Prenatal exposure to parents' smoking and childhood cancer.

The relation between parents' tobacco smoking prior to birth and cancer in the offspring was investigated with the use of data from a case-control study. Incident cases included all children (aged 0-14 years) diagnosed in Denver, Colorado from 1976 to 1983. Controls were selected through random digit dialing, and matched to cases on age, sex, and geographic area. Information on smoking by parents and other household members was obtained by personal interview for 223 cases and 196 controls. After adjustment for father's education, mother's smoking during the first trimester of pregnancy was associated with an increased risk for all cancers combined (odds ratio (OR) = 1.3, 95% confidence interval (CI) 0.7-2.1), acute lymphocytic leukemia (OR = 1.9, 95% CI 0.9-4.1), and lymphomas (OR = 2.3, 95% CI 0.8-7.1). Adjusting for father's education, associations with father's smoking in the absence of mother's smoking were found for all cancers combined (OR = 1.2, 95% CI 0.8-2.1), acute lymphocytic leukemia (OR = 1.4, 95% CI 0.6-3.1), lymphomas (OR = 1.6, 95% 0.5-5.4), and brain cancer (OR = 1.6, 95% CI 0.7-3.5). In spite of imprecision resulting from small numbers of cases in diagnostic subgroups, these results are suggestive of a possible influence of parents' smoking on childhood cancer.     

Incidence of acute leukemias, lymphomas and thyroid cancers in children under 15 years, living around the Marcoule nuclear site from 1985 to 1995]

BACKGROUND: The aim of this investigation was to report incidence of childhood leukemia, lymphoma and thyroid neoplasms in children under 15 years of age living in the vicinity of the French Marcoule nuclear reprocessing plant. METHODS: This exhaustive and retrospective survey was carried out between 1985 and 1995 in children aged under 14 at the time of diagnosis and living inside a 35 kilometer zone around the nuclear site. 656 practitioners, 109 medical analysis laboratories and 5 hospitals or cancer institutes were investigated. A panel of experts checked each case. RESULTS: 48 cases of acute leukemia (39 acute lymphoid leukemia and 9 acute myeloid leukemia), 15 cases of lymphoma (8 Hodgkin lymphomas--53%--and 7 non hodgkinian lymphomas including 5 Burkitt lymphomas), 1 case of chronic myeloid leukemia and 1 case of papillary thyroid cancer, appeared among the 1,116,442 children-years followed. The total incidences of leukemias and lymphomas were respectively 4.12 and 1.29.10(-5). Standardised Incidence Ratios, calculated according to Poisson methods and bayesian inference, with various reference rates did not show any excess of risk: 100.67 (95% confidence interval 72-131) for leukemia. Children under 5 years old and living in non exposed areas to dominant winds or downstream rhodanian water drawing presented a 3 or 4 fold decreased risk of leukemia than others (the latter still having an identical risk to that of the general population). This was not true for lymphomas, nor for the other age groups. CONCLUSION: Over the entire zone, children do not have an increased risk of malignant hematology disease but health monitoring by a systematic collection of cases remains useful around Marcoule. The assumption of aquiferous or air contamination thus still remains questionable: further studies investigating models of contamination are needed to take into account all other nonionizing leucemogenic factors (benzene and viral injection in particular) or correlation studies between health indicators and dosimetry.     

