Obesity and outcomes after blunt trauma

BACKGROUND: Obesity has proven to be an independent risk factor of mortality in the intensive care unit (ICU) in both nontrauma and trauma patients. The purpose of this study was to determine whether the detrimental effect of obesity extend to morbidity as well as mortality in the intensive and nonintensive care blunt trauma patients. METHODS: A retrospective comparison of obese (body mass index [BMI] > 30 kg/m2) to nonobese (BMI < 30 kg/m2) blunt trauma patients was performed between January 2004 and December 2005. Patient demographics, morbidity, mortality and ventilator, ICU, and hospital length of stays were analyzed. Continuous variables were evaluated using the Wilcoxon Rank test and the nominal variables were evaluated using the Fisher's exact test. RESULTS: A cohort of 338 nonobese patients was compared with 115 obese patients during the study. These groups were similar in age (p = 0.19), gender (p = 0.37), and mechanism (p = 0.13). Their severity of injury were similar, demonstrated by nonsignificant differences in Injury Severity Score (p = 0.45), New Injury Severity Score (p = 0.51), Abdomen Abbreviated Injury Score (AIS; p = 0.49), and head AIS (p = 0.64). The subset of obese patients who never went to the ICU had a slightly longer hospital stay with a p value of 0.055. Overall the mortality rates were not different between the groups (3.5% obese versus 7.1% nonobese, p = 0.26). CONCLUSIONS: This group of obese blunt trauma patients had similar mortality rates to their leaner counterparts possibly because their complications were minimized. Despite this finding, a subset of obese patients had longer hospital stays which increases the financial burden to the patient and hospital. Effort should be made to facilitate their discharge to avoid complications and minimize cost.     

毛白杨化学成分的研究

从毛白杨(Populus tomentosa Carr.)的叶中分得一个新的黄酮类化合物,鉴定为洋芹素-7-O-(6″-O-p-羟基肉桂酰)-B-D-吡喃葡萄糖甙(Ⅰ),同时还分得四个已知成分分别鉴定为水杨甙(salicin,Ⅱ)、2″-苯甲酰水杨甙(tremulodin,Ⅲ)、特里杨甙(tremulacin,Ⅳ)和胡萝卜甙(dauvasterol,Ⅴ)。     

哺乳期避孕药ST-1435衍生物的合成

19-失碳-16-亚甲基-17α-乙酰氧基黄体酮(3)最早由我国合成,后来西德E.Merk AG药厂使其开发成高效低毒的非口服避孕药,称ST-1435,其皮下埋植缓释系统国外已临床使用,有效避孕期约一年,临床研究还发现它对脂代谢、糖代谢、内分泌与肝功能等均无不良影响,并因其口服无效,近年来国外认为它更适合于哺乳期妇女使用。     

PGD8 Comparison of Prevalence Rates of Low Back Disorders Obtained from Two Large National Claims Databases

Large national claims databases are sources of vital information concerning health care resource utilization. However, the comparability of data obtained from such databases has not yet been ascertained.
OBJECTIVE: To compare prevalence rates of low back disorders obtained from two large national inpatient claims databases and to study variations in length of stay and corresponding costs.
METHODS: Data were obtained from two independent databases with inpatient claims information including ICD-9 codes for specific diagnoses, demographics, length of stay (LOS), and payments or charges made. One of the databases is a 20% national inpatient sample of all community hospitals in the U.S. (HCUP). The other national database consists of data gathered for privately insured population (MarketScan). Claims for specific diagnoses of low back disorders (ICD-9 codes: 720.0–724.9) for 1994 were obtained. Using age, gender, and diagnosis-adjusted rates (direct method), the overall low back disorder rates were compared. Also age, gender, and diagnosis-specific low back disorder rates were compared between two databases.
RESULTS: The overall adjusted prevalence rates of low back disorders were 1.49 and 1.88 per 100 admissions for HCUP and MarketScan, respectively. Significant difference was observed in the age, gender-adjusted rates for diagnosis of displacement of lumbar intervertebral disc without myelopathy, with MarketScan showing a higher rate as compared to HCUP (1.06 vs. 0.78/100 admissions). The adjusted average LOS and age, gender, and diagnosis-specific LOS were higher for HCUP than MarketScan. The specific and adjusted payments (based on MarketScan) were, however, higher than the charges reported in HCUP.
CONCLUSIONS: The prevalence rate of low back disorders is higher in the MarketScan database than in HCUP. The differences in the length of stay and associated costs might be attributable to other variables such as geographical variations.     

Amphistome Species in Cattle in South Coast of Caspian Sea

Background

Knowledge about the amphistomid fauna in Iranian domestic ruminants depends on the studies conducted almost 30 years ago. The last situation in cattle is introduced here in the provinces in south coast of Caspian Sea.

Methods

Amphistomid species were collected from cattle at slaughter houses of the provinces Gilan and Mazanderan in 2010. Median sagittal sections were prepared by the conventional method. Species were identified by the histomorphological pecularities of the muscular argans.

Results

Five amphistomid species, Paramphistomum cevri, P. gotoi, Calicophoron calicophorum, Carmyerius spatiosus and Gastrothylax compressus, recovered. Calicophoron calicophorum is a new species for Iran. Criteria used in identification of the species were illustrated.

