Electroencephalographic study of divers with histories of neurological decompression illness.

OBJECTIVE--To determine whether divers with histories of neurological decompression illness are electroencephalographically distinguishable from non-divers. METHODS--The electroencephalograms (EEGs) from 68 divers with histories of neurological decompression illness and 45 non-diver controls were examined independently by two clinical neurophysiologists. RESULTS--The diver and non-diver groups were electroencephalographically indistinguishable. CONCLUSION--There is no electroencephalographic evidence for the existence of cerebral dysfunction in divers with histories of decompression illness.     

Relations of smoking and diving experience to pulmonary function among U.S. Navy divers

The relations of 4 pulmonary function parameters (measured from the forced expiratory spirogram) with diving experience (in years) and indices of cigarette smoking were examined in a group of 93 healthy U.S. Navy divers. Years of diving was not significantly related to lung function. The value for pack-years of smoking was inversely associated with both percentage of predicted forced expiratory volume in 1 s (FEV1) and percentage of predicted maximal midexpiratory flow rate (MMFR). Divers who have relatively heavy smoking histories may be at greater risk for developing significant decline in pulmonary function, and diving exposure factors other than years of diving may contribute to this risk.     

A study of decompression sickness after commercial air diving in the Northern Arabian Gulf: 1993-95

Over 50,000 commercial air dives carried out in the Northern Arabian Gulf over a three-year period were analyzed to identify risk factors for decompression sickness. Dive depth and bottom time were found to be the only significant factors and occurrence rates were comparable to those found in the 1980s in the North Sea.     

Evaluation of decompression safety in an occupational diving group using self reported diving exposure and health status

Background: Many occupational diving groups have substantially different diving patterns to those for which decompression schedules are validated.

Aims: To evaluate tuna farm occupational diving practice against existing decompression models and describe a method for collecting and modelling self reported field decompression data.

Methods: Machine readable objective depth/time profiles were obtained from depth/time recorders worn by tuna farm occupational divers. Divers' health status was measured at the end of each working day using a self administered health survey that produces an interval diver health score (DHS) with possible values ranging from 0 to 30. Depth/time profiles were analysed according to existing decompression models. The contribution of diving exposure and between diver variability to DHS was evaluated using linear regression.

Results: The mean risk of decompression sickness was calculated as 0.005 (SD 0.003, n = 383). The mean DHS following diving was 3 (SD 2, n = 383) and following non-diving activities was 1 (SD 1, n = 41). After accounting for between diver variability in intercept, DHS was found to increase one unit for every 1% increase in the risk of decompression sickness.

Conclusions: A method has been established for the collection and analysis of self reported objective decompression data from occupational diving groups that can potentially be used as the basis for development of purpose designed occupational diving decompression schedules.

     

Physical characteristics and ventilatory function of 404 commercial divers working in the North Sea.

The physical characteristics and simple lung ventilatory indices (FVC, FEV 1, FEV 1/FVC) of 404 commercial divers employed by companies operating in the North Sea were analysed. These findings were correlated with the diving experience and maximum operating depth of each diver. All the divers were men of average height 176-9 cm, and weight 77-1 kg which is greater than average for active Western males, but only 6% were more than 120% of their predicted weight. The average duration of commercial diving was 7-1 years, 11% of divers having less than one year's experience. Sixty-seven per cent had worked at a maximum depth of 200 ft (61 m) and only 6% had worked deeper than 500 ft (153 m). The mean forced vital capacity (FVC) was 120-4% of the predicted value which indicated that they could voluntarily move large amounts of gas in and out of their lungs. This was greatest in the divers who when deepest. The mean forced expired volume in one second (FEV 1) was 117% of the predicted value showing that expiratory airflow capacity was also increased, but to a lesser extent than the FVC. Thper and activated by zinc. Plasma protein protected the enzyme from both inhibition and activation. ALAD activity was found to be an indicator of the total metal ion concentration in the blood and was therfore considered to be of doubtful value in screening large population for increased lead absorption.     

