Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

2011年温州城乡九所中小学生超重肥胖患病状况调查

【目的】 调查温州城乡中小学生超重肥胖的患病状况。 【方法】 2011年5-8月随机抽取温州城区、城乡结合部及农村中小学共9所学校进行整群调查。记录学生的一般资料,同时测量身高体重两项发育指标,计算体质指数,按照2004年中国肥胖问题工作组(WGOC)推荐的诊断标准,评价温州市中小学生的超重及肥胖患病状况。 【结果】 共9 657名在校学生参与调查,其中男生5 114 名,女生4 543名,平均年龄(14.95±4.53)岁,被调查人群中超重占7.6%,肥胖占2.6%,男生超重和肥胖患病状况均显著高于女生(9.8% vs 5.2%,5.2% vs 1.2%,P值均<0.01),各年龄段中以7岁儿童肥胖及超重状况最为严重(27.15% vs 7.955%),城区及城乡结合部超重肥胖患病状况明显高于农村(P值均<0.01)。 【结论】 温州中小学校肥胖和超重总患病约为10%,男性,尤其是城区及城乡结合部男生超重肥胖患病情况最为严重,需要引起高度重视。     

Efficacy of single and double doses of albendazole and mebendazole alone and in combination in the treatment of Trichuris trichiura in school-age children in Uganda

A randomised clinical trial was conducted in Kabale District, southwestern Uganda, to compare the efficacies of single and double doses of a combination of 400 mg albendazole (ALB) and 500 mg mebendazole (MBZ) with those of single and double doses of each drug given alone in the treatment of Trichuris trichiura. Infected pupils (n = 611) were randomised to six treatment groups. Three groups received either a single dose of ALB, MBZ or the combination (ALB+MBZ). The other three groups received either a double dose of ALB (ALB/ALB), MBZ (MBZ/MBZ) or the combination (ALB+MBZ/ALB+MBZ). All double doses were given 8 h apart. Children were followed-up weekly for 1 month. Cure rates were significantly higher using double doses compared with single doses (irrespective of drug; z = −4.02, P < 0.0005) as well as using the drug combination compared with single drugs (irrespective of doses; z = −7.64, P < 0.0005). Cure rates measured at Day 7 were significantly higher than on Days 14 and 21 after treatment (Day 14, z = 9.90, P < 0.0005; Day 21, z = 7.36, P < 0.0005). Geometric mean (GM) intensities of positives were significantly lower on Day 7 compared with all other subsequent days (P < 0.00005), and on Day 28 GM intensities reached pre-treatment levels (P = 0.096). Whilst there was no difference in egg excretion between single and double doses of the same drug or drug combination (F_(df1) = 0.28, P = 0.60), the combination treatment resulted in lower egg excretion than use of single drugs (F_(df2) = 50.90, P < 0.00005). All the tested regimens of ALB and MBZ had low cure rates against T. trichiura in Uganda, but both combination treatments showed satisfactory egg reduction rates 3 weeks after treatment. [ClinicalTrials.gov identifier: NCT01050452]     

儿童铁和锌缺乏与营养素补充

营养性铁和锌缺乏症是严重影响儿童健康的常见营养素缺乏问题,在发展中国家是导致疾病负担加重和高死亡率的重要因素.铁和锌缺乏症每年引起约数万名5岁以下儿童死亡.婴幼儿是铁和锌缺乏的高危人群,摄入不足是造成铁和锌缺乏的主要原因.6～24个月婴幼儿的铁缺乏可对其智力发育产生不可逆的损害;锌缺乏是引起2岁以下幼儿生长发育迟缓的主要原因之一.补充微量营养素以及应用微量营养素强化食品可减少儿童铁和锌缺乏的发生,并具有较高的成本效益,应作为优先推荐的干预措施.该文就铁和锌缺乏的危害和干预研究进展作以综述.     

