北京市小学生日晒危害认知和防晒行为的调查

目的调查北京市小学生对日晒危害的认知及其防晒措施。方法以问卷调查形式,了解北京市部分小学生对有关日晒引起皮肤损害、采取的防晒措施,以及获得日晒危害和防护知识的渠道。结果共有560人完成问卷调查,平均年龄(10±1)岁。大部分小学生知道过度日晒可以引起皮肤灼伤、晒黑,50%的学生知道过度日晒可致皮肤老化、皮肤肿瘤。大部分小学生在进行户外活动时采取防晒措施,但仅有18.5%的小学生外用防晒化妆品。电视传媒是北京市小学生获得日晒对皮肤危害及其防护知识的主要来源。结论北京市小学生对有关日晒引起皮肤危害的认知及防护知识还不太满意,需要加强这方面的宣传和教育,以获取相关信息。     

Sun exposure,birth weight,and childhood lymphomas: a case control study in Greece

Objectives To explore whether the inverse association of sun exposure with non Hodgkin lymphoma among adults is also evident among the childhood population and test the specificity of the relation by contrasting the findings to those for Hodgkin lymphoma. Methods A total of 87 cases of childhood (0–14 years) with non Hodgkin lymphoma and 71 with Hodgkin lymphoma, diagnosed in Greece through the national network of childhood Hematology-Oncology Units, during a 7-year period, along with 164 age- and gender-matched control children were enrolled in the study. The guardians of all eligible children were interviewed in person on the basis of a structured questionnaire covering socio-demographic, anthropometric, and perinatal characteristics. Average time of sunbathing per year at a seaside resort was used as a proxy variable of exposure to sun controlling for use of sun protection measures. Results The estimated incidence of 10.2 cases per 1,000,000 children-years {95% Confidence Intervals (CI), 8.4–12.1} for NHL during the study period in Greece is around the average figure in countries of the European Union. There was an inverse association of sun exposure with Non Hodgkin lymphoma, namely, for an increment of 15 days of sunbathing at seaside resorts children had almost 40% lower risk (Odds Ratio: 0.60, 95% CI: 0.43–0.83), whereas no such association was evident for Hodgkin lymphoma. The risk for non Hodgkin lymphoma has been found to be statistically and significantly higher in birth weight (Odds ratio: 1.42 and 95% CI, 1.04–1.92, for every 500 g increment), whereas there was no substantial indication that maternal education or maternal smoking during the child’s life were important risk factors for the disease. Conclusions This is the first study to provide epidemiological evidence that increased sun exposure of children may also be associated with a decreased risk of developing childhood non Hodgkin, but not Hodgkin lymphoma. The Childhood Hematology-Oncology Group—Polychronopoulou Sophia, Department of Pediatric Hematology-Oncology, “Aghia Sophia” General Children's Hospital Athens, Greece. Moschovi Maria, Hematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, “Aghia Sophia” General Children's Hospital, Athens, Greece. Athanassiadou- Piperopoulou Fani, 2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA General Hospital, Greece. Pourtsidis Apostolos, Department of Pediatric Hematology –Oncology, “Pan.&Agl. Kyriakou” Children’s Hospital Athens, Greece. Kalmanti Maria, Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Greece.     

Sun exposure and age at natural menopause: a cross-sectional study in Turkish women

OBJECTIVES: In a cross-sectional study of 157 Turkish women attending outpatient clinics of a university hospital during April-May 2003, association between various subject characteristics and menopause timing was investigated. METHODS: Characteristics were self-reported by women aged 45-60. Of the lifestyle factors, sun exposure, physical activity, food intake and dressing with headscarf were obtained as recalled average lifelong practices up to time of menopause. Cox proportional hazard modeling was used, censoring for hysterectomy, oopherectomy and HRT use. RESULTS: Median age at natural menopause was 52 years. In multivariate analysis, earlier natural menopause was associated with low level of lifelong sun exposure (HR=6.381, 95% CI: 2.996-13.588, p< or =0.0001), heavy physical activity (HR=2.335, 95% CI: 1.305-4.177, p=0.0043), current calcium supplement use (HR=3.191, 95% CI: 1.361-7.485, p=0.0076), diagnosis of hypertension (HR=2.002, 95% CI: 1.186-3.378, p=0.0093), not owning a house (HR=3.002, 95% CI: 1.148-7.852, p=0.0250) and longer years on oral contraceptives (HR=1.085, 95% CI: 1.000-1.176, p=0.0487). Engagement in farming (HR=2.043, 95% CI: 1.056-3.952, p=0.0339), height (cm) (HR=0.953, 95% CI: 0.907-0.994, p=0.0279) and fish consumption (servings/week) (HR=0.600, 95% CI: 0.375-0.960, p=0.0331) were associated with age at menopause in univariate analysis only. For n=109 women who recalled whether maternal menopausal age was <50 or > or =50, sun exposure (HR=7.221, 95% CI: 2.971-17.547, p<0.0001) was a stronger predictor of age at natural menopause than maternal menopausal age (HR=2.882, 95% CI: 1.477-5.621, p=0.0019). CONCLUSIONS: We identify some previously unrecognized correlates of age at natural menopause, namely self-reported lifelong sun exposure, lifelong physical activity, house-ownership, current use of calcium supplements, and lifelong fish consumption. These findings should be confirmed in larger studies.     