Lidocaine as an adjunct to hyperbaric therapy in decompression illness: a case report.

A recreational scuba diver with nervous system decompression illness had a poor response to hyperbaric therapy. On the basis of available and supportive in vivo data, he was then given a continuous infusion of lidocaine (serum levels, low therapeutic range: 6.4-9.1 mumol/liter). Within 24 h of the start of this infusion he experienced a full resolution of his neurologic deficits. His symptoms recurred 3 days later, but again completely resolved after further hyperbaric therapy and concurrent administration of lidocaine (serum levels: 6.9-9.1 mumol/liter). This observation supports the need to conduct trials of lidocaine as an adjunct to hyperbaric therapy in decompression illness.     

脑外伤继发颅内感染患者血浆细胞因子及高迁移率族蛋白-1表达与病情相关性

目的探究脑外伤继发颅内感染患者血浆细胞因子及高迁移率族蛋白-1(HMGB-1)、晚期糖基化终产物受体(RAGE)表达与病情相关性。方法选择2015年1月-2018年12月贵州省人民医院急诊外科收治的脑外伤继发颅内感染患者60例作为研究对象,根据感染程度分为:轻度感染29例、中度感染20例、重度感染11例;同期收治的脑外伤未感染患者30例作为未感染组。比较不同感染程度和未感染组RAGE、HMGB-1、辅助型T细胞(Th)1、Th2、Th1/Th2细胞比率、血浆细胞因子水平及血液流变学指标。结果随着感染程度加重,HMGB-1及RAGE水平不断增加,均高于未感染组(均P<0.001);Th1、Th1/Th2比例不断降低,Th2比例不断升高,与未感染组比较,差异具有统计学意义(均P<0.001);随着感染程度加重,IL-4、IL-6水平逐渐升高,均高于未感染组,差异具有统计学意义(均P<0.001),血浆黏度、全血黏度低切、全血黏度高切、Fib血液流变学指标逐渐升高,与未感染组比较,差异均具有统计学意义(均P<0.001)。结论脑外伤继发颅内感染患者体内细胞因子含量异常,Th1/Th2平衡偏移,血液流变学异常,HMGB-1及其主要受体RAGE表达显著上升,与病情严重程度密切相关。     

Zoonotic illness--determining risks and measuring effects: association between current animal exposure and a history of illness in a well characterised rural population in the UK.

STUDY OBJECTIVES--To recruit a representative sample of farmworkers, accurately quantify the range and extent of their animal exposures, and measure the associated risks of illness. DESIGN--Inception cohort. SETTING--The study was undertaken among farmworkers living in five local authority areas in the catchment of Hereford and Preston Public Health Laboratories, England. PARTICIPANTS--A quota sample of 404 people on 255 agricultural holdings took part. The holdings were selected at random from the Ministry of Agriculture, Fisheries and Food register. Altogether 58% of eligible subjects approached agreed to participate. MEASUREMENTS AND MAIN RESULTS--The sample had the same sex distribution as the 1991 census for those giving their occupation as agriculture. The mean age was significantly (p < 0.01) higher (44.6 years v 42.2 years) than that of those giving their occupation as agriculture, forestry or fishing in the census, although the modal range (45-59 years) was the same. At enrollment interviews, subjects individually reported contact with up to nine animal species (mode 4) out of 26 reported in all. Based on the numbers contacted and the frequency and intimacy of contact, scores on a ranked ordinal scale from 0-5 were constructed for each species and frequencies for each score were plotted. Subjects also reported past operations and serious illness. A history of pneumonia was significantly (p < 0.05) associated with a pigeon loft on the farm (relative risk (RR) 7.3) and attending farrowing pigs (RR 6.6), and one of leptospirosis with a rat problem on the farm (RR 28.1). Cattle contact was associated with a significantly lower likelihood (protective) of glandular fever (RR 0.19) and rheumatic or scarlet fever (RR 0.12). These effects were significantly related to rankings of the extent of exposure. CONCLUSIONS--It is possible to recruit a representative sample of farmworkers and measure their animal exposures in great detail. Among these exposures, associations with plausible risk factors for pneumonia and leptospirosis and apparently protective factors for glandular fever, scarlet fever, and rheumatic fever have been demonstrated, which further show a relationship between the extent of exposure and response. These findings can be tested further by examining the relationship of exposures to serological evidence of illness or by further prospective follow up of this and similarly well characterised cohorts, or both.     

