营山县2014年健康人群麻疹、风疹、腮腺炎抗体水平监测结果分析

目的:了解营山县健康人群麻疹、风疹、腮腺炎抗体水平,评价疫苗接种效果和人群免疫状况,为制定免疫规划策略和相应传染病防制措施提供依据。方法:按照分层随机抽样的原则,分<1岁、1岁~、3岁~、5岁~、7岁~、15岁~、≥20岁7个年龄组,每个年龄组随机抽取30人作为监测对象,共210人,采用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)法检测麻疹IgG、风疹IgG、腮腺炎IgG。结果:共检测210份血清标本,麻疹IgG阳性率为86.19%,风疹IgG阳性率为80.48%,腮腺炎IgG阳性率为63.81%。结论:营山县健康人群麻疹IgG抗体水平1岁以上年龄组人群均达到《预防接种规范》要求的85%免疫成功率指标,建立了有效免疫屏障。风疹IgG抗体和腮腺炎IgG抗体水平较低,不足以达到有效免疫屏障,提示我们要加强风疹、腮腺炎接种率和接种质量。     

合肥市 2011 年健康人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的研究人群麻疹、风疹、流行性腮腺炎免疫状况,为制定免疫对策提供科学依据。方法随机抽取1422名0～30岁健康人员及部分育龄期女性,用酶联免疫吸附试验检测麻疹、风疹、流行性腮腺炎IgG抗体水平,并进行分析。结果1422名健康人员麻疹抗体阳性1071人,抗体阳性率为75．3％;风疹抗体阳性1149人,抗体阳性率为80．8％;流腮抗体阳性1097人,抗体阳性率为77．1％。结论合肥市麻疹有出现散发和小范围流行的可能,风疹和流行性腮腺炎学龄组出现暴发的可能性较高。在认真完成麻疹疫苗的常规接种的前提下,对大年龄组儿童进行MMR疫苗的强化免疫或查漏补种是消除麻疹和控制风疹及流行性腮腺炎的有效方法和途径。     

郑州市2004～2005年几种急性传染病流行特征分析

目的 分析郑州市2004-2005年麻疹、流行性腮腺炎、风疹几种急性传染病的流行特征和趋势，为修订防治措施提供依据。方法 对郑州市2004-2005年麻疹、流行性腮腺炎、风疹的流行情况和预防控制措施的实施效果进行调查分析。结果 郑州市2004与2005年麻疹、流行性腮腺炎及风疹的发病率分别为6．28％/10万、34．19/10万和4．38/10万与22，17/10万、16．86/10万和2．07/10万。流行性腮腺炎、风疹发病总体呈下降趋势，但局部地区和个别年龄段发病显著上升。结论 提高常规免疫接种率，及时对适龄儿童进行麻疹疫苗复种，并有计划的开展麻疹疫苗强化免疫，加强流动人口管理，消除免疫空白，以达到迅速控制麻疹，是控制麻疹需要解决的问题。     

维生素A在麻疹防控中的作用

维生素A可以完善、维持呼吸道上皮细胞的正常代谢,增强呼吸道的抗感染能力,降低呼吸道感染发病风险。麻疹患者临床治疗时适量补充维生素A可以降低肺炎、腹泻、中耳炎等并发症的发生率和患者病死率,缩短麻疹患者病程,促进患者康复。婴幼儿接种麻疹疫苗时补充维生素A可以促进麻疹抗体IgG的产生,延长抗体的持续时间。合理补充维生素A能预防其缺乏,提高机体免疫力,减少麻疹的发生率。     

咸阳市2006年对2～7岁儿童实施麻疹复种活动评价

目的 为完成咸阳市2～7岁儿童的麻疹疫苗复种，使该年龄组儿童麻疹疫苗的免疫次数达到2剂次。方法 我市于2006年3—4月份对全市2～7岁儿童开展麻疹疫苗复种活动。结果 全市共登记适龄儿童209683人，实际接种201317人。接种率95．92％，13县（区、市，下同）报告接种率为86．18％～99、18％。分年龄组统计，接种率最高为5岁组（97．35％），最低为7岁组（94、32％），其他年龄组接种率为96．47％～97．35％。以乡为单位报告接种率为81．66％～100．00％。利用市统计人口资料、疫苗分发数对报告情况进行评估。结论 由于该次麻疹疫苗复种活动积极部署，广泛宣传，技术培训到位，现场督导有力，基本达到了预期目标和要求。     

Knowledge regarding Ebola Hemorrhagic Fever among private dental practitioners in Tricity,India: A cross-sectional questionnaire study

Background:

Ebola viral fever, a highly contagious haemorrhagic disease has today become a major public health concern in the developing countries worldwide.

