综合治疗对脑梗塞相关危险因素的影响

目的　探讨综合治疗对脑梗塞复发的相关危险因素的影响。方法　随机选择85 例脑梗塞伴各类危险因素患者在综合治疗前后,对他们进行血压、空腹血糖、胆固醇、甘油三酯及血液流变学等8 项指标的测定。结果　经过1 ～3 年临床观察随访,有50 % 以上高血糖、高血脂、高粘滞血症患者检验指标趋于正常,94 .3 % 的高血压得到控制与稳定,经t 检验,血液流变学4 项P 值< 0 .05 ,差异有显著意义,高血压、空腹血糖、胆固醇、甘油三酯的P 值< 0 .01 ,差异有非常显著意义。结论　综合治疗对控制相关危险因素,预防脑梗塞复发有重要临床意义     

Ⅱ型糖尿病并发心脏病危险因素的logistic回归分析

探讨Ⅱ型糖尿病并发心脏病的危险因素,用ｌｏｇｉｓｔｉｃ回归模型对糖尿病并发心脏病的危险因素进行分析,结果显示患者体重指数较大、心理评分较高、舒张压高及血脂高,其发生心脏病的风险增加;饮食评分较高,较好的控制饮食,其并发心脏病的风险较低。故较好的控制患者血压、血脂和饮食可以减少并发症的发生、延长患者的寿命 。     

Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships

The National Women's Study, a 2-year, three-wave longitudinal investigation, employed a national probability sample of 3,006 adult women to: (a) identify separate risk factors for rape and physical assault, and (b) identify separate risk factors associated with post-rape posttraumatic stress disorder (PTSD) and post-physical assault PTSD. This investigation differed from previous studies in that it prospectively examined risk factors at the multivariate, as opposed to univariate level. Overall, past victimization, young age, and a diagnosis of active PTSD increased women's risk of being raped. By contrast, past victimization, minority ethnic status, active depression, and drug use were associated with increased risk of being physically assaulted. Risk factors for PTSD following rape included a history of depression, alcohol abuse, or experienced injury during the rape. However, risk factors for PTSD following physical assault included only a history of depression and lower education.     

A study on the role of the family and other risk factors in HCV transmission

Background/aims: To understand the intrafamilial transmission and the existing risk factors related to HCV infection in subjects confirmed anti-HCV positive, their sexual partners and household contacts in Friuli, North-East Italy. Methods: We enrolled all the subjects that were consecutively identified as HCV positive during routine laboratory testing in six health districts and their household contacts. From each subject we obtained a blood sample, demographic data and a medical history including the existence of risk factors for HCV. Antibodies to HCV were detected employing a commercially available second-generation enzyme immunoassay (EIA); positive serum specimens were retested using a second-generation recombinant immunoblot assay (RIBA-2). Results: We recruited 743 subjects, 229 first subjects identified as HCV positive and 514 household contacts. There were no statistically significant differences in positivity among household contacts. Analysing intracouple transmission we found no significant differences by gender in couples both with and without parenteral risk factors. We found, both with univariate and multivariate analysis, as statistically significant risk factors in all the subjects: age older than 60, blood transfusions (particularly those performed before 1984), surgical procedures such as abortion and/or uterine curettage, history of HBV infection, intravenous drug use, and tattooing. Conclusions: Our results stress the low relevance of sexual transmission in the intrafamilial context, the importance of abortion and/or uterine curettage, the important role of blood transfusions in the past, a higher prevalence of HCV infection within a household of a HCV positive member compared to all other existing data in the area.     

Correlation between mortality trends of ischaemic cardiopathy and some nutritional factors in Spain 1968–1986

After describing the evolution of mortality from ischaemic cardiopathy (IC) in Spain from 1951 to 1986, which is tending to stabilize in some age groups, and from cerebrovascular accidents (CVA), which is clearly declining, an attempt is made to relate these developments to the prevalence of the main risk factors (hypertension, cholesterol, tobacco) associated with IC and CVA. Certain advances, though of a limited number, have been made in recent years in the control of arterial hypertension in Spain, although campaigns on a national scale as in other countries have not been carried out. Regarding alimentary factors, there is an obvious increase in the consumption of food rich in proteins and animal fats, abandoning to a great extent the traditional Mediterranean diet, with health care action being limited to the improvement of nutrition education of the public. Furthermore, the consumption of tobacco has been increasing in Spain during the study period in spite of health legislation in force in recent years.It is therefore deduced that there is no obvious relationship between mortality due to IC and CVA and the prevalence of the main risk factors associated with these diseases, especially when taking into account that preventive actions on a public health level have been very limited.Corresponding author.     

