常州市低于8月龄婴儿麻疹传播影响因素分析

目的探讨0~7月龄儿童中麻疹易感因素,探索可能对其采取的保护措施。方法选取常州市范围内在2009-2013年发病的0~7月龄儿童,采用病例对照研究的方法,就病例和对照的发病与就诊情况、可能的暴露史、居住地和旅行史、既往麻疹患病史、卫生服务情况、社会人口学和经济学信息等内容进行入户个案访谈调查。结果单因素及多因素分析结果显示:发病前7~21 d医院暴露史(OR=8.976,OR95%CI=4.087~19.713)、尤其是地市级(OR=8.00,OR95%CI=2.14~29.85)和县区级(OR=6.33,OR95%CI=1.81~22.11)医院暴露史以及病人接触史(OR=11.4,OR95%CI=1.207~107.653)是0~7月龄儿童麻疹发病的危险因素。结论加强传染源的管理,防止医源性感染,开展育龄妇女、流动人口等成人强化免疫是目前消除0~7月龄儿童麻疹的有效手段。     

温州市麻疹流行因素调查分析

目的探讨温州市麻疹流行的因素,为控制麻疹提供科学依据。方法采用成组病例对照研究,对108例麻疹病例和179例对照进行分析。结果病例组麻疹疫苗(MV)接种率非常显著地低于对照组(χ2=35.31,P<0.001);MV效力为83%,说明MV接种仍是有效的保护因素;医院暴露、与麻疹病人接触、人口流动是本次麻疹传播的重要危险因素。结论提高MV接种率,加强病人和密切接触者的管理,防止院内感染,完善流动人口管理机制,是控制麻疹发生与流行的有效措施。     

麻疹减毒活疫苗效力的Meta分析

目的了解麻疹减毒活疫苗(MV)效力。方法对国内1998年3月~2007年3月公开发表的符合入选标准的有关MV效力的研究文献,根据各研究结果的一致性,利用随机效应模型或固定效应模型进行Meta分析。结果有7篇文献符合入选标准,均为MV效力的病例对照研究。结果发现MV效力为82.9%[95%可信区间(CI)66.5%~91.7%],低年龄儿童MV效力为85.2%(95%CI:65.2%~93.7%),高年龄儿童MV效力为65.7%(95%CI:42.3%~79.6%)。结论MV效力低于理论的95%,提示为预防和控制麻疹爆发、流行,应提高和维持高水平的MV初免和复种接种率。     

一起医院内暴露导致的麻疹爆发疫情分析

目的 探讨正阳县麻疹爆发危险因素,为控制麻疹提供科学依据.方法 采用描述流行病学、病例对照研究分析危险因素.结果 2006年12月～2007年3月,正阳县共报告麻疹357例,发病率达47.2/10万,全县均有病例分布,51.3%的病例<3岁.对71例麻疹和91例对照进行麻疹发病危险因素的病例对照研究.麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)接种率的比值比(OR)=0.3,95%,可信区间(CI)=0.1～0.8;发病前1～2周医院暴露史的OR=22.7,95%CI=6.1～99.5;与麻疹病人密切接触史的OR=40.4,95%CI=5.5～829.1.为避免MV接种的影响,将<8月龄的儿童单独进行分析,结果显示,仅医院暴露史有显著统计学意义,OR=15.1,95%CI=1.4～377.2.结论 除较低的MV接种率外,发病前1～2周的医院暴露是本次疫情爆发的主要危险因素,必须重视医院内感染在控制麻疹爆发中的作用.     

常州市8月龄~14岁儿童麻疹传播影响因素分析

目的探讨8月龄~14岁儿童中麻疹传播影响因素,评价现行免疫措施实施效果,探索可能对其采取的保护措施。方法选取常州市范围内在2009-2013年发病的8月龄~14岁儿童,采用病例对照研究的方法,就病例和对照的发病与就诊情况、可能的暴露史、居住地和旅行史、既往麻疹患病史、卫生服务情况、社会人口学和经济学信息等内容进行入户个案访谈调查。结果单因素及多因素分析结果显示:家长对预防接种的态度积极(OR=0.041,OR95%CI=0.004~0.404)、有麻疹疫苗接种史(OR=0.013,OR95%CI=0.003~0.051)是8月龄~14岁儿童麻疹发病的保护因素,外来流动人口(OR=6.016,OR95%CI=2.341~15.462)、发病前7~21 d医院暴露史(OR=7.015,OR95%CI=2.846~17.290)、接种次数较少(OR=5.865,OR95%CI=1.679~20.485)是8月龄~14岁儿童麻疹发病的危险因素,疫苗接种次数越少危险性越大。结论高质量的麻疹疫苗常规免疫和强化免疫可以减少8月龄以上儿童发病,并应重视加强流动儿童和院内感染的管理。     

泉州市麻疹发病危险因素调查

[目的]探讨泉州市麻疹发病的危险因素,为控制麻疹提供科学依据。[方法]采用采用1︰2病例对照研究方法。[结果]接种麻疹疫苗是保护因素,MV的保护效力为91.5%～99.9%;发病前1～3周医院就诊史和接触出疹性病人是危险因素,暴露于医院的次数越多,危险度越高,分别暴露于乡村级卫生医疗单位、县级医疗单位、市级儿童医院发病的危险度逐渐上升,市级儿童医院最高,OR=54.160(95%CI=7.219～406.317)。[结论]提高麻疹疫苗接种率,加强传染源的管理,防止医源性感染,是泉州市麻疹防控的主要措施。     

麻疹发病与麻疹疫苗接种的病例对照研究

目的探讨甘肃省部份地区发生麻疹爆发或流行的原因,分析麻疹减毒活疫苗(MV)效力与麻疹发病之间的关系。方法选择4个县进行1∶1配对病例对照研究。结果共调查病例和对照各358人,病例中<7岁儿童占27.65%,7~14岁占66.48%,平均年龄8.62岁。病例组MV接种率36.87%,对照组MV接种率89.94%;接种MV后≥5年发病者占68.94%,7~9岁发病儿童距接种MV≥5年的占74.47%。1∶1配对病例对照研究计算,接种MV与麻疹发病的比值比95%可信区间为0.028~0.079,MV效力95%可信区间为92.1%~97.2%。结论甘肃省部份地区发生麻疹爆发或流行的主要原因是MV接种率过低,存在免疫空白。提高MV接种率,缩短MV 2针接种间隔时间,适时开展MV强化免疫可有效控制麻疹。     

大连市8月龄～2岁儿童麻疹发病特征及影响因素分析

目的分析大连市8月龄~2岁儿童麻疹发病特征及影响因素,为制定针对性预防控制措施提供参考。方法从中国麻疹监测信息报告管理系统导出大连市2014—2016年报告的8月龄~2周岁麻疹病例,对病例的基本情况进行描述;纳入同时期因其他疾病就诊儿童,采用1∶1病例对照研究分析儿童麻疹发病的危险因素。结果 2014—2016年大连市共报告8月龄~2周岁麻疹病例99例,其中男童62例,女童37例,发病主要集中在9月龄~10月龄(50.51%),发病高峰在4—5月(55.56%),病例主要居住在城乡结合部和农村(82.82%)。条件Logistic回归分析结果显示,发病前7~21 d有医院就诊史(OR=7.17,95%CI:1.89~27.27)和发热伴出疹患者接触史(OR=23.07,95%CI:1.85~288.33)、麻疹类疫苗接种不足2剂(OR0剂=86.39,95%CI:16.18~461.27;OR1剂=14.58,95%CI:2.70~78.70)和居住在农村(OR城区=0.02,95%CI:0.00~0.09;OR城乡结合=0.29,95%CI:0.06~1.37)是麻疹发病的危险因素。结论大连市8月龄~2岁儿童麻疹发病水平较低,建议提高麻疹类疫苗接种的覆盖率,同时加强院内感染控制。     

我国婴儿麻疹危险因素的meta分析

目的探讨我国婴儿麻疹发病的危险因素,为预防婴儿麻疹发病提供科学依据。方法采用STATA 14.0软件,对2000年1月—2016年5月国内外已发表的有关婴儿麻疹发病危险的病例对照研究进行meta分析。结果医院暴露史(OR=8.23,95%CI:2.88~23.53,P0.05)、接触史(OR=7.15,95%CI:2.70~18.89,P0.05)、流动人口(OR=2.19,95%CI:1.02~4.73,P0.05)为婴儿麻疹发病的危险因素;婴儿麻疹接种(OR=0.47,95%CI:0.39~0.57,P0.05),母亲麻疹接种史(OR=0.39,95%CI:0.16~0.95,P0.05)是婴儿麻疹发病的保护因素。结论婴儿麻疹的影响因素众多,需要通过多种方式预防婴儿麻疹的发病。     

福建省育龄妇女麻疹发病相关因素的病例对照研究

目的探讨福建省育龄妇女麻疹发病的危险因素。方法采用病例对照研究,收集福建省2007-2011年发生的全部育龄妇女麻疹病例477例和1 431例健康人群的一般社会人口经济学、麻疹疫苗免疫史、人口性质、医院暴露史和病人接触史等信息。结果多因素分析显示,病例组中未接种麻疹疫苗的比例明显高于对照组(OR=0.34,95%CI=0.27～0.43),病例组中医院暴露的比例明显高于对照组(OR=2.28,95%CI=1.17～4.43),病例组中有接触史的病例明显高于对照组(OR=4.43,95%CI=2.94～6.67);单因素分析提示,两组人群的家庭人均月收入差异有统计学意义(OR=0.35,95%CI=0.28～0.44)。结论无麻疹疫苗免疫史人群、医院暴露人群、有接触史人群、家庭人均收入低的人群是福建省育龄妇女麻疹发病的高危人群。     

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.