乳胶手套致临床护士Ⅳ型超敏反应的研究

目的 了解我国临床护士中乳胶手套所致Ⅳ型超敏反应的发生情况.方法 选择临床护士100人,其中乳胶手套过敏组69人,无乳胶手套过敏者(对照组)31人.用瑞敏变应原斑贴试剂盒进行斑贴试验检查.比较2组斑贴试验变应原阳性情况.结果 乳胶手套过敏组中斑贴试验阳性率高达73.9％,而正常对照组为25.8％,二者差异有统计学意义;氯化钴、重铬酸钾是2组中最常见的变应原,但只有甲醛和对苯二胺基质的阳性率过敏组明显高于对照组.乳胶手套过敏组中橡胶添加剂斑贴试验阳性率为26.1％,而对照组均为阴性.结论 乳胶手套过敏护士中手部皮炎主要由日常用品接触所致,乳胶手套所致Ⅳ型超敏反应发生率较高.     

过敏性疾病患儿婴儿期喂养行为及相关因素的调查分析

目的探讨婴儿期喂养行为及相关因素与过敏性疾病之阳J的关系。方法按照匹配原则对375例过敏体质儿童和375例非过敏体质儿童的家长进行问卷调查,比较2组患儿过敏性疾病的发生在不同情况下的差异;采用Logistic回归分析,探讨影响儿童过敏性疾病发生的主要影响因素。结果有过敏家族史、有被动吸烟史及高收入家庭的儿童过敏性疾病的发病率高;母亲生育年龄大、文化程度高及母亲是企事业人员或医务人员,儿童过敏性疾病发病率高;多因素Logistic回归分析表明,影响儿童过敏性疾病的主要危险因素是：家族史、被动吸烟史、儿重性别、母亲文化程度高、母亲职业、胎次、蛋类添加时间。结论遗传因素仍然是影响过敏性疾病的最重要因素;家庭收入高、母亲文化程度高的婴儿过敏性疾病发病率高;对过敏体质儿童制订有针对性的早期喂养策略;面向全体家长宣扬正确的育儿观念,尤其是卫生观念。对于一些经济条件较好的家庭,树立正确合理的卫生观念是预防过敏性疾病发生的首要措施。     

广州地区婴儿喘息发生危险因素的病例对照研究和Logistic分析

目的 研究广州地区的婴儿喘息发生的危险因素.方法 采用病例对照的方法分析101例喘息患儿的临床资料,应用单因素及逐步前进法Logistic多因素回归统计分析.结果 单因素分析婴儿喘息发生的危险因素与过敏性疾病家族史、个人过敏史、病毒感染、肺炎支原体感染、母亲被动吸烟和孕龄有关（P〈0.01）,而与喂养方式、分娩方式、同胞数量、患儿性别无关.Logistic回归分析发现过敏陛疾病家族史（OR=13.0258,95％ CI2.8951～58.6060,P〈0.001）、肺炎支原体感染（OR=10.5962,95％ CI2.5356～44.28 10,P〈0.01）、病毒感染（OR=38.8702,95％ CI7.4108,P〈0.001）、母亲孕龄（OR=1.4139,95％ CI1.0955～1.8248,P〈0.01）、母亲被动吸烟（OR=17.6636,95％ CI4.4270～70.4772,P〈0.001）是婴儿发生喘息的独立危险因素.结论 婴儿喘息发生与个人过敏史、过敏性疾病家族史、病毒感染、肺炎支原体感染、母亲被动吸烟和孕龄有关,而后五者为其独立危险因素.     

过敏家族史与婴儿过敏性疾病的关系

目的评估过敏家族史对婴儿过敏性疾病的阳性预测价值.方法 304例婴儿于3个月、6个月、12个月、18个月各电话或门诊随访一次并详细记录.采用SPSS11.0软件进行统计分析.结果过敏家族史阳性的婴儿77例,过敏的发生率为57.1%;阴性的婴儿为38.3%,两组有显著性差异(P=0.004).父亲过敏史与婴儿荨麻疹有关,母亲过敏史与婴儿湿疹有关,双亲过敏史与婴儿反复喘息有关.过敏家族史对婴儿过敏的PPV为55.8%,特异性为80.5%,敏感性为33.1%.结论阳性过敏家族史是婴儿过敏性疾病的高危因素.     

