阿藿烯对四氯化碳所致大鼠肝纤维化的保护作用

目的探讨阿藿烯对四氯化碳(CCl4)所致大鼠肝纤维化的保护作用。方法将40只SD大鼠随机分为对照组、模型组、低(25mg/kg)和高剂量(50mg/kg)阿藿烯组,用40%CCl4皮下注射制作肝纤维化模型,阿藿烯按低和高剂量分别连续灌胃6w后,检测血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)活性、总蛋白(TP)和清蛋白(ALB)含量、总胆红素(TBIL)和间接胆红素(DBIL)及肝纤维化的透明质酸(HA)和层粘连蛋白(LN)水平;检测肝组织超氧化物歧化酶(SOD)活性和脂质过氧化(MDA)水平;并进行肝脏组织病理学检查。结果低、高剂量组阿藿烯均可显著降低血清ALT和AST活性、TBIL、DBIL、HA和LN水平(P<0.01或P<0.05);增加ALB含量(P<0.05);提高肝脏SOD活性和减少MDA含量(P<0.01);并明显改善肝脏的纤维化程度(P<0.01或P<0.05)。结论阿藿烯能够减轻CCl4所致的大鼠肝纤维化作用,其机制可能与抗氧化作用有关。     

亚砷酸钠致大鼠肝功能损伤和肝纤维化形成及其机制探讨

目的探讨亚砷酸钠致大鼠肝功能损伤和肝纤维化形成及其机制。方法将32只成年清洁级SD大鼠随机分为对照(普通饲料)组和低、中、高剂量亚砷酸钠(饲料中砷含量分别为25、50、100 mg/kg)染毒组,每组8只,雌雄各半。采用喂饲法进行染毒,连续染毒3个月。检测大鼠肝砷含量及血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)的活力和透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)的含量以及纤维化面积。结果与对照组比较,各剂量亚砷酸钠染毒组大鼠的肝砷含量均升高,肝脏增生纤维组织面积均增大,差异有统计学意义(P0.05);与对照组比较,各剂量亚砷酸钠染毒组大鼠血清HA的含量和高剂量亚砷酸钠染毒组大鼠血清LN含量及高剂量亚砷酸钠染毒组雌性大鼠血清PCⅢ的含量以及中、高剂量亚砷酸钠染毒组雄性大鼠血清PCⅢ、Ⅳ-C的含量均升高,差异有统计学意义(P0.05);与对照组比较,各剂量亚砷酸钠染毒组大鼠血清ALT、AST的活力均升高,除雌性大鼠中、低剂量组外,差异有统计学意义(P0.05);且随着亚砷酸钠染毒剂量的升高,大鼠的肝砷含量、肝脏增生纤维组织面积及血清ALT、AST的活力和HA、LN、PCⅢ、Ⅳ-C的含量均呈上升趋势。结论亚砷酸钠饲料染毒可导致大鼠肝功能的损伤,进而发生肝纤维化。     

健脾活血软肝汤治疗早期肝硬化大鼠模型的实验研究

目的研究健脾活血软肝汤在防治早期肝纤维化的效果,初步探讨其作用机理。方法以四氯化碳造模法诱导的早期肝纤维化大鼠为试验对象,以健脾活血软肝汤高剂量组、健脾活血软肝汤低剂量组、秋水仙碱组作为阳性对照,模型对照组作为阴性对照。以大鼠血清ALT、AST、ALB、GLB、A/G、HA、LN、PCⅢ、Ⅳ-C、肝组织进行HE常规染色和VG特殊染色作为主要观察内容。结果健脾活血软肝汤高剂量组、秋水仙碱组与模型对照组比较ALT、AST、ALB、HA、LN、PCⅢ、Ⅳ-C、体密度均有显著性意义(p<0.05)。健脾活血软肝汤高剂量组与秋水仙碱组比较ALB、HA、LN、PCⅢ、Ⅳ-C、体密度均有显著性意义(p<0.05)。健脾活血软肝汤高剂量组与低剂量组比较ALT、AST、ALB、HA、LN、PCⅢ、Ⅳ-C、体密度均有显著性意义(p<0.05)。结论健脾活血软肝汤比抗肝纤维化药物秋水仙碱效果更好,而且高剂量优于低剂量,可以抑制胶原合成,防治肝纤维化,其作用机制之一可能与抑制肝细胞损伤,减轻炎症反应,促进白蛋白合成,抑制细胞外间质的合成等有关。     

