Descriptive epidemiology of limb reduction deformities in Hawaii, 1986-2000

The relationship between limb reduction deformities and clinical and demographic factors in Hawaii during 1986-2000 were examined using population-based birth defects program data. The limb defect rate was highest with maternal age less than 20 years, and the defect was more common among males. Among racial/ethnic groups, Pacific Islanders and Filipinos had higher rates than whites and Far East Asians.     

Rates for specific birth defects among native Hawaiians compared to whites, Hawaii 1986-2000

Rates for many birth defects have not been identified for native Hawaiians. Using birth defects regstry data, the total major birth defect rate for whites was found to be 4.70% and for native Hawaiians was 4.75%. After adjusting for maternalage, the rates were lower among native Hawaiians for 40 (74.1%) of 54 selected birth defects.     

Epidemiology of neural tube defects, Hawaii, 1986-1997

Neural tube defects (NTDs) in Hawaii between 1986 and 1997 were examined using data from a statewide birth defects surveillance system. The prevalence increased significantly over the twelve-year period. NTD prevalence did not appear to vary by place of residence. The relationship of type of defect, maternal age, and infant/fetus sex was similar to that reported in the literature.     

Descriptive epidemiological analysis of diving accidents in Hawaii from 1983 to 2001

The Hyperbaric Treatment Center (HTC) at the University of Hawaii, has evaluated and treated over 1100 divers for dysbaric disease from 1983 to 2001. We describe some epidemiological parameters and compare trends between local residents and tourist divers in this article. Data obtained from this review were analyzed for age, gender, type of injury and resident status. While trends in Hawaii have mirrored national figures, we did determine that there were some significant differences between resident and tourist divers' patterns of injury over this period of time.     

Rates of selected birth defects in relation to folic acid fortification, Hawaii, 1986-2002

Because of studies suggesting that folic acid use reduces risk of various birth defects, the Unites States fortified enriched cereal grains with folic acid in 1998. To determine whether this fortification reduced rates for birth defects in Hawaii, rates were calculated before and after fortification. Of the 19 birth defects categories studied, the rates for 16 were lower after fortification.     

Hepatic viral infections in Yemen between 2000--2005

OBJECTIVE: To determine the prevalence of hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) antibodies in Sanaa, and other governorates of Yemen. METHODS: By systematic review with meta-analysis we collected the research performed in different governorates of Yemen during the period 2000--2005. This included the published papers (peer reviewed), and the papers presented at Yemeni conferences. RESULTS: We identified 4 groups with separate prevalences. We found HBsAg to be 8% in healthy volunteers, 10.8% in blood donors, 12.3% in patients under dialysis, and 23% in patients with chronic liver diseases. Antibodies to HCV show different results, namely, 1.7% in healthy volunteers, 2.7% in blood donors, 33.8% in patients under dialysis, and 33.75% in patients with chronic liver diseases. The viral markers in different governorates showed significant differences in healthy and blood donor groups. The means of HBsAg and HCV antibodies in patients with liver diseases were recorded to be 26.2% for HBsAg, and 33.8% for HCV antibodies, with a total of 60%. The means in patients under dialysis, for HBsAg was 10.9%, and for HCV antibodies was 33.8%, with a total mean of 44.7%. CONCLUSION: Hepatitis B and C appear to be a major health problem in our community. Our study results indicate an intermediate level risk of hepatitis B virus infection. There are some geographic areas in the country that may be at high risk. Control strategies should take these differences into account.     

Racial disparities in infection-related mortality at Alice Springs Hospital, Central Australia, 2000--2005

OBJECTIVE: To compare infection-related mortality rates and pathogens isolated for Indigenous and non-Indigenous adult patients at Alice Springs Hospital (ASH). DESIGN, PARTICIPANTS AND SETTING: Retrospective study of inhospital deaths of adults (patients aged > or = 15 years) associated with an infection during a medical or renal admission to ASH between 1 January 2000 and 31 December 2005. MAIN OUTCOME MEASURES: Admission- and population-based infection-related mortality rates and mortality rate ratios (MRRs) for Indigenous versus non-Indigenous adults. RESULTS: There were 513 deaths, of 351 Indigenous and 162 non-Indigenous patients. For Indigenous patients, 60% of deaths were infection-related, compared with 25% for non-Indigenous patients (P < 0.001). The admission-based infection-related MRR for Indigenous versus non-Indigenous adults was 2.2 (95% CI, 1.6-3.1) (15.3 v 6.8 deaths per 1000 admissions; P < 0.001). After adjusting for age and year of death, the population-based infection-related MRR was 11.3 (95% CI, 8.0-15.8) overall (351 v 35 deaths per 100,000 population; P < 0.001) and 31.5 (95% CI, 16.1-61.8) for patients aged < 60 years. The median age of patients who died with an infection was 49 (interquartile range [IQR], 38-67) years for Indigenous and 73 (IQR, 58-80) years for non-Indigenous patients (P < 0.001). For Indigenous patients, 56% of infection-related deaths were associated with bacterial sepsis, with half of these due to enteric organisms. Other deaths followed chronic hepatitis B infection, invasive fungal infections and complications of strongyloidiasis. CONCLUSION: Indigenous patients at ASH are 11 times more likely than non-Indigenous patients to die with an infectious disease. This racial disparity reflects the ongoing socioeconomic disadvantage experienced by Indigenous Australians.     

大理市1986年～2000年孕产妇死亡分析

目的:为进一步降低孕产妇死亡率提供科学依据,总结大理市孕产妇系统管理工作的经验教训.方法:回顾性分析大理市15a孕产妇死亡病例.结果:大理市15a孕产妇死亡率逐年下降,从1986年的127.4/10万降至2000年的49.4/10万.死亡原因前五位依次为产科出血、妊高症、产褥感染、羊水栓塞、妊娠合并心脏病.结论:本市的孕产妇死亡原因主要与医疗保健人员知识技能水平相关、家庭个人知识水平及经济状况相关.     

先天性髋关节脱位的遗传流行病学研究

目的:探讨先天性髋关节脱位(CDH)的相关危险因素。方法:应用病例对照研究方法,对444例CDH先证者及其对照的家系资料进行遗传流行病学调查,采用Logistic回归分析方法进行多因素分析;Falconer多基因阈值模型进行遗传度估算。结果:先证者一级、二级亲属CDH患病率(2.68%,0.45%)显著高于对照组亲属(0.11%,0.13%),其OR值及95%可信区间分别为25.441(3.440￣188.150)、3.453(1.135￣10.502),患病率先证者一级亲属>二级亲属>三级亲属>对照组亲属。先证者一级、二级、三级亲属的遗传度分别为(67.88±5.12)%(、48.53±11.06)%(、31.82±42.89)%,三者加权平均遗传度为(41.74±4.62)%。臀位妊娠和双下肢捆绑的OR值及95%可信区间分别为3.49(2 2.116￣5.556)、4.877(3.623￣6.566)。结论:CDH具有多基因遗传病的特点,遗传因素在决定CDH的易患性上起重要作用,臀位妊娠和双下肢捆绑是CDH的重要环境危险因素之一。     

107例先天梅毒临床流行病学研究

目的先天梅毒(congenital syphilis,CS)近年在中国呈快速上升趋势,本文通过研究先天梅毒临床流行病学,旨在分析当前先天梅毒诊疗中存在的问题。方法对1999年2月至2003年2月间复旦大学附属儿科医院收治的107例先天梅毒患儿围产期、临床诊疗资料进行分析。结果在先天梅毒患儿母亲中,89.7%为流动人口,30.8%未进行妊娠期梅毒血清学筛查,94.4%未予正规青霉素治疗。先天梅毒新生儿期表现多变,以皮肤黏膜、骨骼损害较为特异,其比例分别为72%、40%。结论先天梅毒的发生多见于流动人口,孕妇缺乏梅毒血清学筛查和正规青霉素治疗是导致先天梅毒发生的最主要因素,政府应该加强对流动人口先天梅毒防治的管理。     

先天性脐尿管脓肿的诊治体会——附1例报告

[背景 ]提高对先天性脐尿管脓肿的认识和诊治水平 .[病例报告 ]根据典型的病史、B型超声波和CT、穿刺抽液及囊内注入造影剂检查等辅助检查方法诊断先天性脐尿管脓肿 1例 ,并进行相应的治疗 .术中诊断及病理检查证实为先天性脐尿管脓肿 .患者术后 12d痊愈出院 ,随访 3个月 ,无复发和癌变 .[讨论 ]穿刺抽液及囊内注入造影剂检查、B型超声波、CT等辅助检查是有效的诊断方法 .手术应尽可能切除包括脐部到膀胱顶部的整个脐尿管 ,以免复发和癌变     

脑脊液置换对脑室内出血术后脑积水的影响

目的探讨脑脊液置换对脑室内出血术后并发脑积水的影响。方法41例脑出血病例术前头颅CT检查均有不同程度急性脑积水，采用手术清除血肿，脑室外引流或置管尿激酶冲洗引流。术后给予脑脊液置换治疗，CT观察脑积水缓解情况，随访一年了解迟发性脑积水的发生。结果41例病人中，37例脑积水明显缓解，4例脑积水缓解不明显。4例中3例因脑压高仅行2次脑脊液置换治疗，1例做3次后放弃。27例随访，其中20例随访一年，无迟发性脑积水发生，4例因其它疾病死亡，3例失访。结论脑脊液置换术可减少脑室内出血术后并发脑积水的发生。