Case-control study of childhood cancer and exposure to 60-Hz magnetic fields

Concern with health effects of extremely low frequency magnetic fields has been raised by epidemiologic studies of childhood cancer in relation to proximity to electric power distribution lines. This case-control study was designed to assess the relation between residential exposure to magnetic fields and the development of childhood cancer. Eligible cases consisted of all 356 residents of the five-county 1970 Denver, Colorado Standard Metropolitan Statistical Area aged 0-14 years who were diagnosed with any form of cancer between 1976 and 1983. Controls were selected by random digit dialing to approximate the case distribution by age, sex, and telephone exchange area. Exposure was characterized through in-home electric and magnetic field measurements under low and high power use conditions and wire configuration codes, a surrogate measure of long-term magnetic field levels. Measured magnetic fields under low power use conditions had a modest association with cancer incidence; a cutoff score of 2.0 milligauss resulted in an odds ratio of 1.4 (95% confidence interval (CI) = 0.6-2.9) for total cancers and somewhat larger odds ratios (ORs) for leukemias (OR = 1.9), lymphomas (OR = 2.2), and soft tissue sarcomas (OR = 3.3). Neither magnetic fields (OR = 1.0) nor electric fields (OR = 0.9) under high power use conditions were related to total cancers. Wire codes associated with higher magnetic fields were more common among case than control homes. The odds ratio to contrast very high and high to very low, low, and buried wire codes was 1.5 (95% CI = 1.0-2.3) for total cases, with consistency across cancer subgroups except for brain cancer (OR = 2.0) and lymphomas (OR = 0.8). Contrasts of very high to buried wire code homes produced larger, less precise odds ratios of 2.3 for total cases, 2.9 for leukemias, and 3.3 for lymphomas. Adjusted estimates for measured fields and wire codes did not differ from crude results, indicating an absence of confounding. Limitations to the study are nonresponse (especially for field measurements), differential mobility of cases and controls, and a presumably nondifferential exposure misclassification from the use of imperfect surrogates for long-term magnetic field exposure history. In spite of these concerns, the results encourage further examination of the carcinogenic potential from this form of nonionizing radiation.     

Incidence of childhood cancer in Ho Chi Minh City, Vietnam, 1995-97

Incidence rates of childhood cancer for the city of Ho Chi Minh are presented for the first time. For the 3-year period 1995-97, a total of 302 cancer cases were registered in children under 15 years of age, with a male to female ratio of 1.1. The overall crude rate was 78.8 and the age-standardised incidence rate was 88.4 per million person-years, which was low in comparison with other countries in eastern Asia and with the predominantly white population of Australia. Leukaemia (principally acute lymphocytic), brain tumours and lymphomas were the most common childhood neoplasms, which is consistent with the pattern observed in other registries of the region. The rate of retinoblastoma was higher than in the other regional registries. On the other hand, no cases of hepatocellular carcinoma were registered.     

Cancer risk and parental pesticide application in children of Agricultural Health Study participants

Parental exposure to pesticides may contribute to childhood cancer risk. Through the Agricultural Health Study, a prospective study of pesticide applicators in Iowa and North Carolina, we examined childhood cancer risk and associations with parental pesticide application. Identifying information for 17,357 children of Iowa pesticide applicators was provided by parents via questionnaires (1993-1997) and matched against the Iowa Cancer Registry. Fifty incident childhood cancers were identified (1975-1998). Risk of all childhood cancers combined was increased [standardized incidence ratio (SIR) = 1.36; 95% confidence interval (CI), 1.03-1.79]. Risk of all lymphomas combined was also increased (SIR = 2.18; 95% CI, 1.13-4.19), as was risk of Hodgkin's lymphoma (SIR = 2.56; 95% CI, 1.06-6.14). We used logistic regression to explore associations between self-reported parental pesticide application practices and childhood cancer risk. No association was detected between frequency of parental pesticide application and childhood cancer risk. An increased risk of cancer was detected among children whose fathers did not use chemically resistant gloves [odds ratio (OR) = 1.98; 95% CI, 1.05-3.76] compared with children whose fathers used gloves. Of 16 specific pesticides used by fathers prenatally, ORs were increased for aldrin (OR = 2.66), dichlorvos (OR = 2.06), and ethyl dipropylthiocarbamate (OR = 1.91). However, these results were based on small numbers and not supported by prior biologic evidence. Identification of excess lymphoma risk suggests that farm exposures including pesticides may play a role in the etiology of childhood lymphoma.     