儿童期受虐待经历与大学生实施网络欺凌的相关性

目的探讨儿童期虐待经历与大学生实施网络欺凌的关系,为大学生实施网络欺凌的早期干预提供理论支持。方法采用分层随机整群抽样方法抽取山西省6所高校的大二和大三共3 850名学生,采用《网络欺凌情况调查问卷》和《儿童期虐待问卷中文版》进行调查。结果男生性虐待、情感忽视、躯体忽视的报告率均高于女生(χ²值分别为5.22,4.39,7.53),父母离异大学生儿童期虐待各因子报告率均高于父母未离异大学生(χ²值分别为86.80,134.06,130.18,175.64,118.46);除躯体忽视外,独生子女的情感虐待、躯体虐待、性虐待、情感忽视等因子报告率均高于非独生子女(χ²值分别为9.44,12.44,21.18,21.26),差异均有统计学意义(P值均<0.05)。男生实施网络欺凌网络言语欺凌、隐匿身份、网络伪造欺诈因子得分及总分均高于女生(t值分别为9.35,5.59,5.83,7.57),独生子女实施网络欺凌各因子得分及总分均高于非独生子女(t值分别为2.79,3.74,4.78,4.40),父母离异学生实施网络欺凌各...     

重症肺炎患儿危重症评分与凝血指标的相关性

目的：探讨重症肺炎患儿危重症评分与凝血指标的关系。方法选择2011年8月至2013年3月期间,河北省唐山市丰润区人民医院重症监护室收治的重症肺炎患儿共160例作为实验组,同期选择60例门诊体检健康儿童作为对照组,分析两组患者数据进行分析。结果实验组可溶性P选择素、D-二聚体均较对照组高,血小板计数较对照组低,差异具有统计学意义（t可溶性P选择素＝10．52,tD-二聚体＝5．03,t血小板计数＝11．66,均P＜0．05）;而活化部分凝血酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（Fib）经比较差异无统计学意义（tAPTT ＝0．87,tPT ＝1．05,tFib ＝0．72,均P＞0．05）。随着病情程度加重,可溶性P选择素、D-二聚体均较前升高,血小板计数较前降低,组间比较差异具有统计学意义（ F可溶性P选择素＝50．45,FD-二聚体＝50．88,F血小板计数＝24．49,均P＜0．05）,APTT、PT无明显变化,差异无统计学意义（FAPTT ＝0．61,FPT ＝0．77,FFib ＝0．66,均P＞0．05）。可溶性P选择素和D-二聚体与疾病危重程度呈现正相关,血小板计数与疾病危重程度呈现负相关。结论重症肺炎患儿容易出现凝血机制异常,可溶性P选择素、D-二聚体和血小板计数与疾病危重程度密切相关,指导临床治疗。     

