Report from the 1st Japanese Urological Association-Japanese Society of Medical Oncology joint conference, 2006: ''A step towards better collaboration between urologists and medical oncologists''

The 1st Japanese Urological Association-Japanese Society of Medical Oncology Joint Conference, titled 'A step towards better collaboration between urologists and medical oncologists', was held to coincide with the 44th Meeting of the Japan Society of Clinical Oncology, Tokyo, in October 2006. The main theme of the conference addressed the need for a subspecialty of medical oncologist within urology to keep abreast of advances in medical oncology. Urologists should become more involved in the postoperative management of urologic cancer. Consensus on the optimal way to move forward in the treatment of urological cancer is needed. The conference featured eight lectures surveying the present status of uro-oncology in Europe, the USA, Korea, Singapore, and Japan; the relationship between surgical oncologists and medical oncologists; global trends and international clinical trials in uro-oncology; and the future of urologic oncology. These were followed by a general discussion titled 'Achieving better collaboration between the surgical oncologist and the medical oncologist.' This report presents a roundup of the 1st Japanese Urological Association-Japanese Society of Medical Oncology Joint Conference.     

陕西省2000～2002年麻疹流行病学分析及控制策略探讨

为了解陕西省麻疹流行状况 ,以加速控制麻疹 ,对陕西省 2 0 0 0～ 2 0 0 2年麻疹发病资料进行流行病学分析。结果显示 :陕西省 2 0 0 0～ 2 0 0 2年麻疹年平均发病率比 1997～ 1999年上升了 6 5 7%。病例分布广泛 ,流行模式为爆发和散发并存 ,局部麻疹爆发影响着全省的麻疹发病水平。 3～ 6月为麻疹高发季节 ,0～ 2岁和 6～ 8岁为麻疹高发年龄组。对麻疹病例的免疫史分析表明 ,2 5 %的麻疹病例未接种麻疹疫苗 (MV) ,2 4 %的病例免疫史不详。报告病例的年龄和免疫史状况说明 ,MV的初种和复种需加强 ,同时要在全省范围开展一定年龄组儿童的MV强化免疫 ,调整现行MV的免疫程序 ,健全麻疹监测系统。     

conference report: Mental health and intellectual disability: an international perspective

The present paper reports on the inaugural meeting of the Mental Health Special Interest Research Group (SIRG) of the International Association for the Scientific study of Intellectual disability which was held at Fitzwilliam College, Cambridge, UK, in March 1998. The meeting was organized in conjunction with the Ninth Annual SIRG on ageing and intellectual disability. Representatives from North America, several European and Scandinavian countries, Australia, and Israel attended. Two broad themes had been determined prior to the meeting: ‘Improving the detection of mental health problems’ and ‘Research strategies for identifying risk factors for mental health problems’. In the presentations and subsequent discussions, it was apparent that there were extrenely diverse perspectives both across and within the different countries represented. Not only were individuals' experiences very different, but most strikingly, the theoretical frameworks were very diverse. This was partly a function of there being understandable differences in perspectives across disciplines, but at its most marked, there were fundamental differences in the way both intellectual disability and mental health were conceptualized.     

Die Rolle coagulasenegativer Staphylokokken in Mischinfektionen: Assoziationstestungen als in-vitro-Modell

Zusammenfassung Die Zunahme von Infektionen durch hochresistente grampositive Kokken hat in den letzten Jahren vornehmlich auf Intensivstationen zu erheblichen therapeutischen Problemen geführt. Hierbei ist eine Gruppe von Erregern in den Vordergrund getreten, die früher als harmlose Saprophyten galten: coagulasenegative Staphylokokken (CNS). In der vorliegenden Arbeit werden zunächst Daten zur Incidenz in verschiedenen Versorgungsbereichen unserer Klinik und zur Coincidenz mit anderen Erregern auf unserer Intensivstation vorgestellt. Es konnte gezeigt werden, daßS. aureus zwar der zahlenmäßig häufigste grampositive Erreger war, aber CNS sowohl aus Wundabstrichen der Intensivstation als auch aus Blutkulturen deutlich häufiger isoliert werden konnte. Ein gleichzeitiger Nachweis von CNS mitS. aureus und den neun häufigsten Enterobacteriaceae konnte in durchschnittlich 6% erbracht werden. Durch mögliche Interaktionen zwischen unterschiedlichen Erregern kann eine Veränderung der in Einzeltestung beobachteten Resistenzen auftreten. Um dies nachzuweisen, wurden sechs Erregerpaare einzeln und in Assoziation gegen Amoxicillin und Amoxicillin/Clavulansäure getestet. Unter Assoziation wurde das gemeinsame Wachstum zweier Keime unter kontrollierten Bedingungen in Boullionverdünnungsreihen oder einem Laborautomaten zur Resistenztestung (Cobas Bact) verstanden. In allen Fällen zeigte sich, daß die-Lactamasen der CNS in Assoziation die MHK der anderen Erreger deutlich erhöhte, was durch den Zusatz von Clavulansäure verhindert werden konnte. Eine Einzeltestung gibt also bei Mischinfekten mit Beteiligung von-Lactamasebildnern nur einen eingeschränkten Eindruck von der tatsächlichen Resistenzsituation.

