热带气旋与医院门诊呼吸系统疾病日就诊量的病例交叉研究

目的 探讨2012~2013年浙江省沿海地区热带气旋对医院门诊呼吸系统疾病日就诊量的影响。 方法 使用时间分层的病例交叉研究,控制气象因素的混杂作用,以Poisson回归模型分析浙江省苍南县2012~2013年夏季(7~10月)热带气旋与医院门诊呼吸系统疾病日就诊量的关系,并按性别、年龄进行分层分析。 结果 在热带气旋影响期,全人群、男性和女性的呼吸系统疾病发病风险均上升,分别在滞后第3、4、6天达到最大值。<15岁人群呼吸系统疾病发病风险上升,在滞后第6天达到最大值(RR=1.298, 95%CI:1.016~1.658)。热带气旋对15~65岁人群及>65岁人群的呼吸系统疾病发病影响无统计学意义(P>0.05)。 结论 热带气旋可增加呼吸系统疾病的发病风险且存在滞后效应,<15岁人群为易感人群。     

Post-disaster medical rescue strategy in tropical regions

BACKGROUND:

Earthquakes, floods, droughts, storms, mudslides, landslides, and forest wild fires are serious threats to human lives and properties. The present study aimed to study the environmental characteristics and pathogenic traits, recapitulate experiences, and augment applications of medical reliefs in tropical regions.

METHODS:

Analysis was made on work and projects of emergency medical rescue, based on information and data collected from 3 emergency medical rescue missions of China International Search and Rescue Team to overseas earthquakes and tsunamis aftermaths in tropical disaster regions — Indonesia-Aceh, Indonesia-Yogyakarta, and Haiti-Port au Prince.

RESULTS:

Shock, infection and heat stroke were frequently encountered in addition to outbreaks of infectious diseases, skin diseases, and diarrhea during post-disaster emergency medical rescue in tropical regions.

CONCLUSIONS:

High temperature, high humidity, and proliferation of microorganisms and parasites are the characteristics of tropical climate that impose strict requirements on the preparation of rescue work including selective team members suitable for a particular rescue mission and the provisioning of medical equipment and life support materials. The overseas rescue mission itself needs a scientific, efficient, simple workflow for providing efficient emergency medical assistance. Since shock and infection are major tasks in post-disaster treatment of severely injured victims in tropical regions, the prevention and diagnosis of hyperthermia, insect-borne infectious diseases, tropic skin diseases, infectious diarrhea, and pest harms of disaster victims and rescue team staff should be emphasized during the rescue operations.KEY WORDS: Disasters, Tropical regions, Earthquake, Emergency medical rescue     

Cancer Burden and Trends in the Asian Pacific Rim Region

This paper describes the current cancer burden and time trends, discusses dominant risk factors and prevention ‍and control strategies, and makes future projections for the top eight cancers (stomach, lung, liver, colon/rectum, ‍esophagus, breast, cervix, and leukemia) in the Asian Pacific Rim region. The future cancer trends through to the ‍year 2050 are projected based on population dynamics, including population growth and ageing. In 2000, the Asian ‍Pacific Rim had over 3 million new cancer cases, over 2 million cancer deaths, and 5.4 million people living with ‍cancer. In 2050, 7.8 million new cancer cases and 5.7 million deaths from cancer are projected. The current cancer ‍burden and the future projection provide facts that cancer is and will be a very serious public health problem in the ‍Asian Pacific Rim region and will assist public health officers and cancer researchers in the design and establishment ‍of public health policies, prioritization of future research, and application of current knowledge in the prevention ‍and control of cancer. ‍     

The Role of Lifestyle Risk Factors on Mortality from Colorectal Cancer in Populations of the Asia Pacific Region

