Marital support,spousal contact and the course of mild hypertension

OBJECTIVE AND METHODS: To define marital support (MS) and its correlates in a sample of mild hypertensives where marital adjustment (by Dyadic Adjustment Scale, DAS) was related to 3-year left ventricular mass, a secondary analysis was performed on 103 men and women who underwent 24-h ambulatory BP (ABP) monitoring, M-mode echocardiography and completed psychosocial questionnaires at baseline and 3 years. RESULTS: MS, defined as the presence of both marital satisfaction and cohesion (upper quartiles of DAS subscales) at baseline, predicted 3-year left ventricular mass (P=.007), which decreased 8% in the MS group and increased 6.26% in the low MS group. The MS group also had lower 24-h diastolic BP over 3 years (P=.016) than the low MS group. Based on the amount of spousal contact during ABP, MS subjects spent much more time together after 3 years than at baseline (P=.008) and compared to the low MS group (P=.027). CONCLUSION: MS, a construct of both the quality and quantity of contact between spouses, was related to improved 3-year outcome in mild hypertension. Prospective clarification of the role of MS in mild hypertension is required.     

CT scores of emphysema and oxygen desaturation during low-grade exercise in patients with emphysema

Purpose: We evaluated the usefulness of CT for assessing oxygen desaturation during walking in patients with emphysema.Material and Methods: The study comprised 32 patients with emphysema (mean age 67±6 years). Serial CT images of 5 mm were obtained from the apex to the basal regions of the lung during deep inspiration. The severity of emphysema was scored by four physicians according to a visual method. A six-minute walking test and oxygen desaturation (pSO₂) measurements were performed.Results and Conclusion: The mean CT score of the four observers was signfiicantly correlated with the nadir pSO₂ and ΔpSO₂, but did not correlate with the total distance walked. These results suggest that CT may be used for the assessment of oxygen desaturation during low-grade exercise in patients with emphysema.     

Testing for acanthocytosis

Abstract The presence of acanthocytosis in peripheral blood smears remains the hallmark of the clinical diagnosis of most neuroacanthocytosis syndromes, such as chorea-acanthocytosis (ChAc) and McLeod syndrome. Genetic analyses and/or specific laboratory tests are available only for a minority of these disorders. Testing for acanthocytosis is hampered by the lack of data on normal amounts of acanthocytes assessed by a standardized method. We report a prospective reader-blinded study designed to establish control values for abnormally shaped erythrocytes in healthy volunteers and patients with movement disorders (MDs) using light microscopic assessment of erythrocyte morphology in standard EDTA and isotonically diluted blood samples. We investigated a total of 100 patients fulfilling clinical criteria of specific MDs, 31 patients with MDs not matching any clinical criteria, and 37 healthy controls. In patients with diagnosed MDs and healthy controls, acanthocytes in dry blood smears were significantly more frequent following isotonic dilution compared with standard EDTA blood. In unfixed wet blood preparations of both EDTA blood and isotonically diluted blood, acanthocyte levels were significantly higher than in standard dry blood smear preparations. There were no statistical differences of acanthocyte levels in all test conditions between diagnosed MDs and healthy volunteers. There was no significant correlation of acanthocyte levels in all blood samples and preparations with age, sex or diagnosis. Thus, normal values were defined as the 99th percentile of combined results of the two groups of volunteers. Diluted blood combined with wet blood preparation showed high specificity (0.98) and the highest sensitivity of all test procedures (all genetically confirmed ChAc patients were detected). The reported method is cheap, readily available, and provides high specificity and sensitivity in respect to clinically relevant acanthocytosis. The use of isotonically diluted blood samples combined with unfixed wet blood preparation with a normal range of <6.3% of total erythrocytes is recommended to search for significant acanthocytosis in movement disorders.     

针尖穿刺力实验室间比对验证

本文主要通过组织8个实验室进行一次性使用无菌注射针“针尖刺穿力”的能力比对验证实验,验证该项目检验方法的有效性和可比性,以及各检验实验室检验该项目的差异。     

Effects of angle and laminectomy on triangulated pedicle screws

We aimed to demonstrate the effect of angle and laminectomy on paired pedicle screws to determine whether a 90 degrees screw angle is optimal as has been previously suggested. According to the angle between right and left screws, 28 calf vertebrae were divided into three groups and instrumented as follows: Group I: 60 degrees screw angle; Group II: 90 degrees angle; Group III: 60 degrees angle with laminectomy. The screws were connected using rods and cross-fixators and tested to peak pullout force. Triangulated pedicle screws provided 76.5% more pullout strength than single screws. Most of the specimens failed through loss of convergence angle (toggling of screws on the rods) and subsequent uni- or bilateral screw pullout. Mean+/-SD peak loads were: Group I: 2071+/-622 N; Group II: 1753+/-497 N; Group III: 2186+/-587 N. The differences were not significant (p>0.05). 90 degrees triangulation was not associated with a superior pullout performance versus conventional 60 degrees triangulation, suggesting that achieving additional triangulation angle is not necessary to obtain increased pullout strength. Laminectomy did not alter the effect of triangulation on fixation strength.     

Predictors of compulsory admission in schizophrenia-spectrum patients: excitement, insight, emotion perception

Purpose

We explored socio-demographic and clinical variables associated with compulsory admissions (CA) compared with voluntary admissions in schizophrenia-spectrum patients; moreover, we investigated the ability of excitement, emotion perception, and lack of insight to predict CA.

