丹东国境口岸朝鲜劳务人群肺结核监测分析

目的 防止活动性肺结核在国际间的传播,为丹东地方经济发展提供安全卫生口岸环境.方法 对2012-2014年朝鲜来丹东劳务人员进行临床体检、流行病学调查等方法确定的肺结核患者,并对调查结果进行统计学分析.进行胸部X线检查,并运用BACTEC MGITTM 960系统对胸部X线异常者进行痰涂片和痰培养检查.结果 丹东国际旅行卫生保健中心进行体检的朝鲜劳务人员共9 500人,共检出肺结核患者33例,其中男性11例,女性22例,检出率为0.35％.结论 朝鲜劳务人员肺结核流行情况严重,应加大丹东地区肺结核病防治工作力度,并采取相应措施加强朝鲜劳务人员肺结核的监测和口岸肺结核监管.     

龙口口岸出入境人员肺结核检测结果分析

〔目的〕了解和掌握出入境人员这一特殊人群中肺结核病的流行情况,有效地防止肺结核在国际间的传播,进一步有针对性的开展肺结核的防治工作。〔方法〕采用X射线检查,并结合临床症状,询问病史及做痰涂片检查,对2001￣2005年龙口口岸的5756名出入境人员进行了活动性肺结核的监测。〔结果〕共检出活动性肺结核29例,其中,男性检出28例,女性检出1例。检出率随年龄的增长呈上升的趋势,其中50￣59岁年龄组检出率最高。经过痰涂片检查,29例肺结核患者中,阳性5例。〔结论〕出入境人员的流动性很大,应加强这一人群的结核病监测工作。特别是在日常工作中应通过多种途径,加强预防肺结核病知识的宣传和教育,认真做好疾病监测工作,有效地防止传染病在国际间的传播。     

2012-2015年辉县市涂阳肺结核密切接触者筛查报告分析

目的了解全市2012-2015年四年来涂阳肺结核密切接触者检查出活动性肺结核的检出率以及有关影响因素。方法对涂阳病人的密切接触者筛查,采用PPD试验、胸部X线检查、痰涂片检查和痰培养检查。结果我市涂阳肺结核密切接触者中活动性肺结核的检出率是3.54%,其中涂阳肺结核的检出率是1.23%,60岁年龄组活动性肺结核检出率高于其他年龄组,经统计学处理,差异有统计学意义(P0.05);排菌量3+的病人与排菌量2+的病人密切接触者活动性肺结核检出率差异有统计学意义(P0.05)。结论涂阳肺结核密切接触者筛查是早期发现活动性肺结核的有效手段。     

赴新加坡劳务人员胸部X线检查结果分析

〔目的〕对赴新加坡劳务人员的胸部X线检查做出较为正确地诊断,及时发现胸部患病者,以避免劳务人员出国后因健康原因被退回事件的发生〔。方法〕采用日本岛津RS50A诊断X线机,相对固定投照焦点距离、电压范围和mAS值范围,对715名出国劳务人员作胸部X线检查。〔结果〕检出胸部异常者77例,检出率为10.77%。其中疑似肺结核检出率为1.67%;陈旧性病灶性质检出率为9.09%;男性检出率为10.27%,女性检出率为12.17%,女性检出率略高于男性。在胸部异常者中,40~49岁年龄组所占比例最大,占异常者总数的50.65%;男性占70.13%,女性占29.87%;从职业上看,胸部异常者中97.40%为农民。〔结论〕检查结果显示,在正常人群中肺结核和胸部其它疾病的发病率是很高的,出国劳务人员中的农民工更为突出,加强对出国劳务人员胸部X线检查,及早发现胸部疾病,保护劳人员身体健康的有效方法。     

2001年度赴美移民活动性肺结核检出结果分析

[目的]了解活动性肺结核在赴美移民中的流行情况,防止结核病传人国外.[方法]采用X射线检查结合询问病史及痰涂片检查,对2001年9376名赴美移民进行了活动性肺结核的检查.[结果]共检出活动性肺结核患者49例,总检出率为522／10万;男性检出率为815／10万;女性检出率为300／10万;男女性别比为2.721.检出率随年龄的增长而上升,70岁以上年龄组检出率最高,达1263／10万,男性高达2192／10万.活动性肺结核患者以广东省人员为主,占总病例数的75.51％,其中广州市人占30.61％,境外人员未检出.经痰涂片检查,49例患者中,阳性8例,涂阳率16.67％.[结论]老年人肺结核患病率高,而且排痰和耐药情况严重,应引起高度重视;提高活动性肺结核的检出率,应将X射线检查与痰涂片检查以及询问病史、体征结合起来.     