Conclusion

Iran has a rich amphistomid fauna and mostly under the influence of oriental conditions.     

Physiological reactivity in response to a fear‐induced virtual reality experience: Associations with psychopathic traits

Despite the longstanding discussion around the link between psychopathy and fearlessness, few studies have explicitly tested this association, and results have been mixed. This may be due, in part, to the lack of specificity in fear assessment. Further, the relation between psychopathy and fear may be better understood using the two‐factor model because, in theory, fear has opposing associations with interpersonal‐affective (Factor 1) and impulsive‐antisocial (Factor 2) traits. The present study aimed to test if the two factors of psychopathy are deferentially related to fear reactivity. To examine this, we collected sympathetic (SNS; skin conductance) and parasympathetic (PNS; respiratory sinus arrhythmia) nervous system reactivity to an interactive virtual reality horror video in a nonclinical sample (N = 103). Also, we included measures of emotional reactivity to fear and self‐report of situational fear. Results indicated that coinhibition (i.e., low PNS and SNS) of the two physiological systems predicted Factor 1, suggesting that individuals high on Factor 1 showed little change in both branches of the autonomic nervous system in response to fear. In contrast, Factor 2 was predicted by high PNS reactivity, suggesting a vulnerability to emotion dysregulation. On emotional reactivity, Factor 1 was related to feeling happier after the fear condition, whereas Factor 2 was related to feeling less in control. Factor 1 was inversely associated with situational fear, specifically, lower scores of social phobias, fear of aggression, and physical injury. In summary, the results provide evidence that psychopathy is related to fearlessness; however, this is unique to the personality features of psychopathy.     

仰卧和俯卧位心脏对煤尘肺患者肺组织体积与功能的影响

目的:观察仰卧位和俯卧位心脏对煤尘肺患者肺组织体积和肺功能的影响,为临床应用俯卧位治疗成人呼吸窘迫综合征等肺部疾病提供依据。方法:2006-08/2007-01河南鹤煤集团公司总医院放射科对10例煤尘肺患者行仰、俯卧位高分辨螺旋CT扫描,分别测量位于心脏下方肺组织的体积,测量仰、俯卧位状态下肺功能,用配对t检验进行统计学分析。结果:10例患者均进入结果分析。①CT扫描心脏压迫下的肺组织体积:俯卧位时均小于仰卧位[左肺:(7.74±9.55),(242.60±72.11)mm3;右肺:(12.21±11.41),(156.49±76.54)mm3,P均<0.01]。②肺功能测量结果:仰卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.14±0.58)L、(1.62±0.79)L、(89.80±29.26)、(3.42±1.98)L/s;俯卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.36±20.79)L、(1.80±0.77)L、(100.10±22.46)、(4.30±2.37)L/s。俯卧位时肺功能明显优于仰卧位(P<0.05)。结论:俯卧位时位于心脏下方的肺组织明显减少,可显著改善人体的肺换气功能。     

腰椎椎弓根通道不同头尾偏角方向变化规律的数字解剖学特点

目的:观察个体化腰椎椎弓根通道在外偏角不变而不同头尾偏角方向的变化规律。方法:实验于2005-09/2006-09在广东省医学生物力学重点实验室完成。选取1例健康成人腰椎CT连续扫描数据集,应用Mimics8.11三维重建腰椎数字解剖模型,将腰椎数字模型导入Surface10.0,获得椎弓根通道的正投影区内边界及其正投影区内边界内、外切圆,获得内切圆经椎板、椎弓根与椎体的通道长度,获取各内、外切圆半径大小,对获取相关数据进行定量分析与椎弓根通道的可视化显示。结果:①内切圆半径:L1～5左右椎弓根通道正投影区内切圆半径在设定头尾偏角大小范围内变化不明显,左侧内切圆半径分别为(3.01±0.02),(3.89±0.03),(4.13±0.04),(5.16±0.43),(5.37±0.73)mm,右侧分别为(3.49±0.03),(4.34±0.06),(4.55±0.13),(5.26±0.36),(5.27±0.83)mm。②外切圆半径:L1～5左右椎弓根通道正投影区外切圆半径在设定头尾偏角大小范围内变化不明显,左侧外切圆半径分别为(7.22±0.81),(7.96±0.43),(8.04±0.34),(8.15±0.21),(11.00±0.40)mm,右侧分别为(7.82±0.55),(8.03±0.26),(7.76±0.40),(7.81±0.29),(10.77±0.30)mm。③通道长度:L1～5左右椎弓根通道正投影区内切圆通道长度随头尾角度的增大呈逐渐增大而后又逐渐减小趋势,左侧通道长度分别为(40.49±6.73),(41.49±6.12),(42.02±7.55)(37.02±7.58),(38.87±10.37)mm,右侧分别为(38.08±6.33),(41.16±5.03),(42.01±6.53),(37.94±7.71),(37.66±4.32)mm。结论:腰椎椎弓根通道大小是随头尾偏角方向不同而不同的连续动态变化过程,应用数字技术可以获得其通道大小连续动态的变化规律,临床应用选择合适直径、长度大小的螺钉及确定最佳进钉方向需要依循这一规律。