血清可溶性CD163水平与子痫前期孕妇病情程度的关系

目的 分析子痫前期(PE)孕妇和正常孕妇血清中可溶性CD163(sCD163)和肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8、IL-10的相关性,评价PE中sCD163的表达水平及其临床意义。方法 选择2019年1月-2019年6月在郑州大学第三附属医院住院的轻症PE孕妇为子痫前期轻症组、重症PE孕妇为子痫前期重症组和正常孕妇为对照组,各20例。比较三组孕妇间的一般临床资料,采用酶联免疫吸附试验(ELISA)检测三组孕妇血浆中TNF-α、IL-6、IL-8、IL-10和sCD163的浓度,利用Pearson相关性分析三组孕妇sCD163与TNF-α、IL-6、IL-8和IL-10的相关性。结果 子痫前期轻症组和子痫前期重症组的收缩压、舒张压和24 h尿蛋白高于对照组,且子痫前期重症组收缩压和24 h尿蛋白高于子痫前期轻症组(P<0.05)。子痫前期轻症组和子痫前期重症组血浆中TNF-α、IL-6、IL-8的浓度高于对照组,sCD163和IL-10的浓度低于对照组(P<0.05)。对照组孕妇sCD163与IL-10呈正相关(r=0.569,P=0.00...     

大学生不同错畸形与体像烦恼的相关度

  目的  探析大学生错畸形与体像烦恼的相关性, 以引导大学生形成积极的体像观念以及对有体像烦恼的错畸形在校大学生提供心理帮助。  方法  2018年9—12月在荆楚理工学院、湖北职业技术学院、襄阳职业技术学院分层整群抽取1 851名在校大学生, 随后参照Angle分类法筛查出不同类型的错畸形大学生, 运用青少年学生体像烦恼问卷进行调查评定, 探求在校大学生中不同类型错畸形与体像烦恼之间的关系。  结果  在校大学生Ⅰ、Ⅱ、Ⅲ类错畸形的比例分别为71.21%, 16.32%, 12.47%;在校大学生Ⅰ、Ⅱ、Ⅲ类错畸形中存在体像困扰的检出率分别为36.64%, 54.78%, 65.83%。在青少年学生体像烦恼分值比较中, Ⅰ、Ⅱ、Ⅲ类不同错类型在校大学生在性器官烦恼、性别烦恼检出率差异均无统计学意义(χ2值分别为0.75, 0.53, P值均>0.05);而容貌烦恼检出率分别为27.59%, 33.12%, 50.83%, 形体烦恼检出率分别为24.09%, 31.21%, 44.17%, 差异均有统计学意义(χ2值分别为5.62, 2.89, P值均 < 0.05)。  结论  大学生具有体像烦恼比例最高是Ⅲ类错畸形, 其中容貌烦恼和形体烦恼维度是大学生最希望解决的问题。口腔临床医师在矫治过程中特别需要重视Ⅲ类错畸形在校大学生的心理需求, 从而提高患者满意度。     

血液炎性指标与脓毒血症细菌感染患者病情的相关性研究

目的分析脓毒血症细菌感染患者血液炎性指标与病情的关系。方法收集2013年7月-2016年1月医院收治的脓毒血症患者100例,参照病情程度分作脓毒血症组36例、重度脓毒血症组34例、脓毒性休克组30例,分析脓毒血症患者细菌感染情况,比较3组脓毒血症患者血液炎性指标水平(LPS、CRP、PCT、IL-6、WBC)及急性生理与慢性健康状况评分Ⅱ(APACHE-Ⅱ),并分析血液炎性指标水平与APACHE-Ⅱ评分的相关性。结果脓毒血症患者细菌感染主要为大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌及金黄色葡萄球菌,其次为鲍氏不动杆菌及阴沟杆菌;脓毒血症组LPS(28.75±5.69)ng/L、CRP(68.54±12.73)mg/L、PCT(0.84±0.21)μg/L、IL-6(29.85±6.47)ng/L、WBC(9.81±2.54)×109/L分别低于重度脓毒血症组LPS(37.18±7.24)ng/L、CRP(129.20±17.62)mg/L、PCT(8.41±0.81)μg/L、IL-6(53.22±11.41)ng/L、WBC(11.35±3.06)×109/L,且低于脓毒性休克组LPS(44.79±8.25)ng/L、CRP(153.24±21.38)mg/L、PCT(11.37±1.05)μg/L、IL-6(85.60±16.28)ng/L、WBC(14.79±3.54)×109/L,比较差异有统计学意义(P<0.05);脓毒血症组APACHE-Ⅱ评分(12.16±3.51)分低于重度脓毒血症组(21.12±4.93)分且低于脓毒性休克组(26.29±5.63)分,比较差异有统计学意义(P<0.05);脓毒血症患者血液LPS、CRP、PCT、IL-6、WBC水平和APACHE-Ⅱ评分为正相关,差异有统计学意义(P<0.05)。结论脓毒血症细菌感染患者血液炎性指标水平与病情程度表现为正相关,可以作为临床上评估患者病情、预后的可靠指标。     

