育龄妇女接种麻疹疫苗对婴儿麻疹抗体及麻疹疫苗接种的影响

目的：研究育龄妇女接种麻疹疫苗后所生婴儿的胎传麻疹抗体的动态变化,并了解其对婴儿接种麻疹疫苗的影响。方法：选择2012年1月1日至2012年12月31日300位育龄妇女纳入本研究,检测麻疹IgG抗体后进行随机对照试验（RCT）,设立高抗体无疫苗接种组（I组,52例）、高抗体疫苗接种组（II组,53例）、低抗体无疫苗接种组（III组,98例）和低抗体疫苗接种组（IV组,97例）。I组和III组不接种疫苗,II组和IV组接种麻腮风联合减毒活疫苗,各组均于待产时检测麻疹IgG抗体。检测育龄妇女所生婴儿出生时、8月龄大时、接种麻疹疫苗后半个月和接种麻疹疫苗后3个月血麻疹IgG抗体,于接种麻疹疫苗后半个月同时检测麻疹IgM抗体。分析育龄妇女待产时麻疹IgG抗体水平与婴儿出生时IgG抗体水平的相关性,分析婴儿麻疹IgG抗体的动态变化及IgM抗体的情况。结果：对育龄妇女待产时麻疹IgG抗体水平与新生儿脐带血麻疹IgG抗体水平进行pearson相关分析,显示相关系数为0.85,P=0.00,提示存在相关性。重复测量方法分析结果显示,I组和II组、III组和IV组之间婴儿麻疹IgG抗体变化差均异有统计学意义（均P=0.00）,而I组和III组、II组和IV组之间差异无统计学意义（分别为P=0.11和P=0.45）。接种后3个月各组间比较,F=1.36,P= 0.26,提示各组间此时间点上差异无统计学意义。婴儿IgG抗体趋势图显示,婴儿的胎传麻疹抗体水平随时间逐步减少,在接种麻疹疫苗3个月时又明显升高。I～IV组婴儿麻疹IgM抗体样本/临床值比值（S/CO值）经单因素方差分析,F=0.95,P=0.42,提示各组间差异无统计学意义。结论：育龄妇女接种麻疹疫苗可提高所生婴儿胎传麻疹抗体水平,使婴儿在接种麻疹疫苗前获得足够的保护性抗体,也不会影响婴儿接种麻疹疫苗的效果。     

Seroconversion after administration of measles vaccine to central Australian Aboriginal children at nine months of age

A simple procedure for examining the seroconversion rates to measles vaccines in outlying communities is described; this involves the storage and transportation of dried-blood samples on filter paper, which is followed by the detection of measles-specific antibodies by means of a commercially-available immunofluorescence assay. Among 82 susceptible central Australian Aboriginal infants who were vaccinated at nine months of age, 76 (93% [95% confidence limits, 84.9%-96.6%]) children demonstrated seroconversion as a result of the vaccine, which is a figure that is similar to those that have been reported from some developing countries. The implications for a measles-vaccination policy are discussed.     

Optimal age for measles and mumps vaccination in Australia

Trivalent measles-mumps-rubella vaccine has recently replaced measles-mumps vaccine in Australia and is recommended as a single dose at the age of 12 to 15 months, with the exception of Aboriginal children in central Australia who are vaccinated at 9 months. The timing of measles vaccination has been controversial not only in Australia but also in the United States, where measles outbreaks continue to occur. This study aimed to determine seroconversion rates for measles-mumps vaccine in children aged 12 to 18 months and to make a recommendation for the timing of vaccination based on seroconversion rates and attack rates. The parents of 425 children aged 12 to 18 months gave consent for their children to have serum collected at the time of measles-mumps vaccination and three months later. The mean age at vaccination of the children who had two serum samples for measles and mumps antibody estimations was 13.9 months (mode, 13.1). The seroconversion rate for measles was 95% (314/329) (95% confidence interval (CI), 92.5% to 97.3%) and for mumps 97% (309/320) (95% CI, 93.8% to 98.1%). There were no statistically significant differences in the rates of seroconversion for measles or mumps related to age in months at the time of vaccination or in post-vaccination measles antibody titres related to age at vaccination. Post-vaccination mumps antibody titres tended to be lower in older vaccinees. None of the children who presented for vaccination had serological evidence of prior measles infection but five had evidence suggestive of prior mumps. As the seroconversion rates for measles and mumps vaccines were very high in these children it was concluded that no advantage resulted from delaying vaccination until 15 months and that the current National Health and Medical Research Council recommendations for vaccination at age 12 to 15 months should remain.     

