感染性休克病死率和危险因素分析

目的：回顾性分析感染性休克的病死率和相关危险因素。方法：回顾性分析71例1994年1月～2004年10月源自中山大学附属第二医院的感染性休克患者资料，比较近10年死亡率的变化，对感染性休克的病死危险因素做单因素分析和多因素Logistic回归。结果：1994年～2004年间，感染性休克患者的总死亡率是64．8％．近10年间病死率无明显变化(P=0．725)；合并器官功能衰竭的数目越多，死亡率越高；性别(OR=0．206)、MODS数目(OR=11．387)、SIRS数目(OR=6．335)均是危险因素，其中MODS数目是强危险因素。结论：近10年感染性休克的病死率无明显下降趋势，需注重防治MODS，及早采取各种保护器官功能的支持疗法。     

The VS and V blood group polymorphisms in Africans: a serologic and molecular analysis

BACKGROUND: VS and V are common red cell antigens in persons of African origin. The molecular background of these Rh system antigens is poorly understood. STUDY DESIGN AND METHODS: Red cells from 100 black South Africans and 43 black persons from Amsterdam, the Netherlands, were typed serologically for various Rh system antigens. Allele-specific polymerase chain reaction and sequencing of polymerase chain reaction products were used to analyze C733G (Leu245Val) and G1006T (Gly336Cys) polymorphisms in exons 5 and 7 of RHCE and the presence of a D-CE hybrid exon 3. RESULTS: The respective frequencies of all VS+ and of VS+ V-(r's) phenotypes were 43 percent and 9 percent in the South Africans and 49 percent and 12 percent in the Dutch donors. All VS+ donors had G733 (Val245), but six with G733 were VS- (4 V+w, 2 V-). The four VS- V+w donors with G733 appeared to have a CE-D hybrid exon 5. T1006 (Cys336) was present in 12 percent and 16 percent of donors from the two populations. With only a few exceptions, T1006, a D-CE hybrid exon 3, and a C410T (Ala137Val) substitution were associated with a VS+ V-phenotype ((C)ces or r's haplotype). Two VS+ V-individuals, with the probable genotype, (C)ces/(C)ces), were homozygous for G733 and for T1006. CONCLUSIONS: It is likely that anti-VS and anti-V recognize the conformational changes created by Val245, but that anti-V is sensitive to additional conformational changes created by Cys336.     

Prevalence and predictors of antioxidant supplement use during breast cancer treatment

BACKGROUND.

Although many patients take antioxidant dietary supplements during breast cancer treatment, the benefits of such supplementation are unproven. The authors of this report analyzed the prevalence of and factors associated with antioxidant supplement use during breast cancer (BC) treatment among women who participated in the Long Island Breast Cancer Study Project.

METHODS.

From 2002 through 2004, women with BC who had participated a case‐control study from 1996 to 1997 were invited to participate in a follow‐up interview. Antioxidant supplement use was defined as any self‐reported intake of supplemental vitamin C, vitamin E, β‐carotene, or selenium in individual supplements or multivitamins.

RESULTS.

Follow‐up interview participants were younger, more predominantly white, and of higher socioeconomic status than women who did not respond. Among 764 participants who completed the follow‐up interview, 663 (86.8%) reported receiving adjuvant treatment for their BC. Of those 663 women, 401 (60.5%) reported using antioxidants during adjuvant treatment: One hundred twenty of 310 women (38.7%) used antioxidants during chemotherapy, 196 of 464 women (42.2%) used them during radiation, and 286 of 462 women (61.9%) used them during tamoxifen therapy. Of 401 antioxidant users, 278 women (69.3%) used high doses (doses higher than those contained in a Centrum multivitamin). The factors that were associated with high antioxidant supplement use during treatment were higher fruit and vegetable intake at diagnosis (relative risk [RR], 1.71; 95% confidence interval [CI], 1.13‐2.59), tamoxifen use (RR, 3.66; 95% CI, 2.32‐5.78), ever using herbal products (RR, 3.49; 95% CI, 2.26‐5.38), and ever engaging in mind‐body practices (RR, 1.72; 95% CI, 1.13‐2.64).

CONCLUSIONS.

Given the common use of antioxidant supplements during BC treatment, often at high doses and in conjunction with other complementary therapies, future research should address the effects of antioxidant supplementation on BC outcomes. Cancer 2009. © 2009 American Cancer Society.     

ABO血型不合红细胞输注的临床转归

在过去的30年中,输血安全有了巨大的进步,大部分感染性风险下降,然而,输血仍然有致病和致死的潜在风险.对于受血者来说,最大的风险之一是来自于差错导致输入了不正确的血液成分.     

Hypnic Headache Due to Hypoglycemia: A Case Report

Hypnic headache (HH) is a rare primary headache disorder and pathophysiology is still poorly understood. It is considered a chronobiological disorder in almost all published cases. Few secondary cases have been described so far. We report a case of a 64-year-old woman presenting headaches exclusively during sleep and fulfilling the diagnostic criteria for HH, but a 72-hour glucose monitoring showed hypoglycemia episodes related to the onset of headaches. To our knowledge, this is the first report of symptomatic HHs associated with hypoglycemia and it suggests direct evidence of HH due to a metabolic disorder.     

Hair as a Biopsy Material

Lead was measured by atomic absorption spectrometry in the hair of a random sample of the population of the Republic of Panama. Age, sex, and place of residence were found to influence the lead concentration of hair. Lead concentration increased in a rural-urban gradient, with females having higher concentrations than males. Awareness of these factors will increase the utility of hair as 2 biopsy material in the assessment of environmental exposure.     

HIV Case Manager Preparedness for Practice in Ryan White CARE Act Funded Settings

While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice.