余姚地区结核病流行病学抽样调查及预防措施分析

目的:探讨余姚地区结核病流行病学特征及预防措施。方法:采取分层整群等比例随机抽样方法在余姚地区进行结核病流行病学调查,计算该地区结核病患病率,分析患病特点、诊断治疗及预防措施。结果:该次抽样调查共30 671人,发现活动性肺结核病人87例,其中菌阳肺结核13例,涂阳肺结核6例,全区活动性肺结核患病率283.7/10万,涂阳肺结核患病率42.4/10万,菌阳肺结核患病率19.6/10万。随着年龄的增大,肺结核患病率逐渐增加,且45岁开始后,患病率增加明显,60岁以上老人肺结核患病率增加更为显著。活动性肺结核病人、菌阳肺结核病人、涂阳肺结核病人中男性占较大比例,结核病知识知晓率为51.7%。87例肺结核患者家庭收入低于余姚平均水平的有68例,占78.2%。87例活动性肺结核患者给予强化治疗后,2个月转阴67例,转阴率为77.0%,3个月转阴80例,转阴率为92.0%。结论:余姚地区结核病情依然严峻,活动性结核患病率较高,仍为耐药性结核病的高发区,以老年男性为主,因此当地应加强健康教育,呼吁市民养成良好的卫生习惯,降低传染机会,并采取有效防治措施来控制结核病。     

镇江市1992年～2001年肺结核病登记及转归分析

肺结核病人的登记与转归分析是国家结核病控制规划中的重要内容。为了评价镇江市结核病防治工作效果 ,为制定防治规划提供依据 ,现将本市1 992年～ 2 0 0 1年的资料作如下分析。1　材料与方法1 .1　资料来源　 1 992年～ 2 0 0 1年本市所辖 6个县区上报的结核病登记年报表。人口资料由镇江市公安局提供。1 .2　方法　不同性别与年龄组人数按 1 994年全国年龄别人口数构成比推算。2　结果2 .1　发病情况　 1 0年累计登记活动性肺结核病人 1 3 1 6 5例 ,年平均登记率为 5 0 .6 3 /1 0万 ,其中涂阳肺结核病人 2 0 3 9例 ,占登记病人总数的1 5 .…     

2000年浙江省肺结核疫情分析

为全面掌握全省结核病疫情 ,了解发展趋势。对 2 0 0 0年全省各市、县上报的结核病人登记年报表进行统计分析 ,现报告如下。疫情资料1　登记率与涂阳登记率　 2 0 0 0年全省活动性肺结核病人14 0 2 9例 ,登记率为 31 2 3/10万 ;涂阳登记病人 4 2 96例 ,涂阳登记率 9 5 7/10万。其中 4 2个卫生部项目县 ,占全省人口的 5 3% ,活动性肺结核病人 714 0例 ,登记率为 30 0 4 /10万 ;涂阳登记病人 2 4 12例 ,涂阳登记率 10 15 /10万。非项目县活动性肺结核病人 6 889例 ,登记率为 32 5 9/10万 ;涂阳登记病人 1884例 ,涂阳登记率 8 91/10万。2　…     

结核病健康教育调查分析

目的了解结核病健康教育情况,探索结核病健康教育工作对策。方法于2004年6月—2005年12月对龙岩市第一医院门诊及住院病人中疑似肺结核和确诊肺结核病人1 330人进行了结核病健康教育现况调查。结果接受过防治结核病宣传的仅占42.3%,其中只接受过单一形式卫生宣传的占41.4%。结论结核病健康教育覆盖面小,形式不多。分析原因,采取针对措施非常必要。     

肺结核的健康教育

近年来 ,结核病发病率普遍增高。目前我国结核菌感染人数约为 3.3亿 ,其中有 80 %的病人在农村 ,有6 0 0万肺结核病人 ,15 0万有传染性 ,每年结核病死亡的人数高达 2 5万[1] 。该院门诊 2 0 0 2年 1～ 12月肺结核病人共有 132 8人次。文章对肺结核的健康教育作一简要介绍     

安徽省结核病疫情形势分析与防治对策

1　我省结核病疫情现状按卫生部统一部署 ,我省于 2 0 0 0年进行了全国第四次结核病流行病学抽样调查 ,结果显示 :全省活动性肺结核患病率为 5 0 4 / 10万 ,涂片阳性肺结核患病率为15 3/ 10万 ,男性活动性肺结核患病率和涂阳肺结核患病率分别是女性的 2 .8倍和 4 .1倍 ;山区活动性肺结核患病率和涂阳肺结核患病率分别是平原的 1.5倍和1.4倍 ;农村活动性肺结核患病率和涂阳肺结核患病率分别是城镇的 2 .1倍和 3.9倍。结核病死亡专率为9.3/ 10万 ,推算每年因结核病死亡约 6 0 0 0多人。查出的病人中复治病人占 38.2 % ,比 1990年的 2 7.1%有较…     