大黄总蒽醌对免疫性肝纤维化大鼠的保护作用及机制探讨

目的探索大黄总蒽醌对免疫性肝纤维化大鼠的作用及对基质金属蛋白酶-13(MMP-13)和基质金属蛋白酶抑制剂-1(TIMP-1)的调控。方法 SD大鼠按体重随机分为正常组、模型组、秋水仙碱阳性组、大黄总蒽醌低、中、高剂量组,除正常组外,其余大鼠均腹腔注射猪血清建立免疫性肝纤维化模型。从第7周开始灌胃给药,每天1次,连续60d,末次给药后,分析血清中丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的活性和层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(PCⅢ)的含量,观察肝组织病理学改变,Western blot分析MMP-13和TIMP-1的蛋白表达。结果与正常组比较,模型组大鼠ALT、AST、LN、HA和Ⅳ-C水平显著升高,肝组织中MMP-13水平降低,TIMP表达增加(P0.05);与模型组相比,大黄总蒽醌中、高剂量组大鼠ALT、AST、LN、HA和Ⅳ-C的水平均不同程度地降低,肝中MMP-13的表达增加,TIMP的表达减少(P0.05);病理显示,各给药组均能减轻猪血清造成的肝损伤。结论大黄总蒽醌可有效改善肝纤维化,其机制可能与MMP-13、TIMP-1的表达调控有关。     

慢性轻度高同型半胱氨酸血症对大鼠NO影响

目的观察蛋氨酸强化或叶酸缺乏膳食诱导的慢性高同型半胱氨酸血症(HHcy)大鼠体内一氧化氮(NO)的生成和代谢转化情况,从而探讨同型半胱氨酸(Hcy)致动脉粥样硬化(AS)中NO的可能作用。方法36只SD大鼠,按体重随机分为3组;对照组、高蛋氨酸组和叶酸缺乏组,分别饲以美国营养学会1993年公布的生长期啮齿类动物纯化配方饲料(AIN-93 G饲料)及强化1%L-蛋氨酸或不含叶酸的AIN-93 G饲料。14周后测定血浆总Hcy,血清NO、丙二醛(MDA)等含量,主动脉一氧化氮合酶(NOS)活性及主动脉硝基化酪氨酸(NT)含量。结果高蛋氨酸和叶酸缺乏膳食均可升高血浆Hcy水平,各组的NO含量及NOS活性差异无统计学意义,但2个HHcy实验组的MDA含量和主动脉NT表达量均高于对照组。结论膳食诱导的慢性HHcy大鼠体内NO总量及主动脉NOS活性并没有变化;氧化应激生成过氧化亚硝基阴离子(ONOO-)等反应使NO的生物可用性降低。     

肝复乐对四氯化碳致大鼠肝纤维化作用的影响

目的:研究肝复乐对CCl4化学性肝纤维化大鼠的保护作用.方法:以大鼠背部皮下注射CCl4诱导化学性肝损伤的纤维化动物模型;以肝复乐3.5g·kg-1,7.0g·kg-1连续灌胃给药9周,强肝胶囊为阳性对照药;全自动生化分析仪测定ALT、AST水平:放射性免疫方法测定大鼠血清中HA、LN、PCⅢ水平;化学法测定肝脏Hyp含量;光镜观察肝脏病理形态学改变.结果:肝复乐3.5g·kg-1,7.0g·kg-1均能改善CCl4致肝纤维化大鼠肝功能,使血清ALT、AST下降;降低血清HA、LN、PCⅢ和肝匀浆Hyp含量;减轻肝脏纤维化的病理组织学改变.结论:肝复乐对化学性肝纤维化大鼠有明显的改善作用.     

甜菜对胆碱缺乏诱导高同型半胱氨酸血症大鼠的影响

目的探讨富含甜菜碱的甜菜对由胆碱缺乏导致的大鼠高同型半胱氨酸血症的抑制效果。方法健康Wistar大鼠共48只随机分为6组:对照组25%大豆分离蛋白(25S);胆碱缺乏组(25SCD);25SCD+0.05%甜菜碱(Bet)组;25SCD+0.10%Bet组;25SCD+4.12%甜菜(Beet)组和25SCD+8.24%Beet组。实验喂养10天后处死动物,测定血浆和肝脏中同型半胱氨酸(Hcy)、半胱氨酸等氨基酸指标以及高半胱氨酸甜菜碱甲基转移酶(BHMT)和胱硫醚β-合酶(CBS)等酶学指标。结果胆碱缺乏使血浆Hcy的浓度从(11.8±0.4)μmol/L(对照组25S)显著升高到(33.2±0.6)μmol/L(25SCD),P<0.05。0.10%甜菜碱和8.24%甜菜的添加显著降低了血浆Hcy,并且呈现明显的剂量依赖性(P<0.05)。甜菜添加对BHMT活性的改善效果已明显高于对照组。结论饲料中添加富含甜菜碱的甜菜促进了大鼠体内同型半胱氨酸的再甲基化和胱硫醚的合成,显著抑制了由胆碱缺乏诱导的高同型半胱氨酸血症的发生。     