Cancer incidence and risk factors among Montreal residents of Italian origin

Cancer risks associated with Italian ethnicity were investigated using data from a large case-control study on the aetiology of several cancer sites in the male population of Montreal. Two approaches were taken. First, incidence rates were computed for Italians and for others in the Montreal area using our ascertained cases as numerators and census-derived denominators. Secondly, for respondents to the case-control study, an analysis was carried out with Italian ethnicity as the risk factor and a number of covariates as potential confounders. Out of 4553 incident cases in men aged 35-69, 301 were of Italian origin. As compared with other Montreal males, those of Italian origin had higher incidence rates for cancers of the stomach (p = 0.016, based on 31 cases) and of the colon and rectum (p = 0.102, based on 75 cases) and lower rates for cancer of the lung (p = 0.006) and prostate (p = 0.102, based on 24 cases). For other sites the differences between Montrealers of Italian and non-Italian origins were small. Montreal Italians manifested risks similar to those of the country of origin for cancer of the prostate and similar to the host country for cancers of the colon, rectum and liver. For other sites it was difficult to characterize the pattern because of wide variations among Italian registries. Over 80% of the study subjects in Montreal were interviewed and odds ratios (OR) for Italian ethnicity were estimated for each cancer site using all other sites as controls, adjusting for five potential confounders.(ABSTRACT TRUNCATED AT 250 WORDS)     

Childhood cancer survival in Cuba

Reports dealing with childhood cancer population-based survival have not yet been published in Cuba. A survival study including cases reported to the National Cancer Registry in the period 1988–1989 have been accomplished in the National Cancer Registry of Cuba. A comprehensive view of its results in childhood cancer is intended to be shown in this paper. All sites childhood cancer cases aged below 15 years (400) and reported in this period were included derived from a total of 578 incident cases. Vital status of cases was checked-up to December of 1994 by a mixed follow-up. Survival analysis was achieved by the life-table method using the SPSS for Windows software. Relative survival rates were not included because no differences were appreciated with the observed ones. Cases between 0–4 years and females account for the highest frequencies. Leukaemia accounts for 27% of the cases, followed by lymphomas and tumours of the central nervous system. Lymphoid and non-lymphoid acute leukaemia had 41 and 9% 5-year survival rate respectively being the latter comparable with Bangalore, India (10%). For lymphomas, Hodgkin's disease present better prognosis compared with non-Hodgkin lymphoma with 73 and 35% 5-year survival rates, respectively. Figures are comparable to the corresponding to Bangalore, India (72 and 33%, respectively). For time trends survival distribution were compared by period of diagnosis (1982/1988–1989). In all cases differences resulted statistically non-significant with lower rates for 1988–1989 except for lymphomas. International reports show increasing time trends for childhood cancer. Nevertheless, these results may serve as a milestone for future comparisons, corresponding with the creation of the National Program for Childhood Cancer Control and future studies will confirm the success of its measures.     

Body size across the life course, mammographic density, and risk of breast cancer

Adult body mass index (BMI) is inversely associated with premenopausal breast cancer risk, and childhood and adolescent body size is inversely associated with breast cancer risk in pre- and postmenopausal women. Breast density is inversely related to body size and may play a role in the association of body size with breast cancer risk. The authors conducted a nested case-control study including 1,528 cases and 2,844 controls from the Nurses' Health Study (1989-2004) and Nurses' Health Study II (1996-2003). Prior to breast cancer diagnosis, participants reported their body fatness during childhood and adolescence, BMI at age 18 years, and current BMI. Mammographic density was measured by using a computer-assisted thresholding method. The inverse association between adult BMI and premenopausal breast cancer (for BMI ≥30 vs. BMI 20-22.4, odds ratio = 0.64, 95% confidence interval: 0.38, 1.06) (P(trend) = 0.36) became positive after adjustment for mammographic density (odds ratio = 1.28, 95% confidence interval: 0.72, 2.30) (P(trend) = 0.07). Conversely, the inverse association between childhood and adolescent body size and breast cancer risk remained after adjustment for mammographic density. The inverse association between adult BMI and premenopausal breast cancer risk may be partially due to negative confounding by mammographic density. Conversely, mammographic density does not appear to explain the inverse association between childhood and adolescent body fatness and breast cancer risk.     

