目的构建呼吸危重症精准诊疗体系,探索该体系对促进抗菌药物合理使用的价值,从源头上促进呼吸危重症抗菌药物合理使用。方法以2012—2021年中南大学湘雅医院呼吸重症监护专科出院病例为研究对象,将抗菌药物科学化管理模式融入呼吸危重...目的构建呼吸危重症精准诊疗体系,探索该体系对促进抗菌药物合理使用的价值,从源头上促进呼吸危重症抗菌药物合理使用。方法以2012—2021年中南大学湘雅医院呼吸重症监护专科出院病例为研究对象,将抗菌药物科学化管理模式融入呼吸危重症精准诊疗体系,对比该体系实施前后抗菌药物使用情况。结果共纳入出院病例2947例,其中实施前病例1105例,实施后病例1842例。出院诊断中涉及感染病例2643例,占89.7%,其中实施前963例(占87.1%),实施后1680例(占91.2%)。实施后在感染病例占比增加的情况下,抗菌药物使用率较实施前下降2.9%(97.0%VS 94.2%,P<0.001);抗菌药物使用强度较实施前下降12.4%(244.4 DDDs VS 214.1 DDDs),特殊使用级抗菌药物使用强度较实施前下降14.4%(131.0 DDDs VS 112.2 DDDs),均由高位波动转为线性下降(P<0.001)。结论呼吸危重症精准诊疗体系有效促进抗菌药物合理、精准使用,临床诊疗团队是该体系的核心,新兴诊疗技术发挥重要作用。展开更多
Pesticide packaging waste in Thailand has recently been valued as a kind of commercial product. Selling empty pesticide packaging to reuse/recycling business has been increased in all over the country. Subject to the ...Pesticide packaging waste in Thailand has recently been valued as a kind of commercial product. Selling empty pesticide packaging to reuse/recycling business has been increased in all over the country. Subject to the resource conservation and global climate change, this could be defined as sustainable or green consumption for the most beneficial use of natural resources. However, on the point of environmental and public health, this is the way to disperse harmfulness of pesticide into non-target areas. Human and environmental health risk of exposure due to pesticide residue in such packaging waste could be a co-incident. This paper was aimed to determine a practical model for pesticide packaging waste management appropriate for Thailand based on the context of country＇s circumstances and the best practices reported around the world. Establishing some necessary components has been proposed, i.e. multiple rinse method applied by farmers conscientiously, central collecting site driven by local community, waste recovery program offered by pesticide production enterprises, and sanitary glass bottle washing plant registration and regulations launched by the government. In conclusion, governmental initiative and all stakeholders including in pesticide packaging waste supply chain should be encouraged to contribute their participation towards sustainable management.展开更多
文摘目的构建呼吸危重症精准诊疗体系,探索该体系对促进抗菌药物合理使用的价值,从源头上促进呼吸危重症抗菌药物合理使用。方法以2012—2021年中南大学湘雅医院呼吸重症监护专科出院病例为研究对象,将抗菌药物科学化管理模式融入呼吸危重症精准诊疗体系,对比该体系实施前后抗菌药物使用情况。结果共纳入出院病例2947例,其中实施前病例1105例,实施后病例1842例。出院诊断中涉及感染病例2643例,占89.7%,其中实施前963例(占87.1%),实施后1680例(占91.2%)。实施后在感染病例占比增加的情况下,抗菌药物使用率较实施前下降2.9%(97.0%VS 94.2%,P<0.001);抗菌药物使用强度较实施前下降12.4%(244.4 DDDs VS 214.1 DDDs),特殊使用级抗菌药物使用强度较实施前下降14.4%(131.0 DDDs VS 112.2 DDDs),均由高位波动转为线性下降(P<0.001)。结论呼吸危重症精准诊疗体系有效促进抗菌药物合理、精准使用,临床诊疗团队是该体系的核心,新兴诊疗技术发挥重要作用。
文摘Pesticide packaging waste in Thailand has recently been valued as a kind of commercial product. Selling empty pesticide packaging to reuse/recycling business has been increased in all over the country. Subject to the resource conservation and global climate change, this could be defined as sustainable or green consumption for the most beneficial use of natural resources. However, on the point of environmental and public health, this is the way to disperse harmfulness of pesticide into non-target areas. Human and environmental health risk of exposure due to pesticide residue in such packaging waste could be a co-incident. This paper was aimed to determine a practical model for pesticide packaging waste management appropriate for Thailand based on the context of country＇s circumstances and the best practices reported around the world. Establishing some necessary components has been proposed, i.e. multiple rinse method applied by farmers conscientiously, central collecting site driven by local community, waste recovery program offered by pesticide production enterprises, and sanitary glass bottle washing plant registration and regulations launched by the government. In conclusion, governmental initiative and all stakeholders including in pesticide packaging waste supply chain should be encouraged to contribute their participation towards sustainable management.
