广东地区围绝经期综合征患病状况及其影响因素

目的 :了解广东地区围绝经期综合征的患病情况及其影响因素。方法 :采用统一的调查问卷 ,对广东省 9个地区的 44 89例 4 0～ 6 5岁围绝经期妇女进行调查。结果 :在 4 4 89例被调查者中 ,出现围绝经期综合征者 30 5 7例 ,发生率为 6 8.1% ,其中以心理症状、躯体症状为主 ,分别为 85 .9%、86 .0 % ,最为痛苦的是失眠 ,肌肉、骨关节疼痛 ,烦躁 ,头晕。性欲下降情况农村高于城市 ,而心理症状、血管舒缩症状、泌尿生殖系统症状城市高于农村。躯体症状、性欲下降情况随着年龄的增加患病率相应增加 ,5 1～ 6 0岁为患病高峰。心理症状、躯体症状、性欲下降情况、泌尿生殖系统症状随着月经的改变而逐渐升高。未怀孕者的心理症状、躯体症状、血管舒缩症状、性欲下降均高于曾怀孕者 ,泌尿生殖道症状在足月妊娠、人工流产、早产者的患病机率高。患病与年龄、职业、婚姻状况、文化程度、家庭人口、经济收入、孕产次、月经、是否服用激素等密切相关。出现围绝经期综合征后就医者仅占 2 8.8% ,农村高于城市 ,分别为 31.5 % ,2 6 .6 %。结论 :应加强围绝经期妇女的保健工作 ,尤其是心理保健 ,以减少躯体疾病的发生 ,缓解围绝经期症状 ,提高生活质量。     

The Effect of Antifibrinolytic Prophylaxis on Postoperative Outcomes in Patients Undergoing Cardiac Operations

Antifibrinolytic agents such as aprotinin and epsilon aminocaproic acid limit postoperative bleeding and blood transfusion in patients undergoing cardiac operations using cardiopulmonary bypass (CPB). Recent evidence suggests that these agents have adverse side effects that influence operative mortality and morbidity. We studied postoperative bleeding, transfusion rates, and operative outcomes in our patients in order to assess the efficacy of these agents during cardiac operations requiring CPB. We reviewed records of 520 patients undergoing a variety of cardiac operations between January 2005 and May 2009. We measured multiple variables including pre-operative risk factors, antifibrinolytic agent used, and outcomes of operation, such as measures of bleeding and blood transfusion, as well as serious operative morbidity and mortality. Postoperative bleeding rates varied significantly between patients receiving aprotinin and those receiving aminocaproic acid (P < 0.05). There was an associated 12% decrease in operative site bleeding in aprotinin-treated patients compared with aminocaproic acid. There was no significant difference in the transfusion rates of packed red blood cells between patients receiving aminocaproic acid or aprotinin (P > 0.05), though individuals in the aprotinin group did receive FFP more frequently than patients in the aminocaproic acid group (P < 0.05). There was no significant difference in morbidity and mortality rates between patients in either drug group (P > 0.05). Our study shows that aprotinin is more effective at controlling operative site bleeding than aminocaproic acid. Reduced operative site bleeding did not portend better outcome or differences in transfusion requirements. Aminocaproic acid remains a safe and cost-effective option for antifibrinolytic prophylaxis because of unavailability of aprotinin.     

Radiothérapie conformationnelle avec modulation d’intensité dans les cancers du col : vers un nouveau standard ?

Intensity modulated radiation therapy has demonstrated its ability to prevent xerostomia in the treatment of head and neck cancers, as well as post-radiation related proctitis in prostate cancer. In the management of cervical carcinomas, many published dosimetric studies have shown its ability to limit the irradiation of organs at risk. However, clinical data remain limited to comparisons of cohorts, mostly retrospective, but promising. This review aims to update the current state of knowledge.     

