60例妊娠合并糖尿病孕妇母婴结局分析

目的研究妊娠合并糖尿病（GDM）对母婴结局的影响。方法选取60例妊娠合并糖尿病患者（观察组）和同期59例健康孕妇（对照组）的母婴结局观察比较。结果观察组剖宫产率、产后出血量、住院天数、并发症发生率均显著高于对照组（P〈0.05）;对照组新生儿出生体重、Apgar评分、围产儿并发症显著优于观察组（P〈0.05）。结论 GDM对母婴结局危害较大,临床工作者应加强GDM相关知识宣教及血糖监测。     

孕期规范化诊疗和管理对双胎妊娠结局的影响分析

目的探讨双胎妊娠孕期规范化诊疗和管理对妊娠结局的影响。方法回顾性分析2015年1月至2018年1月在民勤县中医院进行早孕建档的61例双胎妊娠孕妇的临床资料。比较分析孕期给予常规检查(A组,n=31)与规范化诊疗和管理(B组,n=30)对孕妇的分娩方式、围产儿结局和并发症发生的影响。结果 B组孕妇的剖宫产率和早产率低于A组(P0. 05),流产、妊娠高血压、糖耐量异常和贫血的发生率两组差异无统计学意义(P0. 05); B组围产儿生长受限发生率低于A组(P0. 05),但新生儿死亡、新生儿窒息、低体重儿、双胎输血和胎儿畸形两组差异无统计学意义(P0. 05); B组的母婴同室率、1 min和5 min Apgar评分高于A组,入NICU率低于A组(均P0. 05)。结论双胎妊娠孕期实施规范化诊疗和管理可显著降低剖宫产率和早产率,且可降低胎儿的生长受限发生率,提高母婴同室率和1 min、5 min Apgar评分,显著改善双胎妊娠的母儿结局。     

妊娠期糖尿病孕妇母婴结局及其糖化血红蛋白含量分析

目的分析妊娠期糖尿病(gestational diabetes mellitus,GDM)患者糖化血红蛋白(glycated hemoglobin,HbAlc)含量和母婴结局相关性,为临床患者诊疗提供借鉴。方法回顾性分析2015年5月至2017年5月在中国人民解放军联勤保障部队第九四医院妇产科住院分娩GDM孕妇218例,依据HbAlc数值分成两组,未达标组(6.1%～7.0%)96例和达标组(5.1%～6.0%)122例,选取同期进行产前体检、HbAlc含量低于5%且产前两次血糖检测正常产妇100例作为对照组。记录3组孕妇妊娠与围生儿结局状况。结果未达标组产妇剖宫产、妊娠期高血压、羊水过多、子痫前期及胎膜早破比例高于达标组、正常组,妊娠周数低于达标组、正常组,差异均有统计学意义(P0.05);未达标组围产儿中早产儿、新生儿低血糖、巨大儿、1min Apgar评分≤7分比例及新生儿体重高于达标组、正常组,差异均有统计学意义(P0.05);Pearson相关分析显示,达标组和未达标组产妇血清HbAlc含量和妊娠周期为负相关关系(r=-0.169、-0.175,P0.05),达标组和未达标组产妇HbAlc含量和新生儿1min Apgar评分为负相关关系(r=-0.161、-0.158,P0.05)。结论 GDM产妇血清HbAlc含量和母婴结局联系紧密,血清HbAlc含量越高,妊娠和分娩期间母婴并发症率越高,HbAlc可作为孕期血糖含量和GDM筛查的重点指标,做好相关干预可降低围生期不良结局发生率。     

孕妇产前健康教育与妊娠结局关系的探讨

目的:探讨孕妇产前健康教育与妊娠结局的关系。方法:选择住院分娩且自愿接受产前健康教育的116例初产妇为实验组,选择同期住院分娩未接受产前健康教育的100例初产妇为对照组,比较两组产妇分娩方式、高危妊娠发生率、围产儿死亡率。结果:实验组剖宫产率、高危妊娠发生率显著低于对照组(P<0.05);实验组围产儿死亡率低于对照组,两组差异无统计学意义(P>0.05)。结论:孕妇产前健康教育可有效提高孕妇对孕期保健知识的掌握,降低剖宫产率、高危妊娠发生率,防止并发症的发生,保障母婴健康。     

重度子痫前期孕妇早产及自发性早产的母婴结局比较

目的比较重度子痫前期孕妇早产及自发性早产的母婴结局。方法选取2013年1月-2016年1月住院的48例重度子痫前期终止妊娠患者为观察组,选取同期38例自发性早产孕妇为对照组。对比分析两组母婴结局。结果两组孕妇剖宫产率及并发症发生率比较差异均有统计学意义(P0.05)。两组新生儿1 min Apgar评分与5 min Apgar评分比较,差异均有统计学意义(P0.05)。两组新生儿并发症发生率比较差异无统计学意义(P0.05)。观察组男性新生儿平均出生体重略低于对照组,差异无统计学意义(P0.05);观察组女性新生儿平均出生体重略高于对照组,差异无统计学意义(P0.05)。结论重度子痫早产和自发性早产均对孕妇和新生儿健康有一定的不良影响,剖宫产率和并发症发生率相对较高。临床治疗中应加强对病情进展的关注,采取有效的干预措施,积极改善母婴结局。     

