孕前优生指导及孕期保健指导对妊娠结局的影响

目的:探讨孕前优生指导及孕期保健指导对妊娠结局的影响.方法:选择30例由我中心承担孕前优生指导的孕妇作为观察组,并与同期未予孕前优生指导的30例孕妇进行对比研究,对照组进行常规产检,观察组给予孕前的优生指导及孕期的健康教育、运动、饮食等孕期保健指导,对两组孕妇的妊娠结局进行跟踪分析.结果:观察组的妊娠结局明显优于对照组.结论:通过有效的孕前优生指导和孕期保健指导,对妊娠结局有着显著的改善作用.     

大样本孕前保健检查在优生遗传咨询中的应用价值研究

目的分析大样本孕前保健检查结果及妊娠结局,探讨孕前保健在优生遗传咨询中的必要性和价值。方法选取重庆市中医院2013年5月-2016年12月行优生遗传咨询的3 268名育龄女性设为观察组。所有入选者妊娠后均在医院建卡行孕期保健,并在医院生产、儿保检查。选取同期未行孕前检查妊娠后进行优生遗传咨询者2 138名孕妇设为对照组。观察组育龄女性在备孕前3个月按照中华医学会妇产科学分会产科学组制定的《孕前和孕期保健指南(第1版)》中制定的孕前保健检查原则和内容进行孕前健康教育及指导、常规保健、辅助检查,根据孕前保健检查结果,对育龄妇女所存在的遗传风险、生殖风险、慢病风险、感染风险、营养风险、行为风险进行评估,并对其作出优生遗传咨询建议。两组受试者在孕期保健过程中对其进行优生遗传咨询。对两组孕妇的妊娠结局、产妇并发症、新生儿健康检查结果等指标进行比较,分析孕前保健检查在优生遗传咨询中的应用价值。结果观察组3 268名行孕前保健检查的育龄女性经孕前保健检查,共1 085名出现结果异常,检查结果异常指标构成情况。经妊娠健康风险分析,1 061名受试者有孕前健康风险,主要分布在慢性病风险、感染风险、营养风险、行为风险,少部分为遗传健康风险、生殖健康风险。1 085名孕前检查结果异常受试者中,14名建议不妊娠,剔除出组,758名予以健康教育指导、孕前调理,并再次检查消除健康风险,200名行增项检查,10名建议不宜妊娠,剔除出组,103名有孕前高危因素。观察组3 268名受试者中24名经优生遗传咨询不建议妊娠出组,余3 244名受试者妊娠后进入孕期保健及优生遗传咨询程序,观察组孕妇妊娠期间增加相关指标检查频次率、高危妊娠加强监控率、建议终止妊娠率均明显低于对照组(P0.05)。观察组妊娠结局不良率、产妇并发症率、新生儿出生缺陷率均明显低于对照组(P0.05)。结论孕前保健检查可以为优生遗传咨询提供客观数据,给予备孕育龄女性给予科学的健康指导,提升妊娠安全性及母婴妊娠结局质量,孕前保健检查对优生优育意义重大。     

孕前优生健康检查及妊娠结局调查分析

目的:探讨孕前优生健康检查对妊娠结局的影响。方法:调查2017—2018年本院产前检查妇女1037例,参与孕前优生健康检查524例(检查组)及未参与513例(未检查组);问卷调查两组相关知识、妊娠结局,分析妇女参与孕前优生健康检查影响因素。结果:检查组妇女优生健康检查相关知识知晓评分优于未检查组,妊娠结局正常比例高于未检查组,不良妊娠结局低于未检查组,新生儿评分高于未检查组(均P0.05);妊娠结局正常与不良结局妇女在计划妊娠、不知道孕前需健康优生检查、没必要孕前健康优生检查、没时间孕前健康优生检查、做过孕前健康优生检查等方面存在差异(P0.05);经logisitic分析,影响不良妊娠结局妇女参与孕前优生健康检查的因素为非计划妊娠、不知道要孕前健康优生检查、没必要参加孕前健康优生检查。结论:加强待孕妇女孕前优生健康检查宣传教育,提高参与积极性,做好计划妊娠,降低不良妊娠发生。     

上海市闸北区1138对孕前优生健康检查结果分析

目的通过分析1138对孕前医学检查的夫妇检查结果,探讨行孕前保健对优生优育的重要价值。方法选择2012年l-l2月在上海市闸北区妇幼保健所进行免费孕前检查的1138对夫妇作为研究对象,按照国家免费孕前优生健康检查项目流程,收集体检及化验资料,进行数据录入与统计分析。结果 66.43%的女性检查出有各项异常,其中妇科及影响优生的疾病占51.19%,以中重度子宫颈炎、阴道炎居多。35.94%男性检查出有各项异常,以高血压及肝功能异常居多。结论闸北区孕前人群的健康状况不容乐观,孕前人群的健康意识有待提高,优质的孕前保健服务至关重要。     