2006—2008年某高校新生体检肺结核检查结果分析

目的了解某高校新生在健康体检中无症状肺结核的检出情况,为及早发现和治疗肺结核提供依据。方法对6 814名新生进行健康体检,以X线胸透检出肺结核改变作为无症状肺结核的初筛判断,对阳性检出者再行X线胸部摄片和痰涂片检查以确诊。结果 X线胸透检出39人有肺结核改变(呈片状影、结节状影或条索状影),总检出率为5.72‰。进一步做X线胸部摄片和痰涂片检查,确诊痰涂片阳性肺结核男生14人、女生9人,痰涂片阳性率为3.38‰。性别分布:肺结核检出率男生为9.09‰,女生为3.12‰,男生高于女生,差异有统计学意义(P<0.01)。结论该校新生无症状肺结核检出率和痰涂片阳性率均高于全国调查结果。在高校新生体检中,结合X线胸透、X线胸部摄片和痰涂片检查有助于及早发现无症状肺结核。     

11579名赴美移民的肺结核检出情况及防治对策

采用常规胸部X线摄片和痰涂片检查的方法,并按照<赴美签证申请人体检指导>中有关肺结核的分级标准对11579名赴美移民进行肺部结核病的检查.发现肺结核表现共1269例,总检出率10.96%,其中检出活动性肺结核52例(A级--渗出性肺结核9例,B1级一渗出性肺结核并部分增殖43例),检出率0.45%;非活动性肺结核B2级(纤维化表现)和B3级(钙化)的检出率分别为2.22%和8.29%.痰涂片检查52例,阳性9例,涂阳率17.31%.对9例涂阳者进行短程化疗,6个月后复查,痰涂阴转率88.89%.本文就如何防止结核病通过移民传播,提出了具体防治对策.     

福建省出国移民活动性肺结核检出情况的分析

〔目的〕加强对出国移民的活动性肺结核监测和控制,严把国门,防止结核病在国际间传播。〔方法〕对2003～2005年49141名福建省出国移民进行胸部X射线检查和痰培养。〔结果〕对49141名出国移民的检查中,共发现182例活动性肺结核,其中男性86例,占病例总数的47.25%;女性96例,占病例总数的52.75%,人群总检出率为0.37%,其中男性为0.38%;女性为0.36%。〔结论〕结核病是我国常见的传染病之一,为防止结核病在国际间传播,应重视对出国移民的胸部X射线检查,加强活动性肺结核的监测和卫生控制,严把国门。     

2007—2011年莱芜市涂阳肺结核患者密切接触者筛查情况分析

目的了解对涂阳肺结核患者密切接触者进行筛查的意义。方法对莱芜市2007—2011年间登记的2 487例涂阳患者密切接触者,均进行痰涂片(夜间痰、晨痰和即时痰)检查和X线胸部拍片检查,对年龄≤15岁者进行PPD试验。结果 2 487例密切接触者发现活动性肺结核19例,检出率0.764%。密切接触者中患活动性肺结核的几率与所接触的涂阳患者的排菌量呈正相关关系。结论对涂阳患者密切接触者进行痰涂片和X线胸片检查,有助于肺结核患者的发现,对此人群开展结核病预防工作具有重要意义。     

涂阳肺结核病人家庭密切接触者检查情况分析

目的调查涂阳肺阳结核病人家庭密切接触者中活动性肺结核患病检出情况。方法接受检查的家庭密切接触者1 236人,年龄0~14岁儿童进行PPD(结核菌素纯蛋白衍化物)试验,≥15岁人群摄X线胸片,对X线胸片提示肺部有异常阴影者进行痰涂片和痰培养检查。结果涂阳肺结核病人家庭密切接触者中活动性肺结核病人检出率为3.0%,涂阳肺结核检出率为0.6%。肺部病灶有空洞和排菌量大的病人其家庭密切接触者活动性肺结核检出率较高。家庭密切接触者中年龄>60岁组活动性肺结核检出率高于15~60岁组结论对涂阳肺结核病人家庭密切接触者进行活动性肺结核筛查,能早期发现高危人群中的活动性肺结核。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.