Sun-exposure- and aging-dependent p53 protein accumulation results in growth advantage for tumour cells in carcinogenesis of nonmelanocytic skin cancer

 Three hundred and sixteen patients with nonmelanocytic skin cancer, including 46 cases of Bowen’s disease (BOD), 134 cases of squamous cell carcinoma (SCC), and 136 cases of basal cell carcinoma (BCC), were examined immunohistochemically using monoclonal antibody DO-7 to assess p53 protein accumulation related to sun exposure and ageing, and growth and differentiation of skin cancer and its precursors. The rates of p53 immunostaining of BOD, SCC and BCC were 80.4%, 76.1% and 70.6%, respectively. p53-positive cells were present not only in cancer nests, but also in dysplastic and even morphologically normal epidermis adjoining cancers. Sun exposure was statistically correlated with the p53 immunostaining scores in morphologically normal epidermis of the three skin cancers and in cancer nests of SCC and BCC. The positivity and score of p53 protein often differed significantly among the three types of cancer, especially in regions of dysplasia. Interestingly, differentiation of SCC was correlated with individual p53 scores for dysplasia and cancer nests, especially for dysplasia. BOD, as the precursor of SCC, demonstrated the strongest p53 expression. Furthermore, 12.3% cases with p53 negative cancer nests showed p53-positive reaction in dysplasia and in morphologically normal epidermis. It seems that the accumulation of p53 protein plays a part in precancerous lesions and in the genesis of more highly differentiated types of skin cancer and affects mainly the growth of tumour cells rather than their differentiation. For BCC, however, age was significantly related to p53 expression. Our findings suggest that overexpression of p53 in normal skin and cancer nests of SCC and BCC is significantly related to sun exposure, that the expression of p53 in BCC is an age-dependent process, and that the early accumulation of p53 protein may be a useful predictor for the detection of nonmelanocytic skin cancer. Received: 7 July 1998 / Accepted: 5 November 1998     

A state of the science on influential factors related to sun protective behaviors to prevent skin cancer in adults

Skin cancer rates have risen over the past decades, making it imperative that adults understand the need for protection from sun exposure. Though some risk factors have been identified as predictive for skin cancers, there is a lack of synthesized information about factors that influence adults in their decisions to engage in sun protective behaviors. The purpose of this paper is to present the current state of the science on influential factors for sun protective behaviors in the general adult population. A rigorous literature search inclusive of a generally White, Caucasian, and non-Hispanic adult population was performed, and screening yielded 18 quantitative studies for inclusion in this review. Findings indicate that modifiable and non-modifiable factors are interdependent and play a role in sun protective behaviors. This study resulted in a proposed conceptual model for affecting behavioral change in sun protection including the following factors: personal characteristics, cognitive factors, family dynamics, and social/peer group influences. These factors are introduced to propose tailored nursing interventions that would change current sun protective behavior practice. Key implications for nursing research and practice focus on feasibility of annual skin cancer screening facilitated by advanced practice nurses, incorporating the identified influential factors to reduce skin cancer risk and unnecessary sun exposure.     

The effect of outfitting style on bone mineral density

Aim Vitamin D deficiency is one of the most important risk factors in the development of osteoporosis. Recently, vitamin D deficiency is more frequently encountered than expected in Mediterranean countries, which are sunny most of the time. Our country is one of these sunny countries and here, we investigated the effect of outfitting style on bone mineral density (BMD) and plasma vitamin D levels in women aged between 30–40 years. Method Eighty women, aged between 30 and 40 years, were included in the study. They were divided into two groups, depending on their dress selection. Group-1 consisted of 40 cases with an open clothing style, while the 40 women in group-2, preferred the covered clothing style. Women were questioned in terms of the risk factors for osteoporosis. Levels of plasma 25(OH)2 vitamin D3 and parathormone (PTH) were tested along with routine blood analyses. BMD of Lumbar 1–4, femur neck, trochanter, and Ward’s triangle were measured. Results In group-2, number of pregnancies and body mass index (BMI) was statistically significantly higher (p < 0.05). When the laboratory parameters were compared, in group-2, only levels of plasma 25 (OH)2 vitamin D3 was significantly lower than group-1 (p < 0.05). There was no significant difference among groups in terms of BMD. In group-2, there was a positive correlation between BMI and BMD at L1–4, hip, femur neck, and trochanter regions (p < 0.01, 0.01, 0.05, and 0.05, respectively). Conclusion Traditional clothing style leads to vitamin D deficiency in women. In order to meet vitamin D need, the face, arm and leg regions of the body should be exposed to one minimal erythemal dose (MED; i.e., slight redness of the skin) of sunlight, at least two or three times a week. We believe that these cases should be more closely monitored for bone loss, especially during postmenopausal period, which is considered as a risky term in terms of osteoporosis development.     

鼻内镜术后鼻粘膜组织病理学观察

目的 研究鼻内镜手术前后鼻粘膜组织病理学变化。方法 对46例患者术前和术后4个月进行鼻内镜检查和光学显微镜观察。结果 术后4个月炎性细胞、粘膜下结构增厚、水肿、鳞状细胞化生和息肉明显减轻，而杯状细胞、粘膜下层腺体、病理性腺体和纤维化，术后无明显变化（P＞0．05）。与术后患者的临床症状和鼻内镜观察相一致。结论 鼻内镜术后4个月鼻粘膜仍不稳定，且仍处于病变恢复阶段。因此术后随访时间应不少于4个月或更长，以防止复发。