Aim:

The purpose of this study was to assess knowledge among dental practitioners regarding Ebola Haemorrhagic Fever (Ebola HF) in Tricity, (Chandigarh, Panchkula and Mohali).

Materials and Methods:

A total of 500 private dental practitioners were randomly approached to participate in this cross-sectional survey. A self-structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding Ebola HF. Knowledge section included questions related to communicability; symptomatology and diagnostics; at-risk individuals; prevention and treatment; and, virus characteristics of Ebola HF.

Results:

The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participants''s demographic and professional characteristics with the knowledge scores. Statistically significant difference was seen when mean knowledge scores were compared based on the locality and qualification of the participants (P < 0.05).

Conclusion:

Dental practitioners from urban areas with higher qualification had better knowledge yet there were notable deficiencies regarding the virus characteristics, diagnostics, elimination and treatment.     

A study of adult rubella outbreak and its implications on increasing number of women in uniform

BackgroundRubella, although a fairly innocuous disease, is a known cause of severe birth defects in newborn. With number of women in uniform on the rise and they being assigned instructional and medical care duties, adult rubella outbreak in a training centre as in this study poses grave threat to them; besides, having disruption potential for their training.MethodsThis study was conducted at an Airmen Training Centre of the Indian Air Force having more than 2500 recruits, in five squadrons. All cases of fever with rash and/or lymphadenopathy were included in the study. The demographic, epidemiological and clinical data of all the cases were analyzed and medical records reviewed.ResultsA total of 31 male recruits reported over 5 days. Among those, 21 cases were from a single squadron to which the index belonged. Twelve women officers were doing instructional duties at the time of outbreak though none became infected. Fever with a rash (90.32%) was the commonest presentation, and lymphadenopathy (64.51%) was the most common sign. Attack rate (AR) with-in the squadron most affected was 4.18%, with an overall AR of 1.23%. The case fatality rate of the disease was nil.ConclusionTill the fully immunized cohort of young recruits start getting enrolled, it will be prudent to introduce rubella vaccine to limit the loss of vital training man-hours and prevent the possibility of congenital rubella syndrome in the women instructors and medical caregivers, working in the line of their duty.     

北京地区1458名中老年人血清同型半胱氨酸分布的横断面调查

目的 描述北京地区中老年社区人群血清同型半胱氨酸(Hcy)的分布特征.方法 对于2009年“北京老龄化多维纵向研究”的数据进行横断面分析,研究对象为北京地区55岁及以上人群共l 458人,Hcy采用循环酶法检测,Hcy＞ 15 μmol/L定义为高Hcy血症.采用我国2000年北京市人口普查的年龄和性别结构对数据进行权重,报告高Hcy血症患病率.对该人群血清Hcy以不同年龄、性别、居住地、生活习惯及心血管病患病情况的分布特点进行统计分析.结果 该人群平均年龄(69.48±8.09)岁,Hcy呈正偏态分布,中位值16.56 μmol/L(四分位间距:13.11～21.78μmol/L).高Hcy血症患病率为57.2％.男性Hcy中位值及高Hcy血症患病率分别为18.24 μmol/L(14.65～25.65 μmol/L)及69.0％,女性分别为15.47 μ,mol/L(12.09-19.62 μ,mol/L)及45.6％,男性均高于女性(P均＜0.001).女性Hcy水平及高Hcy血症患病率均随年龄增长而升高(P均＜0.001),男性则无此趋势(P=0.23,0.374).城市居民Hcy中位数为15.33 μ,mol/L(12.03-19.28 μmol/L),农村为17.42 μmol/L(13.86-23.88μmol/L),农村高于城市(P＜0.001).Hcy浓度及高Hcy血症患病率在有吸烟及饮酒习惯的人群中更高(P均＜0.001),且随肾功能的下降而上升(P均＜0.001).在有高血压、心肌梗死及脑卒中病史的人群中高Hcy血症患病率比无以上病史的人群高(P均＜0.05).结论 北京地区中老年人群血清Hcy存在性别、年龄、城乡、是否患心血管病的分布差异.     