Dissipation and Residues of Difenoconazole and Azoxystrobin in Bananas and Soil in Two Agro-Climatic Zones of China

Residues of a fungicide suspension (12 % difenoconazole, 18 % azoxystrobin) in bananas and soil were studied under tropical and subtropical monsoon climates, in Hainan and Yunnan provinces, respectively. The half-lives in bananas were shorter in Hainan (difenoconazole: 8.4–10.7 days; azoxystrobin: 7.8–8.4 days) than Yunnan (difenoconazole: 11.3–13.0 days; azoxystrobin: 10.4–11.6 days), possibly because of the higher temperatures and solar radiation levels in Hainan. The half-lives in soil were shorter in Yunnan (difenoconazole: 15.5–16.7; azoxystrobin: 11.9–13.9 days) than Hainan (difenoconazole: 23.1–23.2 days; azoxystrobin: 16.0–16.1 days), possibly because the organic carbon content was higher and rainfall lower in Yunnan than Hainan. Their physico-chemical properties suggest difenoconazole and azoxystrobin should be stable in bananas and soil, but both decreased to safe concentrations by the minimum harvest time after spraying the mixture at the recommended dosage and 1.5 times that dosage, through physical, chemical, and biological processes.     

Concentrations of tetrachloroethene in blood and trichloroacetic acid in urine in workers and neighbours of dry-cleaning shops

Summary Tetrachloroethene concentrations in blood and trichloroacetic acid concentrations in urine were determined — primarily over the course of a week — for 29 persons living in the vicinity of dry-cleaning shops. The mean levels of tetrachloroethene increased during the week. In some neighbours concentrations were exceeding the German biological threshold limit value for tetrachloroethene (1000 g/l blood), persisting over the whole week in one case. The concentrations of tetrachloroethene in blood depended on the floor and the construction type of the building where these people were living, but not of the type of system used in the dry-cleaning shops. 5 of 12 drycleaners were found to have tetrachloroethene levels exceeding the German biological threshold limit value, some of them by a considerable amount.     

Toxicity and uptake of TRI- and dibutyltin in Daphnia magna in the absence and presence of nano-charcoal

Butyltins (BTs), such as tributyltin (TBT) and dibutyltin (DBT), are toxic to aquatic organisms, but the presence of the strong adsorbent, black carbon (BC), can markedly influence BT toxicity and uptake in organisms. In the present study, the acute toxicity and uptake of TBT and DBT in the crustacean, Daphnia magna, were investigated with and without addition of nano-charcoal at different pHs and water hardnesses. The results showed that the toxicity of TBT and DBT increased by lowering the pH from 8 to 6. This reflects a relatively higher toxicity of cationic BT species than of the neutral species. At pH 6, by enhancing the water hardness of the media from 0.6 to 2.5?mM, the toxicity of TBT and DBT consistently decreased due to competitive binding of bivalent cations (Mg2?, Ca2?) to biotic ligands of D. magna. Furthermore, the toxicity of TBT to D. magna significantly decreased in the presence of nano-charcoal compared with experiments without nano-charcoal at pH 6 and 8, while no significant decrease in toxicity of DBT was observed in the presence of nano-charcoal. This can be attributed to the insignificant decrease of free DBT concentration in the presence of nano-charcoal compared with that for TBT. Conversely, it was observed that more TBT and DBT were taken up in D. magna in the presence of nano-charcoal due to the uptake of TBT or DBT associated with nano-charcoal by Daphnia in gut systems, as seen by light microscopy. This indicated that only free nonadsorbed BTs were toxic to D. magna, at least during short periods of exposure.     

Relationships between distribution of lead in erythrocytes in vivo and in vitro and inhibition of ALA-D.

Proteins in the ALA-D (delta-aminolaevulinic acid dehydratase) fraction from gel filtration of erythrocyte supernatant (ES) have the highest affinity for lead among erythrocyte constituents in vivo and in vitro. It takes 20-40 hours for erythrocyte components to be equilibrated with lead added in vitro. AT low lead concentrations, under 60 micrograms/100 ml ES, the extent of decrease in ALA-D activity indicates the extent of lead saturation of ALA-D fraction proteins. The saturation is attained at 80-110 micrograms/100 ml ES. Although an appreciable amount of lead is also found in the haemoglobin fraction that contains certain factors concerned in ALA-D inhibition, lead responsible for inducing the inhibition is not bound to haemoglobin fraction proteins but to ALA-D fraction proteins. Of three treatments or agents recovering the enzyme from lead effects, zinc is the only one that can fully restore the inhibition.     