Gunshot injuries in Benghazi–Libya in 2011: The Libyan conflict and beyond

BackgroundSince independence, Libya has never experienced personal ownership of arms. That changed during the Libyan conflict where weapons became widespread in the society. As a result gunshot injuries became a concern for surgeons at our principal surgical hospital (Al-Jalaa). This study aims at analyzing the gunshot injuries that took place during 2011 and highlighting the peculiarities in the Libyan scenario.MethodsPatient records were obtained and gunshot injuries were analyzed for various parameters. Statistical analyses were made taking into consideration situations faced by neighbouring countries.ResultsIn 2011, 1761 patients were admitted with over 95% being male and over 97% were Libyan. The average age of a GSI patient was 28.32 ± 10.01 years. Patients aged 18–35 formed over 70% of the cases with half of all cases being treated by the orthopedics department. Sixty-eight percent of cases were injured in the extremities followed by chest (12.5%) and abdomen injuries (7.8%). The mortality rate for GSI's was found to be 5.6% overall with young age, site of injury (i.e. chest and head) and cause of injury (i.e. war or civilian fighting) being important risk factors.ConclusionsTaking into consideration the difficult operating conditions and limited resources, surgeons at our hospital were able to maintain a low mortality rate. Disarmament needs to begin as soon as possible because these injuries will continue to occur so long firearms are available in society.     

Prevalence and risk factors of restless legs syndrome in peritoneal dialysis patients

Objective To investigate the prevalence of restless legs syndrome (RLS) in peritoneal dialysis patients and analyze the related risk factors. Methods This study was a cross-sectional study. The patients receiving maintenance peritoneal dialysis from January 2017 to December 2017 in the Peritoneal Dialysis Center of the Second Hospital Affiliated to Soochow University were selected as the study subjects. RLS was screened for peritoneal dialysis patients by epidemiological field investigation based on the RLS diagnostic criteria of the International Restless Leg Syndrome Research Group in 2014. Clinical data and laboratory examinations of selected patients were collected and the differences of clinical indicators between RLS and non-RLS patients were compared. The risk factors related to RLS were analyzed by logistic regression. Results Seventy-six cases of RLS were screened out from 396 PD patients. The prevalence of RLS was 19.2%. Compared with non-RLS group, RLS group patients had longer dialysis age, less 24 hours urine volume, and elevated blood intact Parathormone (iPTH) and alkaline phosphatase (AKP) (all P﹤0.05). There was no significant difference in primary disease ratio, sex, age, body mass index, blood pressure, hemoglobin, creatinine, urea nitrogen, uric acid, ferritin, serum iron, transferrin saturation, blood calcium, blood phosphorus, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, eGFR, Kt/V, Ccr between RLS and non-RLS group patients (all P﹥0.05). Multivariate logistic regression analysis showed that long dialysis age (OR=1.010, 95%CI 1.001-1.018, P=0.022) and high blood AKP (OR=1.005, 95%CI 1.001-1.010, P=0.021) were independent risk factors for RLS in peritoneal dialysis patients (both P﹤0.05). Conclusions The prevalence of RLS is high in peritoneal dialysis patients. Long dialysis age and high blood AKP are independent risk factors for RLS.     

Poisonings in the Nordic countries in 2007: A 5-year epidemiological follow-up

Aim. To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002. Methods. Morbidity was as for 2002 defined as acute poisoning (ICD-10 codes, main and subsidiary diagnoses) treated in hospitals. The figures were extracted from the National Patient/Hospital Registers. Deaths recorded as acute poisoning (using corresponding ICD-10 codes) were collected from the National Cause of Death Registers. Results. Annual mortality of acute poisonings per 100000 inhabitants (rate) for 2007 was 22.4 in Finland, an important increase from 16.7 per 100000 in 2002. The increase was mainly due to a change in coding of alcohol, but also represented a slight increase in fatal alcohol intoxications per se. The poisoning death rate in the other Nordic countries varied between 8–13 and was at the same level as for 2002. The morbidity rates for 2007 between158–285 per 100000 inhabitants represented a slight increase compared to 2002 figures. Conclusion. The increase in poisoning death rate for alcohol, and thus total rate in Finland in 2007 compared to 2002, has further increased the gap to the other Nordic countries. Poisoning morbidity rates in the Nordic countries are of the same level, but the variability shown indicates that more harmonization and collaboration is needed to increase the data quality.