脐血铅胎粪铅含量与新生儿神经行为发育的关系

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及胎粪铅含量与神经行为发育的关系。方法 随机选取武汉市青山区第一冶金建筑总公司职工医院妇产科1999年1－10月出生的足月新生儿103例。以脐血铅和胎粪铅含量作为新生儿宫内铅暴露的指标,新生儿神要行为发育评分作为效应指标。采用描述性分析方法评价其相关关系。脐血铅以0．483μmol/L为界、胎粪铅以127．78mg/kg为界,分别将研究对象分为高铅组与低铅组。结果 脐血高铅组与低铅组仅在新生儿神经行为发育总评分（1352．5与4003．5）、生物视听定向反应（1310．5与4045．5）得分上差异有显性,但脐血铅含量与新生儿神经行为发育总评分、非生物听定向反应、非生物视定向反应、生物视听定向反应之间不存在等级相关关系;而胎粪高铅组与低铅组在新生儿神经行为发育总评分（1636．0与3720．0）、非生物听定向反应（2110．5与3245．5）、非生物视定向反应（1836．0与3520．0）、生物视听定向反应（1828．5与3527．5）4项评分上,两组差异有显性或非常显性。胎粪铅含量与新生儿神经行为发育总评分、非生物视定向反应、生物视听定向反应3项神经评分有明确的等级负相关关系。结论 胎粪铅含量可作为妊娠期胎儿体内铅蓄积的指标。     

脐血铅与初乳铅含量与新生儿神经行为发育关系

目的探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系。方法随机选取南京市妇幼保健院医院产科2010-01/04出生的足月新生儿170例。以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为（NBNA）发育评分作为效应指标。结果高暴露组在新生儿主动肌张力、原始反射和神经行为发育总评分上低于低暴露组,差异有统计学意义（t=4.625,P〈0.05）,在新生儿行为能力、被动肌张力、一般估价上差异无统计学意义。结论初乳铅脐血铅水平和与婴儿的早期发育有关,铅可通过乳汁和脐血造成新生儿的铅接触,对新生儿婴儿早期神经行为发育产生不良影响。     

脐血铅、初乳铅含量对新生儿神经行为发育的影响

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系.方法 随机选取南京市妇幼保健院医院产科2010年1-4月出生的足月新生儿170例.以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为NBNA发育评分作为效应指标.结果 高暴露组和低暴露组在新生儿主动肌张力、原始反射和神经行...     

脐血,胎粪铅含量对新生儿神经行为发育的影响

为探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及胎粪铅含量与神经行为发育的关系。随机选取某医院妇产科１９９９年１～１０月出生的足月新生儿１０３例,以脐血铅（ＣＢＰｂ）含量与胎粪铅（ＭＰｂ）含量作为新生儿宫内铅暴露的指标,新生儿神经行为评分（ＮＢＮＡ）作为效应指标。结果显示,与脐血铅含量比较,胎粪铅含量与新生儿神经行为发育的关系更为密切,可作为妊娠期胎儿体内铅蓄积的指标。     

脐血铅水平与新生儿神经行为发育及血锌含量的相关研究

为了探讨宫内铅暴露的神经发育毒性及其预防措施，本研究选择１０１例足月顺产新生儿，以脐血铅水平为宫为暴露指标，新生儿神经行为发育评分为效应指标，结果表明：脐血铅超过０．４８μｍｏｌ／Ｌ（１０．００ μｇ／ｄｌ）时对胚胎神经发育有不良影响；新生儿的行为能力评分和总评分与脐血铅水平在负相关关系；脐血锌含量随血铅水平增高而升高，二者间存在正相关关系，提示铅可能对体内锌的吸收、分布或利用产生影响。     

影响新生儿听定向反应及其附加分的多因素分析

目的 探讨影响新生儿听定向反应及其附加分的多种环境因素及敏感性。方法 随机选取武汉市某医院妇产科1999年1-10月出生的足月新生儿103例，测定新生儿神经行为能力并疏集有关影响因素，同时测定新生儿脐血铅和胎粪铅含量。分别以新生儿非生物听定向反应评分及非生物听定向反应附加评分作为因变量，以影响因素及脐血铅，胎粪铅等24项指标作为自变量，采用多项有序分类反应型变量的logistic逐步回归的分析方法，在P=0.10水平筛选出相应的影响因素。结果 家庭人口数，孕期感染及孕期感染月份3项因素选入影响新生儿非生物听定向反应评分的模型，孕期情绪，孕期服药，新生儿性别，孕期感染，孕期感染月份，孕周，胎粪铅等7项因素选入影响新生儿非生物听定向反应附加评分的模型。结论 孕周长、女性新生儿，孕期情绪好有利于新生儿非生物听定向反应附加评分的发育，孕期早期感染，孕期服药，高胎粪铅水平不利于新生儿非生物听定向反应附加评分的发育。     

