to investigate the relationship between birth place and the likelihood of neonatal survival, for infants of low birth weight (less than 2501 grams) in a series of 19 non-randomized studies. This paper illustrates the utility meta-analysis in evaluating medical technologies described in non-randomized studies, if proper attention is given to biases in those studies. The results of this meta-analysis show strong preferences for inborn status, especially for infants who weigh 1001-2000 grams.

Right-sided brain lesions in infants following extracorporeal membrane oxygenation.

In retrospective review of survivors of neonatal extracorporeal membrane oxygenation, eight patients with varying degrees of right hemispheric brain injury were identified. The extent of preextracorporeal membrane oxygenation hypoxia and ischemia was documented: five of eight patients had arterial PO2 values of less than 40 mm Hg, seven of eight required dopamine for blood pressure support, and five of eight required cardiopulmonary resuscitation. Two patients had proven neurologic abnormalities before extracorporeal membrane oxygenation.