Childhood cancer incidence and arsenic exposure in drinking water in Nevada

Inorganic arsenic exposure through drinking water causes cancer in adults; however, the carcinogenic potential in children remains unknown. A recent leukemia cluster in Churchill County, Nevada, where arsenic levels in water supplies are relatively high, has prompted concern. The authors investigated the incidence of childhood cancer between 1979 and 1999 in all 17 Nevada counties, grouped by low (i.e., < 10 microg/l), medium (10-25 microg/l), and high (35-90 microg/l) population-weighted arsenic levels in public drinking water supplies. The standardized incidence ratios (SIRs) for all childhood cancers combined were 1.00 (95% confidence interval [CI] = 0.94, 1.06), 0.72 (95% CI = 0.43, 1.12), and 1.25 (95% CI = 0.91, 1.69) for low-, medium-, and high-exposure counties, respectively. There was no relationship between arsenic levels in water and childhood leukemia (SIRs = 1.02, 0.61, and 0.86, respectively [95% CIIs = 0.90, 1.15; 0.12, 1.79; and 0.37, 1.70, respectively]). For all childhood cancers, excluding leukemias, the SIRs were 0.99 (95% CI = 0.92, 1.07), 0.82 (95% CI = 0.42, 1.22), and 1.37 (0.92, 1.83), respectively. The excess in 5- to 9-yr-old children and 10- to 14-yr-old children was in bone cancers, and the excess in 15- to 19-yr-old young adults was primarily in lymphomas. The findings in this study are reassuring in that leukemia risks were not increased at the concentrations of arsenic in water found in this study. Nonetheless, the results raise the possibility that there are increased risks for nonleukemic childhood cancers that require confirmation in other studies, particularly those in which higher exposures are addressed.     

Magnetic field exposure from electric appliances and childhood cancer

The effect on childhood cancer of prolonged exposure to 60-H magnetic fields from electric appliances was examined using interview data from a recently completed case-control study. Exposures of children aged 0-14 years whose incident cancers were diagnosed between 1976 and 1983 and who resided in the Denver, Colorado, Standard Metropolitan Statistical Area were compared with those of controls selected by random digit dialing, matched on age, sex, and telephone exchange area. Parents of 252 cases and 222 controls were interviewed at home about the use of electric appliances by the mother during pregnancy (prenatal exposure) and by the child (postnatal exposure). After adjustment for income, prenatal electric blanket exposure was associated with a small increase in the incidence of childhood cancers (odds ratio (OR) = 1.3, 95% confidence interval (CI) 0.7-2.2) that was more pronounced for leukemia (OR = 1.7, 95% CI 0.8-3.6) and brain cancer (OR = 2.5, 95% CI 1.1-5.5). Postnatal exposure to electric blankets was also weakly associated with childhood cancer (OR = 1.5, 95% CI 0.6-3.4), with a larger but imprecise association with acute lymphocytic leukemia (OR = 1.9, 95% CI 0.6-6.5). Water beds and bedside electric clocks were unrelated to childhood cancer incidence. Results are limited by nonresponse and imprecision resulting from the rarity of appliance use, especially for subgroups of cases. Nonetheless, electric blankets, one of the principal sources of prolonged magnetic field exposure, were weakly associated with childhood cancer and warrant a more thorough evaluation.     

Prevalence of occupational allergy to laboratory animals in two towns of northern and central Italy

BACKGROUND: Laboratory animal allergy (LAA) is a well known occupational hazard for workers employed in biological and medical research institutes, but few Italian data on this disease exist. OBJECTIVES: The aim of our study was to evaluate the prevalence of LAA in 45 workers in Trieste (NE-Italy) and in 80 workers in Perugia (Central Italy) and to assess factors predisposing to sensitisation among subjects occupationally exposed to animals. METHODS: All subjects underwent a physical examination and responded to a standardized questionnaire for the evaluation of allergic respiratory symptoms and exposure data. Skin prick tests with common allergens and with hair extract from laboratory animals were performed and specific IgE was measured. Atopy was defined as positive skin prick test to common allergens. RESULTS: There were 60% atopic subjects in Trieste and 55% in Perugia and sensitisation to laboratory animal hair was found in 24.4% subjects in Trieste and in 35% in Perugia. The prevalence rates of LLA were respectively 11.1% and 11.2%; 2.3% and 3.7% complained of asthma while 8.9% and 7.5% complained of rhinitis. The resulting symptoms were significantly related to skin prick tests that were positive to laboratory animal hair (odds ratio (OR) = 7.64; 1.83-44.5), to skin prick test positivity to common inhalant allergens (OR = 5.29; 1.09-50.2), to common allergic symptoms (OR = 3.95; 1.05-18.2) and to exposure time exceeding 5 hours per day (OR = 5.45; 1.31-22.0). CONCLUSION: The role of atopy and of exposure time in causing LLA was confirmed and the need of prevention measures to reduce exposure in people at risk was discussed.     

