Suchergebnisse

This paper describes a sizeable subgroup of the AIDS caseload that has not been widely studied, that is, men with histories of both male homosexual activity and intravenous drug use. In this paper we identify differences and similarities between gay intravenous drug users and gay men with different histories of drug use; examine the relationship between HIV seropositivity and different patterns of drug use; and estimate whether gay intravenous drug users are more likely than other gay men to be a source of continued HIV transmission.

OBJECTIVES. The purpose of this study was to assess the willingness of intravenous drug users to participate in a preventive human immunodeficiency virus (HIV) vaccine efficacy trial. METHODS. Of the 347 intravenous drug users in methadone treatment who were approached for participation, 257 completed a battery of self-administered questionnaires assessing risk behaviors, interest in vaccine trials, and other vaccine-related information. Data from 16 known seropositives and 1 inconsistent responder were dropped from analyses (n = 240). RESULTS. Fifty-two percent of the subjects expressed a willingness to be one of the first individuals to participate in a preventive HIV vaccine efficacy trial. Subjects who had recently shared needles or works and subjects who trusted the government to ensure vaccine safety were both twice as likely to report interest in participation. Twenty-two percent of subjects reported that they would increase needle sharing if vaccinated. Thirty percent did not know what a vaccine was. CONCLUSIONS. These findings suggest that some in-treatment intravenous drug users would volunteer for a preventive HIV vaccine efficacy trial. Education and counseling will be required to ensure that subjects fully understand the trial's purposes, methods, risks and benefits.

Objective: to identify the scientific evidence on Patient Safety (PS) in intravenous therapy in the Intensive Care Unit (ICU). Method: integrative review conducted in the Theses Database Higher Education Personnel Improvement Coordination (CAPES) and the WHO Collaborating Centre for Quality of Care and Patient Safety (PROQUALIS) portal. Results: there were 21 productions, seven studies cited to intravenous therapy. The studies, categorized into levels of evidence 1, 2 and 7, include structural, materials and professional performance of the steps of prescription, dispensing, preparation and administration of medications aspects. The productions have low levels of evidence, and therefore do not exhibit strong degree of recommendation. Conclusion: it is believed that the establishment and maintenance of PS in intravenous therapy in ICU greater investment is needed in research with higher levels of evidence and professional preparation to act as the recommended practices.

AIDS is a severe manifestation of infection with human immunodeficiency virus, a pathogen that destroys the body's immune system response. Homosexual and bisexual men represent the largest risk group for HIV and AIDS, followed by intravenous drug (IV) users. The risk factors associated with IV drug use are numerous, yet as a group, IV users are difficult to impact with AIDS prevention messages.

Objective: To know the specific recommendations of intravenous therapy in the elderly. Method: Bibliographical research, the data sources were Policies and Procedures for Infusion Nursing of the Older Adult, Infusion Nursing Standards of Practice, Policies and Procedures for Infusion Nursing, Practice guidelines for intravenous therapy and Guidelines for the Prevention of Intravascular Catheter Related Infections and analyzed based on content analysis. Results: the professional must know the anatomical and physiological changes of aging, including patients and families in the education process; the puncture site should be greater quantity of subcutaneous tissue and bone support in selecting the catheter considering the smallest gauge possible for therapy prescribed. It is important to obtain a complete history of medications used, including the non-prescribed, phytotherapeutic or homemade preparations. Conclusion: The recommendations show how the elderly are different from young adult; this implies modifications and adaptations in the planning and development of nursing care.

Introduction – Pain is known the most common complaint in emergency departments. Several studies are administered many different protocols to control pain in trauma patients. The aim of the study was to review the major relevant articles in case of application of intravenous paracetamol and intravenous morphine sulfate for management of patients with trauma injuries.

Introduction: Government agencies are increasingly emphasizing opioid safety in hospitals. In 2012, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) started a sentinel event program, the "Safe Use of Opioids in Hospitals." We sought to determine if opioid use patterns in our emergency department (ED) changed from 2011, before the program began, to 2013, after start of the program. Methods: This was a retrospective study of all adult ED patients who received an intravenous opioid and had a serum creatinine measured. We recorded opioids used, dose prescribed, and serum creatinine. As an index of the safety of opioids, uses of naloxone after administration of an opioid was recorded. Results: Morphine is still the most commonly used opioid by doses given, but its percentage of opioids used decreased from 68.9% in 2011 to 52.8% in 2013. During the same period, use of hydromorphone increased from 27.5% to 42.9%, while the use of fentanyl changed little (3.6% to 4.3%). Naloxone administration was rare after an opioid had been given. Opioids were not dosed in an equipotent manner. Conclusion: The use of hydromorphone in our ED increased by 56% (absolute increase of 15.4%), while the use of morphine decreased by 30.5% (absolute decrease 16.1%) of total opioid use from 2011 to 2013. The JCAHO program likely was at least indirectly responsible for this change in relative dosing of the opioids. Based on frequency of naloxone administered after administration of an opioid, the use of opioids was safe.

Dental care for most medically compromised patients can be accomplished If dentists understand the patients' specific medical conditions and use standard conservative behavioral or physical modifications to prevent complications from occurring. However, In patients who have certain types of neurological conditions, specifically Alzheimer's disease and other types of dementia, dental management typically presents a greater challenge, because, in most kinds of dementia, patients are unable to follow directions or cooperate with simple instructions such as opening their mouths or holding their heads still. This report describes a three‐year retrospective chart review of patients, diagnosed with a neurologic impairment, who underwent intravenous sedation at the Department of Veterans' Affairs Medical Center in Lexington, Kentucky. The goals of this review were to investigate the average doses of commonly used sedative agents, review complications as a result of the sedation, and comment on the safety of intravenous sedation as a means to treat elderly adults with a neurological disability.