高血压家系802人的高血压患病率、知晓率、治疗和控制状况调查

目的了解高血压家系人群高血压患病率、治疗率和控制率特点。方法用整群随机抽样调查的方法调查高血压家系高血压的流行和控制情况，分析比较相关指标的差异。结果家系成员高血压患病率为55．86％，存在危险因素聚集现象。高血压的知晓率、治疗率、控制率分别为79．46％、62．72％、19．64％。结论该地区高血压家系高血压患病率较高，遗传因素是重要原因。虽高血压控制水平较高，但需加强高血压的一级预防。     

Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and by key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews; only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by infcrnnants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.     

经内镜鼻胰管引流在重症急性胰腺炎治疗中的应用

目的 :初步总结经内镜鼻胰管引流在重症急性胰腺炎治疗中应用的疗效。　方法 :自 1998年 3月以来 ,在重症急性胰腺炎患者入院后常规非手术监测治疗的同时 ,随机床旁行经内镜置放鼻胰管引流 14例。其中明确合并胆结石 8例。观察每天胰管引流量和入院后第 5天在体温、心率、白细胞计数、血糖、血钙、动脉氧分压和血、尿淀粉酶的变化 ,并与第 1天比较 ,记录治疗结果和住院时间。　结果 :经鼻胰管引流时间为 (7.3± 4 .0 )天 ,前 5天的胰液引流量分别为每天 (2 36 .4± 176 .6 )、(2 87.1± 16 4 .7)、(2 84 .6± 2 16 .4 )、(435 .0± 35 7.8)ml和 (377.8± 2 2 3.8)ml。入院后第 1天和第 5天的体温为 (38.2± 0 .6 )和 (37.2± 0 .8)℃ (P <0 .0 1)、心率为 (10 2 .3± 17.0 )和 (82 .9± 14 .5 )次 /min(P <0 .0 1) ,白细胞计数为 (14 .6± 4 .2 )和 (10 .1± 5 .4 )× 10 9/L(P <0 .0 5 ) ,血糖为 (10 .0± 4 .9)和 (8.6± 3.3)mmol/L(P >0 .0 5 ) ,血钙为 (2 .1± 0 .2 )和 (2 .2± 0 .2 )mmol/L(P >0 .0 5 )　动脉氧分压为 (78.0± 16 .3)和 (113.0± 4 1.6 )mmHg(P <0 .0 1) ,血淀粉酶为 (6 95 .7± 4 4 5 .2 )和 (82 .6± 4 7.1)U/L(P <0 .0 1) ,尿淀粉酶为 (3174 .1± 2 5 4 2 .5 )和(2 86 .8± 2     

Adverse drug reactions: physicians' opinions versus a causality assessment method

Since spontaneous reporting of adverse drug reactions depends on the physician's opinion of the relationship between the drug and the adverse event, we compared physicians' opinions with the scores obtained by the causality assessment method used in France. During a 2 month period, all physicians who reported adverse drug reactions (ADRs) to our pharmacovigilance centre expressed their opinions on the causal link by means of visual analogue scales. ADR reports were then assessed with the French causality assessment method by a clinical pharmacologist who was blind to physicians' opinions.The assessment by both physicians and the standardized method was performed for 75 ADR cases involving 120 drugs. Physicians used a wide range of assessments, with a preponderance of extreme scores, resulting in a U-shaped distribution, while the standardized method gave generally low scores. Scores given by physicians were very high (causality considered very likely or likely) in 60% of cases and very low (causality considered unlikely or dubious/possible) in 32% of cases. Scores obtained using the causality assessment method were low (causality dubious/possible) in 89% of cases and causality considered likely in only 11 cases, essentially in cases with positive rechallenge. Complete agreement occurred in only 6% of cases. Adding complete agreement and minor discrepancies raised the percentage to 49%.     