Review of systems for recognising and responding to clinical deterioration in Singapore hospitals: a nationwide cross-sectional study

INTRODUCTIONThe Rapid Response System for recognising and responding to clinically deteriorating patients has been progressively implemented in acute care hospitals across the globe. This study sought to review the implementation of this system in acute public hospitals in Singapore.METHODSA cross-sectional study using a face-to-face survey questionnaire was conducted.RESULTSFive out of seven invited hospitals completed the questionnaire and rated the Rapid Response System as either high priority or essential, and indicated its importance over other patient safety indicators. Sensitivity and specificity of the triggering criteria and non-adherence to the escalation protocol were highlighted issues. Only two hospitals had a dedicated response team for providing emergency help to deteriorating ward patients. Limited manpower resources, unclear roles between the primary and response teams, and the potential deskilling of ward staff were reported barriers that inhibited the uptake of a response team. All hospitals had a committee that oversaw its system operation, provided training to ward staff, and used information technology to support the implementation.CONCLUSIONA variety of approaches have been taken to support the system of recognising and responding to clinical deterioration. This calls for a national approach to enable the standardisation of clinical processes, sharing of educational resources and multi-site evaluation.     

高碘地区老年人群甲状腺疾病与血脂紊乱的横断面调查研究

目的：调查高碘地区老年人群甲状腺疾病的患病率,分析促甲状腺激素（thyroid stimulating hormone,TSH）水平与血脂紊乱患病率的相关性。方法：筛选该地区65岁及以上老年人258人,根据年龄分为3组（65～69岁组、70～74岁组和≥75岁组）。每位受试者都完成问卷调查、体格检查、甲状腺超声检查和甲状腺功能检测。采用卡方检验比较各个年龄组老年人甲状腺功能异常及结节的患病率和不同TSH水平下血脂紊乱的患病率。使用斯皮尔曼相关分析年龄与TSH之间的相关性,采用简单线性回归建立回归方程。结果：老年人群的中位尿碘浓度为397.60(225.58,647.73)μg/L,甲状腺疾病的总患病率为48.84%(126/258)。其中,甲状腺功能异常和甲状腺结节的患病率均为24.42%(63/258),亚临床甲状腺功能减退症为最常见的甲状腺功能异常,患病率为22.48%(58/258),且随着年龄增加逐渐升高（P<0.01）。年龄与TSH水平呈正相关（相关系数为0.31,P<0.001）。随着TSH水平的逐渐升高,高总胆固醇（total cholesterol,TC）血...     

Faun tail nevus: A series of 15 cases and their management with Intense Pulse Light

BackgroundLocalized lumbosacral hypertrichosis presenting as faun tail nevus often represents an underlying spinal occult or overt abnormality. This study was undertaken to study these abnormalities and assess their treatment outcome with Intense Pulse Light (IPL) for permanent hair reduction.MethodsPatients reporting with localized spinal hypertrichosis underwent clinical examination and radio imaging. Symptomatic neurological deficit underwent definitive neurosurgical intervention (if indicated) before hair removal. IPL was administered as 30 J/cm² four weekly for six sessions. Treatment assessment was based on a Global Physician Assessment Scale and by averaged terminal hair count at four quadrants in 1 cm² area as observed through the hair densitometer before starting treatment, every four weeks and at the end of six months of follow up thereafter. Averaged hair count was interpreted with paired t-test.ResultsThis neurocutaneous marker was observed in 15 patients out of a total of 360,767 patients (0.004%) over a four-year period. Age group of patients ranged from 3 to 26 years, comprising of all female patients. Radio imaging revealed diastematomyelia in 10, spina bifida in 04 and 01 had both as the primary spinal abnormality. Thirteen patients were treated with IPL for a period of six months, assessment after six months revealed a highly statistical significant p > 0.0001 reduction in hair growth consistent when followed up after 18 months.ConclusionThis article aims to present a series of this rare neurocutaneous marker and highlight our experience in their management with IPL served as an effective alternative to traditional lasers.     

