Incidence and severity of ifosfamide-induced encephalopathy

This retrospective trial was performed to determine risk factors, incidence and severity of ifosfamide-induced encephalopathy in correlation with patient and treatment characteristics. Patients receiving ifosfamide were included consecutively with no restrictions concerning disease, prior chemotherapy or disease stage. Incidence and severity of encephalopathy were graduated according to common toxicity criteria. Between July 2001 and July 2002, 60 patients (32 male, 28 female, median age 47.5 years) were included; 26.6% of the patients (n = 16) developed neurological symptoms [grade 1: 6.7% (n = 4); grade 2: 3.3% (n = 2); grade 3: 11.7% (n = 7); grade 4: 5% (n = 3)]. Encephalopathy occurred for the first time in 87.5% (n = 14) in chemotherapy courses 1 and 2. In 56.25% (n = 9) of these 16 patients only one episode was observed. There was no significant difference concerning age (38 versus 50 years, p = 0.08) and dosage (median 2.9 versus 2.8 g, p = 0.74) between patients with and without encephalopathy. No risk factors could be identified by this study, suggesting an individual predisposition in each patient. On the other hand, ifosfamide can be administered in older patients without increased risk of neurotoxicity.     

Incidence and management of poisonings in livestock

Insecticides, nitrates, gossypol, copper, and plants are a few of the common toxicoses observed in livestock in a particular specie due to various factors. Some species may have anatomical or physiological uniquenesses making them more susceptible to certain agents. Another specie may be exposed to some agents more frequently than others, increasing the likelihood of toxicosis in that specie. Once recognized, therapy is often unrewarding due to the advanced stage of the condition when first recognized, the stress involved in administering the treatment, and the unfeasibility of multiple treatments on many animals. Because of the poor response to treatment and the large number of animals potentially at risk, prevention assumes a greater importance in food animals than in companion animals. Prevention consists of making the diagnosis, findings and removing the source of the toxicant, and educating the owner on how future problems can be avoided.     

医院感染横断面调查与分析

目的 了解我院医院感染现状,为提高医院感染管理水平提供科学依据.方法 按照卫生部<医院感染诊断标准>,采用床边调查与住院病历调查相结合,对2009年9月23日本院所有住院患者进行医院感染现患率调查.结果 调查日实查率99.33%;发生医院感染33例,38例次,医院感染现患率为3.71%,例次感染率为4.27%.感染部位...     

Incidence and determinants of long-term use of antidepressants

Objectives The use of antidepressants has increased over the years, which may be due to more new antidepressant users, but also may be due to a longer duration of use. We aimed to assess the prevalence, incidence and average duration of selective serotonin reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) use in the Netherlands during 1992–2001. In addition, we assessed the incidence of long-term use of SSRIs and identified possible determinants of long-term use.Methods We assessed prevalence (number of current users of an antidepressant per 1000 persons assessed on a single day) and incidence (number of new users per 1000 persons per year) of antidepressant use for each year in the PHARMO record linkage system. Long-term use was defined as the consecutive use of any antidepressant for at least 12 months. Relative risks and hazard ratios were calculated and adjusted for possible determinants using Poisson and Cox regression analyses.Results Both prevalent and incident use of SSRIs increased during 1992–2001, while TCA use remained stable. A total of 9857 patients using SSRIs were included in a follow-up study. During the follow-up period, more patients became long-term users, either directly after the start of the initial SSRI or anytime during follow-up (29.5%). The average number of days before start of long-term use decreased from 595 days in 1991 to 19 days in 1997. Female patients, older age, previous use of benzodiazepines and being treated by a psychiatrist increased the probability of becoming a long-term user.Conclusion Both prevalent and incident use of SSRIs increased during the 1990s, implicating an increased number of patients starting SSRIs, but also a longer duration of use of antidepressant therapy. Over the entire follow-up period, almost 30% of the patients became long-term users at anytime during the follow-up period.     

医院感染现患率调查

目的 分析医院感染现患率与科室、病种及其他相关因素之间的关系，以了解医院感染现患率和回顾性调查感染率的差别。方法 采用床旁调查和查阅住院病历相结合的方法，填写个案查表。结果 本院医院感染现患率7．24％，较回顾性调查率5．67％高。结论 现患率调查省时、省力，结果更准确。     

脑卒中发病与环境因素的相关性分析

目的:分析脑卒中发病与环境因素的关系,提出预防脑卒中的建议和方案。方法:选用2012年"高教社"杯全国大学生数学建模竞赛C题的数据,数据来源于中国某城市各家医院2007年1月²010年12月的脑卒中发病病例信息以及相应期间当地的逐日气象资料。用Excel和SPSS9.1软件统计发病人群在不同性别、年龄、职业的分布情况,建立广义线性混合模型,用SAS 9.2版本中的glimmix过程做广义线性混合模型分析。结果:统计分析发现,20072010年12月的脑卒中发病病例信息以及相应期间当地的逐日气象资料。用Excel和SPSS9.1软件统计发病人群在不同性别、年龄、职业的分布情况,建立广义线性混合模型,用SAS 9.2版本中的glimmix过程做广义线性混合模型分析。结果:统计分析发现,2007²010年间该地区脑卒中发病男女比值平均为1.173,发病人群年龄呈偏态分布,发病人群职业集中在农民、退休人员及工人。另外,统计分析结果还表明平均气压与发病数呈正相关(P<0.05),平均气温与发病数呈负相关(P<0.05),平均湿度与发病数呈负相关(P<0.05)。结论:冬季气压偏高、温度低、空气干燥是脑中卒的发病高峰期,所以冬季高血压等疾病患者应积极采取预防措施。同时,医疗卫生部门应加强疾病的宣传与治疗,降低脑卒中发病率、致残率、死亡率。     

Complications of regional anaesthesia Incidence and prevention.

