Partner- and partnership-related risk factors for preterm birth among low-income women in Lima,Peru

A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy. Yet, with the notable exception of intimate partner violence, there has been little previous research addressing the associations between partner- or partnership-related factors and birth outcomes. This analysis tested the hypothesis that risk factors related specifically to partner or partnership characteristics increased the risk for preterm birth. Between 2003 and 2005, a total of 580 preterm cases (20–36 weeks gestational age at delivery) and 633 term controls (≥37 weeks) were selected from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a confidential, structured interview and provided biological specimens within 48 h after delivery. Multivariable logistic regression was used to assess associations between partner and partnership characteristics and preterm birth. After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (aOR = 1.91, 95% CI 1.22–2.99), ever having had anal sex (aOR = 1.40, 95% CI 1.07–1.84), having a current partner with a history of visiting prostitutes (aOR = 1.69, 95% CI 1.22–2.33), and perceiving one's current partner as a “womanizer” (aOR = 1.34, 95% CI 1.02–1.77) were significantly associated with an elevated risk of preterm birth when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with preterm birth risk (per additional partner risk factor: aOR = 1.31, 95% CI 1.16–1.49). These results highlight the importance of considering a broader set of risk factors for preterm birth, specifically those related to a woman's partner and partnership characteristics. Further research could clarify the specific mechanisms through which these partner and partnership characteristics may increase the risk of preterm birth.     

A nationally representative survey of hospital malnutrition: the Italian PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Aim and methods  Nutrition, unhealthy lifestyles and cancer appear to be strictly related, but few authors have analysed the interest in dietary information of cancer patients and their families. This survey was conducted in the Veneto area (Italy) to investigate the concern of cancer patients and their family members about diet as a health tool before and after diagnosis of cancer. Results  Seven hundred and four questionnaires were collected: 380 from cancer patients and 324 from family members of cancer subjects. Breast cancer (BC) was the most frequent disease for patients (61.8%) as well as families (26.5%). Generally, the importance of having precise diet information after diagnosis is recognised by 40.3% of patients, with significant differences between the various types of cancer: gastric and colon/rectum cancer (GCC) patients were more concerned than BC women about precise information concerning a diet to follow immediately after diagnosis (p = 0.000, ODs = 3.10, CI 1.68–5.71) or during treatments (p = 0.001, ODs = 2.67, CI 1.46–4.89). The nutritional information is supplied to patients in 34% of cases and to relatives in 30.3%, often from non-medical sources. In total healthcare workers (family doctor, oncologist, surgeon, dietician) represented the exclusive source of dietary information for 24.9% of patients and 22.9% of family members. Diet after diagnosis changes in 69.1% of GCC patients and in 39.2% of BC women. Relatives, particularly women, report difficulties preparing patients’ meals in 30.7% of cases, changes in the eating habits of the entire family in 29.9% and discontent connected with patients diet in 13.9%. The concern about proper nutrition after diagnosis increases more in GCC subjects (p < 0.025) when compared to BC subjects and in patients with more recent diagnosis (p < 0.041) when compared with patients with diagnosis >5 years ago, while in family members the interest in diet after diagnosis increases more in women than in men (p < 0.030) without other differences regarding the degree of relationship, type of cancer or diagnosis time. Relatives (92.7%) have more interest in nutritional education than patients (74.9%). Cancer patients <65 years were more interested in educational initiatives concerning nutrition (p = 0.000, ODs = 4.46, CI 2.6–7.4) than older patients (>65 years) and female subjects were more concerned than male patients (p = 0.008, ODs = 2.11, CI 1.2–3.6). Conclusions  The interest in the dietary knowledge and in educational initiatives concerning nutrition is high in cancer patients and their relatives, although it decreases with the age. The poor attention paid to nutrition of cancer patients by various healthcare workers deserves consideration, since the psychophysical wellbeing and perhaps also survival of cancer patients can be improved by correct dietary management, as well as, naturally, by the principal treatments themselves.     

头颈部良性神经源性肿瘤1H MRS的表现特点

目的：探讨头颈部良性神经源性肿瘤在单体素^1H MRS上的表现特点。材料和方法：共收集经单体素。HMRS检查，并经手术病理证实的头颈部神经源性肿瘤14例（神经鞘瘤11例，神经纤维瘤2例，颈动脉体瘤1例）。采用点分析波谱法（PRESS：TE=144ms，14例）和激励回波法（STEAM：TE=30ms，11例）进行。HMRS空间定位，以胆碱和脂质代谢物为标准评价所有肿瘤。波谱图上，胆碱和脂质分别在3．2ppm和0．9—1．4ppm区域识别。结果：采用PRESS后，14例神经源性肿瘤中检测出胆碱代谢物者11例，检出脂质代谢物者6例。胆碱和脂质代谢物同时检出者5例，仅检出胆碱者6例，仅检出脂质者1例，胆碱和脂质均未检出者2例。采用STEAM后，11例肿瘤中检出胆碱代谢物和脂质者分别为3例和8例。结论：头颈部良性神经源性肿瘤的单体素。HMRS表现具有多样性，多数肿瘤以长TEPRESS上胆碱峰的显示为特点，长TEPRESS能较STEAM更好地检出良性神经源性肿瘤内的胆碱代谢物。     