Association between participation in sports club activities and decision-making preferences in end-of-life treatment among Japanese elderly people: a cross-sectional study

Introduction: Decision-making regarding treatment at the end-of-life stage is an important issue for the elderly and their families. Such decision-making may be influenced by activities that promote communication and physical health. The purpose of this study was to examine the association between participation in sports club activities and decision-making regarding life-prolonging treatment among the general community-dwelling Japanese elderly. Methods: In this cross-sectional study, which used stratified random sampling, 1,603 elderly people aged 65 years or older as of January 2016, living in Fukushima prefecture, Japan were enrolled. Data was collected by a self-completed questionnaire (effective response rate: 53.4%). The association of sports club activity participation with a preference for accepting or declining life-prolonging treatment was analyzed by multinomial logistic regression analysis. Results: Of those participating in sports club activities, the results revealed an odds ratios of 1.812 for participants declining life-prolonging treatment (95% CI=1.325 to 2.477) and 1.948 for those who preferred life-prolonging treatment (95% CI=1.160 to 3.271). Conclusions: The present study suggests that participation in sports club activities is associated with articulating decisions about life-prolonging treatment in end-of-life care. Consideration of patient involvement in daily activities in non-medical settings may enhance decision-making for end-of-life care planning.     

Risk factors of osteoporosis in soldiers of the Armed Forces: A cross-sectional study from Western India

BackgroundOsteoporosis may result from risk factors such as smoking, alcohol, low body mass index, less physical exercise, and dietary calcium deficiency. The risk of osteoporosis fractures can be reduced with lifestyle changes, which include diet, exercise, and preventing falls. The present study is an effort to measure the burden of risk factors of osteoporosis in adult male soldiers in the Armed Forces.MethodsThe present study was a cross-sectional study among serving soldiers in South-Western part of India, and 400 participants consented to be included in the study. After obtaining informed consent, the questionnaire was distributed. Venous blood samples were collected to measure serum calcium, phosphorus, vitamin D, and parathyroid hormone (PTH).ResultsThe prevalence of vitamin D3 severe deficiency (<10 ng/mL) was 38.5%, and the prevalence of vitamin D3 deficiency (10–19 ng/mL) was 33%. Low serum calcium (<8.4 mg/dL) and serum phosphorus (<2.5 mg/dL) were found among 19.5% and 11.5%, respectively, whereas a raised serum PTH level (>66.5 pg/mL) was seen in 5.5% of the participants. A statistically significant association was found between consumption of milk and milk products and levels of calcium. With a cutoff value of 20 ng/mL for vitamin D3 deficiency, a statistically significant association was found for consumption of fish, physical activity, and sun exposure.ConclusionA remarkably large percentage of otherwise normal healthy soldiers have deficiency or insufficiency of vitamin D and might be prone to osteoporosis. Despite significant advances in our understanding and management options for male osteoporosis, there still remain important gaps in knowledge which needs to be looked into.     

A study of Hepatitis A and E virus seropositivity profile amongst young healthy adults in India

Background

Various Serosurveys and studies provide ample evidence of differing perspectives regarding epidemiology of HAV and HEV in India. This study was conducted to assess the seroprevalence of HAV and HEV and its associated factors with an aim to provide inputs to planners regarding requirement of HAV vaccine.

Methods

A multi-centric cross sectional survey amongst 4175 healthy trainees (young adults) was carried out in training centres, selected by multistage random sampling, giving equal representation to all regions of India. Sample size was calculated by taking prevalence of HAV seropositivity amongst adults as 60% and alpha 0.05.

Results

Seroprevalence for HAV and HEV was 92.68% (95% CI 91.82, 93.47) and 17.05% (15.90, 18.26), respectively. Logistic regression showed that hand washing without soap, regular close contact with domestic animals, consumption of unpasteurized milk and regular consumption of food outside home were risk factors for HAV (p < 0.05). For HEV, irregular hand washing, consumption of unpasteurized milk and irregular consumption of freshly prepared food were risk factors (p < 0.05).

Conclusion

High level of immunity against HAV among the healthy young adults clearly demonstrates that vaccination against HAV is not required at present in our country. The large proportion being susceptible to HEV points towards the requirement of preventive strategies in the form of safe drinking water supply, hygiene, sanitation, increasing awareness and behaviour change with respect to personal hygiene especially hand and food hygiene.     