8月龄婴儿抗体水平对麻疹疫苗接种效果影响

目的 了解0~8月龄婴儿麻疹胎传抗体的消减状况,评价8月龄婴儿的抗体水平对麻疹疫苗接种效果的影响,为制定麻疹的免疫策略和防控措施提供科学依据。 方法 采用随机抽样方法,抽取2017年4月至6月在亳州人民医院就诊的2周岁以内婴幼儿作为调查对象,进行问卷调查并采集婴幼儿外周静脉血分离血清,采用酶联免疫吸附法 (enzyme-linked immunosorbent assay, ELISA) 检测麻疹病毒抗体IgG。 结果 共调查2周岁以内婴幼儿288名,其中159名婴儿未接种过麻疹疫苗,79名婴幼儿接种过一剂次麻疹疫苗,50名婴幼儿接种过两剂次麻疹疫苗。对于未接种过麻疹疫苗的婴儿,0月龄婴儿麻疹抗体阳性率为100.00％,8月龄抗体阳性率为9.52％,随着月龄的增长而降低,差异有统计学意义（P<0.001）;出生年份早于1991年和出生年份在1991年及以后的母亲所生婴儿的麻疹抗体阳性率分别为22.64%和49.06%,差异有统计学意义（P<0.05）;对于接种过一剂次含麻疹成分疫苗（MCV1）的婴幼儿,≥9月龄和8月龄接种MCV1的婴幼儿的麻疹IgG 抗体几何平均浓度（GMC）分别为1 558.22 IU/L和1 133.05 IU/L,差异有统计学意义(P<0.05);出生年份早于1991年和出生年份在1991年及以后的母亲所生婴幼儿接种MCV1后的麻疹抗体GMC分别为 1 410.06 IU/L和999.29 IU/L,差异有统计学意义( P<0.01)。对于接种过两剂次含麻疹成分疫苗（MCV2）的婴幼儿,婴幼儿接种MCV2后的麻疹抗体GMC与性别、地区、首剂接种时间及母亲出生年份等因素均没有关系,差异无统计学意义。 结论 9.52%的8月龄婴儿的麻疹抗体仍为阳性,婴儿体内胎传抗体的存在会影响麻疹疫苗的初次接种的效果,但这种影响会在第二剂次麻疹疫苗接种后被消除。     

8月龄内婴儿麻疹控制方法探讨

目的探讨降低8月龄内婴儿麻疹发病率的方法.方法对2001年1月-2005年8月我院收治的102例8月龄内麻疹患者进行回顾性分析.结果期间收治的麻疹病例共382例,其中小于8月龄102例,占相当比例26.7%.102例中,22例为流动人口,80例为本地居民,占本年龄段的21.6%.结论将婴儿的初免年龄提前至6月龄并对婚前育龄妇女进行麻疹疫苗复种,关注流动人口的麻防工作,是减少8月龄内婴儿麻疹的有效方法.     

中山市小于8月龄婴儿麻疹发病状况分析

目的为制定麻疹免疫程序和消除麻疹控制策略提供依据。方法对2005-2006年中山市报告≤8月龄婴儿麻疹病例及母婴共患麻疹病例进行描述流行病学分析。结果中山市≤8月龄婴儿麻疹发病所占比例从2001年的2．86％逐年上升至2006年的13．01％；2005-2006年报告母婴共患麻疹4例，母亲年龄为25-29岁，本地及流动人口各有2例；婴儿最早发病为出生36h。结论控制小月龄婴儿麻疹关键是控制成人麻疹，建议对婚检育龄妇女进行麻疹疫苗接种。     

45例8个月以内婴儿麻疹临床特点

目的分析2004～2009年东莞市45例8个月以内住院的婴儿麻疹病例进行临床特征。方法分析45例8月龄以下婴儿麻疹病例进行流行病学特征、临床特点。结果 45例病例均经麻疹IgM抗体检测阳性而确诊,患儿均是外来流动人口子女,以6～8月婴儿为主,占60%;1~6月发病者占77.8%;临床表现以中高热为主,占88.9%,发热后第2～3d出疹者,占73.3%,有合并肺炎者占33.7%,腹泻者占20%,绝大部分白细胞计数正常。结论随着儿童麻疹疫苗预防接种工作的加强,麻疹发病有向8月龄以下婴儿发展趋势,在婴儿出现发热伴出疹就诊时应作麻疹IgM抗体检测,提高易感人群麻疹疫苗接种率是降低婴儿麻疹发病率的有效措施。     

Prevalence and determinants of burnout syndrome and depression among medical students at Qassim University,Saudi Arabia

Objectives:To investigate the prevalence and determinants of burnout syndrome and depression among medical students at Unaizah College of Medicine (UCM), Qassim University, Qassim, Kingdom of Saudi Arabia (KSA).Methods:A cross-sectional study of all Saudi medical students studying at UCM, Qassim University, Al Qassim, KSA, between February to March 2020.Results:Of the total 305 students sampled, 153 (50.2%) fit the category of depression. Concerning burnout, only 5.6% of the total population met the Maslach Burnout Inventory diagnostic criteria for burnout, with those determined to have burnout having ranked high on the emotional exhaustion and cynicism subscales, and low on the academic efficacy subscale. Male was strongly associated with burnout, while female gender and raising children were strongly associated with the presence of depression. Emotional exhaustion and high cynicism as determinants of burnout elevate the risk of depression.Conclusion:Our results highlight the high rate of depression and burnout, as well as the need for psychological intervention programs at medical schools to prevent the deterioration of student’s mental health that has been associated with advancement in medical school.     