The experience of chronic illness in women: a comparison between women with endometriosis and women with chronic migraine headaches

The diagnosis of a chronic illness is a life changing event that affects the biological, psychological, and sociological aspects of a person's life. The purpose of the present study was to compare the experiences of pain, physical and psychological well-being, stress, patient satisfaction, social support, and attitudes toward menstruation of women who suffer from endometriosis and women who suffer from chronic migraine headaches. It was hypothesized that women with endometriosis would have more negative scores than women who have migraines on all measures because endometriosis is not understood by society to be a valid source of pain. Participants were 41 women with endometriosis and 32 women with migraines who were recruited from support groups and online listservs. Women with endometriosis reported significantly more pain, stress, and negative attitudes toward menstruation than did women with migraines. Implications for the differential treatment of women with chronic illnesses related to the menstrual cycle are discussed.     

Reframing health and illness: a collaborative autoethnography on the experience of health and illness transformations in the life course

In this collaborative autoethnography, we examine the processes whereby people may reframe their interpretations and understandings of health and illness as a result of new diagnostic information. In so doing, we utilise the first author's experience receiving a conclusive diagnosis of cystic fibrosis after years of misdiagnosis to outline some ways changes in diagnosis facilitate shifts in illness management, the nature of health and illness and the experience of the self in relation to health and medicine. Furthermore, we discuss the ways this case reveals the importance of examining and comparing the social construction and transformation of health and illness within and between different individual and collective lived experiences over time. In closing, we draw out theoretical and empirical implications for understanding transformations in the nature of health and illness over the life course as well as future directions for research investigating shifts in illness management and understanding over time (A virtual abstract of this paper is available to view at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA ).     

Correlation between inhibition, working memory and delimited frontal area blood flow measure by 99mTc-Bicisate SPECT in alcohol-dependent patients.

Recently detoxified non-neurological alcoholic patients appear to be impaired in cognitive tasks measuring inhibitory processes as well as working memory (involving storage and manipulation of information). The aim of this study was to investigate in alcoholic participants the relationship between these two cognitive functions and regional cerebral blood flow (rCBF) studied at rest in regions of interest selected on the basis of recent PET studies which explored inhibitory and working memory in normal subjects. Twenty non-neurological alcoholic patients and 20 normal volunteers were selected for a neuropsychological exploration, including assessment of inhibition processes (by means of the Hayling test) and working memory (by means of the Alpha-span task). rCBF of alcoholics was also evaluated with a semi-quantitative method using a 99mTc-Bicisate single photon emission computed tomography (SPECT) procedure. Alcoholic patients performed worse than controls in the alphabetical condition of the Alpha-span task (involving manipulation and storage of information), and on the Hayling test. Significant correlation emerged between inhibition performance and both the bilateral inferior (left BA 47, r = -0.40; right BA 47, r = -0.599) and median frontal gyrus (left BA 10, r = -0.55; right BA 10, r = -0.59), but not with the region of reference (occipital/cerebellum, r = -0.13). Coordination of storage and manipulation was correlated with bilateral median frontal (left BA 10/46, r = -0.50; right BA 10/46, r = -0.45), but not with bilateral parietal area (left BA 7, r = -0.12, right BA 7, r = -0.18). These results suggest a relationship between inhibition and working memory deficits in alcoholic patients, and regional rCBF measured in frontal areas. Clinical implications of these data related to alcohol relapse are discussed.