外科创伤与术后营养支持:肌肉蛋白质代谢的纵向研究

外科创伤后机体处在分解代谢状态,其中包括体重下降,肌肉萎缩,尿氮丢失量增加;同时伴有肌肉蛋白质合成减少以及大量的氨基酸由肌肉流向内脏器官,最终导致肌肉中的游离氨基酸其中主是谷氨酰胺(GLN)水平下降和肌肉功能减退,这些后果是常规的肠外营养所无法预防的.然而,补充谷氨酰胺的肠外营养可改善外科术后早期氮平衡,预防肌肉蛋白质合成下降及肌肉中游离的谷氨酰胺减少.     

八大护眼营养素 让你越老越“睛彩”

<正>眼睛老化虽然无法避免,但是通过及早预防,仍可以降低眼疾风险,守护眼睛健康。除了平日要做好护眼工作,摄取足够营养也是全方位视力保健的重要关键。1.蛋白质蛋白质是人体不可缺少的营养,也是组成细胞的主要成分,对身体组织(如肌肉的生长和复原)尤其重要。身体组织的修复更新需要不断地补充蛋白质,     

口服胶原蛋白是否真的有效?

口服胶原蛋白之所以成为时髦的保健方法与厂商的宣传分不开,但更主要的原因是消费者不了解生命科学的基本常识.吃胶原蛋白并不能直接增加体内胶原蛋白的合成,虽然它对身体(包括皮肤、关节、骨骼、脏器、肌肉等)具有一定的营养作用,但并没有证据显示它的营养作用会超过鸡蛋、大豆等普通食物中的蛋白质.     

口服胶原蛋白是否真的有效?

口服胶原蛋白之所以成为时髦的保健方法与厂商的宣传分不开,但更主要的原因是消费者不了解生命科学的基本常识.吃胶原蛋白并不能直接增加体内胶原蛋白的合成,虽然它对身体(包括皮肤、关节、骨骼、脏器、肌肉等)具有一定的营养作用,但并没有证据显示它的营养作用会超过鸡蛋、大豆等普通食物中的蛋白质.     

蔬菜的健康威力

<正>对于广大健美爱好者而言,训练、饮食、休息可谓他们塑造完美身材的三大法宝。由此可见合理的饮食对健美爱好者的重要性。肌肉生长需要大量蛋白质和碳水化合物作为吸收来源。因此包括健身爱好者在内的运动员们,在日常的饮食中,十分注重对肉类(蛋白质主要来源)的摄取,而往往忽略了对蔬菜(纤维素及微量元素主要来源)的摄入。也许会有人以为蔬菜不能直接给肌肉带来营养和泵感,从而可以减少对它的摄取。这是对均衡营养理解上的偏差!偏食很容易降低人体免疫系统功能,引起一系列相关炎症。     

8大护眼营养素让你越老越精彩

正眼睛老化虽然无法避免,但是如果及早预防,仍可以降低眼疾风险,守护眼睛健康。除了平日要做好护眼工作,摄取足够营养也是全方位保护视力的关键。1.蛋白质蛋白质是人体不可缺少的营养,也是组成细胞的主要成分,对身体组织(例如肌肉的生长和复原)尤其重要。身体组织的修复更新需要不断地补充蛋白质,因此,一个人若严重缺乏蛋白质,也会影响眼睛的正常视觉。     

职业应激与下肢肌肉骨骼系统疾患的关系

目的 探讨职业应激与下肢肌肉骨骼系统疾患的关系.方法 采用横断面研究设计和自报式问卷调查方法对13家企业5338名工人进行整群调查,采用修订的工作内容问卷和付出-回报失衡模式问卷调查职业应激状况.采用肌肉骨骼系统疾患调查表调查过去1年内下肢肌肉骨骼系统疾患和不良姿势情况.使用logistic回归分析职业应激因素与下肢肌肉骨骼系统疾患检出率之间的关系.结果 2个职业应激模式主要因子中,躯体需求和付出是臀部疾患的危险因素,而工作控制是臀部疾患的保护因素.当2个模式的主要因素一起分析时,仅有躯体需求是臀部疾患的危险因素.以4种工作类型的分类变量进行分析时,工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.随着患病部位的增多,工作紧张和付出-回报失衡的危险增加.工作控制的保护作用随患病部位的增加而增大.以连续变量进行分析时,以躯体需求计算的工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.结论 职业应激与下肢肌肉骨骼系统疾患存在统计学意义的相关,下肢肌肉骨骼系统疾患的预防应考虑控制职业应激因素和增加工作控制.     

高亮氨酸肠外营养对兔烧伤后蛋白质丢失的影响

目的观察不同浓度亮氨酸的肠外营养液对烧伤后家兔肌肉蛋白质丢失的影响,并探讨其机制。方法 40只新西兰兔,经沸水造成15%面积的III度烧伤,7d后给予不同的静脉营养支持,分别为普通糖水(Glu组)、基础肠外营养(BPN组)、支链氨基酸肠外营养(BCAA组)、和高亮氨酸肠外营养(Leu组)。其中BPN,BCAA,Leu组肠外营养液按等氮等能量配置,亮氨酸分别占总氨基酸的6.9%、12.8%、35.9%。营养支持1h后开始L-[1-13C]-苯丙氨酸同位素示踪测定兔下肢肌肉的蛋白质代谢情况。结果与Glu组相比,BCAA组和Leu组蛋白合成速率均有显著提高,且以Leu组更为明显(+206%vs+99%);三组中,只有Leu组有明显改善蛋白平衡的作用,并获得正蛋白平衡[0.38±0.10 g/(kg.d)vs-0.74±0.40 g/(kg.d)]。Glu组和BPN组之间、BPN组和BCAA组之间的各项蛋白质代谢参数均无统计学差异。结论高亮氨酸营养液可有效改善烧伤后兔肌肉的蛋白质丢失,其作用主要通过促进蛋白质合成代谢实现。[营养学报,2012,34(6):549-552]     

肿瘤相关性肌肉减少症的发病机制与干预措施

肿瘤患者肌肉减少症发病机制比较复杂,涉及肿瘤和机体新陈代谢的各个方面,主要与蛋白质分解加速及合成不足有关.肌肉减少症能预测肿瘤患者药物治疗剂量限制毒性反应、增加并发症、降低生存率.肿瘤患者肌肉减少症的治疗包括营养干预、运动干预、激素及其他治疗.单一的治疗方式,不能逆转患者的临床结局.目前各种干预措施仍处于探索阶段,有待更多的循证研究支持.     

维生素防治老年性肌肉衰减综合征

目前研究认为,蛋白质补充与阻抗运动训练可以延缓老年性肌肉衰减现象。维生素是人体必需的一类微量营养素,它改善老年人肌肉功能的作用近年来也逐渐受到重视。本文主要介绍不同种类的维生素与肌肉衰减的关系,从营养角度为预防老年人肌肉衰减综合征提供新的途径。     

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.     

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.     

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.     

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.     

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.     

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.