SEARCH international case–control study of childhood brain tumours: role of index pregnancy and birth, and mother''s reproductive history

A series of co-ordinated population-based case-control studies of childhood brain tumours (CBT) was undertaken under the auspices of the Surveillance of Environmental Aspects Related to Cancer in Humans (SEARCH) programme of the International Agency for Research on Cancer (IARC) to evaluate, inter alia, the risk in relation to characteristics of the index pregnancy and birth, and maternal reproductive history. Subjects comprised 1218 cases aged 0-19 years and 2223 controls. Risk estimates were calculated by unconditional logistic regression, adjusted for age, sex, centre and mother's years of schooling, for all types of CBT combined as well as for four groups defined by histopathology (astrologlial tumours, primitive neuroectodermal tumours of the brain, 'other glial' tumours and 'other histological types') and for five age groups (0-1, 0-4, 5-9, 10-14, 15-19 years). Use of anaesthetic 'gas' was associated with an increased risk of CBT (OR = 1.5, 95% CI [1.1, 2.0]), apparent in children aged 0-4 years (OR = 2.4, 95% CI [1.4, 4.1]) and for astroglial tumours (OR = 1.6, 95% CI [1.1, 2.2]) with non-significantly increased relative risks for each of the other histological groups. However, not all centre-specific relative risks were elevated. No other aspect of the index pregnancy, delivery and early neonatal period or of the mother's previous reproductive history was associated with risk for CBT.     

The protective effect of the Mediterranean diet on lung cancer

There has been growing interest over recent years in the potential preventive role of the Mediterranean diet in the development of cardiovascular disease and cancer. The present study was designed to evaluate the relationship between the components of the Mediterranean diet and lung cancer. A hospital-based, case-control study of lung cancer was conducted on subjects aged 35+ yr living in the Lazio region and admitted to one of the main hospitals in Rome in the period from 1993 to 1996. Cases (n = 342) were patients with newly diagnosed primary lung cancer. Controls (n = 292) were recruited from departments of general surgery, orthopedics, ENT, and general medicine and were frequency matched by sex and age (+/-5 yr) to the cases. Exposure characteristics were obtained by interviewing study subjects. A self-administered food-frequency questionnaire was used. After careful control for several smoking variables, we found a protective effect for high consumption of carrots (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.42-1.05), tomatoes (OR = 0.59, 95% CI = 0.34-1.03), white meat (OR = 0.66, 95% CI = 0.42-1.02), exclusive use of olive oil (OR = 0.67, 95% CI = 0.45-0.99), and regular consumption of sage (OR = 0.43, 95% CI = 0.29-0.65). In a multivariate model, considering all food items simultaneously, the protective effect of exclusive olive oil use and sage remained statistically significant. Our results indicate that some food items typical of the Mediterranean diet are associated with decreased lung cancer risk.     

Evaluation of 60 continuous quality improvement projects in French hospitals.

OBJECTIVE: To evaluate the feasibility of implementing continuous quality improvement (CQI) projects in French health care organizations. DESIGN: The French Ministry of Health issued two calls for CQI projects (in 1995 and 1996). ANAES was commissioned to monitor and evaluate the projects, and to provide advice. SETTING: ANAES in collaboration with French public hospitals. STUDY PARTICIPANTS: A jury selected 64 projects from 483 submissions. The first series of projects related to safety issues (e.g. blood transfusions), the second related chiefly to patient management. INTERVENTIONS: ANAES instructed project leaders in process analysis (modified four-step FOCUS-PDCA model), convened regular meetings between leaders and performed on-site visits. MAIN OUTCOME MEASUREMENTS: Objective outcomes: goal achievement, extension of projects to other topics and departments, allocation of resources. Subjective outcomes: changes in attitudes. Statistics were obtained from two questionnaires completed by project leaders. RESULTS: Four projects were discontinued; 82% (49 out of 60) met more than half their objectives. The CQI method was adopted by other departments in 65% and 50% (1st and 2nd series respectively) of cases. Hospital management often chose to provide continued support (81%/88%), offer training (59%/80%), create a CQI unit (62%/73%), and allocate a budget (61%/65%). A positive impact on staff attitudes was noted in over 75% of projects. CONCLUSION: ANAES' co-ordinated initiative to acquaint a hard core of French public hospitals with CQI proved successful. Identification of the factors for success and of potential hurdles helped pave the way for the national hospital accreditation procedure currently underway.     

