Cadmium levels in kidney and liver of Jamaicans at autopsy

The cadmium concentrations in the kidneys and livers of 39 autopsy cases in Jamaica, in the age group > or = 40 years, are renal cortex: range 6.7-126 mg kg-1, mean 43.8 mg kg-1; liver: range 0.3-24.3 mg kg-1, mean 5.3 mg kg-1. The mean levels in the renal cortex are higher for women than for men but not so significantly, nor are the differences between smokers and non-smokers clear. The observed values are considered high, second only to Japan where cadmium related health impairments have occurred, and nearly twice as high as the values reported from Austria, Australia, the United Kingdom and Sweden. The Jamaican cases were from areas with relatively low soil-cadmium concentrations, and the corresponding values are likely to be significantly higher in central Jamaica where the soil contains unusually high levels of cadmium. An examination of possible contributions of cadmium intake to renal problems in Jamaica now appears to be necessary.     

Challenges of kidney care in a resource poor nation: A study of private kidney care centre in Nigeria

Background:

Resource poor nations are froth with various confounding challenges in their social, political, financial, physical and healthcare needs. Care of patients with health problems’, including those with kidney related disorders is associated with many challenges. This study is aimed to highlight the challenges of kidney care in a resource poor nation.

Materials and methods:

The activity of a private kidney care centre in Nigeria was reviewed from establishment to 6 months of operation. The details were documented and analysed.

Result:

The commencement of the kidney care centre was delayed as a result of financial and bureaucratic challenges. A total of 64 patients were seen during the period studied, 59.4% were male and the mean age was 48.2±5.5 years. 40.3% of the patients had chronic kidney disease. Twenty patients had haemodialysis however only 2 patients sustained the dialysis for the period studied. Most patients were unable to adhere to medication. The centre still depend on the parent hospital financially.

Conclusion:

The challenges of kidney care in resource poor nation are numerous and multifactorial.     

A qualitative study of motivations for non-suicidal self-injury in a sample of psychiatric outpatients in Singapore

Introduction:The popular notion that the need for attention drives non-suicidal self-injury (NSSI) serves to stigmatise rather than understand this warning sign of underlying psychological/psychiatric disorder. Despite the pervasiveness of NSSI in clinical and community settings, effective treatments for this behaviour are lacking. This qualitative research aims to understand the motivations of NSSI in adolescents/young adults in a mental health facility in Singapore.Methods:Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) of the Institute of Mental Health aged 17–29 years who had reported NSSI as part of an earlier survey. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. The main themes and sub-themes were identified and described.Results:A preponderance of motivations served intrapersonal emotion-regulating purposes, which were categorised as to: (a) release bottled-up feelings; (b) self-punish; (c) turn aggression inwards; (d) sensitise oneself; and (e) attain a sense of control and mastery. By contrast, a small subset of motivations served the interpersonal motivation of signaling one''s distress, especially when the capacity for verbal expression was limited or attempts to verbalise distress were futile.Conclusion:Committing NSSI solely for attention-seeking is a myth that perpetuates the stigma and hinders those in need of psychological care from seeking appropriate treatment. NSSIs may be warning signs that indicate not only intrapersonal conflicts but external environments that are perceived unsafe to deal with these intrapersonal conflicts. An understanding of the underlying motives will facilitate better treatment of individuals presenting with NSSI.     