2018年洛宁县大骨节病病区与非病区内外环境硒含量监测分析

目的了解大骨节病病区与非病区内外环境硒含量,为大骨节病防治决策提供依据。方法在洛宁县故县镇选择历史重病区岭南村和非病区窑瓦村作为调查点,了解两村历史及目前儿童病情情况,采集两村6~12岁儿童发样各30份;以调查村为中心,排除近三年施用富硒肥的耕地,在东、南、西、北、东北、东南、西北、西南八个方位,8块农田中采集土样;每村按照东、南、西、北、中五个方位各调查2户家庭,共10户,每户采集白面,黄面,黄豆3种主粮,每份样品不少于50 g,检测样品硒含量。结果共采集6~12岁儿童发样49份,粮样60份,土样20份。病区村与非病区村儿童发硒分别为(0.2726±0.0420)mg/kg和(0.3633±0.0744)mg/kg,土硒分别为(0.1185±0.0092)mg/kg和(0.1194±0.0194)mg/kg,黄豆硒分别为(0.0179±0.0084)mg/kg和(0.0212±0.0112)mg/kg,白面硒分别为(0.0094±0.0059)mg/kg和(0.0643±0.0194)mg/kg,黄面硒分别为(0.0116±0.0011)mg/kg和(0.0150±0.0064)mg/kg。儿童发硒,白面,黄面硒均值比较均有统计学意义(P<0.01)。结论大骨节病区内环境硒营养水平基本充足,但外环境缺硒仍然存在,因此应坚持大骨节病监测,提高病区居民膳食中硒营养水平,及时掌握病情变化趋势,巩固防治成效,实现持续消除大骨节病目标。     

Heart disease mortality in cities of Latin America and in cities and regions of England and Wales

Death rates from heart disease in cities and regions of England and Wales, based on death certificates for 1963, are compared with death rates from the same causes in 10 Latin American cities, San Francisco, USA, and Bristol, England, derived from the Inter-American Investigation of Mortality which obtained histories and clinical records of fatal illnesses for the years 1962-64 by a sampling method. Death rates in Bristol derived from the 2 sources showed an agreement close enough to justify comparisons between official rates for England and Wales and the data for the Latin American cities.     

重庆市医疗卫生机构放射诊疗频度调查分析

目的 掌握2019年重庆市医疗卫生机构放射诊疗频度,为有关单位开展放射诊疗监督监测提供基础数据。方法 采用调查表法,调查放射诊疗机构基本情况,X射线诊断、介入治疗、核医学诊疗、放射治疗等放射诊疗频度。结果 放射诊疗机构1845家,放射诊疗设备3769台,医学放射工作人员8647人。X射线诊断1843.0501万人次（应用频度594.2人次/千人口）,其中常规X射线诊断1300.7987万人次（应用频度419.4人次/千人口）、CT诊断460.7244万人次（应用频度148.5人次/千人口）、其他X射线诊断81.527万人次（应用频度26.3人次/千人口）。介入治疗7.1436万人次（应用频度2.3人次/千人口）,核医学诊断6.681万人次（应用频度2.15人次/千人口）,核医学治疗4340人（应用频度0.14人/千人口）,放射治疗1.6249万人（应用频度0.52人/千人口）。结论 重庆市放射诊疗资源配置与放射诊疗水平发展不平衡,建议有关部门进一步优化放射诊疗资源配置,提升放射诊疗发展水平。     

Establishment of clones of Trypanosoma cruzi and their characterization in vitro and in vivo

An efficient technique for isolating clones of Trypanosoma cruzi from cultures and from animals has been developed. It is based on the inoculation of one organism, obtained by serial dilutions of cultured epimastigotes or isolated blood stream trypomastigotes, into enriched NNN medium (NNN-F:93). The cloning efficiency (percentage of positive cultures over the number inoculated) was 70% for cultured epimastigotes and 30-40% for blood-stream trypomastigotes. In vitro cultural characteristics of 14 secondary clones of an avirulent strain indicated that 12 clones grew in the F-94 medium primarily as epimastigotes at 27 °C and exclusively as amastigotes at 37 °C; 2 clones grew in F-94 medium primarily as amastigotes regardless of incubation temperature (27 °C or 37 °C). In vivo characterization of 7 clones from 2 virulent strains indicated that the virulence of individual clones was low immediately after isolation in NNN-F:93 medium, but the virulence of some clones returned to the level of the parent strain after more than 8 serial passages in CD-1 mice.     

