Bolničke infekcije urinarnog traktaposlije kateterizacije pacijenata u Općoj bolnici Dubrovnik Nosocomial infections of the urinary tract after catheterization of patients at the General Hospital Dubrovnik

Uvod: Kateterizacijamokraćnog sustava u početku je izvođena uporabom šupljihdrvenih cjevčica i palminog lišća. Danas se urinarni kateteri izrađuju od fleksibilnih lako sterilizirajućih materijala.Bolničke infekcije vodeći su uzrok morbiditeta i mortaliteta kod bolesnika u bolničkom režimu liječenja. Usporedo s razvojem materijala za izradu urinarnih katetera povećavala se i njihova uporaba, ali i incidencija infekcija mokraćnog sustava. Bilježenje, analiza i upotreba podataka o infekcijama važan su dio planiranja mjera kojima možemo utjecati na prevenciju, ali i na što učinkovitije liječenje već nastalih infekcija, i to posebice zbog potrebe kontinuiranog smanjenja direktnih i indirektnih troškova liječenja. Metode: Retrospektivno deskriptivno istraživanje. Istraživanje je provedeno u Općoj bolnici Dubrovnik u vremenu od 2011. do 2015. godine. Uključni su kriteriji bili, i to: ukupan broj bolesnika te onih kod kojih je učinjena kateterizacija mokraćnog mjehura; pacijenti s mikrobiološkom analizom verificiranim postojanje infekcija urotrakta, podatci o broju dana bolničkog liječenja, bolnički odjel, u razmatranje je uvršteno pet bolničkih odjela, verificirano postojanje antibiograma pretrage urina. U istraživanom razdoblju iznalazi se da je bolnički liječeno 10615 bolesnika, a uključne kriterije zadovoljavaju 204 bolesnika. Rezultati: Ukupni broj infekcija uzrokovan kateterizacijom mokraćnog sustava iznosio je 1,9%, s najvećom incidencijom u starosnoj dobi većoj od 65 godina [77,45%]. U odnosu na incidenciju, uzročnici infekcije mokračnog sustava bili su, i to: Pseudomonas (22,05%), Klebsiella (19,11%), Enterococcus (15,58%), Escherichia (15,58%) Enterobacter (8,33%). U odnosu na spol, značajno je niža pojavnost kod ženske populacije[54,42%], u odnosu na do danas publicirane rezultate. Značajno je niska pojavnost infekcija uzrokovanih zlatnim stafilokokom [1;0,49%]. Zastupljenost po spolovima u znatnoj je mjeri odstupala od očekivanih rezultata. Literaturni navodi usmjeravaju na očekivanje značajno višeg postotka žena sa IMS-u povezanim s kateterizacijom, u rasponu od 75–80%, ovisno o izvoru. U muškoj populaciji infekcija mokraćnog sutava zabilježena je u obimu od 45,58%. Zaključak: Prevalencija verificiranih infekcija mokraćnog sustava koje su uzrokovane kateterizacijom ne razlikuje se značajno od do danas publiciranih rezultata učinjenih studija. Međutim, iznalazi se značajno veća incidencija infekcije mokraćnog sustava u bolesnika muške populacije u odnosu na publicirane rezultate sličnih studija. Stoga se iznalazi potreba za dodatnom analizom pojavnosti infekcija mokraćnog trakta uzrokovanih kateterizacijom, u kojoj bi trebalo usporediti prevalenciju infekcije u odnosu na pojavnost po svakom pojedinom bolničkom odjelu i to u ovisnosti o sveukupnom broju hospitaliziranih pacijenata i verificiranih dijagnoza. Visoka incidencija infekcije kod bolesnika muške po-pulacije nije kompatibilna s dosad publiciranim rezultatima, te navedeno može biti značajan čimbenik u daljnjoj evaluaciji točnosti podataka informatičkog sustava Opće bolnice Dubrovnik i za provođenje budućih istraživanja