Needs and needs assessment: their components and definitions with reference to dementia

The concept of need and the practice of needs assessment are both subject to a wide range of interpretations, to the likely detriment of individual assessments and to multidisciplinary working. Clear definition is important for individual assessment, for the development of multidisciplinary tools and in gathering planning information. The concept of need is clarified, firstly by distinguishing between need and the difficulties that engender it, and secondly through a taxonomy of need. These assist clear definitions of both need and needs assessment when linked with a consideration of the current help a person receives and a specification of the type of help required by a person to meet their needs. Such definitions have implications for the role of needs assessment in individual assessment, service evaluation, service management and planning and in the development of multidisciplinary needs assessment tools.     

Grip and pinch strength among selected adult occupational groups

A survey of 402 normal subjects (203 men, 199 women) was conducted to assist in distinguishing potential differences in norms of hand strength. Norm data had previously been collected from mixed occupational groups, but in the present study it was hypothesised that people involved in heavy manual work on a daily basis might possess greater hand strength than others. The volunteers were adults working in industry and agriculture; they were subdivided into occupational categories. Measurements of grip, key and palmar pinch using the Jamar dynamometer and B and L pinch gauge were collected, using the protocol described by Mathiowetz. Volunteers also rated their individual hand strength job requirements subjectively. Mean values were established with regard to age, sex, dominance, occupational group and subjective rating. Significant differences were found with regard to age and sex but not to dominance; there was no evidence of differences between occupational groups or between subjective rating and individual scoring, i.e. volunteers who perceived their job as requiring a high degree of strength did not achieve higher test measurements than others. A high interrater reliability was demonstrated when comparing these follow-up measurements with the original data. It was concluded that, for clinical and rehabilitative purposes, therapists can interpret assessment of outcome most accurately by comparing patients' results with the existing norm data.     

Oral sensorimotor therapy: Assessment,efficacy and future directions

This review addresses the current state of knowledge in oral sensorimotor therapy for children with neurological impairments and ingestive problems. Comprehensive assessment of the child with dysphagia looks at the interaction of oral performance and growth. These domains include eating efficiency, oral-motor skills, oral sensory evaluation, classification of the severity of an eating problem, interaction of respiration and ingestion, aspiration, positioning for feeding, social skills assessment, careload and assessment technologies. Oral sensorimotor therapy improves eating but not drinking skills in children 3–12 years of age. Weight gain is sufficient so that children maintain their growth channel but they do not show catchup growth. Many factors thought to contribute to better ingestive performance need further study, such as jaw and lip control in association with drinking. The earliest possible identification of infants at risk for eating impairments needs to be rigorously pursued. Such an approach offers hope that the later growth deterioration now seen in children with eating impairments may be prevented. Finally, the effect of positioning and the use of eating equipment to promote self-feeding need further study.     

Periodontal conditions among the middle-aged and the elderly in Hong Kong

Abstract The aim of this study was to describe the periodontal conditions in 372 35–44-yr-old and 537 noninstitutionalized 65–74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while al the ≥9-mm threshold only 2–3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65–74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as “healthy” (CPI code 0) or had “bleeding only” (code 1) as their highest score. While most subjects scored CPI code 2 or 3 us their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35–44-yr-olds differed little from those reported in 1984.     

The use of experimental studies to reveal suspected neurotoxic chemicals as occupational hazards: acute and chronic exposures to organic solvents.

The nervous system differs from many other body organs by its central control of vital functions and its low regeneration capacity. Organic solvents have, as a group, been suspected to have neurotoxic effects. Because of their similar physical properties and the fact that in industrial uses, they are often present in various mixtures, organic solvents have also been regarded, unfortunately, to induce common neurotoxic effects. However, it is evident from experimental studies using specified exposure conditions that different organic solvents have very diverse neurotoxic effects and also that the toxic mechanism may differ between acute and chronic exposure. No specific method used to describe a neurotoxic effect or single toxic response can be used for the overall occupational risk assessment of all organic solvents. Each solvent has to be considered as having its own unique toxic effects.