Methods

119 consecutive schizophrenia-spectrum patients admitted to the Servizio Psichiatrico di Diagnosi e Cura (SPDC = PES = psychiatric emergency service) of the Department of Neuroscience and Mental Health-San Giovanni Battista Hospital of Turin in the period between December 2007 and December 2009 were enrolled in the study. A backward stepwise logistic regression was used to test factors contributing to CA.

Results

CA rate in our sample was 28.5%. Previous CAs, drop-out, severity of illness, positive symptoms, excitement, emotion perception, and insight were significantly different in CA patients compared to voluntary ones. After backward selection of variables, three variables predicted CA in our sample: excitement, impaired emotion perception and lesser insight. Finally, the effect of excitement on CA status seemed partially mediated by emotion perception, the prediction model accounting for 53.8% of the variance of CA status. Conversely, insight seemed not to be a mediator of excitement on CA.

Implications

Understanding CA patterns in special populations represents a first step towards improving clinical decision-making and developing appropriate interventions and service-provision.     

儿童免疫规划针对性疾病的抗原及抗体检测分析

目的统计南宁市邕宁区儿童免疫规划针对性疾病的抗原及抗体检测结果,了解该区免疫防控效果。方法抽取2012年1月-12月间南宁市邕宁区5个社区行政村或社区适龄儿童150名进行调查,每个社区行政村或社区分别从东西南北中5个方位各随机抽取30名（1~6岁常住儿童各5名）,收集血清样本进行脊髓灰质炎抗体、麻疹抗体、乙肝表面抗原（HBs Ag）、乙肝表面抗体（HBs Ab）、白喉抗体检测。结果共调查适龄儿童150名,乙型肝炎（乙肝）抗原、抗体免疫合格率均较高,其中HBs Ag免疫合格率为99.3%,HBs Ab免疫合格率为88.0%,男女乙肝抗原、抗体合格率差异无统计学意义（P〉0.05）;脊髓灰质炎Ⅰ、Ⅱ、Ⅲ抗体阳性率均达100.0%;各年龄组麻疹抗体检测结果均较满意,其中以2、3岁儿童麻疹抗体阳性率最高,为100.0%,1、4、5、6岁儿童麻疹抗体阳性率依次为96.0%、84.0%、88.0%、96.0%;白喉抗体检测阳性率均为100.0%。结论该区儿童免疫规划针对性疾病抗体均达到理想水平,其中对脊髓灰质炎与白喉预防效果最佳,但对乙肝与麻疹的预防水平还欠佳,故追踪流动儿童免疫接种,提高全民对免疫规划认识,积极主动参与儿童免疫接种,是进一步提高免疫规划针对性疾病预防的关键。     

Significant but weak spousal concordance of metabolic syndrome components in Japanese couples

Objective

This study was initiated to investigate if spousal concordance in metabolic syndrome (MS) components exist in Japan.

Methods

In all, 756 couples (mean age: 48.9 and 47.3 years for husbands and wives, respectively) were identified. Each subject was classified as an MS, MS reserves (MSRES) or no risk of MS (NonMS) case after Japanese Ministry of Health, Labour and Welfare (JMHLW) criteria. Criteria of the National Cholesterol Education Program and of the Joint Interim Statement were also applied.

Results

With Japanese Ministry of Health, Labor and Welfare (JMHLW) criteria, MS, MSRES and NonMS cases accounted for 11.9, 14.7 and 73.4 % in husbands and 1.6, 3.7 and 94.7 % in wives. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP) and hemoglobin A1c (HbA1c) showed significant correlation (p < 0.01). Correlation was also significant (p < 0.05) for mean blood pressure (MBP) and fasting plasma glucose (FPG). When adjusted for age, correlations were significant only for WC, BMI and HbA1c. Furthermore, none of the correlation coefficients were greater than 0.2. Logistic regression analyses did not suggest significant mutual influence in MS status between the couples.

Conclusions

Spousal concordance in MS components was detected for WC, BMI, SBP, MBP, FPG and HbA1c, but the correlation was generally weak and modest in Japanese couples.     

贵州省脑膜炎奈瑟菌药物敏感性检测及结果分析

目的了解贵州省脑膜炎奈瑟菌(Neisserid meningitides,Nm)的敏感性,为制定防控措施提供依据。方法采用纸片扩散法和Etest浓度梯度法对我省58株Nm进行12种抗菌药物的敏感性检测。结果 19株A群和16株B群Nm对四环素、青霉素、阿奇霉素、头孢曲松、头孢噻肟、氯霉素、利福平、美洛培南和氨苄西林均敏感,对复方新诺明、环丙沙星、左氧氟沙星都耐药。3株C群Nm中除1株对利福平不敏感外,其耐药菌谱与A和B群Nm的一致。而20株W135群Nm对青霉素、头孢曲松、氯霉素、美洛培南和氨苄西林敏感,对复方新诺明耐药,但对环丙沙星、四环素、左氧氟沙星、阿奇霉素、头孢噻肟和利福平表现出不同的耐药性特征。结论贵州省A、B、C、W135四个血清型的Nm对青霉素、头孢曲松、氯霉素、美洛培南和氨苄西林普遍敏感,对复方新诺明耐药。部分流脑菌株对一些抗生素具有耐药性,需全面监测病例和健康带菌者流脑菌株的耐药性特征。