孕前优生检测的临床筛查结果分析

目的:分析孕前优生检测对于排查出生缺陷的预防作用。方法:针对2567例孕前优生检测的夫妇进行数据统计,采集样本信息包括病史询问、优生健康教育、实验室检查、体格检查、病毒筛查、地中海贫血筛查、妇科B超检查等,同时对孕前优生检测资料进行风险评估。最后对妊娠结局进行随访统计分析。结果:5134例接受孕前优生检测的案例中,高风险人群为1679例,检出率为32.70%。2567例男性中,存在872例实验室检查异常结果,占比为33.97%。2567例女性中,存在807例实验室检查异常结果,占比为31.44%。在1679例高风险人群中,一类高风险为572人,占比为33.71%;二类高风险为1107人,占比为65.93%。结论:孕前优生检测中发现异常较多,为了达到优生优育的积极效果,降低孕前风险因素,应对鼓励计划妊娠夫妇积极参与孕前检测,可最多限度规避出生缺陷。     

深圳市龙城街道1008对夫妇孕前检查结果分析

目的通过分析1008对计划怀孕夫妇的孕前检查结果,了解夫妇双方健康水平,以便更好地开展孕前保健工作。方法对1008对夫妇的孕前检查结果进行分析,通过SPSS10.0软件进行统计学处理。结果 7.44%的检查对象有异常生育史,68.95%女性检查出有各项异常,其中妇科及影响优生的疾病占56.12%,以宫颈炎、阴道炎居多。48.51%男性检查有明显异常,以男性生殖系统疾病、高血压及肝功能异常居多。结论孕前检查对预防出生缺陷具有重要作用,应当加强对孕前保健必要性的宣传,为孕前人群提供优质的孕前保健服务。     

免费孕前优生健康检查高风险人群结果分析

目的通过对天津市滨海新区大港片区计划妊娠的夫妇进行孕前优生检查的结果分析,对引起出生缺陷的高风险因素及高风险人群进行有效干预、追踪随访,从而达到减少出生缺陷风险的发生。方法对天津市滨海新区大港片区2013-01/2018-09计划妊娠的9 409例夫妇(女性5 091人,男性4 318人)进行孕前优生检查,包括优生优育宣教、病史问询、体格检查、临床实验室检查、风险评估、早孕随访和妊娠结局随访。结果检测出高风险人群2 226例(23.66%)。其中男性796例,高风险发生率18.43%。女性1 430例,高风险发生率28.09%。结论通过对计划妊娠的夫妇进行孕前优生健康检查,对引起不良妊娠结果的高风险因素进行有效干预,并通过随访追踪,可以有效减少出生缺陷的发生。     

孕前优生健康检查一般风险因素分析

目的探讨计划妊娠的夫妇孕前风险因素,降低导致出生缺陷等不良妊娠结局的风险因素。方法收集深圳市罗湖区2013年9 429名计划妊娠夫妇的免费孕前优生检查资料,对待孕夫妇存在的孕前风险因素进行分析。结果女性孕前风险因素排在前五位的是:生殖系统检查异常(60.51%)、甲状腺功能异常(23.56%)、环境风险因素(19.83%)、低体重(18.53%)、不良妊娠史(13.58%)。男性风险因素排在前五位的是:超重和肥胖(41.94%);生殖系统检查异常(30.39%)、吸烟(28.76%)、环境风险因素(20.66%)、心理风险因素(19.14%)。结论应针对孕前风险因素对已婚育龄夫妇进行规范化的孕前优生指导,加强一级预防,减少出生缺陷儿的发生率。     

婚前健康检查和孕前优生健康检查项目实施效果分析

目的分析婚前健康检查和孕前优生健康检查项目的实施效果。方法选取2016年10月-2018年10月计划妊娠的夫妇为研究对象,按照在龙游县妇幼保健院参加的免费婚前健康检查和孕前优生健康检查项目,分为对照组、孕前检查组和联合检查组。比较3组各种疾病检查率。结果 3组早产、低出生体质量及巨大儿发生率比较差异均有统计学意义(均P0.05)。调整了女性年龄、女性民族、女性文化程度、女性妊娠史、男性年龄及男性民族等因素后,孕前检查组和联合检查组低出生体质量发生率低于对照组,联合检查组巨大儿发生率低于对照组。按照女性年龄和妊娠史进行亚组分析,多因素Logistic回归分析结果发现:对于女性≤30岁组,孕前检查组和联合检查组出生缺陷发生率均显著下降。联合检查组有效降低了巨大儿和低出生体质量发生率。结论婚前健康检查和孕前优生健康检查可有效降低不良妊娠结局发生率,在优生优育中有重要作用,且联合检查效果更佳。     

新形势下孕前优生健康检查存在的问题及解决对策

孕前优生健康检查是指为备孕夫妇在受孕前提供的一系列优生保健服务,其在改变妊娠结局、提高生育质量等方面具有重要的现实意义。随着人们生育观念的转变,孕前优生健康检查的实施受到了挑战,逐渐出现诸多问题,导致孕前优生健康检查无法发挥其实际价值。新形势下,加强健康宣教、开设专项门诊、丰富检查内容、开展部门合作、加大人才培养等孕前优生健康检查对策是降低新生儿缺陷发生、提高人口素质和质量的关键。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.