血清肝纤四项与肝功能联合检测对慢性乙肝肝纤维化的诊断价值

目的探讨血清肝纤四项指标与肝功能指标联合检测结果在慢性乙肝肝纤维化诊断中的临床价值。方法选取慢性乙肝患者80例,将其设定为乙肝组,并取同时期在巩义市人民医院接受体检的健康者40例,将其设定为对照组。两组均接受血清肝纤维化指标以及肝功能指标检测,比较两组检测结果。结果相较于对照组,乙肝组血清透明质酸(HA)、IV型胶原(IV-C)、层黏连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和AST/ALT水平均更高,差异有统计学意义(P0.05);血清肝纤维化指标与肝功能指标联合检测阳性检出率高于血清肝纤维化指标的阳性检出率以及肝功能指标阳性检出率,差异有统计学意义(P0.05)。结论血清肝纤四项指标与肝功能联合检测在慢性乙肝肝纤维化诊断中的临床效果显著,效果优于单纯应用血清肝纤维化指标或肝功能指标检测。     

甜菜对大鼠高同型半胱氨酸血症抑制作用

目的探讨富含甜菜碱(glycine betaine)的甜菜(beet)对胍基乙酸(GAA)诱导的高同型半胱氨酸血症的抑制效果。方法将48只健康Wistar大鼠随机分为6组:对照组、模型组(饲料添加0.5%GAA)、甜菜碱低、高剂量组(饲料分别含0.5%GAA+0.05%、0.10%Bet)、甜菜低、高剂量组(饲料分别含0.5%GAA+3.94%、7.88%beet),连续10 d,处死动物,采集血液、肝脏样品,测定血液生化指标及肝脏甲硫氨酸中间代谢物和酶学指标。结果与对照组比较,模型组大鼠血浆和肝脏同型半胱氨酸(Hcy)浓度[分别为(32.2±0.4)μmol/L、(8.93±0.5)nmol/g]明显升高(P<0.05);与模型组比较,高剂量甜菜碱组与甜菜组大鼠血浆和肝脏中Hcy浓度[分别为(21.5±0.7)、(21.1±0.6)μmol/L与(5.75±0.2)、(4.64±0.2)nmol/g]明显下降;与对照组比较,模型组大鼠肝脏中S-腺苷蛋氨酸(SAM)含量[(59.7(1.3)nmol/L]下降、S-腺苷同型半胱氨酸(S-adenosine homocysteine,SAH)含量[(31.8(0.9)nmol/L]升高(P<0.05);与模型组比较,高剂量甜菜碱组与甜菜组大鼠肝脏中SAM含量[(71.4(1.4)、(75.5(4.1)nmol/L]升高,SAH含量[(27.1(0.7)、(26.5(1.6)nmol/L]下降(P<0.05)。甜菜碱和甜菜对GAA诱导的Bet浓度下降、BHMT和CBS活性降低具有拮抗作用;与对照组比较,模型组大鼠肝脏同型半胱氨酸甜菜碱甲基转移酶(BHMT)活性[(1.08±0.07)nmol/mgprot]降低(P<0.05);与模型组比较,高剂量甜菜组大鼠肝脏BHMT活性[(2.05±0.11)nmol/mgprot]升高(P<0.05)。结论富含甜菜碱的甜菜可降低大鼠肝脏和血液中Hcy浓度,抑制由胍基乙酸诱导的高同型半胱氨酸血症,其机制可能与Hcy的再甲基化和胱硫醚的合成有关。     

没食子酸抗实验性肝纤维化作用机制

目的探讨中药单体没食子酸对四氯化碳(CCl4)诱导的大鼠肝纤维化影响及其机制。方法采用CCl4制备大鼠肝纤维化模型,观察没食子酸对大鼠肝功能、超氧化物歧化酶(SOD)、丙二醛(MDA)、L-羟脯氨酸(Hyp)、血清透明质酸(HA)、层粘连蛋白(LN)、III型前胶原(HPCIII)含量影响,观察肝脏显微结构变化。结果与对照组比较,模型组大鼠血清中谷丙转氨酶(ALT)[(342.07±28.03)U/L]、谷草转氨酶(AST)[(532.88±115.55)U/L]、M DA含量[(35.07±11.43)nmol/m L]升高,SOD活力[(147.18±32.27)U/m L]下降,血清中Hyp、HA、LN及HPCIII含量[分别为(49.23±10.87)μg/m L、(161.82±35.24)ng/m L、(46.90±24.52)ng/L、(8.47±1.10)ng/m L]明显升高(P0.01);与模型组比较,高剂量没食子酸组大鼠血清中ALT、AST活力[分别为(280.63±119.50)、(229.82±51.22)U/L]明显下降,MDA含量[(10.32±3.88)nmol/m L]下降、SOD活力[(230.30±17.56)U/m L]升高,血清中Hyp、HA、LN及HPCIII含量[分别为(26.83±8.23)μg/m L、(103.26±7.16)ng/m L、(11.74±3.69)ng/L、(6.00±0.53)ng/m L]明显下降(P0.05);病理切片结果表明,没食子酸对CCl4所致大鼠肝纤维化有明显改善作用。结论没食子酸具有明显的保肝、抗肝纤维化作用,其机制可能与其提高机体抗氧化能力有关。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.