郴州地区支气管哮喘与其他过敏性疾病的相关性调查分析

目的 了解郴州地区支气管哮喘的相关过敏因素,及其他过敏性疾病的相关性.方法 对216例支气管哮喘进行过敏原的相关检测,及其他过敏性疾病的相关性进行临床调查.结果 有176例患者变应原检测阳性,其中吸入性过敏原以户尘螨、粉尘螨阳性率最高,为42.05%,食人性过敏原中以鱼蟹虾的阳性率最高,为28.98%,发现62.04%支气管哮喘患者有变应性鼻炎、湿疹、荨麻疹、过敏性结膜炎、药物过敏等过敏性疾病,51.38%支气管哮喘患者有哮喘疾病家族遗传史.结论 郴州地区的支气管哮喘过敏原检测以粉尘、尘螨最多见,哮喘和其他过敏性疾病及家族史有一定相关性.     

某市农村居民类风湿性关节炎的危险因素分析

目的:分析影响类风湿性关节炎发病的危险因素.方法:采用多级整群抽样法,先从某市37个乡镇中随机抽取3个乡镇,对3个乡镇的全部常住居民进行类风湿性关节炎普查,类风湿性关节炎病例以县及县以上医院的诊断为准.在第一阶段调查发现的344名类风湿性关节炎患者中随机选择144人为病例组,同时选取在性别和年龄构成上与病例组相似的健康人群191人为对照组.调查项目主要包括性别、年龄、受教育程度、婚姻状况、感冒、鱼虾过敏、扁桃体切除、腮腺炎史、职业、劳动强度、外伤史、手术史、输血史、住房类型、居住环境潮湿、青春期前养猫或养狗、类风湿性关节炎或支气管哮喘或过敏性鼻炎家族史、口服避孕药、体质指数、吸烟、戒烟、饮酒、戒酒及饮茶等23个因素.结果:单因素分析结果显示,感冒、超重及肥胖、外伤史、支气管哮喘或过敏性鼻炎家族史、类风湿性关节炎家族史、饮茶、住平房和居住环境潮湿与类风湿性关节炎的关系有统计学意义.将单因素分析中的全部18个变量作为自变量,以是否患类风湿性关节炎作为应变量,采用后退法进行非条件Logistic回归分析,结果显示,感冒、支气管哮喘或过敏性鼻炎家族史、类风湿性关节炎家族史、饮茶、住平房、居住环境潮湿和超重及肥胖与类风湿性关节炎的联系有统计学意义.结论:农村居民的类风湿性关节炎主要与既往感冒、家族史、居住条件及生活习惯相关.     

儿童血管迷走性晕厥反复发作的危险因素分析

目的 探讨儿童血管迷走性晕厥(VVS)反复发作的相关危险因素.方法 选取2018年5月至2020年5月该院儿科门诊收治的VVS患儿88例,根据患儿晕厥首次发作至直立倾斜试验前5年内发作次数,分为晕厥发作次数<4次的低频次组、晕厥发作次数≥4次的高频次组,比较2组临床资料,并对其相关危险因素进行分析.结果 88例VVS患儿中,低频次组59例,高频次组29例.与低频次组比较,高频次组持久站立比例、晕车史比例、阳性家族史比例、VVS类型差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示,持久站立、晕车史、阳性家族史及VVS类型是VVS反复发作的独立危险因素(P<0.05).结论 儿童VVS反复发作的主要危险因素为持久站立、晕车史、阳性家族史和VVS类型,临床应尽早采取相应处理措施,改善患儿预后.     