阜南县2003～2005年结核病控制现状分析

目的分析阜南县结核病控制工作现状,为控制结核病提供依据。方法根据县结核病登记本、月报、季报资料,分析结核病发现、治疗管理现状及存在问题。结果全县2003~2005年发现并登记活动性肺结核病人2 634例,其中涂阳1 586例,涂阳病人占活动性肺结核病人的比例从54.8%上升到63.4%,涂阳病人新登记率从18.7/10万上升到52.7/10万;涂阳病人主要集中在55~74岁年龄组,此年龄段发病人数占总数的41.6%;涂阳病人治愈率达94.0%。结论应用现代结核病控制策略(DOTS),阜南县结核病防治工作取得一定成效。     

龙岩市实施全国结核病防治规划阶段性评估分析

[目的 ]评价龙岩市实施《全国结核病防治规划 ( 2 0 0 1～ 2 0 10年 )》阶段性工作成效。 [方法 ]按照“《规划》阶段性评估方案” ,查阅有关文件和业务资料 ,并进行现场调查。 [结果 ] 2 0 0 1年至 2 0 0 3年 6月 ,合计登记可疑肺结核病人 7417例 ,其中胸部X线检查 673 0例 ,异常 5 2 5 1例 ;痰结核菌涂片检查 65 72例 ,发现活动性肺结核病人 3 466例 (初治涂阳 15 2 9例 ,复治涂阳 497例 ) ,重症涂阴病人 43例。 2 0 0 1～ 2 0 0 2年全市登记涂阳肺结核 15 62例 ,接受治疗 15 3 4例 ,全程督导 14 0 8例 ,规律治疗 13 76例 ,治愈 13 5 1例。 2 0 0 2年抽查 2 3所医疗单位 ,肺结核病人转诊率为 88 2 % ,转诊到位的占 73 9% ;2 0 0 3年抽查 7所县级综合性医院 ,第 1季度肺结核病人疫情报告率为 90 5 % ,转诊率为 90 5 % ,转诊到位率为 75 4%。 [结论 ]龙岩市实施《规划》取得了阶段性成果 ,但化疗管理存在薄弱环节 ,村医对病的督导尚有差距。     

新诊断痰涂片阳性肺结核病例家庭密切 接触者的活动性肺结核患病率调查

目的 了解新诊断涂片阳性肺结核病例家庭密切接触者的活动性肺结核患病情况.方法 以阜阳市2006年新发现痰涂片阳性肺结核患者为指示病例,追踪其家庭密切接触者,并进行结核菌素、X线胸片和3次痰涂片检查,确定密切接触者中活动性肺结核感染情况.结果 2006年阜阳市共报告1386例新诊断的痰涂片阳性肺结核病例,追踪发现5392名家庭密切接触者.检查家庭密切接触者发现其活动性肺结核患病率为3.76%,家庭密切接触者＜15岁年龄组和≥55岁以上年龄组的活动性肺结核患病率高于其他各年龄组(χ2=15.381,P＜0.01),密切接触者中活动性肺结核患病率随着指示病例的痰检排菌量增多而增高(Υ=0.998,P＜0.01).平均每100名指示病例可追踪发现15例新的活动性肺结核病例.结论 对新诊断痰涂片阳性病例家庭密切接触者进行结核病筛查,有利于提高活动性肺结核患者的发现率.     

朝阳市出国劳务人员结核病防治核心信息知晓率抽样调查

目的了解朝阳市出国劳务人员结核病防治核心信息知晓率现状,为进一步加强结核病防治健康教育与健康促进工作提供科学依据。方法采用整体随机抽样方法,随机抽取朝阳市900名申请出国务工的人员作为调查对象,采用《全国结核病防治规划(2011-2015年)知晓率调查方案》的调查问卷进行问卷调查。调查内容包括调查对象一般情况、结核病防治核心信息、接受健康教育情况等。结果 5条结核病核心信息总知晓率为75.8%(3410/4500)。随着年龄增大,总知晓率有降低的趋势,20~岁年龄组最高(79.3%),60~岁年龄组最低(73.2%),差异有统计学意义(P0.05);城市居民总知晓率为70.2%,农村居民为87.0%,差异有统计学意义(P0.05);接受过宣传教育的居民总知晓率(80.4%)高于未接受过宣传教育的居民(68.4%),差异有统计学意义(P0.05);5条核心信息中,第3条"怀疑自己得了肺结核,最好应到正规医疗机构就诊"知晓率最高,为97.0%;第2条"出现反复咳嗽、咳痰或痰中带血应该怀疑得了肺结核"的知晓率为89.0%;第1条"肺结核(肺痨)主要通过呼吸道传染"的知晓率为82.6%;第5条"肺结核大部分能治好"的知晓率为62.3%;第4条"我国对肺结核患者实施部分免费政策"的知晓率为48.0%,差异有统计学意义(P0.05)。结论朝阳市申请出国劳务人员的结核病防治知识知晓率未达到国家指导要求,有必要加强结核病健康教育工作。     

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 occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.