Tobacco smoking, smoking cessation, and cumulative risk of upper aerodigestive tract cancers

Upper aerodigestive tract cancers are strongly related to smoking, and their incidence is substantially lower in former smokers than in continuing smokers. To estimate the effect of smoking cessation on the cumulative incidence of these cancers by age 75 years (in the absence of competing causes of death), the authors combined odds ratios for males from a network of Italian hospital-based case-control studies (1984-2000) with 1993-1997 incidence data for Italian men. The studies included 961 cases with oral/pharyngeal cancer, 618 cases with esophageal cancer, and 613 cases with laryngeal cancer, plus 3,781 controls. For all upper aerodigestive tract cancers, the cumulative risks by 75 years of age were 6.3% for men who continued to smoke any type of tobacco, 3.1% and 1.2% for men who stopped smoking at around 50 and 30 years of age, respectively, and 0.8% among lifelong nonsmokers. Corresponding figures were 3.3%, 1.4%, 0.5%, and 0.2% for oral/pharyngeal cancer; 1.0%, 0.5%, 0.4%, and 0.2% for esophageal cancer; and 2.1%, 1.1%, 0.2%, and 0.2% for laryngeal cancer. In this Italian population, men who stopped smoking before age 50 years avoided more than half of the excess risk of upper aerodigestive tract cancer as men who did not, and men who stopped smoking before age 30 years avoided more than 90% of the risk.     

上海市儿童恶性肿瘤发病情况和时间趋势分析

目的 描述上海市 <15岁儿童恶性肿瘤发病情况和发病变化趋势。方法 利用上海市恶性肿瘤病例报告系统收集的儿童恶性肿瘤发病资料,采用儿童肿瘤国际分类(ICCC-3)进行归类,分析2009-2011年上海市儿童恶性肿瘤的发病情况及其性别、年龄别分布特征,并应用Joinpoint软件计算年度变化百分比(APC),对2002-2013年上海市儿童恶性肿瘤发病率时间趋势进行分析。结果 2009-2011年上海市共诊断儿童恶性肿瘤病例460例,占所有部位肿瘤的0.3%,粗发病率为129.0/100万,标化发病率(ASR)为129.6/100万。男童恶性肿瘤发病率高于女童,ASR分别为142.1/100万和116.4/100万,男女童发病比为1.2(95%CI:1.0～1.5)。白血病是最常见的儿童恶性肿瘤(35.9%,165/460,ASR:47.0/100万),其次为中枢神经系统(19.8%,91/460,ASR:25.6/100万)和淋巴瘤(9.8%,45/460,ASR:12.6/100万)。2002-2011年性别、年龄组(0～、5～和10～14岁)儿童恶性肿瘤发病率无明显改变,不同肿瘤[白血病、中枢神经系统(CNS)肿瘤以及淋巴瘤]发病率也无明显改变。结论 上海市男童恶性肿瘤发病率高于女童。白血病、CNS肿瘤和淋巴瘤是最常见的儿童恶性肿瘤。2002-2011年上海市儿童恶性肿瘤发病率无明显改变。     

