1991～2000年浙江省糖尿病患者慢性并发症患病率及相关因素分析

目的 探讨浙江省糖尿病患者慢性并发症的患病情况以及相关因素。方法 对浙江省1083例糖尿病患者慢性并发症的回顾性调查资料进行描述性分析，并采用logistic回归分析对影响糖尿病患者慢性并发症患病的相关因素进行深入分析，初步建立慢性并发症与相关因素的数学模型。结果 糖尿病患者慢性并发症(患病率π的95％CI)有：心血管疾病(27．91％～33．41％)、眼科疾病(27．46％～32．92％)、肾病(23．87％～29．13％)、感觉神经疾病(23．6％～28．84％)、植物神经疾病(7．6％～11．06％)、脑血管疾病(6．08％～9．24％)、下肢血管疾病(1．42％～3．2％)和运动神经疾病(0．42％～1．62％)。结论 浙江省糖尿病患者并发症患病率最高的是心血管疾病，其次是眼科疾病和肾病。主要的相关因素有糖尿病病程、高血压病程、年龄、诊断年龄、血压、空腹血糖、餐后两小时血糖、糖化血红蛋白、甘油三脂、胆固醇、高密度脂蛋白、低密度脂蛋白等。     

糖尿病患者慢性并发症患病率及相关因素分析

目的 探讨糖尿病患者慢性并发症的患病情况以及相关因素。方法 对浙江省1083例糖尿病患者慢性并发症的回顾性调查资料进行描述性分析,并采用logistic回归对其相关因素进行深入分析,初步建立慢性并发症相关因素的数学模型。结果 糖尿病患者慢性并发症有心血管疾病、眼科疾病、肾病、感觉神经疾病、植物神经疾病、脑血管疾病、下肢血管疾病和运动神经疾病。主要的相关因素有糖尿病病程、高血压病程、年龄、诊断年龄、血压、空腹血糖、餐后2 h血糖、糖化血红蛋白、甘油三酯、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等。结论 文中采用的分析方法适用于其他慢性病并发症的患病情况和相关因素的研究;在此基础上可以建立其鉴别函数,为临床上的诊断提供参考依据。     

上海市黄浦区社区2型糖尿病患者慢性并发症现况调查

目的分析黄浦区社区2型糖尿病患者慢性并发症的发病情况。方法采用单纯随机抽样方法,从黄浦区社区糖尿病患者管理系统中收集病例516例,通过采用自行设计的问卷调查采集患者的慢性并发症资料。结果糖尿病患者中有慢性并发症者401人,总患病率为77.71%,其中心血管疾病、感觉神经病变、眼科疾病和脑血管疾病的患病率分别为64.92%、29.26%、28.10%和20.15%。女性心血管疾病、感觉神经病变和眼睛疾病患病率高于男性。2型糖尿病各并发症患病率随着年龄、病程的增长而呈上升趋势,在不同年龄段和病程中以心血管疾病患病率最高。结论社区糖尿病患者中慢性并发症的患病率明显升高,加大社区糖尿病患者并发症的早期发现和治疗的力度,可以防止或延缓并发症的发生,提高糖尿病患者的生活质量。     

常熟市社区2型糖尿病患者慢性并发症患病率及相关因素分析

目的了解常熟市社区2型糖尿病(T2DM)患者慢性并发症的患病率及其相关危险因素,为糖尿病并发症的预防和治疗提供科学依据。方法于2013年12月至2014年1月采用多阶段分层整群抽样的方法,对常熟市已纳入基本公共卫生服务管理并登记的12个乡镇中11 539名T2DM患者进行问卷调查、体格检查和实验室检测。采用logistic回归分析影响糖尿病患者慢性并发症患病的相关因素。结果 T2DM患者慢性并发症患病率分别为:心血管疾病6.2%、脑血管疾病6.9%、肾病4.5%、眼科疾病11.8%、糖尿病足2.1%和神经病变2.7%,总患病率为25.6%。多因素logistic回归分析显示,年龄(以60岁组为对照,60~组OR=1.474,95%CI:1.307~1.662,70~组OR=2.040,95%CI:1.790~2.326)、吸烟(OR=1.334,95%CI:1.180~1.508)、体质指数(OR=1.107,95%CI:1.005~1.220),糖化血红蛋白(以7%组为对照,7%~组OR=1.116,95%CI:1.004~1.240,9%~组OR=1.183,95%CI:1.041~1.346)、糖尿病病程(以5年组为对照,5~年组OR=1.475,95%CI:1.315~1.655,10~年组OR=1.858,95%CI:1.653~2.089)、高血压(OR=1.424,95%CI:1.237~1.638)、血酯异常(OR=1.377,95%CI:1.253~1.513)、高尿酸症(OR=1.354,95%CI:1.185~1.547)、糖尿病家族史(OR=1.194,95%CI:1.076~1.325)为糖尿病慢性并发症的独立影响因素。结论常熟市社区T2DM患者糖尿病慢性并发症患病率较高,必须严格控制吸烟、体质指数、糖化血红蛋白水平、高血压、血脂异常、高尿酸症等危险因素,以减少或延缓并发症的发生。     