Clinico-pathologic study of odontogenic cysts in a Mexican sample population

BACKGROUND: Odontogenic cysts are uncommon lesions that frequently behave agressively and attain a large size. Unfortunately, information on the relative incidence of these cysts from different populations is not abundant. In Mexico, for example, only a few examples have been reported. The aim of this study was to ascertain the frequency of odontogenic cysts in a Mexican sample and to compare these data with previously reported studies from other countries. METHODS: The files of the Oral and Maxillofacial Pathology Diagnosis Service at the School of Dentistry at the Universidad Nacional Autónoma de México (UNAM) were reviewed and all accessions of odontogenic cysts were listed. Clinical and radiographic data were recorded and microscopic slides evaluated according to the most recent World Health Organization (WHO) classification (1992). RESULTS: Three hundred and four cases of odontogenic cysts (55.9% male predominance) were found. The most frequent odontogenic cysts were the following: periapical cyst (38. 8%); dentigerous cyst (35.5%), and odontogenic keratocyst (18.8%). Periapical cyst was more frequent in females, and maxillary anterior teeth were most commonly involved. Dentigerous cysts appeared in males at a rate of 64.8%, this cyst found more frequently between the 1st and 2nd decades of life and in the molar zone. Odontogenic keratocyst was more frequent in males (59.6%), between the 2nd and 4th decades of life and more common in the molar zone. CONCLUSIONS: More than 50% of the sample were aggressive cysts (dentigerous and keratocyst). Our results suggest that Mexican patients develop aggressive odontogenic cysts more commonly than other populations. Our figures point to the need for a precise diagnosis in order to institute the correct surgical procedure, prevent recurrence, and forestall more extensive tissue destruction.     

胎盘绒毛膜血管瘤超声征象对比研究

目的 通过对比研究胎盘绒毛膜血管瘤超声声像与其他胎盘肿瘤超声声像,探讨胎盘绒毛膜血管瘤特殊类型的超声征象特点,提高产前诊断准确率。方法 分析2010年1月至2011年6月间首都医科大学附属北京妇产医院诊断的20例胎盘绒毛膜血管瘤病例资料,研究产前二维、三维及彩色多普勒超声声像与彩色血流特点,结合病理特点,同时与其他胎盘肿瘤超声声像相鉴别,总结出胎盘绒毛膜血管瘤特殊类型的超声征象特点。结果 20例胎盘绒毛膜血管瘤中,10例(50%)为常见超声特征表现(胎盘实质内边界清晰的圆形或椭圆形实性低回声或中等回声,回声低于胎盘,瘤体内见丰富血流信号),6例(30%)呈现出特殊的超声声像(胎盘实质内边界清晰范围较小的实性低回声内仅见1条粗大的血流信号),4例(20%)胎盘绒毛膜血管瘤误诊。结论 常见的胎盘绒毛膜血管瘤超声声像易发现、易诊断,可是在以往的实际工作中仍易漏诊、误诊。本次研究发现并总结出胎盘绒毛膜血管瘤特殊类型的超声声像特点,可提高临床的正确诊断率。     

Nodal vascularity as an indicator of cervicofacial metastasis in oral cancer: A Doppler sonographic study

Background:

The objective of this study was to assess nodal vascularity by Doppler sonography and to find out the correlation between clinical and various Doppler sonographic features for the detection of the metastatic nodes in oral cancer patients.

Patients and Methods:

A total number of 55 patients of histopathologically proven oral cancer presenting with enlarged superficial cervicofacial lymph nodes were included in the study. Patients were subjected to clinical examination according to a specially designed proforma and the TNM staging was done. If more than one enlarged nodes were present, then the node with the largest diameter was chosen for further Doppler ultrasonographic examination followed by fine needle aspiration cytology test of the same node.

Results:

Correlations of patterns of color Doppler flow signals with cytological diagnosis showed that central type of vascular pattern was statistically significant parameter for benign lymph nodes and peripheral type of vascularity was highly significant parameter for malignant lymphadenopathy. It was found that the cut-off value of resistive index 0.6 was statistically significant in the assessment of metastatic node (P < 0.01) with a sensitivity of 45.5% and specificity of 93.9%. On comparison of the clinical features (TNM staging) with Doppler sonographic features, it was found that the characteristic features suggestive of malignant lymph nodes on Doppler sonography such as peripheral blood flow and high resistive index were more consistently and frequently associated with the higher sub-stages of T3 and T4 and N2b and N2c of TNM staging system.

Conclusion:

Nodal vascularity may be used to differentiate benign from malignant lymphadenopathy. Proper judicious use of non-invasive color Doppler ultrasonographic examination provides an opportunity to eliminate the need for biopsy in reactive nodes and provide treatment in a more precise manner.     