缺血性脑卒中复发的危险因素分析

目的探讨缺血性脑卒中复发的相关危险因素,为防治提供理论依据。方法提取新疆生产建设兵团医院脑卒中登记库中760例缺血性脑卒中(其中新发445例,复发315例)患者的临床资料,按复发和未复发两组对复发危险因素进行单因素和多因素Logistic回归分析。结果单因素分析显示短暂性脑缺血发作(TIA)史、高血压史、糖尿病史、吸烟、血压控制情况、颈动脉斑块、脑卒中家族史是缺血性脑卒中复发的危险因素;多因素分析显示糖尿病史、血压控制情况、颈动脉斑块、脑卒中家族史与脑梗死复发的关系最为密切,OR值分别为4.75,3.99,4.01,3.20,P均0.05。结论缺血性脑卒中复发危险因素主要是糖尿病史、血压控制情况、颈动脉斑块和卒中家族史。     

偏头痛多种危险因素的分析

目的：研究偏头痛的危险因素。方法：用1：1配对对照的方法进行单因素分析,再用Mc Nemar‘s test公式计算卡方,求得P值,并计算相对危险度。结果：家族遗传史、过敏性疾病史,在病例组与对照间有非常 显著性;睡眠不足、夜间工作,病例组与对照组间有显著性差异。结论：家族遗传史、过敏性疾病史是偏头痛的危险因素。     

湖北地区冠心病危险因素的调查研究

目的:分析湖北地区人群冠心病主要危险因素。方法:选取湖北地区冠心病病例和对照各961例,了解吸烟、饮酒、高血压和糖尿病等病史,及空腹血糖、血脂、血压、体质指数等值。结果:病例组和对照组比较,高血压史、糖尿病史、吸烟史、冠心病家族史、收缩压水平、空腹血糖水平和饮酒史差异有显著性(P<0.05)。非条件Logistic回归分析显示冠心病显著危险因素为高血压史、糖尿病史、吸烟史、冠心病家族史、饮酒史和性别。结论:湖北地区人群中,高血压史、糖尿病史、吸烟史、冠心病家族史、饮酒史和性别是冠心病的主要危险因素。     

Research based prevention strategies. Management of latex allergy in the workplace.

1. Facility-wide goals should combine primary and secondary prevention approaches to reduce or minimize contact and aerosolized natural rubber latex exposure for clients, employees, and visitors. 2. Potential immune sensitization or continuation of symptoms of latex allergy can be reduced by using screening questionnaires to recognize potential risk factors or history of latex allergy; documentation of a referral to a physician for diagnosis; standardization of facility-wide general product selection; and work environment controls by discriminate, appropriate, informed glove choices. 3. Discriminate glove choices of nonlatex, non-powedered, or low allergen/non-powdered natural rubber latex gloves have become the primary proactive strategy adopted by hospitals and clinics to create a latex minimized environment.     

Perioperative care of patients with latex allergy

Initially identified in the pediatric population, latex allergy and sensitivity now are seen at increasingly higher rates in all age groups, and are especially prevalent in health care workers. Knowledge about the sources of latex in the environment, the signs and symptoms seen in latex sensitivity and allergic reaction, risk factors for sensitivity, and how to assess patients and those working in the health care profession for possible latex sensitivity is important for perioperative nurses.     

Hand dermatitis risk factors among clinical nurses in Japan

The purpose of this study was to establish hand dermatitis (HD) risk factors among Japanese nurses. A questionnaire was administered to 1,162 clinical nurses, from whom 860 replies were received (response rate of 74.0%). Their overall HD prevalence was 53.3%. Several risk factors were identified: using latex gloves (odds ratio [OR] 1.9), allergies in adulthood (OR 2.7), urticaria as an adult (OR 1.5), atopic dermatitis as an adult (OR 2.7), any allergies to latex products (OR 5.2), skin irritation following contact with latex (OR 4.1), contact dermatitis following contact with latex (OR 3.5), family history of hay fever (OR 1.6), and family history of atopic dermatitis (OR 1.9). The use of hand cream was associated with a 50% reduction in HD risk (OR 0.5). In this study, we found that Japanese clinical nurses suffer a significant occupational burden from HD. As such, it is essential that hospital managers consider interventions to reduce this troublesome occupational disease among clinical nurses in Japan, as elsewhere.     

The use of latex gloves in the school setting.

