Schmerzmanagement bei Kindern in der Schweiz

Zusammenfassung: Hintergrund: Schmerzen bei stationär aufgenommenen Kindern werden häufig unzureichend behandelt. Bisher gab es keine Informationen zum Schmerzmanagement von Kinderkrankenhäusern in der Schweiz. Ziel der vorliegenden Studie war, den aktuellen Stand der Schmerzerfassung, -interpretation und -behandlung zu bestimmen. Studiendesign: Ein Fragebogen wurde an alle pädiatrischen Krankenhäuser in der Schweiz gesendet. Ergebnisse: Insgesamt antworteten 27 von 45Einheiten (Antwortrate: 60%). Die meisten Abteilungen verwenden Schmerzerfassungstools (96%) und führten diesbezügliche Leitlinien ein (78%). Die Behandlung von Schmerzen erfolgt ebenfalls meist nach hausinterner Leitlinie (78%). Prozedurale und postoperative Schmerzen werden stets (100%) analgetisch behandelt. Bei Frühgeborenen und Kindern auf Intensivpflegestationen werden bei invasiven Eingriffen häufig Analgetika (> 87%) verwendet. Auf Intensivstationen liegen in 44% diesbezügliche Leitlinien vor. Resümee: Der Nutzen eines effektiven Schmerzmanagements bei Kindern ist eindeutig belegt. Viele Ansätze zur Verbesserung werden in der Schweiz gut umgesetzt. Vor allem im internationalen Vergleich verbesserte sich das Schmerzmanagement. Es gibt aber noch Optimierungsmöglichkeiten. Beispielsweise besitzen weniger als die Hälfte aller schweizerischen Intensivstationen eine Leitlinie für die Behandlung von Schmerzen bei invasiven Eingriffe

GAIA: Composition, Formation and Evolution of the Galaxy

The GAIA astrometric mission has recently been approved as one of the next two `cornerstones' of ESA's science programme, with a launch date target of not later than mid-2012. GAIA will provide positional and radial velocity measurements with the accuracies needed to produce a stereoscopic and kinematic census of about one billion stars throughout our Galaxy (and into the Local Group), amounting to about 1 per cent of the Galactic stellar population. GAIA's main scientific goal is to clarify the origin and history of our Galaxy, from a quantitative census of the stellar populations. It will advance questions such as when the stars in our Galaxy formed, when and how it was assembled, and its distribution of dark matter. The survey aims for completeness to V=20 mag, with accuracies of about 10 microarcsec at 15 mag. Combined with astrophysical information for each star, provided by on-board multi-colour photometry and (limited) spectroscopy, these data will have the precision necessary to quantify the early formation, and subsequent dynamical, chemical and star formation evolution of our Galaxy. Additional products include detection and orbital classification of tens of thousands of extra-Solar planetary systems, and a comprehensive survey of some 10^5-10^6 minor bodies in our Solar System, through galaxies in the nearby Universe, to some 500,000 distant quasars. It will provide a number of stringent new tests of general relativity and cosmology. The complete satellite system was evaluated as part of a detailed technology study, including a detailed payload design, corresponding accuracy assesments, and results from a prototype data reduction development.Comment: Accepted by A&A: 25 pages, 8 figure

Outbreak of CTX-M-15-producing Enterobacter cloacae associated with therapeutic beds and syphons in an intensive care unit

International audienceAn outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae (ESBL-ECL) occurred in our intensive care unit (ICU) and involved 18 patients (8 infected and 10 colonized). The mean age of patients was 69 years, and all infected patients had underlying medical conditions. Within hours' recognition of the spread of ESBL-ECL, the infection control team requested for staff education, reinforcement of infection control measures, and environmental screening. New transmissions were observed in the institution after weeks of enhanced infection control measures. Microbial swabbing revealed bacterial contamination of some mattresses and syphons with epidemiologic links between environmental, screening, and clinical isolates. This outbreak resulted in the temporary closure of the ICU for complete biocleaning