基于事件前瞻记忆脑神经机制的功能磁共振成像研究

目的 应用功能磁共振成像(fMRI)技术探讨前瞻记忆(PM)的脑区激活及神经机制.方法 共有15名健康志愿者入组,以基于事件前瞻记忆(双任务范式,包括进行中任务和前瞻记忆任务)作为刺激任务,应用GRE-EPI序列采集血氧水平依赖性(BOLD) fMRI信号.应用SPM8软件对图像数据进行预处理和统计分析.结果 (1)相对于对照任务,进行中任务主要激活双侧前额叶额极(x,y,z =6/-2,54/42,- 8/- 12,t=3.71),右侧的体感联合区(x,y,z=14,- 62,64,t=4.64)、颞上回(x,y,z=42,- 46,16,t=3.95)及旁中央小叶(x,y,z=10,- 22,76,t=4.01),差异具有统计学意义(P＜0.01).(2)前瞻记忆任务主要激活双侧前额叶额极(x,y,z=-2/6,42/54,- 12/- 12,=3.28)及旁中央小叶(x,y,z=- 30/10,-22/-22,72/76,t=4.25),左侧中央后回(x,y,z=-38,-46,64,t=3.13)及枕叶(x,y,z=-30,-70,0,=3.97),差异具有统计学意义(P＜0.01).结论 前额叶额极(布罗德曼10区,BA10区)是前瞻记忆的关键激活脑区,BA10区内侧可能参与对外部线索的监控,支持前瞻记忆的BA10门控假说.     

Dietary sodium intake in a multiethnic Asian population of healthy participants and chronic kidney disease patients

INTRODUCTION

Clinical practice guidelines recommend dietary sodium restriction in chronic kidney disease (CKD) patients. Compliance with this recommendation in a multiethnic Asian population is not clear. This study assessed the urinary sodium excretion profile of a multiethnic Asian population to estimate the population’s dietary sodium intake.

METHODS

Data on the urinary sodium excretion of 335 participants were obtained from the Asian Kidney Disease Study and Singapore Kidney Function Study. Standard statistical tests and linear regression were used to assess the association between various continuous variables and sodium excretion.

RESULTS

Our study cohort consisted of 335 participants (232 with CKD, 103 healthy) – 51.0% were male; 38.5% were Chinese, 29.6% were Malay, 23.6% were Indian; and 57.3% were hypertensive. The mean age was 53.5 ± 15.1 years and mean urinary sodium excretion was 124.9 ± 68.3 mmol/day. The mean blood pressure of the healthy participants was lower than that of the patients with CKD (p < 0.001). Patients with CKD stages 1–3 excreted an average of > 100 mmol sodium/day. Overall, 40.1% patients with CKD excreted < 100 mmol sodium/day. Indians had higher urinary sodium excretion than the Chinese (p = 0.016) and Malays (p = 0.002). The distribution of urinary sodium excretion in the healthy participants (37.9% excreted < 100 mmol sodium/day) was similar to that seen in the patients with CKD.

CONCLUSION

Although patients with CKD stages 4–5 achieved sodium restriction, healthy persons and patients with early-stage CKD need to increase their efforts in reducing their sodium intake, especially for patients of Indian ethnicity.     

北京地区646名健康成年男性前列腺特异性抗原水平的调查

目的 探讨北京地区部分健康成年男性中总前列腺特异性抗原（ＰＳＡ），游离前列腺特异性抗原（ｆＰＳＡ）和游离前列腺特异抗原与总前列腺特异性抗原（ｔＰＳＡ）比值的水平，并评价年龄与上述指标水平的相关性。方法 应用电化学发光免疫分析方法测定６４６名２０～９０岁健康男性血清ｔＰＳＡ、ｆＰＳＡ水平及ｆＰＳＡ／ｔＰＳＡ比值。同时应用两个变量间的直线相关方法统计年龄与各ＰＳＡ水平的相关性。结果 ２０～３０岁组血清     