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Role of coagulase negative staphylococci in mixed infections: associative testing as in vitro model

Summary Infections due to coagulase negative staphylococci (CNS) are of growing concern mainly in patients hospitalized in intensive care units (ICU). The ability of CNS to adhere and to grow on plastic devices and resistance to many antibiotics, including oxacillin, contributes to their pathogenicity. Using the computer assisted system of the Medical Microbiology Department, the incidences of different pathogens and the coincidence of CNS with other bacteria were evaluated in a surgical department.Staphylococcus aureus revealed to be the predominant pathogen; however, CNS showed an increasing incidence in wound specimens and blood cultures of patients on the ICU. Coincidence of CNS withS. aureus and the nine most frequent species of gram negative bacteria could be shown in 6%. To investigate the influence of-lactamases produced by CNS in mixed infections, association experiments were performed. Association means a controlled growth of two or even more bacteria in a susceptibility testing system, either a broth dilution method or an automated broth disk elution method (Cobas Bact). The association experiments showed a significant increase of amoxicillin MIC's of the pathogen associated with CNS. Addition of clavulanic acid restored activity of amoxicillin. It could be shown that in mixed infections CNS may contribute to the failure of antibiotic regimens by production of-lactamases.

     

Use of HLA marker associations and HLA haplotype linkage to estimate disease risks in families with gluten-sensitive enteropathy

Based on a two-locus, double recessive model, we derive formulas for the risks that relatives of individuals with gluten-sensitive enteropathy (GSE) will also develop the disease. The calculations take advantage of: the linkage between the HLA locus and one of the two proposed GSE loci, and the preferential association of the HLA-DR3 and DR7 alleles with the GSE disease allele that occupies the HLA-linked locus. We use Bayes' rule to quantitate the strength of the association between the GSE disease allele and the HLA marker allele. This method predicts that siblings of the proband have an overall 10% risk for GSE, which is consistent with observed family data. This predicted risk rises to 30% when siblings are HLA-identical to the proband (also consistent with observed data) or when the sibling has the DR3 allele in the HLA haplotypes not shared with the proband. In those populations where DR7 also is associated with GSE, siblings of probands have a 10% predicted risk for GSE when only one HLA haplotype is shared with the proband and DR7 is included in the unshared haplotype. Other DR alleles are associated with much lower disease risks. By separating individuals into high and low risk groups, HLA typing identifies those individuals who would benefit from further diagnostic procedures. This general strategy should be applicable to other multilocus, marker-associated diseases.     

海南省山区霍乱流行病学分析

目的 为了解海南省山区的霍乱流行特点,为今后更好地预防、控制山区的霍乱流行提供理论依据。方法 采用统一制定的霍乱个案调查表和流行病学调查表进行调查,然后做统计分析。结果 1994～1998年,海南省山区发生6起食物型霍乱爆发疫情,发病191例,罹患率13．12％,病死6例,病死率3．14％。患者皆为黎族居民,各年龄组均有发病,以20～40岁组的青壮年所占比例最高,为67．54％。男性患者(65．97％)明显多于女性(34．03％)。疫情波及4个县(市)、8个乡(镇)、40个自然村。轻型病例仍然占大多数(62．30％)。对82株菌株的鉴定结果全部为小川lb型,与该省沿海地区自1994年后以小川1b型为优势流行株相一致。结论 导致这6起霍乱爆发的最主要原因是丧事聚餐,可疑食物均来自某市的海鱼。     

The Liver Retransplantation Risk Score: a prognostic model for survival after adult liver retransplantation

High-risk combinations of recipient and graft characteristics are poorly defined for liver retransplantation (reLT) in the current era. We aimed to develop a risk model for survival after reLT using data from the European Liver Transplantation Registry, followed by internal and external validation. From 2006 to 2016, 85 067 liver transplants were recorded, including 5581 reLTs (6.6%). The final model included seven predictors of graft survival: recipient age, model for end-stage liver disease score, indication for reLT, recipient hospitalization, time between primary liver transplantation and reLT, donor age, and cold ischemia time. By assigning points to each variable in proportion to their hazard ratio, a simplified risk score was created ranging 0–10. Low-risk (0–3), medium-risk (4–5), and high-risk (6–10) groups were identified with significantly different 5-year survival rates ranging 56.9% (95% CI 52.8–60.7%), 46.3% (95% CI 41.1–51.4%), and 32.1% (95% CI 23.5–41.0%), respectively (P < 0.001). External validation showed that the expected survival rates were closely aligned with the observed mortality probabilities. The Retransplantation Risk Score identifies high-risk combinations of recipient- and graft-related factors prognostic for long-term graft survival after reLT. This tool may serve as a guidance for clinical decision-making on liver acceptance for reLT.     

甲型肝炎疫苗免疫前后发病情况分析

为比较沙县在甲型肝炎（甲肝）疫苗免疫前后甲肝的发病情况,对本站疫情定收集的1990～1997年报告的882例甲肝病例进行了分析。结果表明,疫苗免疫前甲肝发病率在63.36／10万～99.90／10万,免疫后为16.20／10万～21.87／10万,免疫前后平均发病率之比为422：1。按＜15岁、15～44岁和≥45岁分组,发病率下降最明显的是＜15岁,其次是15～44岁和≥45岁,依次下降了91.9％、70.1％和37.1％．工人、农民、学生（大、小、小学生）不同职业人群,以学生下降最明显,农民下降不明显,存在差别的原因可能是甲肝疫苗接种率的高低。甲肝疫苗接种的成本效益为1：953．