血透对慢性肾功能衰竭患者心脏结构和功能的影响

目的 探讨慢性肾功能衰竭（ＣＲＦ）患者心脏结构和功能的改变及血液透析对心脏的影响。方法 ４０例正常对照及２０例慢性肾衰患者血透前后分别用彩色多普勒超声心动图（ＵＣＧ）进行心脏结构和功能的测定,并监测透析前后血压、肾功能的变化。结果 ＣＲＦ患者与正常对照组相比,ＳＢＰ显著升高（Ｐ〈０．０１）,ＡＯＥ降低,ＬＡＤ、ＲＡＡ、ＩＶＳＴ、ＬＶＰＷＴ及ＬＶＭＩ均明显增高（Ｐ〈０．０１）,心脏收缩功能代偿性增强     

Prevalence of antibody to Trypanosoma cruzi among blood donors in Los Angeles, California

Transfusion-associated Chagas' disease is a serious public health problem in Central and South America. With the recent influx of immigrants from Chagas' disease-endemic areas, concern about the risk of disease from blood transfusion has increased in the United States. To assess the prevalence of Trypanosoma cruzi infection in one area, 1024 consecutive blood donations from 988 voluntary blood donors at a medical center in Los Angeles County were screened serologically. The median age of donors screened was 32.5 years; 53.4 percent were male, and 38.4 percent were born in Chagas' disease-endemic countries. All donor sera were tested by complement fixation (CF) and indirect immunofluorescence (IIF) tests. A radioimmunoprecipitation assay (RIPA) was also done on all sera from CF- or IIF-reactive donors and an equal number of sera from nonreactive donors. A second serum specimen was obtained, and interviews were completed for 18 (67%) of 27 donors with an initial CF titer greater than or equal to 8 or an IIF titer greater than or equal to 64. The overall seroreactivity (by CF and IIF) was 1.1 percent (11/988). One donor (0.1%) had antibody specific to the 72- and 90-kDa antigens of T. cruzi on RIPA. Seven recipients of blood components from the seroreactive donors were located and were seronegative at 3 to 6 months. Seroreactive donors were 3.6 times more likely to have been born or to have resided in Mexico or Central America, 8.7 times more likely to have donated blood in the past, and 11.8 times more likely to have a history of malaria prophylaxis or treatment.     

A device to measure in vivo forces in human flexor tendons during carpal tunnel operations

An apparatus has been designed to measure the in vivo forces transmitted along human hand flexor tendons during carpal tunnel release procedures. The tendon will be run through three hooks, the central one of which is attached to a load cell. The rationale is that once these forces are known this will aid in the design of repair techniques and rehabilitation regimens. As a first stage, an in vitro validation study is presented using cord subjected to varying forces to mimic an in vivo flexor tendon under varying conditions of use. Our results show that we can accurately and reproducibly measure the force in the cord.     

男男性行为者公开性取向与艾滋病相关行为的关系研究

目的了解男男性行为者（MSM）公开性取向与艾滋病相关行为的关系。方法从MSM不同年龄、活动场所等“亚群”特征中招募符合条件的“种子”共8人,结合滚雪球抽样法招募调查对象,进行相关行为匿名调查和血清学检测,应用Y。检验、非条件logistic回归分析进行数据分析。结果合格调查401例,公开性取向11．0％（44／401）。公开性取向／未公开性取向艾滋病病毒（HIV）确证感染率6．8％（3／44）／6．4％（23／357）,梅毒累计感染率15．9％（7／44）／22．1％（79／357）,现症感染率6．8％（3／44）／9．5％（34／357）（X2=0．107、0．900、0．096,P均〉0．05）。单因素分析：年龄、职业、婚姻状况、性取向、收入、近1年接受HIV检测、自认感染风险、阳性结果的态度、认识当地MSM朋友数、家庭关系、固定性伴侣（BF）间感情付出、更多寻找一夜情性伴的原因、近6月男性肛交数、商业性行为,女性性行为、有BF性伴、无保护性口交、累计BF数、有过异性性行为、商业性行为与公开性取向相关（X2=6．921、3．927、6．678、4．767、7．565、5．083、4．104、6．165、12．455、13．257、14．315、6．471、12．062、10．432、4．951、4．692、7．205、5．019、8．568、7．233,P均〈0．05）。多因素分析,公开性取向的独立影响因素：收入（OR=3．745,95％CI：1．446～9．687）、BF间感情付出（OR=5．863,95％CI：2．257～14．256）、近6月男性商业性行为（OR=8．000,95％CI：1．468～43．478）、近6月男性肛交数（OR=3．706,95％CI：1．324～10．367）,收入较高,BF间感情付出很多,近6月男性肛交数≥5、有男性商业性行为者公开性取向的比例较高。结论MSM公开性取向很少,其公开性取向与否对社会及社群健康的影响极具双面性,在艾滋病防治中应针对各自特征开展健康教育和行为干预。     