In 1987, when the U.S. Centers for Disease Control and Prevention recommended the use of universal precautions in response to the HIV/AIDS epidemic, the demand for medical gloves dramatically increased. Unfortunately, the manufacturing techniques for the most widely-used gloves-natural rubber latex-also changed, in order to expedite production. These changes resulted in an increase in latex allergies, because excessive residual proteins that cause allergies remained on the gloves and became airborne with the gloves' high level of powder. This allergy concern is especially relevant in the school setting where school nurses are not only concerned about their own well-being, but the well-being of the children in their care. Today, latex gloves are still the most widely used of any medical gloves, but they have much lower levels of protein and are available in low- or no-powder. This article examines whether the current latex gloves indeed reduce the allergenicity of the gloves and how allergy and barrier protection data can assist school nurses in making informed glove choices.     

Consideration of barrier protection and latex protein allergy in the evaluation of medical gloves.

The issues surrounding medical gloves have become increasingly complicated over the past 15 years. The AIDS epidemic, allergies, needlesticks, new glove materials, and, most recently, an increased risk of biohazards all factor into the choice of medical gloves. This article examines the research available on two of the issues affecting medical glove choice: barrier protection and latex protein allergy.     

An epidemiological study of atopy in children

A sample of 930 children, between 9 years and 15 years old from six Italian towns, were studied. Their family history of allergy, personal allergy and medical history, current allergy symptoms, exposure to environmental allergens, feeding as infants, and their parents' occupations were recorded. They were skin-prick tested (SPT) with a range of common allergens. A subject was defined as atopic if at least one SPT caused a weal greater than 3 mm diameter. The association between the recorded information and atopy was investigated by logistic multiple regression. Atopy was positively associated with: high density housing; medium or high exposure to environmental allergens; a history of rhinitis, asthma or atopic eczema; male gender; and a history of breastfeeding. It was independent of infectious diseases, vaccinations and operations, social class and family history. Thus, there was no evidence of a genetic factor in atopy, other than sex.     

Surgical glove perforation among nurses in ophthalmic surgery: A case‐control study

Many of the ophthalmic surgical instruments are extremely fine and sharp. Due to the dim light environment required for ophthalmic surgical procedures, the passing of sharp instruments among surgeons and scrub nurses also poses a risk for glove perforations. A case‐control study was performed to determine the number and site of perforations in the surgical gloves used by a group of scrub nurses during ophthalmic surgery. All six nurses working in an eye and refractive surgery centre in Hong Kong participated in the study. A total of 100 (50 pairs) used surgical gloves were collected following 50 ophthalmic surgeries. Fifty pairs of new surgical gloves were also collected. Every collected surgical glove underwent the water leak test. The surgical procedure perforation rate was 8%, and none of the perforations were detected by the scrub nurses. No perforations were found in any unused gloves. The findings indicate that glove perforations for scrub nurses during ophthalmic surgery do occur and mostly go unnoticed. Future studies should continue to explore factors contributing to surgical glove perforation.     

Medical gloves and glove materials

Latex gloves are widely used in health care, but latex allergy is increasingly becoming a problem. Nurses should be aware of the alternatives to latex gloves and when these can be used. Nurses should know their organisation's policy on glove use and latex allergy.     

Prevalence of adverse reactions to latex gloves in Korean operating room nurses

This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. Among hospital personnel working in operating rooms, 41.4% reported adverse reactions to latex. Especially among OR nurses, the prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. Common symptoms were rash, skin itching, dizziness, and eye itching. Atopics had more latex allergy than the non-atopics. There was no difference in the incidence rate of latex allergy among the five gloves by the prick test. But with the exposure test, ordinary gloves had a higher latex allergy incidence than hypoallergenic gloves.     

Latex glove allergy--dilemma for health care workers. An overview.

1. The prevalence of latex allergy in health care workers is estimated to be between 10% and 17%. 2. Reactions from wearing latex gloves can include irritant contact dermatitis, allergic contact dermatitis, and contact urticaria from latex proteins. 3. Individuals with a history of atopy, multiple surgeries early in life (particularly with bladder catheterization), or allergies to certain foods are considered at risk of latex allergy. 4. An early intervention protocol and documentation forms are offered for occupational health nurses faced with assessing potentially latex allergic employees.