Italian healthcare workers' views on mandatory vaccination

Background  

Mandatory vaccination has contributed to the success of immunisation programmes but voluntary vaccination allows people to be responsible for their own health. There are benefits from both policies and the arguments between them remain subject to debate within and without the scientific community, both nationally and internationally. The aim of this study is to assess the opinions of those who actually work in the Vaccination Service.     

Enhanced antigen-specific delayed-type hypersensitivity and immunoglobulin G2b responses after oral administration of viable Lactobacillus casei YIT9029 in Wistar and Brown Norway rats.

In this study, the effects of orally administered viable Lactobacillus casei Shirota strain YIT9029 on the immunity parameters of Wistar and Brown Norway rats were examined. For this purpose, we used the Trichinella spiralis host resistance model. Two weeks before and during T. spiralis infection, rats were fed 10(9) viable L. casei bacteria 5 days per week. The T. spiralis-specific delayed-type hypersensitivity (DTH) response was significantly enhanced in both Wistar and Brown Norway rats given L. casei. In both rat strains fed L. casei, serum T. spiralis-specific immunoglobulin G2b (IgG2b) concentrations were also significantly increased. In the model, no significant effects of L. casei on larval counts or inflammatory reactions in the tongue musculature, body weights, or lymphoid organ weights were observed. Serum specific antibody responses, other than IgG2b, were not changed by feeding of L. casei. In contrast to L. casei, it was shown that orally administered Bifidobacterium breve or Bifidobacterium bifidum had no influence on the measured infection and immunity indices in the rat infection model. Since the rat DTH response is considered to be a manifestation of Th1 cell-mediated immunity and the IgG2b isotype has been associated with Th1 activity, it was concluded that Th1 cells could play an active role in the immunomodulatory effects of orally administered L. casei. Furthermore, our data do not indicate that the effect of oral supplementation with L. casei is dependent on the genetic background of the host.     

International Headache Society classification: interobserver reliability in the diagnosis of primary headaches

We assessed interobserver reliability of the International Headache Society (IBIS) classification for diagnosis of primary headaches. The study was performed on 103 patients consecutively seen at two Headache Centres. Each patient was given a structured interview recorded on videotape. Four experienced clinicians then reviewed the interviews separately and made a diagnosis of headache according to IHS criteria at the one- and two-digit levels. At both the one- and the two-digit level the agreement was substantial (Kappa = 0.74 and 0.65, respectively). The analysis of reliability for each of nine items necessary for diagnosis showed an agreement ranging from substantial (Kappa = 0.69) to almost perfect (Kappa = 0.89). Our results indicate that the IHS classification has a good reliability for the diagnosis of primary headaches at the one- and two-digit levels.     

研究生一年级学生运动等级与其健康状况的相关性

目的:调查研究生一年级学生的体育锻炼和健康状况,并分析其相关性。方法:调查于2005-09/10完成。选取西南大学和重庆大学2005级研究生一年级学生作为调查对象,共发放问卷190份,男90份,女100份。进行问卷调查,当场收回问卷。问卷内容:①自测健康评定量表:由48个条目构成,1～17为自测生理健康评定子量表(170～0分),19～34为自测心理健康子量表(150～0分),35～47为自测社会健康子量表(120～0分),分数越高代表越健康。②体育活动等级量表:主要调查调查对象上1个月参加体育锻炼的运动量,运动量=强度×时间×频率,强度与频率从1～5等级分别计1～5分,时间从1～5等级分别计0～4分,故运动量最高分为100分,最低分为0分。结果:有效回收176份问卷进入结果分析。①不同性别调查对象在运动等级上的分布情况:研究生一年级男女新生的运动量水平都偏低(男生:31.80±23.19,女生:15.57±15.39),且性别对运动量有显著的主效应(P<0.01),女生在运动量上的得分显著偏低。②调查对象健康状况各维度与运动量的相关性:运动量与总体健康、生理健康、心理健康和社会健康都存在显著相关性(r=0.150～0.238,P<0.05～0.01),生理健康对运动量有显著的预测作用(P<0.05)。③不同运动量等级调查对象的健康量表得分:运动等级对生理健康有显著的主效应(P<0.01),随着运动量的增加,研究生一年级学生的生理健康水平不断提高。结论:研究生一年级学生的体育锻炼运动量与健康水平存在着明显的正相关,随着运动量的增加,生理健康、心理健康及社会健康水平均不断增加。     

多普勒超声诊断移植肾排斥反应与病理检查及肾功能指标的对比分析

目的：以病理活检结果为金标准，评估多普勒超声检查对移植肾排斥反应的诊断价值。方法：选择2003—01/2006—12在中国医科大学附属第一医院器官移植科行肾移植并在术后行超声检查的患者176例，均知情同意。①实验分组：根据术后移植肾功能分为2组，移植肾功能不良组78例，其中30例次行病理活检；移植肾功能正常组98例。②实验方法及评估：对患者移植肾行多普勒超声检查，参数选择峰收缩期流速、平均舒张期流速、阻力指数及血管显示率。血管显示率的评估标准（0～5级）：0级为肾动脉及其远侧血管未显示；5级为肾各级血管均显示良好。以病理活检结果为金标准，分别选取阻力指数=0．7，0．75，0．8，0．85为诊断界值进行诊断试验。结果：169例患者进入结果分析，脱落7例。①峰收缩期流速、平均舒张期流速不呈正态分布，无法作为肾功能评价指标。30例次病理活检中共有28例次被确诊为排斥反应，急性排斥反应15例次，慢性排斥反应13例次。②肾功能正常组患者中血管显示率5级者占63．30％，4级者占36．73％。肾功能不良组患者中血管显示率4级者占41．03％，3级者占46．15％，2级者占10．30％，1级者占2．60％。③移植肾功能不良组患者阻力指数显著高于移植肾功能正常组（P〈0．01）。移植肾功能不良组患者移植肾功能恢复后阻力指数显著低于移植肾尚未恢复时（P〈0．01），其中99％以上的患者△（阻力指数）≥0.20。④界值阻力指数=0．75的诊断试验的敏感性、特异性和准确性最高，均达到100％。结论：当移植肾血管阻力指数升高至0．75以上，特别是同一患者自身对照升高超过0.2以上和或血管显示率低于4级，结合临床表现和生化结果，提示可能出现移植肾排斥反应。     

Health impacts of family planning

Among the many effects of family planning is the influence ithas on mortality and morbidity in women and children throughthe mechanism of changing the number and spacing of children.There is a complex set of relationships between mother's age,parity, birth spacing and infant and child mortality and morbidity.Much effort has been put into untangling this web in the hopeof identifying clear causal connections, but for the most parton the basis of inadequate data. Rather than attempt to establishthe relative importance of child spacing as a cause of decreasesin mortality, this paper takes as its starting point that thereis a connection, and presents some possible causal mechanismswhich explain how short birth intervals and child mortalitycould be related. In addition the most frequently cited hypotheses-maternaldepletion and sibling competition-a third is examined-birthcrowding which, it is suggested, influences the pattern of thetransmission of infectious diseases and, in turn, mortality. In the field of maternal mortality, the data which could beused to quantify the benefits of family planning are in evenshorter supply; however, the causal connections are rather moreeasily identified. The final section combines parity-specificdata on maternal mortality with evidence of changes in fertilitypatterns brought about by family planning to assess how successfulwe can hope to be in reducing through birth control the numberof women who die in childbirth.