16、20、24、28通道记录对平均平方根值脑电地形图的影响

目的评估不同的电极密度对BEAM数据精确性的影响。方法32名年龄50~59岁正常受试者。采用1和4点插值计算方法计算平均平方根功率BEAM。对比16、20、24、28通道记录的BEAM。结果6个脑电频段61%(11/18)的高功率值电极部位不在16通道的记录电极之内。其中73%(8/11)的高功率电极位于中线电极(Fz、Cz、Pz、OZ)。16通道记录时各个频段的功率值明显降低。增加记录电极,BEAM的精确性增加。结论16通道记录的BEAM存在明显的失真,在低密度电极记录的条件下计算BEAM至少20通道。     

Allergic characteristics of urban schoolchildren with atopic eczema in Ghana

Background Atopic eczema is an increasing clinical problem in Africa. Objective To determine allergic characteristics and to identify possible risk factors for eczema among schoolchildren in an urbanized area in Ghana. Patients and methods Schoolchildren aged 3–16 years with eczema were recruited. For each patient, one to three age‐ and sex‐matched controls were selected. All children completed a questionnaire and were skin prick tested with a panel of allergens. Blood was drawn to determine the total and allergen‐specific IgE. Conditional logistic regression models with the matching factors included in the model were used to calculate the odds ratios and to adjust for possible confounders. Results A total of 52 children with eczema (27 boys and 25 girls) and 99 controls were included. Levels of total IgE were found to be 9.1 (1.1; 78.4) times more often elevated in children with eczema. This association was mainly driven by elevated IgE levels against cockroach antigen. Children with eczema were found to have 2.0 (0.87; 4.7) times more often positive skin prick tests (SPT), but this association diminished to 1.2 (0.40; 3.6) after adjustment for total IgE levels. Frequent washing with soap was identified as a risk factor for the development of eczema among these children. Conclusion Schoolchildren with eczema in Ghana were characterized by elevated IgE levels especially against cockroach antigen. The association between eczema and positive SPT was much weaker suggesting immune hyporesponsiveness of the skin. After adjustment for IgE level, SPT were less suitable to distinguish children with and without eczema.     

A systematic review of methods to diagnose oral dryness and salivary gland function

ABSTRACT: BACKGROUND: The most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva (sialometry). Since there is an expected and wide variation in salivary flow rates among individuals, the assessment of dysfunction can be difficult. The aim of this systematic review is to evaluate the quality of the evidence for the efficacy of diagnostic methods used to identify oral dryness. METHODS: A literature search, with specific indexing terms and a hand search, was conducted for publications that described a method to diagnose oral dryness. The electronic databases of PubMed, Cochrane Library, and Web of Science were used as data sources. Four reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The database searches resulted in 224 titles and abstracts. Of these abstracts, 80 publications were judged to meet the inclusion criteria and read in full. A total of 18 original studies were judged relevant and interpreted for this review.In all studies, the results of the test method were compared to those of a reference method.Based on the interpretation (with the aid of the QUADAS tool) it can be reported that the patient selection criteria were not clearly described and the test or reference methods were not described in sufficient detail for it to be reproduced. None of the included studies reported information on uninterpretable/intermediate results nor data on observer or instrument variation. Seven of the studies presented their results as a percentage of correct diagnoses. CONCLUSIONS: The evidence for the efficacy of clinical methods to assess oral dryness is sparse and it can be stated that improved standards for the reporting of diagnostic accuracy are needed in order to assure the methodological quality of studies.There is need for effective diagnostic criteria and functional tests in order to detect those individuals with oral dryness who may require oral treatment, such as alleviation of discomfort and/or prevention of diseases.     

Pain and fear in connection to orthodontic extractions of deciduous canines

International Journal of Paediatric Dentistry 2010; 20: 193–200 Background. Interceptive extractions of deciduous canines are, from a patient perspective, poorly investigated. Aims. To describe pain, discomfort, and dental fear in connection to extractions of the deciduous canines, indicated as an orthodontic treatment procedure. Design. Thirty‐two Swedish children aged 7–9 years had all four deciduous canines extracted over three occasions. The children rated procedural and postoperative pain on visual analogue scales. Acceptance of injections and extractions was assessed by the treating dentists. Analgesic consumption and recovery time for drinking and eating was reported by parents. Dental fear was assessed using the Children’s Fear Survey Schedule questionnaire. Results. Procedural pain showed low median levels, although some individuals reported high values. Boys reported significantly more pain at appointments when two (as opposed to one) canines were extracted. Postoperative pain levels were low and use of analgesics sparse. Dental fear paralleled norm values and did not increase from pre‐ to post‐extraction. Conclusions. Pain management routines during extractions of this kind should be revised. Single tooth extractions seem to be preferable to extractions of two canines at the same appointment. Extraction of four deciduous canines should not cause major postoperative inconvenience; these extractions neither triggered nor increased dental fear.