Estimating the occurrence of amyotrophic lateral sclerosis among Gulf War (1990-1991) veterans using capture-recapture methods

OBJECTIVE: Using data from a recent report that indicated a 2-fold higher risk of amyotrophic lateral sclerosis (ALS) among veterans of the 1991 Gulf War, we applied capture-recapture methodology to estimate possible under-ascertainment of ALS cases among deployed and non-deployed military personnel who were on active duty during that war. STUDY DESIGN AND SETTING: One of the most serious concerns facing field epidemiological investigations is that of case ascertainment bias, particularly when it is differential among the study groups. Capture-recapture methods, however, have promise as an approach to assessing the impact of case ascertainment bias in such studies. To overcome potential limitations of any one approach, three different estimation methods were used: log-linear models, sample coverage, and ecological models, to obtain a comprehensive view of under-ascertainment bias in these populations. RESULTS: All three approaches indicated differential undercount of ALS cases with modest under-ascertainment likely to have occurred among non-deployed military personnel, but little under-ascertainment among the deployed. After correcting the rates for under-ascertainment, the age-adjusted risk of ALS remained elevated among military personnel who had been deployed to S.W. Asia during the 1991 Gulf War, confirming the earlier report. CONCLUSIONS: Capture-recapture methods are a useful approach to assessing the magnitude of case ascertainment bias in epidemiological studies from which ascertainment-adjusted estimates of rates and relative risks can be calculated.     

口腔复发性阿弗它性溃疡(RAV)的心理分析与治疗

目的通过对RAV患者发病前后的心理因素分析,显示RAV的发生、发展与患者精神因素的关系.方法从540例RAV门诊病例中分离出具有明显心理因素的100例RAV病人.1∞例中发生于精神创伤之前43例,发生于精神创伤之后57例.结果痊愈58例(58%),显效14例(14%),有效13例(13%),无效15例(15%).本文对RAV病人的心理因素分析及精神治疗与护理体会进行了讨论.结论口腔复发性阿弗它性溃疡(RAV)的发生、发展与患者的精神心理因素有密切关系.     

The Possible Importance of Glutamine Supplementation to Mood and Cognition in Hypoxia from High Altitude

Hypoxia induced by low O₂ pressure is responsible for several physiological and behavioral alterations. Changes in physiological systems are frequent, including inflammation and psychobiological declines such as mood and cognition worsening, resulting in increased reaction time, difficulty solving problems, reduced memory and concentration. The paper discusses the possible relationship between glutamine supplementation and worsening cognition mediated by inflammation induced by high altitude hypoxia. The paper is a narrative literature review conducted to verify the effects of glutamine supplementation on psychobiological aspects. We searched MEDLINE/PubMed and Web of Science databases and gray literature by Google Scholar for English articles. Mechanistic pathways mediated by glutamine suggest potential positive effects of its supplementation on mood and cognition, mainly its potential effect on inflammation. However, clinical studies are scarce, making any conclusions impossible. Although glutamine plays an important role and seems to mitigate inflammation, clinical studies should test this hypothesis, which will contribute to a better mood and cognition state for several people who suffer from problems mediated by hypoxia.     

Sexually Transmitted Infection (STI) screening,case and contact treatment,and condom promotion resulting in STI Reduction two years later in rural Malawi

As part of a longitudinal cohort study in rural Malawi in 2000, 469 men and 758 women were asked to respond to a series of surveys, were tested for gonorrhea and chlamydia, and received their results and treatment, if applicable, for themselves and up to 2 partners if positive for either sexually transmitted infection (STI). Two years later, in 2002, 328 men and 525 women were again asked to respond to survey questions, tested again for gonorrhea and chlamydia, and were also tested for HIV - of these, 247 men and 453 women had also given urine samples in 2000. In 2000, the gonorrhea and chlamydia prevalence was 6.2% and 5.8% among men, and 3.6% and 4.9% among women. Two years later, prevalence of gonorrhea and chlamydia was 0.7% and 1.4% among men, and 1.3% and 1.1% among women. Although we did not test for HIV in the first round, the HIV prevalence in 2002 was 19.2%. The implications of the findings are discussed in the context of interventions for STI prevention and to reduce HIV transmission in sub-Saharan Africa.     

四妙勇安汤加味对脑卒中患者复中的预防作用研究

目的观察四妙勇安汤加味方对脑卒中患者复发中风（复中）的预防作用。方法选取复中患者184例,分为对照组与治疗组。对照组予常规西药治疗,治疗组在西医治疗基础上或停用西医治疗情况下予四妙勇安汤加味治疗。观察两组复中与死亡情况,同时比较四妙勇安汤对两组患者血压、精神、情绪等的影响。结果对照组5年内复中率为17.39%、死亡率为34.78%,治疗组复中率为4.35%,死亡率为14.13%。经比较,治疗组的复中率和死亡率明显低于对照组。结论四妙勇安汤是预防脑卒中患者的复中的有效方剂,可降低患者血压,稳定患者情绪。长期使用未发现不良反应或副作用。     

大剂量黄芪注射液与激饲液治疗肝硬化的临床研究

目的探讨黄芪注射液与激饲液治疗肝硬化的疗效.方法68例肝硬化(肝功能失代偿期)患者配对分组治疗组34例,给予黄芪注射液40～50 ml,激饲液(维生素K1注射液40mg,维生素C3 g),1天1次,25天一疗程,30天后重复.对照组34例,给肝胺注射液250ml,维生素C3g,肌苷0.6 g,1天1次,疗程同治疗组.两个月后观察疗效.结果治疗组从临床症状到血清各项指标改善情况均优于对照组(P＜0.05～0.01).两组均无不良反应.结论大剂量黄芪注射液与激饲液治疗肝硬化(肝功能失代偿期),近期疗效显著,且无副作用.     

Prognostic significance of cholestatic alcoholic hepatitis

Tissue cholestasis is a histologic feature in some patients with alcoholic liver disease, but its significance is unknown. We studied prospectively the clinical, laboratory, and histologic findings of 306 chronic male alcoholics in whom liver tissue was available. Tissue cholestasis permitted identification of two groups: group I, absent or mild cholestasis (239 patients), and group II, moderate to severe cholestasis (67 patients). Statistical evaluation was performed by Student's ttest and regression analyses. In patients with tissue cholestasis, 97% had elevated serum cholylglycine levels, while only 61% had significant jaundice (serum bilirubin > 5 mg/dl). In patients without tissue cholestasis, 66% had elevated serum cholylglycine and 13.5% jaundice. Highly significant statistical correlations (P <0.0001) were found between cholestasis and malnutrition, prothrombin time, AST, alkaline phosphatase, bilirubin, Maddrey's discriminant function, serum cholylglycine level, albumin, and histologic severity score. In group I, 54% survived 60 months versus 22% in group II (P <0.0001). Highly significant statistical correlations (P <0.0001) were noted between serum cholylglycine levels and the parameters enumerated earlier, but not with survival. We conclude that tissue cholestasis is a highly significant prognostic indicator of outcome in alcoholic hepatitis and is more consistently associated with bile salt retention than jaundice.