How to Develop Pervasive Social Applications with the SAPERE Middleware

SAPERE ("Self-Aware Pervasive Service Ecosystems'') is a general framework to support the decentralized execution of self-organizing pervasive computing services. In this paper we present the rationale underlying SAPERE and its reference conceptual architecture. Following, we sketch the middleware infrastructure of SAPERE and detail the interaction model implemented by it, based on a limited set of "eco-laws'' allowing general-purpose distributed self-organizing schemes. Finally, we show how a social application can be easily implemented exploiting such an infrastructure and report on performances

Design and Implementation of a Socially-Enhanced Pervasive Middleware

Abstract—Middleware infrastructures for pervasive computing, in order to be able to support services and users activities, have to deal with both spatially-situated and socially-situated interactions. In this paper we present the solution adopted in the SAPERE middleware that exploits the graph of a social networks, and combines it with relations deriving from spatial proximity, to drive the topology of interactions among users, devices and services. This results in a middleware that facilitates the development and management of services that are adaptive to both spatial and social concerns, and can support effective service discovery and orchestration, and naturally tackles privacy issues. Keywords-pervasive middleware; social interaction; proximity I

Ubiquitous Browsing of the World

The imminent mass deployment of pervasivecomputing technologies such as sensor networks andRFID tags, together with the increasing participationof the Web community in feeding geo-locatedinformation within tools such as Google Earth, willsoon make available an incredible amount ofinformation about the physical and social worlds andtheir processes. This opens up the possibility ofexploiting all such information for the provisioning ofpervasive context-aware services for “browsing theworld”, i.e., for facilitating users in gatheringinformation about the world, interacting with it, andunderstanding it. However, for this to occur, propermodels and infrastructures must be developed. In thischapter we propose a simple model for therepresentation of contextual information, the designand implementation of a general infrastructure forbrowsing the world, as well as some exemplarservices we have implemented over it

Pervasive Middleware Goes Social: the SAPERE Approach

Pervasive computing middleware, to support thespatially and socially situated activities of users, has to eectivelysupport both self-organizing spatial activities and socialmodels of interactions. In this paper, we present the solutionthat we are going to integrate in the SAPERE middleware totackle this problem. The basic idea is to exploit the graph of asocial network (e.g., Facebook), in conjunction with relationsderiving from spatial proximity, to drive and rule the actualtopology of interactions among devices, users, and services. Aswe will discuss trough this paper, such an approach: facilitatesthe autonomous and adaptive activities of pervasive serviceswhile accounting for both social and spatial issues; supportseective service discovery and orchestration; enables tacklingcritical privacy issues

A Simple Model and Infrastructure for Context-aware Browsing of the World

The imminent mass deployment of pervasive computing technologies such as sensor networks and RFID tags, together with the increasing participation of the Web community in feeding geo-located information within tools such as Google Earth, will soon make available an incredible amount of information about the physical and social worlds and their processes. This opens up the possibility of exploiting all such information for the provisioning of pervasive context-aware services for "browsing the world", i.e., for facilitating users in gathering information about the world, interacting with it, and understanding it. However, for this to occur, proper models and infrastructures must be developed. In this paper we propose a simple model for the representation of contextual information, the design and implementation of a general infrastructure for browsing the world, as well as some exemplar services we have implemented over it

Integrating Pervasive Middleware with Social Networks in SAPERE

Abstract—Any middleware for pervasive computing services has to effectively support both spatially-situated activities and social models of interactions. In this paper, we present the solution integrated in the tuple-based SAPERE middleware to tackle this problem. The idea is to exploit the graph of a social network along with relations deriving from spatial proximity to rule the actual topology of interactions among devices, users and services. The proposed approach can facilitate the autonomous and adaptive activities of pervasive services while accounting for both social and spatial issues, can support effective service discovery and orchestration, and can enable tackling critical privacy issues. I