Assessment of quality of life in Saudi patients with vitiligo in a medical school in Qassim province, Saudi Arabia

OBJECTIVE: To determine the quality of life in Saudi patients with vitiligo and to detect the variables that could influence it by using the Dermatology Life Quality Index (DLQI). METHODS: One hundred and nine Saudi vitiligo patients were recruited from Qassim Medical College clinics between November 2004 and September 2006. We included 61 males, 48 females with an age range of 18 to 47 years, and a mean of 26.94 (SD +/- 9.73) years. Quality of life was evaluated using DLQI questionnaire and related to variables as age, gender, marital status, and extent of cutaneous involvement. RESULTS: Family history of vitiligo in first degree relatives was positive in 27.5%. The mean DLQI for all cases was 14.72 (SD +/-5.173) that showed no statistical difference between males and females. Patients on light therapy and with generalized vitiligo had significantly higher DLQI scores than patients on topical treatments and localized cutaneous involvement. Women are more embarrassed and self-conscious on the disease with more impairment of their social life, personal relationships, sexual activities, and more influenced in their choice of clothing than men. CONCLUSION: Vitiligo is associated with severe impairment of quality of life among Saudi patients. Dermatologists should pay careful attention to the psychosocial impact of vitiligo in the patients' life. Involvement of psychologist and even psychiatrist should be an essential part in the management of these cases.     

深圳市宝安区适龄儿童麻疹疫苗初免成功率监测

目的　评价麻疹疫苗免疫效果 ,为修订麻疹疫苗免疫规划策略提供参考依据。　方法　分别取 8月龄儿童在接种麻疹疫苗前和完成基础免疫后 1个月的血清标本各 79份 ,用酶联免疫吸咐法检测麻疹IgG抗体 ,抗体滴度≥ 1:2 0 0判断为阳性。　结果　 79份标本 ,免疫前阳性率为 1 2 7% (1 79) ,免疫后阳性率为 77 2 2 % (61 77) ,免疫成功率为 75 95 %。　结论　免疫前后麻疹抗体阳性率差异有显著意义 (x2 =95 0 ,P <0 0 5 ) ,但检测结果未达到规定的免疫成功率考核标准 (85 % )。原因可能与疫苗本身滴度、疫苗的使用和个体因素等有关     

Phosphate binders usage,patients knowledge,and adherence: A cross-sectional study in 4 centers at Qassim,Saudi Arabia

Objectives:To assess phosphate binders’ usage, knowledge regarding their utilization, and adherence among hemodialysis patients in Qassim, Saudi Arabia.Methods:A prospective cross-sectional study conducted at 4 dialysis centers in Qassim, Saudi Arabia with inclusion of 237 patients’ undergoing hemodialysis between November 2018 to January 2019. The study involved interviewing the patients, reviewing their medical records for biomarkers used to assess kidney function, and assessing the patients’ knowledge-based regarding dietary phosphate control, as well as adherence to phosphate binders’ usage.Results:Out of 237 included patients, male to female ratio was 54:46. The prevalence of prescribing non-calcium phosphate binders was 82.7% whereas prescribing calcium phosphate binders was 73.8%. A total of 63% of patients showed a medium level of adherence to phosphate binders. Although adherence level was not poor, therapeutic efficacy was affected by other factors such as administration time adherence positively correlated with the serum phosphate level (p=0.00).Conclusion:Phosphate binders usage is frequent among hemodialysis patients in Qassim centers. Circulating phosphate level was affected by the extent of patients’ knowledge of dietary control and adherence to the usage of phosphate binders. Thus, we recommend enhancing patient education in reference to high- and low- phosphate-rich diet to take wise dietary decisions, lower pill burden, and improve adherence toward the control of hyperphosphatemia     

5162例社区12月龄婴儿智力发育筛查及影响因素分析

目的 探讨与社区12月龄婴儿智力发育水平有关的影响因素,为早期干预提供理论依据。 方法 采用整群抽样的方式抽取于2011年1月至2014年12月期间出生、在上海市静安区妇幼保健所和所辖5家街道社区卫生服务中心儿童保健门诊接受过儿童保健检查且检查记录完整的5162例12月龄婴儿为研究对象。采用上海市Denver Ⅱ发育筛查量表对所有研究对象进行智力发育筛查,通过单因素和多因素Logistics回归模型分析影响12月龄婴儿智力发育的影响因素。结果 本研究的5162例婴儿发育筛查未通过率(可疑和异常)达3.5%,多因素逐步Logistic回归分析显示: 婴儿12月龄时肥胖(OR=1.50,95%CI: 1.13～1.85)、超重(OR=1.38,95%CI: 1.11～1.90)、消瘦(OR=2.36,95%CI: 1.48～3.89);出生早产合并低出生体质量(OR=2.47,95%CI: 1.61～3.80)、巨大儿(OR=1.99,95%CI: 1.25～3.18)、出生窒息(OR=3.25,5%CI: 2.82～5.22)是婴儿智力发育筛查未通过的危险因素。 结论 社区12月龄婴儿早期智力发育水平主要与婴儿营养状况和出生高危因素有关,应采取针对性的早期干预措施预防婴儿智力发育障碍。