Component structure of the SF-36 in Jamaicans with sickle cell disease

OBJECTIVES: Sickle cell disease (SCD) is the commonest genetic disorder in Jamaica and greatly affects the quality of life (QOL) of those who are afflicted. The Short Form 36 survey (SF-36) questionnaire is one of the most commonly utilized measures of QOL. Physicians cannot interpret QOL measures until the instruments being used to make assessment are adequately established in their population. The Jamaican cultural and educational systems expose its people to many stresses which likely impact on their QOL. It is thus postulated that the QOL construct may exhibit a different structure for the population with sickle cell disease. SUBJECTS AND METHODS: The SF-36 v.2 was interviewer administered to the Jamaican Sickle Cell Disease Cohort Study participants ('Cohort' sample) and a random sample of adult sickle cell unit patients ('Main'sample). Demographic data were also collected on both groups. Both of the samples did not meet the five rule criteria for compliance with the original SF-36 component structure. Hence, principal components analysis was used to determine the component structure of the SF-36 in both groups. RESULTS: Three dimensions may underlie the SF-36 for both groups and these could be labelled 'Physical Health', 'Mental Health' and 'Role Limitations'. This solution accounted for 45.8% of the variability underlying the SF-36 in the 'Cohort'sample and 54.6% of the variability in the 'Main' sample. CONCLUSIONS: It concluded that within Jamaican samples of patients with sickle cell disease, the SF-36 has a component structure which is quite distinct from that initially proposed by its creators.     

Prevalence of early stages of chronic kidney disease in healthy army personnel

Introduction: Chronic kidney disease (CKD) is associated with significant morbidity and mortality. Screening and detection of early stages of CKD can help institute interventions that may delay the progression of the disease. One aim was to study the prevalence of early stages of CKD in the Army.Methods: A cross-sectional study ofArmy Personnel in an Army cantt in Central India was carried out. All participants filled a structured questionnaire and anthropometric data was collected. Investigative profile included routine urine exam, semi-quantitative microalbuminuria (MAU), serum creatinine, lipid profile and fasting blood glucose. Glomerular Filteration rate (eGFR) was calculated using the Modification of Diet in Renal Diseases (MDRD) study equation.Result: A total of 1920 subjects were examined with 731 (38.07%) from Arms and 1189 (6I.93%) from Services. 348 were excluded and of the remaining 1572 subjects, 141 (8.97%) had MAU and 157 (9.99%) had deranged Albumin Creatinine Ratio (ACR). Mean eGFR by MDRD equation was 102 ± 25.84 ml/min/1.73m². Early CKD was seen in 150 (9.54%) with 84 (5.34%) in stage I CKD, 55 (3.5%) in stage II and 11 (0.7%) in stage III. Multiple logistic regression showed BMI > 23, the presence of DM and HTN were independent risk factors for CKD.Conclusion: 9.54 % of healthy army personnel were found to have early stages of CKD. Institution of screening programs can result in early detection of CKD.     

1100例健康人血液粘度测定分析

应用锥板式粘度计测定1100例17～76岁的健康人的血液粘度,为河南省提供了正常参考值,并对职业、年龄、性别及测量方法与血液粘度的关系加以讨论。     

健康人感染HBV或HCV中动脉硬化的研究

背景：HBV或HCV感染对动脉硬化的影响尚不明确。一项横断面研究旨在明确HBV和HCV感染对动脉硬化的影响。方法：将来Shimane环境与健康公共机构例行查体的1806例健康作为研究对象。检测所有受试的血清总胆固醇、HDL-胆固醇、甘油三酯、血糖水平。动脉硬化程度以收缩压、双侧踝臂指数（ABI）、心-颈动脉脉搏波速率（HCPWV）和心-踝脉搏波速率（HAPWV）加以评价。比较对照组与HBV和HCV感染的心血管参数，采用协方差分析以校正混淆因素（性别、年龄、体重指数及吸烟与饮酒）。结果：1806例受试中，诊断为HBV与HCV阳性的患分别为39例和31例。其余1736例为对照。HBV与HCV感染校正的血脂水平低于对照。