Reevaluation of the radiosensitizing effects of sanazole and nimorazole in vitro and in vivo

Sanazole (AK-2123, 3-nitrotriazole derivative, N1-(3-methoxypropyl)-2-(3-nitro-1 H-1,2,4-triazol-1-yl)acetamide) and nimorazole (5-nitroimidazole derivative, 4-(2-(5-nitro-1H-1-imidazolyl)ethyl)morpholine) have been tested clinically as hypoxic cell radiosensitizers, mainly outside Japan. To determine if these sensitizers deserve clinical investigation in Japan, we reevaluated the radiosensitizing effects of these compounds in vitro and in vivo, in comparison with a fluorinated 2-nitroimidazole derivative KU-2285 (N1-(2-hydroxyethyl)-1,2-difluoro-3-(2-nitro-1 H-1-midazolyl)propanamide). KU-2285 is a known and established radiosensitizer, but is not suitable for clinical studies because of the high cost of synthesis. In vitro, the radiosensitizing effects of the three compounds on SCCVII (squamous cell carcinoma line in C3H mice) tumor cells were examined at 0.5 and 1 mM under aerobic or hypoxic conditions, using a colony assay. In vivo, SCCVII tumors grown subcutaneously in the hind legs of C3H/HeN mice were irradiated with or without prior intraperitoneal administration of 100, 200 or 400 mg/kg of the drugs. Thereafter, tumor growth delay was measured. In vitro, no sensitizing effect was observed under aerobic conditions at 1 mM. Under hypoxic conditions, the sensitizer enhancement ratio (SER) determined at 1% cell survival level for sanazole, nimorazole and KU-2285 was 1.55, 1.45 and 1.95, respectively, at 1 mM, and 1.40, 1.40 and 1.75, respectively, at 0.5 mM. In vivo, all three compounds had significant radiosensitizing effects; their effects appeared to decrease in the order of KU-2285, sanazole, and nimorazole. It was suggested that sanazole may be more suitable for clinical trials than nimorazole.     

Cost of illness and drivers of cost in atrial fibrillation in Sweden and Germany

Background

Atrial fibrillation (AF) is an important public health problem in European countries. AF is associated with increased morbidity and mortality, e.g. from heart failure and thromboembolic events. Little data have previously been presented regarding the costs of treatment in patients with AF.

Objective

To estimate total direct and indirect costs in patients with AF in Sweden and Germany, and to identify determinants of total costs.

Methods

A cross-sectional observational study was conducted through surveys to patients and their treating physician in primary care and in hospital outpatient cardiology departments in Sweden and Germany. A total of 922 patients with AF as diagnosed in clinical practice were enrolled and completed the study. Data were collected on medical history, treatment, medical and non-medical resource use, and employment status. Costs (year 2005 values) were calculated by multiplying resources used with prices specific for Sweden and Germany, respectively.

Results

Total annual costs per patient were €7241 in Sweden and €5586 in Germany. Slightly less than 70% of total costs were judged as being AF related in both countries. Costs of AF-related medication were about 2% of total costs in both countries. In a generalized regression model, costs were found to increase with age, but were lower in patients aged >65 years than in those aged ≤65 years, due to the absence of indirect costs in older patients. Costs were highest in patients with persistent AF and lowest in those with permanent AF. Co-morbidities with a significant influence on costs included coronary heart disease, cerebrovascular disease, heart failure and asthma.

Conclusions

Current costs in AF patients are driven by the consequences of AF, while costs for specific treatments for AF are low. The addition of new, effective and safe treatment options could potentially reduce overall healthcare costs in AF.     

Electrostimulation and magnetic therapy in the treatment of accommodation cramp and in the prevention of progressive myopia in children and adolescents

The paper presents a procedure and results of use of electrostimulation, magnetic therapy, and electrophoresis during treatment for accommodation cramp and in the prevention of myopia in children and adolescents. Data that characterize the dynamics and stability of achieved results are given.