妊娠晚期羊水Ⅲ度污染行剖宫产对母婴妊娠结局的影响

目的研究妊娠晚期羊水Ⅲ度行剖宫产对母婴妊娠结局的影响。方法选择2014年6月-2017年6月本院收治的100例妊娠晚期羊水Ⅲ度患者作为研究对象,根据分娩方式分为对照组(40例)和观察组(60例)。对照组采用阴道分娩,观察组采用剖宫产;比较两组产妇产后并发症,新生儿体质量、1 min Apgar评分和新生儿并发症。结果观察组孕妇并发症发生率明显低于对照组(P0.05),两组新生儿体质量比较差异无统计学意义(P0.05),但观察组1 min Apgar评分明显高于对照组(P0.05),新生儿并发症发生率明显低于对照组(P0.05)。结论妊娠晚期羊水Ⅲ度行剖宫产可显著改善母婴妊娠结局。     

妊娠合并隐性梅毒治疗与围产儿预后关系的临床观察

目的探讨妊娠合并隐性梅毒治疗与围产儿预后的关系。方法选取我院妊娠合并隐性梅毒患者108例,根据妊娠期是否行全疗程抗梅毒治疗,将孕妇分为早期治疗组(妊娠20周内,40例)、晚期治疗组(妊娠20~37周,35例)和未治疗组(33例),组间比较妊娠不良结局、围产儿不良预后新生儿Apgar评分与新生儿先天梅毒发生率的差异。结果早期治疗组足月分娩率、正常新生儿率明显高于晚期治疗组与未治疗组,妊娠不良结局率与围产儿不良预后率均明显低于晚期治疗组与未治疗组,晚期治疗组上述指标均明显优于未治疗组,比较差异具有统计学意义(P<0.05),早期治疗组新生儿1 min,5 min Apgar评分明显高于晚期治疗组与未治疗组,新生儿梅毒甲苯胺红不加热血清反应素试验(TRUST)阳性率,先天梅毒发生率明显低于晚期治疗组与未治疗组,晚期治疗组上述指标均明显优于未治疗组,比较差异具有显著性(P<0.05)。结论抗梅毒治疗有助于改善妊娠合并隐性梅毒患者的妊娠与围产儿不良结局,降低新生儿先天梅毒风险,其中治疗时机越早,其对妊娠与围产儿不良结局的改善效果更佳。     

产前抑郁症对妊娠期糖尿病产妇分娩方式、并发症及围生儿结局的影响

目的评估产前抑郁症对妊娠期糖尿病(GDM)产妇分娩方式、并发症及围生儿结局的影响,为GDM产妇的情绪管理提供理论依据。方法选取2015年10月-2016年10月该院接诊的100例患有产前抑郁症的GDM产妇作为观察组,另选取同期在该院分娩的100例无产前抑郁症的GDM产妇作为对照组。对两组产妇进行抑郁自评量表(SDS)评定,对比分析两组产妇的分娩方式、并发症及围生儿结局的差异。结果观察组产妇阴道分娩率低于对照组,观察组产妇并发症发生率高于对照组,观察组早产儿、巨大儿、新生儿窒息、新生儿呼吸窘迫综合征发生率均高于对照组,差异均有统计学意义(均P0.05)。结论产前抑郁症对GDM产妇分娩方式、并发症和围生儿结局具有较大影响,增加了产妇剖宫产率和并发症发生率,降低了新生儿的健康指数,临床应引起重视。     

过期妊娠胎盘成熟度分级和围产儿结局的关系

目的 探讨过期妊娠胎盘成熟度分级与围产儿结局的关系.方法 采用回顾性方法,对124例过期妊娠患者在分娩前1 d进行B超检查.根据Gmnum胎盘成熟度分级,将孕妇分为Ⅱ级胎盘组和Ⅲ级胎盘组,比较两组间孕妇一般情况和新生儿预后指标.结果 两组孕妇间一般情况、新生儿Apgar评分、新生儿体重、围产儿结局差异无统计学意义(P＞0.05).结论 过期妊娠胎盘的形态学改变与胎儿不良预后无明确的因果关系,超声不能作为预测过期妊娠围产儿结局的独立指标.     

妊娠期糖尿病筛查时限与母婴结局的相关分析

目的:探讨妊娠期糖尿病筛查时限与母婴结局的关系,指导临床重视妊娠期糖尿病早期诊断及管理,降低母婴并发症。方法:回顾性分析76例妊娠期糖尿病临床资料,28周前确诊为44例(A组),28周之后确诊32例(B组),通过饮食加运动疗法及胰岛素治疗,比较两组母婴并发症及妊娠结局。结果:A组剖宫产率、孕妇并发症发生率、巨大儿发生率、新生儿窒息发生率及死胎发生率均低于B组。结论:GDM的确诊时限十分重要,如在28周之前确诊,系统正规管理,母婴结局良好,反之GDM患者孕期并发症及剖宫产率增加,围产儿结局不良。     

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.