Hospital illness

Medical Programs. Large chemical plants have at least one hill-time physician who is at the plant five days a week and on call at all other times. Smaller plants either have part-time physicians or take injured employees to a nearby hospital or clinic by arrangement with the company compensation-insurance carrier. When part-time physicians or outside medical services are used, there is Httle opportunity for medical personnel to become familiar with plant operations or to assist in improving the health aspects of plant work. Therefore, it is essential that chemical-ha2ards manuals and procedures, which highlight symptoms and methods of treatment, be developed. A hill-time industrial physician should devote a substantial amount of time to becoming familiar with the plant, its processes, and the materials employed. Such education enables the physician to be better prepared to treat injuries and illnesses and to advise on preventive measures. 

Kntmch, m. crane, krank, a. ill, sick (of wood) rotten, kriliikelii, v.i. be ailing, be sickly. Kranken-anstalt. /. hospital, -haus, n. hospital, -heilanstalt, /. sanatorium, hospital, -kost, /. sick diet. 

In hospitals, chemical analysis is widely used to assist in the diagnosis of illness and in monitoring the condition of patients. In farming, the nature and level of fertiliser application is based upon information obtained by analysis of the soil to determine its content of the essential plant nutrients, nitrogen, phosphorus and potassium, and of the trace elements which are necessary for healthy plant growth. 

Nurses play an important role in monitoring for adverse readions. The FDA considers serious adverse readions those that may result in death, life-threatening illness, hospitalization, or disability or those that may require medical or surgical intervention. 

Unless ordered otherwise, the nurse should save all stools that are passed after the drug is given. It is important to visually inspect each stool for passage of the helminth. If stool specimens are to be saved for laboratory examination, the nurse follows hospital procedure for saving the stool and transporting it to the laboratory. If the patient is acutely ill or has a massive infection, it is important to monitor vital signs every 4 hours and measure and record fluid intake and output. The nurse observes the patient for adverse drug reactions, as well as severe episodes of diarrhea. It is important to notify the primary health care provider if these occur. 

Patients with massive helminth infections may or may not be acutely ill. The acutely ill patient requires hospitalization, but many individuals with helminth infections can be treated on an outpatient basis. 

A patient receiving an antianxiety drug may be treated in the hospital or in an outpatient setting. Before starting therapy for the hospitalized patient, the nurse obtains a complete medical history, including mental status and anxiety level. In the case of mild anxiety, patients may (but sometimes may not) give a reliable history of their illness. 

Schwartz J, Levin R, Hodge K (1997) Drinking water turbidity and paediatric hospital use for gastrointestinal illness in Philadelphia. Epidemiology 8 615-620... 

Neurological effects related to cholinesterase depression occurred in seven children acutely exposed to methyl parathion by inhalation as well as orally and dermally (Dean et al. 1984). The children were admitted to a local hospital with signs and symptoms of lethargy, increased salivation, increased respiratory secretions, and miosis. Two of the children were in respiratory arrest. Two children died within several days of each other. All of the children had depressed plasma and erythrocyte cholinesterase levels (Table 3-2). These effects are similar to those occurring in methyl parathion intoxication by other routes (see Sections 3.2.2.4 and 3.2.3.4). Three adults exposed in the same incident had normal plasma (apart from one female) and red blood cell cholinesterase, and urinary levels of 4-nitrophenol (0.46-12.7 ppm) as high as some of the ill children. 

In countries with an existing (social) health insurance system, it is usually rather simple do receive a close-to-reality estimate of the provider Costs-of-Illness. The insurance pays the bills of general practitioners, specialists, hospitals, pharmacies, laboratories, etc. so that the total costs per patient can easily be determined. However, in some countries we cannot receive this data, and sometimes confidentiality regulations do not permit the transfer of insurance data, so that, for instance, provider costs of difference phases of HIV/AIDS can be calculated. In this case, a sample of patient files has to be analyzed with permission of the patients so that the provider costs can be recorded. 

The calculation of direct household costs of HIV/AIDS is quite difficult. First, resource consumption is hardly documented, so that patients have to be interviewed or be asked to keep household diaries for all expenditure due to their disease. Second, it is frequently not easy to allot a certain expenditure to a specific disease. Co-payments for drugs, practitioner, and hospital services as well as transport to and from the provider are easily allocated to the COI of this disease. But other direct household costs might be even higher, such as the costs of a special diet, but it is very difficult to analyze whether these costs are really incurred due to this illness. Studies demonstrate that direct household costs might be small in developed countries, but they might make up to 50% of the total COI in developing countries (Su et al. 2006). 

