北京市崇文区社区居民（1985－1993）死因分析

对本医院所管社区（崇文门外１５个居委会２２６８２人）１９８５─１９９３年九年人口全死因进行分析，总死亡率为６．８‰。列死亡原因前三位的是：脑血管疾病、心血管疾病和恶性肿瘤，三种死因占总死亡人数的５９．７％（１９８５～１９８７年）、６４．０％（１９８８～１９９０年）６５．０％（１９９１～１９９３年），且有逐年上升的趋势，尤其心血管疾病死亡率上升更为明显，由１９８５～１９８７年间的６９．６／１０万，上升到１２５．７％／１０万（１９８８～１９９０年），１２１．１／１０万（１９９１～１９９３年）。死亡的年龄段主要集中在中、老年特别是老年前期（５０岁组）、老年期（６０岁组）和老年后期（７０岁以上组），三组死亡数占总死亡人数的８２．３％。恶性肿瘤分类以肺癌死亡率最高，其次为胃癌、贲门癌和肝癌。肺癌死亡率呈逐年上升的趋势，分别占恶性肿瘤死亡人数的２９．６％（１９８５～１９８７年），２４．４％（１９８８～１９９０年）和３１．１％（１９９１～１９９３年）。     

2002年新疆哈巴河县和青河县人群肝包虫病B超筛检报告

为了解新疆阿勒泰地区人群肝包虫病患病近况 ,以囊性包虫声像图特征为诊断标准 ,于 2 0 0 2年对该地区两县居民14 2 5人进行超声检查 ,其中哈巴河县 889人 ,青河县 5 3 6人 ,结果显示 ,肝包虫病人 48例 ,患病率 3 .3 7% ,其中哈巴河县1.91% ,青河县 5 .78% ,差别有统计学意义 (P <0 .0 5 ) ;男女患病率分别为 3 .5 9% ,4.0 3 % ,差别无统计学意义 (P >0 .0 5 ) ;汉族患病率高于哈萨克族 ,差别无统计学意义 (P >0 .0 5 ) ;不同职业组患病率有差别 ,差别有统计学意义 (P <0 .0 5 ) ;在肝包虫病人中 ,青少年和青壮年所占比重最大 ,为 70 .83 %。     

重庆市渝东北地区全科医生转岗培训效果研究

目的 了解重庆市渝东北地区全科医生转岗培训的效果,探讨培训中存在的问题及原因。方法 选取渝东北地区参加转岗培训的学员总计326名及其所属单位领导总计150人进行问卷调查（其中回收学员问卷307份,回收学员所属单位领导问卷150份）,采用柯氏模型从“反应、学习、行为、结果”四个层级进行分析,结果 用百分比进行描述。结果反应层：42．02％（129／307）的学员不满意临床培训阶段培训时间安排。学习层：参训学员三门实践类课程不及格率较高,分别为19．54％（60／307）、22．8％（70／307）和17．92％（55／307）。行为层：81．43％（250／307）的参训学员认为培训有效果。结果层：94．00％（141／150）的单位认为培训对实际工作产生了积极影响。结论 参训学员对临床培训阶段培训时间安排的不满意率较高,对体格检查以及辅助检查的仪器使用和结果判读能力欠佳。多数调查对象认为全科医生转岗培训有实际效果。     

Impact of a cleaners’ strike on compensation claims for asthma among teachers in Ontario

BACKGROUND:

A review of Workplace Safety and Insurance Board (WSIB) claims in Ontario from 1998 to 2002 showed an unusual spike in the number of claims accepted for work-exacerbated asthma (WEA) in April 2001.

OBJECTIVE:

To identify the cause for the spike in the number of WSIB claims for WEA in April 2001.

METHODS:

File reviews were performed to identify the occupations of workers with claims accepted for WEA in April 2001 compared with claims during March and May 2001, and during the same months in 2000 and 2002.

RESULTS:

In April 2001, there were 61 accepted WEA claims; the most common occupation was ‘teacher’. In contrast, among educational workers, there was only one WEA claim in the previous month and one in the following month. From March to May in the preceding and following years, there were only four and two claims, respectively. The most frequently implicated causative agents were dust and dirt exposure, which were responsible for 98% of claims; the mean (± SD) number of lost workdays was 6.5±10. The only identified environmental change associated with this spike was a cleaners’ strike at all elementary and high schools in the Toronto District School Board in Ontario, which started on March 31, 2001 and ended on May 1, 2001.

CONCLUSION:

The spike in accepted WEA claims in Ontario in April 2001 was temporally associated with a strike by Toronto District School Board cleaners, suggesting acute symptomatic effects of poor workplace (school) maintenance on asthmatic employees. The WSIB database was sufficiently sensitive to capture this phenomenon.     

西藏亚东地区蜱类调查报告

于１９９２年５－７月在西藏亚东地区进行了蜱类调查，采用在灌丛挥摆或拖拉布旗及牛体检查，获蜱３属５种，其中阿坝革蜱为西藏新记录蜱种；对蜱在不同生境的分布、牛体寄生情况及卵形硬蜱的季节消长作了分析。     

DIAMOND: a Computerized System for the Management and Evaluation of District-wide Diabetes Care

A computerized diabetic clinic management system, DIAMOND, has been developed with the collaboration of local general practitioners (GPs) to assist communication about diabetic patients across the district. DIAMOND is written in a Windows format using Microsoft Access and its dataset is in line with BDA and Diabcare recommendations. DIAMOND is user-friendly and includes displays and help messages throughout and does not require advanced computer knowledge. The main index contains two primary tables: a patient registration table with demographic data and an episode table with clinically important physical and biochemical measures. All entered data are coded to facilitate audit and an audit function, which automatically presents data, either numerically or graphically, is included in the report facility. DIAMOND also incorporates a system for patient education and training (PEATS) which may be operated by a health professional or the patient. Over 4500 patients in Newham are presently registered on DIAMOND with in excess of 15000 episodes. Evaluation of this information is providing important clinical information both within individual GP practices and district-wide to assist future plans for health care provision.     

Tinea capitis among rural school children of the district of Magude, in Maputo province, Mozambique

The study was carried out in two rural primary schools of the District of Magude, the largest district of Maputo Province in 2001. The prevalence of tinea capitis in each school was 11.6% (49/422) and 6.8% (18/263) and affected predominantly male children. The most common dermatophytes isolated from both schools were Microsporum audouinii. However, Trichophyton mentagrophytes was also found to be an important causal agent of tinea capitis in the District of Magude. Although the prevalence of tinea capitis found in our study is relatively high compared to previous cross-sectional studies carried out in Mozambique, it is still closely related to the prevalence rates reported for African countries. Tinea capitis continues to be an important public health issue in Mozambique, particularly in primary school setting.     

Fracture of an ossified Achilles tendon.

A case of rupture of an ossified Achilles tendon is described. It is suggested that the management of this condition is surgical. Previously undescribed histological appearances demonstrate osteogenic potential. The significance of subcutaneous Achilles tenotomy is discussed.     

Thoracic aortic dissection following cannulation for perfusion

Three patients with aortic dissection originating from a thoracic aortic cannulation site are discussed and recommendations are made for preventing this complication.