铀矿接尘人员矽肺发生的特点

目的 了解铀矿接尘人员矽肺发生的规律与特点。方法 利用单因素分析法对核工业矿山与地质系统间、纯铀矿与混铀矿接尘人员间,矽肺患者的发病工龄、发病年龄、病程及死亡年龄进行分析。结果 随着时间的推移,铀矿接尘人员的发病工龄、发病年龄、病程及死亡年龄均延长。地质系统的矽肺Ⅰ期患者的发病工龄、发病年龄分别为(10.15±5.95)年、(40.60±9.86)岁,短于矿山系统的患者[(14.23±8.12)年、(41.38±10.98)岁];地质系统的矽肺Ⅰ期患者的病程(P50)及死亡年龄分别为14.29年及(53.69±10.04)岁,长于矿山系统的患者[12.52年及(51.45±10.85)岁]。纯铀矿的矽肺Ⅰ期患者的发病工龄为(11.78±8.06)年,发病年龄为(38.04±9.89)岁,短于混铀矿的患者[(12.74±6.29)年、(41.40±10.67)岁];纯铀矿的矽肺Ⅰ期患者的病程(P50)为14.59年,死亡年龄为(53.93±10.60)岁,均长于混铀矿的患者[13.20年、(51.82±10.20)岁]。结论地质系统与矿山系统、纯铀矿及混铀矿接尘者矽肺发生情况的差别可能与所接触粉尘的理化性质及各自的工作环境有关。     

NMDA receptor genotypes associated with the vulnerability to develop dyskinesia

Dyskinesias are involuntary muscle movements that occur spontaneously in Huntington''s disease (HD) and after long-term treatments for Parkinson''s disease (levodopa-induced dyskinesia; LID) or for schizophrenia (tardive dyskinesia, TD). Previous studies suggested that dyskinesias in these three conditions originate from different neuronal pathways that converge on overstimulation of the motor cortex. We hypothesized that the same variants of the N-methyl--aspartate receptor gene that were previously associated with the age of dyskinesia onset in HD were also associated with the vulnerability for TD and not LID. Genotyping patients with LID and TD revealed, however, that these two variants were dose-dependently associated with susceptibility to LID, but not TD. This suggested that LID, TD and HD might arise from the same neuronal pathways, but TD results from a different mechanism.     

Apoptosis in peripheral blood leukocytes induced by hyperthermia and prednisolone in patients with dysadaptation

We studied morphological changes in blood leukocytes produced by prednisolone and hyperthermia. Patients with dysadaptation were characterized by activation of spontaneous apoptosis and inhibition of induced apoptosis in neutrophils and lymphocytes compared to healthy donors.     

Arterial hypertension as a psychosomatic problem

Current conception of stratification of arterial hypertension (AH) risk comprises a general strategy of its prevention, treatment and prognosis with consideration of personality, medical and social characteristics of the patients. In view of this AH is regarded a psychosomatic problem including somatic, psychic and social aspects. Of importance is AH study in patients with nonpsychotic mental disorders using methods of systemic analysis, multivariate probability models, in particular. The most adequate model is logistic regression. Our study included 1350 patients with borderline conditions. The developed model systems allowed isolation of the most significant somatic, psychic and psychosocial factors which can be applied as additional predictors of AH risk. Also, the results of the analysis may be useful in preventive interventions regarding individual spectrum of AH risk under joint efforts of internists, psychiatrist and psychotherapist.     

Laser-induced thermal occlusion of berry aneurysms: initial experimental results

An intravascular laser-catheter technique was used to occlude 12 experimental berry aneurysms, ranging in size from 4 X 3 mm to 8 X 6 mm (length X width), while the patency of adjacent arteries was preserved. A small steel cap on the end of an optical fiber was fluoroscopically positioned within the aneurysm. The cap was rapidly heated by the optical transmission of laser energy. This produced a thermal tissue reaction within the aneurysm, resulting in its occlusion. After treatment, the steel cap was detached atraumatically from the fiber and left as a permanent implant within the occluded aneurysm. This method has an advantage over the use of a bare-ended intravascular optical fiber because the steel cap provides a uniform distribution of thermal energy, thereby reducing the risk of unexpected perforation during treatment. The radiologic and histologic results of using this laser-catheter system were evaluated 1-21 weeks after treatment.     

Shifts in Case Mix and Locus of Mental Health Care for Washington State Adults with Severe Mental Illness

The author describes outcomes of interventions that were aimed at decreasing high use of state hospitals. Research focused on changes in state hospital case mix and dynamics of use by individuals identified as high utilizers before and after the Washington State Mental Health Division (MHD) implemented a series of interventions designed to reduce use. A set of recommendations are offered for policymakers who plan interventions that shift the locus of care for severely and persistently mentally ill adults.     

Signs of apoptosis of immunocompetent cells in patients with depression

A total of 26 patients with depression and 20 healthy subjects were studied. Measures of apoptosis of peripheral blood lymphocytes and serum cortisol concentrations were determined. A significant increase in lymphocyte apoptosis was found in patients with depression, resulting in an increase in the proportion of lymphocytes expressing the FAS receptor; cells with morphological signs characteristic of apoptosis (nuclear condensation, vacuolization) were also seen. Changes in cellular immunity were observed on the background of clinical depressive symptomatology, with decreases in the total numbers of T-lymphocytes (CD3⁺), T-helpers (CD4⁺), and natural killer cells (CD16⁺) as compared with numbers in healthy subjects. Serum cortisol levels were elevated. Correlation analysis revealed an interaction between high cortisol levels and decreases in T-helper cells (CD4⁺) and increases in apoptosis receptor expression in patients with depressive disorder. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 106, No. 5, pp. 49–51, May, 2006.     

Factors and outcomes associated with the induction of labour in Latin America

Objective  To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America.
Design  Analysis of the 2005 WHO global survey database.
Setting  Eight selected Latin American countries.
Population  All women who gave birth during the study period in 120 participating institutions.
Methods  Bivariate and multivariate analyses.
Main outcome measures  Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes.
Results  Of the 97 095 deliveries included in the survey, 11 077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay >7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding.
Conclusions  In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.