脐血铅水平与新生儿神经行为发育及血锌含量的相关研究

为了探讨宫内铅暴露的神经发育毒性及其预防措施,本研究选择101例足月顺产新生儿,以脐血铅水平为宫内暴露指标,新生儿神经行为发育评分为效应指标,结果表明:脐血铅超过0.48μmol/L(10.00μg/dl)时对胚胎神经发育有不良影响;新生儿的行为能力评分和总评分与脐血铅水平存在负相关关系;脐血锌含量随血铅水平增高而升高,二者间存在正相关关系,提示铅可能对体内锌的吸收、分布或利用产生影响。     

新生儿脐血铅含量与神经行为发育的关系

目的 :探讨孕期低水平铅暴露下 ,脐血血铅含量对新生儿神经行为发育的影响。方法 :随机选择 2 0 0 3年 1～4月出生足月新生儿 135例。以脐血铅作为孕期铅暴露的指标 ,新生儿神经行为发育 (NBNA)评分作为效应指标 ,采用描述性分析方法评价二者之间的相关性。结果 :高暴露组和低暴露组在新生儿主动肌张力、神经行为发育总评分上差异有显著性 (P<0 .0 5 ) ,原始反射评分差异有非常显著性 (P<0 .10 ) ,在新生儿行为能力、被动肌张力、一般估价上差异无显著性。结论 :孕期低水平铅暴露对新生儿神经行为发育影响明显。     

孕期被动吸烟对新生儿脐血铅及听力的影响

目的 探讨孕期被动吸烟与宫内铅暴露水平及新生儿听神经发育的关系.方法 经过问卷调查,选择符合条件的孕妇及其新生儿105例,分为对照组(36例)、暴露组[包括高暴露组(36例)和低暴露组(33例)],以新生儿脐血铅含量作为胎儿宫内铅暴露的指标,新生儿耳声发射听力筛查(OAE)3日初检阳性率作为听神经发育受损概率的指标,比较组间差异.结果 对照组、暴露组的脐血铅水平的几何均值分别为:21.38、33.88μg/L(高暴露组和低暴露组分别为39.81μg/L和30.20 μg/L),各组比较,差异均有统计学意义.对照组、暴露组的新生儿OAE 3日初检阳性率分别为11.11%,31.88%(高暴露组和低暴露组分别为38.89%和15.15%),各组比较,对照组与暴露组及对照组与高暴露组的差异有统计学意义,对照组与低暴露组的差异无统计学意义.将母血铅与脐血铅进行总的及各组内的相关性分析,均呈正相关.结论 孕期被动吸烟可以明显提高脐血铅水平并可能至少在短期内进一步影响新生儿的听神经发育;母血铅水平可作为胎儿宫内铅暴露的指标,用于评价铅暴露对新生儿神经行为发育的影响.     

影响新生儿神经行为发育的多因素分析

目的：探讨影响新生儿神经行为发育的多种因素及敏感性。方法：随机选取中国第一冶金建筑公司职工医院妇产科1999年1-10月出生的足月新生儿103例，用鲍秀兰的20项新生儿神经行为检查法测定新生儿神经行为能力，用武汉科技大学医学院附属医院儿科设计的问卷收集有关影响因素，同时测定新生儿脐血铅和胎粪铅含量。以新生儿神经行为总评分作为因变量，以问卷中的影响因素及脐血铅、胎粪铅等24项指标作为自变量，采用多项有序分类反应型变量的logistic逐步回归的分析方法，在P=0.10水平筛选出相应的影响因素。结果：孕周、孕期服药月份、血红蛋白、孕期情绪、胎粪铅、孕期服药6项选入模型。结论：新生儿神经行为发育受多项因素的影响。孕期营养状况好、孕周长、孕期情绪好有利于新生儿神经行为的发育。孕期服药不利于新生儿神经行为的发育，尤其是妊娠早期用药。胎粪铅含量增高将不利于新生儿神经行为的发育。     

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.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.