初诊2型糖尿病患者微血管病变与相关危险因素分析

目的:分析初诊2型糖尿病患者微血管病变(周围神经病变、视网膜病变、糖尿病肾病)与其相关危险因素关系.方法:对120例新诊断的2型糖尿病患者进行神经传导速度、眼底荧光造影和尿微量白蛋白及相关指标测定,计算微血管病变的患病率,并对相关因素分析.结果:(1)初诊患者中糖尿病周围神经病变的患病率为34.6%,糖尿病视网膜病变的患病率为15.4%,糖尿病肾病的患病率为13.4%.(2)年龄、空腹血糖、餐后2 h血糖、收缩压、舒张压、糖化血红蛋白、总胆固醇均为糖尿病周围神经病变的独立危险因素.(3)糖化血红蛋白、尿微量白蛋白、收缩压为糖尿病视网膜病变独立危险因素.结论:初诊2型糖尿病患者有一定微血管病变患病率,应强化对血压、血糖、血脂相关危险因素的干预以控制和延缓糖尿病微血管病变的发生、发展.     

天津市新诊断2型糖尿病患者慢性并发症发病率与相关医疗费用研究

目的探究天津市新诊断2型糖尿病患者慢性并发症的发病率与相关医疗费用,并重点关注心血管疾病、脑血管疾病以及肾病三类常见并发症。方法基于2008-2015年天津市城镇职工医保数据库,纳入2009-2014年入组的新诊断的2型糖尿病患者,研究患者心血管疾病、脑血管疾病、外周血管病变、足病、肾病、视网膜病变、神经病变7种慢性并发症的发病率与次均医疗费用。结果本研究共纳入新诊断2型糖尿病患者114847人,平均年龄为56.9岁,其中45.5%为女性。7种慢性并发症中,肾病的发病率最高,为316.6/1000人年,其次为神经病变(257.7/1000人年)、外周血管疾病(167.6/1000人年)、视网膜病变(153.6/1000人年)和心血管疾病(101.3/1000人年)。以足病为主要诊断的次均住院费用最高(25825元),其次为外周血管疾病(20797元)和心血管疾病(19349元);次均门诊费用在不同并发症之间差异不大。7类慢性并发症的次均门诊费用集中在448元至214元之间。结论慢性并发症进展较快,同时也给患者带来了沉重的经济负担,特别是心血管疾病和肾病。因此,糖尿病患者需通过适当控制血糖及并发症相关危险因素,同时定期进行并发症筛查,预防和及时发现并发症。     

无锡市社区人群代谢综合征现况调查及特点分析

目的了解无锡市社区人群代谢综合征(MS)的患病水平及影响MS患病的相关因素与后果。方法采用整群抽样方法调查无锡市社区20岁以上人群10833人,按照国际糖尿病联盟(IDF)标准分析MS及其各组分代谢紊乱的患病情况和代谢综合征人群的空腹血糖受损及糖尿病患病率;logistic多因素分析MS患病危险因素以及MS人群发生空腹血糖受损和糖尿病的危险因素。结果无锡市社区人群MS标化患病率为18.8%。随年龄的增加MS患病率逐步增高,女性MS标化患病率高于男性。无论男性还是女性,中心性肥胖伴高血压、高血脂是MS患者的主要代谢紊乱表现。MS人群中空腹血糖受损的患病率为6.01%,糖尿病患病率为21.14%。logistic多因素分析结果显示,女性、年龄大、高血压家族史、饮食偏咸和常吃烟熏食物是MS患病的危险因素,糖尿病家族史是MS患者发生空腹血糖受损和糖尿病的危险因素,文化程度高是保护因素。结论无锡市社区人群中MS患者代谢紊乱状态以中心性肥胖伴高血压、高血脂为特点,MS人群中发生空腹血糖受损及糖尿病者高于一般人群,年龄大以及伴有糖尿病家族史的代谢综合征患者更易发生空腹血糖受损和糖尿病。     