肾嫌色细胞癌的影像表现与病理对照分析

目的分析肾嫌色细胞癌（CCRC）的影像表现特征并与病理结果进行对照，以提高诊断准确性。方法回顾性分析了12例CCRC的资料，其中10例经CT检查，包括平扫、皮质期和髓质期动态增强扫描（1例无皮质期扫描）。2例经MR检查，包括平扫T1WI、T2WI及皮质期和髓质期动态增强T1WI。结果病灶位于左肾4例，右肾8例，最大径24．0～125．0mm，平均56．7mm。10例CT检查中，6例在平扫上密度均匀一致，5例增强后扫描强化均匀一致，与病理上该肿瘤较少发生坏死、囊变、出血对应。皮质期，9个病灶的强化程度均高于髓质，低于皮质，强化程度与微血管密度密切相关；髓质期，10个病灶密度均明显低于髓质。2个体积较大的病灶内见中央星状瘢痕。4个病灶周围见假包膜。MR检查的2例相对于髓质，病灶在平扫T1WI上呈高信号，在T2WI上，表现为明显的低信号。病灶的强化方式与CT相似。结论CCRC在CT及MRI上的均质性特点、独特的强化方式及T1WI上呈相对于髓质的明显低信号，具有一定的特征性，有助于与其他肿瘤鉴别。     

微创锁定加压接骨板内固定治疗胫骨骨折

臀肌挛缩症的手术治疗方法较多,我们采用大转子后上方双侧小“S”微创切口,每侧切口长约2~3 cm,对挛缩组织进行切断,广泛松解,重症患者行臀中小肌“Z”形延长,松解髋关节囊,并行屈膝屈髋、交叉架腿、划圈征等各项指标评价,配合术后早期功能锻炼治疗,效果满意,1997-2005年8月,共收治2 518例患者,重点研究讨论其病因、分类及治疗。1临床资料1·1诊断臀肌挛缩症的诊断包括病史,特别是婴儿期臀部反复肌肉注射史,特有的外“八”字步态,并膝下蹲困难,站立时的尖臀征,快步行走或跑步时呈跳步征。臀部触诊时可触及索带硬块,划圈征、二郎腿试验及平…     

基层医院腹腔镜胆囊切除术1696例的治疗体会

目的:探讨腹腔镜在基层医院普及开展的可行性和主要并发症的预防。方法:回顾分析1999年6月至2006年5月我院1 696例腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床资料。结果:1 696例LC成功1 635例,中转开腹61例,中转率3.6%,发生并发症17例,其中胆管损伤1例,腹腔内出血2例,胆漏2例,腹腔感染1例,胆管残石3例,遗漏腹腔内病变6例,上消化道出血2例。结论:LC在基层医院的开展日益成熟,成为治疗胆囊良性疾患的“金标准”。术前注意鉴别诊断,术中操作轻柔,辨明胆囊三角结构,能避免严重并发症的发生。     

病理性瘢痕裸鼠模型的建立

目的 验证所构建裸鼠瘢痕疙瘩和增生性瘢痕模型在病理性瘢痕研究中的可行性。方法 将0．8cm×0．8cm×0．5cm的人瘢痕疙瘩和增生性瘢痕组织块移植到裸鼠皮下，大体观察裸鼠及植入物情况。移植后第16天取出移植物与原标本进行下列指标的比较：体积、瘢痕的镜下特征、酸性黏多糖含量及Ⅰ、Ⅱ型胶原含量。结果 移植后裸鼠全部存活且创面愈合良好。瘢痕疙瘩、增生性瘢痕组织块的酸性黏多糖含量移植前分别为3448±1452、1940±509，移植后分别为3237±1871、1809±552，移植前后比较，差异无统计学意义（P〉0．05）。植入物保持着原有的胶原特性及含量，未检测到细胞变性坏死。结论 增生性瘢痕和瘢痕疙瘩以适当体积移植到裸鼠皮下，其生物学特性可在一定时间内保持稳定，该动物模型适用于病理性瘢痕的临床研究。     

经前后路联合手术治疗L5S1椎体结核

目的 探讨一期经前路病灶清除后路植骨内固定治疗L5S1椎体结核的临床疗效.方法 对40例L5S1椎体结核患者,采用一期经前路病灶清除椎体间植骨加后路椎弓根螺钉内固定植骨融合治疗.结果 所有患者随访6～24个月,35例植骨融合良好,5例融合欠佳;有1例出现尿路感染.结论 一期经前路病灶清除椎体间植骨加后路椎弓根螺钉内固定椎板植骨治疗L5S1椎体结核能在彻底清除病灶的前提下保证脊柱的稳定性,提高植骨块的融合率和缩短患者卧床时间.     

关节镜监视下治疗胫骨平台骨折

2004—2006年，我院采用关节镜监视和定位治疗胫骨平台骨折，获得了良好的效果。     

Enhancing Nurse Assessment of Alcohol and Drug Dependency: A Preliminary Study

The purpose of this project was to prepare nurses to provide brief interventions for clients with alcohol or other drug (AOD) dependency in order to reduce hospitalization, morbidity, and mortality. The project was a collaborative process between a major medical center and a school of nursing. Nurses were surveyed for understanding of alcohol and other drug assessment, and a day long training was provided to teach techniques of brief interventions. The short-term results included increased knowledge of nurses about AOD assessment. Long-term results indicated that 95% of patients referred to the AOD team were confirmed to have AOD problems (Dunn & Ries, 1997). This project documents the need for nurses to have more knowledge about AOD problems and brief intervention techniques.