Scitovsky et al. (1986) calculated the average cost per AIDS-related hospital admission as US 9,024 ranging from US 7,026 to US 23,425. A more comprehensive picture is presented by Scitovsky and Rice (1987), who estimated provider cost of the AIDS epidemic in the United States in 1985, 1986, and 1991, based on prevalence estimates provided by the Center for Disease Control (CDC). They predicted that the core provider costs of AIDS would rise from US 630 million in 1985 to US 1.1 billion in 1986 and to US 8.5 billion in 1991. The authors compared their estimates of the cost of AIDS in the USA with the estimates for end-stage renal disease (US 2.2 billion), traffic accidents (US 5.6 billion), lung cancer (US 2.7 billion), and breast cancer (US 2.2 billion). They concluded that the core provider costs of AIDS were relatively low in comparison with the provider costs of all illness as well as the costs of these other diseases. However, they also assessed the non-care costs (e.g., for research) to rise from US 319 million in 1985 to US 542 million in 1986 and to US 2.3 billion in 1991. 

Two nine-year-old boys have been taken to hospital from school, as they both became very ill during the lunch break. Nobody seems to know why, but they were seen buying some tablets from an older boy outside of the school.This boy told them that the tablets would make them feel really good. 

Acquired resistance to the glycopeptides is transposon-mediated and has so far been largely confined to the enterococci. This has been a problem clinically because many of these strains have been resistant to all other antibiotics and were thus effectively untreatable. Fortunately, the enterococci are not particularly pathogenic and infections have been confined largely to seriously ill, long-term hospital patients. Two types of acquired glycopeptide resistance have been described (Woodford et al. 1995). The VanA phenotype is resistant to vancomycin and teicoplanin, whereas VanB is resistant... 

Brain-injured patients commonly experience fever, and hyperthermia may correlate with poor outcome in these patients, although a direct causative link has yet to be established. The impact of fever on patients in a neurocritical care unit has been evaluated, and after controlling for severity of illness, diagnosis, age, and complications, increased body temperature was found to strongly associate with an increased length of ICU and hospital stay, as well as higher mortality and... 

In degreasing operations, there may be exposures to carbon monoxide, which may compound symptoms reported by workers (NIOSH 1973). Illnesses of certain employees, documented at a neighboring hospital, included headache, nausea, dizziness, and chest pain. The NIOSH report concluded that the first employee illness reports were due to toxic effects of carbon monoxide complicated by trichloroethylene exposure. The... 

Siebenga, J. J., Beersma, M. F., Vennema, H., van Biezen, P., Hartwig, N. J., and Koopmans, M. (2008). High prevalence of prolonged norovirus shedding and illness among hospitalized patients A model for in vivo molecular evolution. J. Infect. Dis. 198,994—1001. 

Venous thromboembolism (VTE) is one of the most common cardiovascular disorders in the United States. VTE is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE) resulting from thrombus formation in the venous circulation (Fig. 7-1).1 It is often provoked by prolonged immobility and vascular injury and is most frequently seen in patients who have been hospitalized for a serious medical illness, trauma, or major surgery. VTE can also occur with little or no provocation in patients who have an underlying hypercoagulable disorder. 

Uncomplicated exacerbation Not requiring hospitalization Less than 3 exacerbations per year No comorbid illness I I V, greater than 50% predicted No recent antibiotic therapy Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis Oral Macrolide (azithromycin, clarithromycin) Second- or third-generation cephalosporin (cefuroxime, cefpodoxime, cefdinir, cefprozil) Doxycycline Ketolide (telithromycin) P-Lactam/P-Iactamase inhibitor (amoxicillin-clavulanate) Intravenous Not recommended... 

Acute renal failure (ARF) is a potentially life-threatening clinical syndrome that occurs primarily in hospitalized patients and frequently complicates the course of the critically ill. It is characterized by a rapid decrease in glomerular filtration rate (GFR) and the resultant accumulation of nitrogenous waste products (e.g., creatinine and urea nitrogen), with or without a decrease in urine output. A recent consensus statement... 

Between 5% and 25% of all hospitalized patients develop ARF.2 A greater prevalence of ARF is found in critically ill patients.3 Despite improvements in the medical care of individuals with ARF, mortality generally exceeds 50%.4... 

Despite the growing emphasis on pain management, pain often remains undertreated and continues to be a problem in hospitals, long-term care facilities, and the community. In one series of reports, 50% of seriously ill hospitalized patients reported pain however, 15% were dissatisfied with pain control, and some remained in pain after hospitalization.14,15... 

For approximately 20% to 30% of people with schizophrenia, drug treatment is ineffective. A standard definition of treatment resistance includes patients who have persistent positive symptoms despite treatment with at least two different antipsychotics given at adequate doses (at least 600 chlorpro-mazine equivalents) for an adequate duration (4 to 6 weeks). In addition, patients must have a moderately severe illness as defined by rating instruments, and have a persistence of illness for at least 5 years.40 These patients are often highly symptomatic and require extensive periods of hospital care. 

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