2型糖尿病患者糖尿病肾病患病率及其相关因素分析

目的 了解2型糖尿病患者糖尿病肾病(DN)患病率及其相关因素.方法 对常住本溪市中心城区的2 276例2型糖尿病患者进行问卷调查,采集临床资料.结果 糖尿病患者DN患病率为20.43%,病程≥10 a者DN患病率(10 a～为25.66%,≥20 a～为39.83%)随病程增长而上升(χ2=17.707,P<0.05).吸烟(24.46%)、高血压(22.91%)、血脂异常(23.24%)、高尿酸血症(26.83%)、HbAIC≥8%(24.25%)、合并糖尿病周围神经病变(35.22%)者DN患病率高于无相关因素(分别为18.97%,17.58%,12.31%,19.19%,18.50%,13.53%)者(P<0.05).饮茶者DN患病率低不饮茶者(χ2=5.713,P<0.05).吸烟(OR=1.817,95%CI:1.372～2.185)、高血压(OR=1.115,95%CI:1.053～1.663)、血脂异常(OR=1.605,95%CI:1.195～2.154)、高尿酸血症(OR=1.544,95%CI:1.269～1.847)、HbAIC≥8%(OR=1.294,95%CI:1.021～1.640)、合并糖尿病周围神经病变(OR=5.797,95%CI:4.580～7.338)是DN患病危险因素.结论 有不良生活习惯及糖尿病并发症者DN患病率较高,且是DN患病的危险因素.     

广州市钢铁企业从业人员代谢综合征患病调查

目的 了解广州市钢铁企业从业人员代谢综合征(MS)及相关疾病的患病状况.方法 整群随机抽取广州市某钢铁集团16个单位4 241名(20～60岁)员工进行问卷调查和体检.采用国际糖尿病联盟(IDF)的MS诊断标准进行分析.结果 MS的粗患病率为9.70%(男9.80%,女9.40%),经年龄和性别标准化后患病率为7.95%(男8.87%,女6.97%);中心性肥胖、高甘油三脂(TG)血症、低高密度脂蛋白(HDL-C)血症、血压升高、高空腹血糖(FPG)糖尿病的标准患病率分别为15.84%,27.04%,20.46%,17.19%,8.29%;MS的患病率随年龄增长而增高;有1种～MS组分异常的人占55.7%;有高腰臀比、饮酒、缺乏运动、高血压家族史、糖尿病家族史、高尿酸血症、吸烟指数＞100等因索的人群MS患病率较高.结论 广州市钢铁企业从业人员MS及其相关疾病的患病率在20～29岁处于较高水平,且20～49岁人群患病率高于某些地区;MS代谢异常组分的患病和个体聚集在该人群中较普遍.     

糖尿病肾病与非肾病患者冠心病患病率及相关危险因素分析

目的 探讨糖尿病肾病与非肾病患者冠心病患病率及其危险因素的相关性.方法 回顾性分析295例2型糖尿病患者的临床资料,根据Mogensen糖尿病肾病诊断标准分为糖尿病肾病组(ON组)和非肾病组(N-DN组),比较两组患者性别、年龄、病程、吸烟史、体质指数(BMI)、糖化血红蛋白(HbA1C)、血压、血脂谱、血清尿酸(UA)、血浆纤维蛋白原(FIB)、血清肌酐(Cr)、肌酐清除率(CCr)、24 h尿微量白蛋白(uMA)水平及冠心病患病率;采用Logistic回归分析糖尿病肾病对冠心病患病的影响.结果 DN组患者Cr(97.17vs71.34)、uMA(279.56vs14.56)高于N-DN组,CCr低于N-DN组(94.82vs121.94),差别有统计学意义(P<0.01). DN组冠心病患病率(57.33%vs38.62%)、糖尿病病程、血压、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、uA及FIB水平高于N-DN组(P<0.05);单因素Logistic回归分析显示,糖尿病肾病与糖尿病病程、血压、TC、LDL-C、UA及FIB显著正相关;多因素Logistic回归分析显示,CCr(OR=0.987,95%CI:0.987～0.996)、年龄(OR=1.040,95%CI:1.015～1.065)、收缩压(OR=1.017,95%CI:1.005～1.029)是冠心病的独立危险因素.结论 糖尿病肾病患者冠心病患病率较高;CCr下降是2型糖尿病患者合并冠心病的独立危险因素.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.