内蒙古地区医院感染现患率调查分析

目的了解内蒙古地区医院感染现状,为制定医院感染管理措施提供依据。方法采用横断面调查方法,依据全国医院感染监测网2018年医院感染现患率调查要求,内蒙古地区所有三级、二级综合医院和专科医院自愿参加调查,自主选取调查日期填写统一调查表。结果 2018年内蒙古地区共有169所医院参加现患率调查,调查患者61 469例,1 016例(1 100例次)发生医院感染,医院感染现患率为1.65%,例次现患率为1.79%。≥900张床位医院的医院感染现患率较高,为2.60%。医院感染现患率位于前三位的科室为综合ICU(12.70%)、血液病科(6.55%)、儿科新生儿组(5.98%)。医院感染部位主要为下呼吸道(44.82%)、泌尿道(16.82%)、上呼吸道(10.82%)等。抗菌药物使用率为28.04%,不同规模医院的抗菌药物使用率比较,差异有统计学意义(χ2=650.353,P0.001)。治疗性使用抗菌药物患者病原学送检率为36.08%。规模越大的医院的治疗用药病原学送检率越高,差异有统计学意义(χ2=449.309,P0.001)。治疗使用抗菌药物位于前3位的科室为儿科非新生儿组1 821例(98.11%)、呼吸科2 463例(97.62%)和肾病科334(96.53%);预防使用抗菌药物较多的科室为产科484例(82.59%)、妇科395例(66.72%)和骨科1 106例(64.68%)。共检出医院感染病原体457株,其中革兰阴性菌325株(71.12%)、革兰阳性菌82株(17.94%)、真菌30株(6.57%)。医院感染主要病原体为肺炎克雷伯菌(82株)、大肠埃希菌(81株)、铜绿假单胞菌(76株)等。结论本次现患率调查结果较全国及其他地区低。医院感染管理部门可针对重点科室、主要感染部位采取有效的感染预防与控制措施,提高规模较小医院的治疗性使用抗菌药物病原学送检率。     

Intake of fruits, vegetables, and soy foods in relation to breast cancer risk in Korean women: a case-control study

We conducted a case-control study to examine the relationship between fruit, vegetable, and soy food intake and breast cancer risk in Korean women. Incident cases (n=359) were identified through cancer biopsies between March 1999 and August 2003 at two university hospitals in Seoul, Korea. Hospital-based controls (n=708) were selected from patients in the same hospitals during the same period. Subjects were asked by personal interview to indicate their average fruit, vegetable, and soy food intake for a 12-mo period 3 yr prior to the baseline phase. A food intake-frequency questionnaire (98 items) was given by a trained dietitian. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for confounding factors and total energy intake. There was no association between the intake of total fruits, vegetables, or soy food and breast cancer risk. Increasing consumption of grapes was linked to a significant protective effect against risk of breast cancer (OR=0.66; 95% CI=0.41-0.86; P<0.01). Among the vegetables, reduced risk was observed with high tomato intake (OR=0.62; 95% CI=0.38-0.81; P<0.01). Among soy foods, high consumption of cooked soybeans, including yellow and black soybeans, had an association with reduced breast cancer (OR=0.67; 95% CI=0.45-0.91; P<0.02). Our data suggest that increased intake of some fruits, vegetables, and soy foods may be associated with breast cancer risk reduction in Korean women.     

An assessment of spatial clustering of leukaemias and lymphomas among young people in New Zealand

STUDY OBJECTIVE: To assess spatial clustering of childhood leukaemias and lymphomas in New Zealand, using a national dataset from a country with no nuclear installations. DESIGN: New Zealand Map Grid coordinates, derived from the birth addresses of cases and controls were used in clustering analyses that applied Cuzick and Edwards' method. SETTING: The whole of New Zealand. PARTICIPANTS: The cases were ascertained from the New Zealand Cancer Registry. They were diagnosed with leukaemia or lymphoma at ages 0-14 years during the period 1976 to 1987. For Hodgkin's disease, the age range was extended to include those aged from 0-24 years. The cancer registrations were linked with national birth records, to obtain the birth addresses of the cases. The controls were selected at random from birth records, with matching to cases (1:1) on age and sex. The analyses included 600 cases and 600 controls. MAIN RESULTS: There was no statistically significant spatial clustering for any tumour group overall, including acute lymphoblastic leukaemia, acute nonlymphoblastic leukaemia, other leukaemias, non-Hodgkin's lymphomas, Hodgkin's disease, and all these combined. Significant clustering was found in a sub-analysis for one of three age specific subgroups of acute lymphoblastic leukaemia (ages 10-14 years, p = 0.003). CONCLUSION: The subgroup finding may have been real or a chance association, as several comparisons were made. This study found little evidence for spatial clustering of leukaemias or lymphomas in a population with no nuclear installations.