Toll样受体2、3、4、9在胎盘组织中的表达及其与自发性早产的关系

目的：探讨Tol 样受体（TLRs）2、3、4、9在不同孕期胎盘组织中的表达及其与自发性早产的关系。方法选择自发性早产患者的胎盘样本38份作为早产组（其中孕28-34周和孕35~36周各19份）。选择同期正常妊娠自然分娩产妇的胎盘样本38份（孕37-40周）作为对照组。采用real- time PCR法检测两组胎盘中TLR 2、3、4、9 mRNA的表达,并用Western blot法检测胎盘中TLRs 2、3、4、9蛋白的表达,对结果进行统计学分析。结果（1）两组孕产妇胎盘组织中均可检测到TLRs 2、3、4、9的表达。（2）早产组胎盘组织TLR 2、3、9 mRNA的表达均高于对照组,两者间差异有统计学意义（均P＜0.05）;TLR4 mRNA的表达两组间无统计学差异（P＞0.05）。（3）早产组TLR 2、3、4、9的蛋白表达均高于对照组,两者差异均有统计学意义（均P＜0.05）。（4）早产组中,28~34孕周组和35~36孕周组胎盘中TLRs mRNA表达量均无统计学差异（均P＞0.05）。结论早产患者胎盘组织中TLRs过度表达,提示TLRs介导的母胎界面的免疫反应可能是启动自发性早产的重要因素。     

A study of Hepatitis A and E virus seropositivity profile amongst young healthy adults in India

Background

Various Serosurveys and studies provide ample evidence of differing perspectives regarding epidemiology of HAV and HEV in India. This study was conducted to assess the seroprevalence of HAV and HEV and its associated factors with an aim to provide inputs to planners regarding requirement of HAV vaccine.

Methods

A multi-centric cross sectional survey amongst 4175 healthy trainees (young adults) was carried out in training centres, selected by multistage random sampling, giving equal representation to all regions of India. Sample size was calculated by taking prevalence of HAV seropositivity amongst adults as 60% and alpha 0.05.

Results

Seroprevalence for HAV and HEV was 92.68% (95% CI 91.82, 93.47) and 17.05% (15.90, 18.26), respectively. Logistic regression showed that hand washing without soap, regular close contact with domestic animals, consumption of unpasteurized milk and regular consumption of food outside home were risk factors for HAV (p < 0.05). For HEV, irregular hand washing, consumption of unpasteurized milk and irregular consumption of freshly prepared food were risk factors (p < 0.05).

Conclusion

High level of immunity against HAV among the healthy young adults clearly demonstrates that vaccination against HAV is not required at present in our country. The large proportion being susceptible to HEV points towards the requirement of preventive strategies in the form of safe drinking water supply, hygiene, sanitation, increasing awareness and behaviour change with respect to personal hygiene especially hand and food hygiene.     

Risk factors for under-nutrition among children aged one to five years in Udupi taluk of Karnataka,India: A case control study

Background

Despite her apparent economic success, India is plagued by a high burden of under-nutrition among children under five. This study was aimed at understanding some of the risk factors for under-nutrition in a region with favourable maternal and child health indicators.

Method

A case control study was carried out among children aged one to five years attending the paediatric outpatient department in six rural health care centres in Udupi taluk of Karnataka in Southern India. A total of 162 children were included in the study, of which 56 were cases. A semi-structured questionnaire was used to interview the caregivers of the children and the nutritional status was graded according to the Indian Academy of Paediatrics (IAP) grading of protein-energy malnutrition.

Results

Under-nutrition was associated with illness in the last one month [OR– 4.78 (CI: 1.83 –12.45)], feeding diluted milk [OR–14.26 (CI: 4.65 – 43.68)] and having more than two children with a birth interval ≤2 years [OR– 4.93 (CI: 1.78 – 13.61)]. Lack of exclusive breast feeding, level of education of the caregiver and environmental factors like source of water did not have an association.

Conclusion

Childhood illness, short birth interval and consumption of diluted milk were some of the significant contributory factors noted among this population. Information, Education, Communication (IEC) campaigns alleviating food fads and promoting birth spacing is needed.