The complications of failure, neural injury and local anaesthetic toxicity are common to all regional anaesthesia techniques, and individual techniques are associated with specific complications. All potential candidates for regional anaesthesia should be thoroughly evaluated and informed of potential complications. If there is significant risk of injury, then these techniques should be avoided. Central neural blockade (CNB) still accounts for more than 70% of regional anaesthesia procedures. Permanent neurological injury is rare (0.02 to 0.07%); however, transient injuries do occur and are more common (0.01 to 0.8%). Pain on injection and paraesthesiae while performing regional anaesthesia are danger signals of potential injury and must not be ignored. The incidence of systemic toxicity to local anaesthetics has significantly reduced in the past 30 years, from 0.2 to 0.01%. Peripheral nerve blocks are associated with the highest incidence of systemic toxicity (7.5 per 10000) and the lowest incidence of serious neural injury (1.9 per 10000). Intravenous regional anaesthesia is one of the safest and most reliable forms of regional anaesthesia for short procedures on the upper extremity. Brachial plexus anaesthesia is one of the most challenging procedures. Axillary blocks are performed most frequently and are safer than supraclavicular approaches. Ophthalmic surgery is particularly suited to regional anaesthesia. Serious risks include retrobulbar haemorrhage, brain stem anaesthesia and globe perforation, but are uncommon with skilled practitioners. Postdural puncture headache remains a common complication of epidural and spinal anaesthesia; however, the incidence has decreased significantly in the past 2 to 3 decades from 37 to approximately 1%, largely because of advances in needle design. Backache is frequently linked with CNB; however, other causes should also be considered. Duration of surgery, irrespective of the anaesthetic technique, seems to be the most important factor. The syndrome of transient neurological symptoms is a form of backache that is associated with patient position and use of lidocaine (lignocaine). Disturbances of micturition are a common accompaniment of CNB, especially in elderly males. Hypotension is the most common cardiovascular disturbance associated with CNB. Severe bradycardia and even cardiac arrest have been reported in healthy patients following neuraxial anaesthesia, with a reported incidence of cardiac arrest of 6.4 per 10 000 associated with spinal anaesthesia. Prompt diagnosis, immediate cardiopulmonary resuscitation and aggressive vasopressor therapy with epinephrine (adrenaline) are required. New complications of regional anaesthesia emerge occasionally, e.g. cauda equina syndrome with chloroprocaine, microspinal catheters and 5% hyperbaric lidocaine, and epidural haematoma formation in association with low molecular weight heparin. Even so, after 100 years of experience, most discerning physicians appreciate the benefits of regional anaesthesia.     

Modulation of the Incidence of Murine Leukemia and Lymphoma

Abstract

Globally, oral cancer is one of the ten common cancers. In some parts of the world, including the Indian subcontinent, oral cancer is a major cancer problem. Tobacco use is the most important risk factor for oral cancer. The most common form of tobacco use, cigarette smoking, demonstrates a very high relative risk — in a recent cohort study (CPS II), even higher than lung cancer. In areas where tobacco is used in a smokeless form, oral cancer incidence is generally high. In the West, especially in the U.S. and Scandinavia, smokeless tobacco use consists of oral use of snuff. In Central, South, and Southeast Asia smokeless tobacco use encompassesnass, naswar, khaini, mawa, mishri, gudakhu, and betel quid. In India tobacco is smoked in many ways; the most common isbidi, others beingchutta, including reverse smoking,hooka, and clay pipe. A voluminous body of research data implicating most of these forms of tobacco use emanates from the Indian subcontinent. These studies encompass case and case-series reports, and case-control, cohort, and intervention studies. Collectively, the evidence fulfills the epidemiological criteria of causality: strength, consistency, temporality, and coherence. The biological plausibility is provided by the identification of several carcinogens in tobacco, the most abundant and strongest being tobacco-specificN-nitrosamines such asN-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). These are formed byN-nitrosation of nicotine, the major alkaloid responsible for addiction to tobacco. The etiological relationship between tobacco use and oral cancer has provided us with a comprehensive model for understanding carcinogenesis.     

社区感染和院内感染发生率的调查分析

目的：分析我院社区感染、院内感染的发生率和死亡率。方法：对自1998年7月1日至1999年6月30日呼吸科和泌尿外科病房的738例住院病例进行统计分析。结果：社区获得性感染共计264例，发生率为35．8％，院内获得性感染共计34例，发生率为4．6％。社区获得性感染中有13例死亡，死亡率为4．9％，院内获得性感染中有2例死亡，死亡率为5．9％。结论：我院院内获得性感染发生率不高，院内获得性感染的死亡率高于社区获得性感染。     

产前护理干预对产后抑郁的影响

目的研究产前护理干预对产后抑郁发生率的影响。方法将180例产前检查的孕妇随机分为观察组（90例）和对照组（90例）,对照组对孕妇进行常规孕期教育;观察组在接受常规孕期教育的基础上进行全方位的整体健康教育,利用孕妇学校等对孕妇及家属进行产前健康教育,帮助其树立正确的生育观,针对存在的健康问题制定教育措施,有针对性的进行心理疏导和行为干预。分别于产后42天采用产后抑郁量表（EPDS）对两组进行调查。结果产后42d,研究组产后抑郁发生率为5.7%,对照组为18.6%,研究组产后抑郁发生率明显低于对照组（χ2=11.96,P〈0.005）。结论产前护理干预能有效预防产后抑郁的发生。