Although colorectal cancer is one of the leading malignancies worldwide, there are few data on aetiologicalrelationships from the Asia-Pacific region. Therefore, a collaborative study was conducted involving over half amillion subjects from 33 cohort studies in the region. Age-adjusted death rates from colorectal cancer, over anaverage of 6.8 years follow-up, were 12 and 14 per 100,000 person-years among Asian women and men,respectively; corresponding values in Australasia were 31 and 41. Height was strongly associated with deathfrom colorectal cancer: an extra 5cm of height was associated with 10% (95% confidence interval, 3% - 18%)additional risk, after adjustment for other factors. Smoking increased risk by 43% (9% - 88%), although nosignificant dose-response relationship was discerned (p >0.05). Other significant (p <0.05) risk factors werebody mass index and lack of physical activity. There was no significant effect on colorectal cancer mortality foralcohol consumption, waist circumference, fasting blood glucose or diabetes, although the latter conferred anotable 26% additional risk. Height may be a biomarker for some currently unknown genetic, or environmental,risk factors that are related both to skeletal growth and mutanogenesis. Understanding such mechanisms couldprovide opportunities for novel preventive and therapeutic intervention.     

Genetic mechanisms underlying the pathogenesis of tropical calcific pancreatitis

Chronic pancreatitis is known to be a heterogeneous disease with varied etiologies. Tropical calcific pancreatitis （TCP） is a severe form of chronic pancreatitis unique to developing countries. With growing evidence of genetic factors contributing to the pathogenesis of TCP, this review is aimed at compiling the available information in this field. We also propose a two hit model to explain the sequence of events in the pathogenesis of TCP.     

Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma

BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) as predictors of outcome in children with impaired consciousness.     

Early life stress of infants in the SPRING home visits intervention promoting child growth and development in rural India (SPRING-ELS): development of stress measures for administration at scale

Background

SPRING-ELS (Early Life Stress) is a substudy of the SPRING cluster randomised controlled trial that is assessing a home visits programme in rural India promoting early child development and growth. Early life stress interferes with healthy child development so our aim was to evaluate its role in the SPRING causal pathway. We report findings from the preparatory phase of SPRING-ELS.

Spread of Cryptococcus gattii into Pacific Northwest Region of the United States

Cryptococcus gattii has emerged as a human and animal pathogen in the Pacific Northwest. First recognized on Vancouver Island, British Columbia, Canada, it now involves mainland British Columbia, and Washington and Oregon in the United States. In Canada, the incidence of disease has been one of the highest worldwide. In the United States, lack of cryptococcal species identification and case surveillance limit our knowledge of C. gattii epidemiology. Infections in the Pacific Northwest are caused by multiple genotypes, but the major strain is genetically novel and may have emerged recently in association with unique mating or environmental changes. C. gattii disease affects immunocompromised and immunocompetent persons, causing substantial illness and death. Successful management requires an aggressive medical and surgical approach and consideration of potentially variable antifungal drug susceptibilities. We summarize the study results of a group of investigators and review current knowledge with the goal of increasing awareness and highlighting areas where further knowledge is required.     

Seroprotection associated with infant vitamin A supplementation given with vaccines is not related to antibody affinity to Hepatitis B and Haemophilus influenzae type b vaccines

Vaccines are usually assessed by analyses of their safety and immunogenicity to determine the effectiveness of eliciting antibody responses against target organisms. However, it is equally important to establish antibody affinity because of its specific role in protection from infection. Antibody affinity can be determined by comparisons of various antibody concentrations in dose–response curves. During a study on the immunogenicity of a pentavalent vaccine in 888 infants, antibody affinity analyses of the hepatitis B and Haemophilus influenzae type b components were investigated in infants given 15 mg RE vitamin A with their vaccination and those who were not given vitamin A. In this paper we present the results of 222 infants; a 25% sub-sample of the original study. Analyses were carried out using dilutions of serum samples from fitted values corresponding to optical densities from antibody detection assays. These were obtained from the ligand binding equation and mid point titres in dose–response curves were then calculated. Vitamin A supplementation had no effect on the midpoint titres of Hepatitis B and H. influenzae type b vaccine derived antibodies. The significant effect of vitamin A supplementation on the Hepatitis B vaccine component observed in a previous seroprotection analysis is probably due to the amount of antibodies since affinity was unaffected.