Relative risk factors for osteoporotic fracture: A pilot study of the MEDOS questionnaire

Summary This study tested selected elements of a questionnaire devised to detect risk factors for osteoporosis in a large case-control study of hip fracture. The questions were applied to two separate studies. The first utilised a hospital sample of postmenopausal women with established vertebral osteoporosis, and responses were compared to woman with primary osteoarthritis. In a second study, the questionnaire was applied to apparently healthy women participating in a study of bone density. Significant differences between patients with osteoporosis and osteoarthritis were observed in body mass index, the prevalence of appendicular fractures, the degree of immobilisation, the age of menarche, exposure to sunlight and indices of physical activity. Significant differences were found in bone mass in healthy women divided according to the age of menarche, parity and duration of lactation. These data identify previously established risk factors for osteoporosis and suggest that the MEDOS questionnaire will provide a powerful tool for the future assessment of risk factors in osteoporosis. Collaborating centers: Dilen G., Istanbul; Gennari C., Siena; Lopez Vaz A.A., Porto; Lyritis G., Athens; Mazzuoli G.D., Rome; Miravet L., Paris; Passeri M., Parma; Perez Cano R., Sevilla; Rapado A., Madrid; Ribot C., Toulouse. Project group: Allander E., WHO Collaborating Centre for the Epidemiology of Rheumatic Conditions, Huddinge; Dequeker J., WHO Consultant, Leuven; Gonzalez A., Sandoz, Basle; Kanis J.A., European Osteoporosis Foundation, Sheffield; Keen D., Sandoz, Basle; Khaltaev N., WHO Non-communicable Diseases, Geneva; Plüss M., Sandoz, Basle.     

中医证的构成与证的表现形式--临床辨证灵活性的理论基础

提出中医“证的构成”与“证的表现形式”，阐述临床上证候表现之所以错纵复杂、变化多端的关键所在，意为临床辨证的灵活性提供理论依据。     

Diagnostic Rules for Children with PDD-NOS and Multiple Complex Developmental Disorder

This study was designed to examine the classification performance of diagnostic rules for pervasive developmental disorder not otherwise specified (PDD-NOS) and multiple complex developmental disorder (McDD), with clinical diagnosis as the gold standard. McDD is an heuristic concept of a developmental disorder characterised by social impairments, affective dysregulation, and thought disturbance. Detailed information on the symptoms, reliably extracted from the charts of 103 children with PDD-NOS and McDD, 32 with autistic disorder, and 96 with non-PDD disorders, was used to determine the presence of the DSMIV criteria of autistic disorder and the criteria of McDD. A scoring rule for PDD-NOS based on a short set of seven DSM-IV criteria with a cut-off point of three items and one social interaction item set as mandatory had the best balance between high sensitivity and high specificity. The most effective and simple rule based on McDD criteria had a cut-off of three items, out of six items of anxieties and thought disturbance.     

Risk factors for respiratory syncytial virus associated apnoea

Respiratory syncytial virus (RSV) infections are characterized by upper or lower respiratory tract symptoms including bronchiolitis and pneumonia. Apnoea may be the first sign of disease in children with RSV infection. The aims of this study were the identification of independent risk factors for RSV associated apnoea and the prediction of the risk for mechanical ventilation in children with RSV associated apnoea. Medical records of children younger than 12 months of age admitted with RSV infection between 1992 and 1995 to the Sophia Children's Hospital, were reviewed. Demographic parameters, clinical features and laboratory parameters (SaO₂, pCO₂ and pH) were obtained upon admission and during hospitalization. Children with and without apnoea were compared using univariate and multivariate logistic and linear regression analysis. One hundred and eighty-five patients with RSV infection were admitted of whom 38 (21%) presented with apnoea. Patients with apnoea were significantly younger, had a significantly lower temperature, higher pCO₂ and lower pH and had on chest radiographs also more signs of atelectasis. The number of patients admitted to the ICU because of mechanical ventilation and oxygen administration was significantly higher in children with RSV associated apnoea. Apnoea at admission was a strong predictor for recurrent apnoea. The relative risk for mechanical ventilation increased with the number of episodes of apnoea: 2.4 (95% CI 0.8 – 6.6) in children with one episode of apnoea (at admission) versus 6.5 (95% CI 3.3 – 12.9) in children with recurrent episodes of apnoea. Conclusions Age below 2 months is the strongest independent risk factor for RSV associated apnoea. Apnoea at admission increases the risk for recurrent apnoea. The risk for mechanical ventilation significantly increases in children who suffer from recurrent apnoea. Received: 12 May 1997 / Accepted in revised form: 22 August 1997