Skin problems after a tsunami

BACKGROUND: On December 26, 2004, the biggest earthquake for 40 years, measuring 9.0 on the Richter scale, triggered a tsunami that pounded the coastal areas of South Asia and East Africa. The effects of the tsunami on skin conditions have not been evaluated. OBJECTIVE: To determine the influence of the tsunami on skin conditions by evaluating the skin problems of patients presenting at hospitals after the tsunami. METHODS: Between 5 and 25 January 2005, two dermatologists evaluated patients who complained of skin problems at an outpatient clinic and emergency room of a general hospital in Banda Aceh, Aceh Province, Indonesia. RESULTS: The total number of patients that presented during the study period was 235 (131 males and 104 females), and they had a total of 265 skin problems. In terms of age distribution, most subjects were in their fourth decade (23.0%), followed by the third (22.6%) and fifth decade (16.6%). The most prevalent skin problems were infections-infestations (32.5%), followed by eczemas (29.8%) and traumatic skin disorders (29.4%). In males, traumatic skin disorders were most common. The great majority of infection-infestation cases involved superficial fungal infections. Contact dermatitis accounted for three-quarters of eczema cases, and mainly involved the arms (40.0%) and legs (27.1%). The majority of traumatic skin disorders were lacerations, punctures and penetrations, and the feet (44.7%) and hands (18.8%) were most frequently affected. CONCLUSIONS: Unhygienic conditions, exposure to a hazardous environment and contact with various objects during and after the tsunami probably increased the prevalence of infections-infestations, traumatic skin disorders and contact dermatitis. To prevent these problems and associated secondary bacterial infections, health-related education and early medical management are required.     

生物可降解性尿道内支架修复战伤性尿道狭窄的研究

目的建立战伤性尿道狭窄动物模型,探讨生物可降解性尿道内支架对其进行重建修复的可行性。方法将新西兰雄兔28只分为两组,实验组(n=20):以定位爆炸法建立尿道狭窄模型。一月后行逆行尿道造影、尿道镜检查,并切除狭窄段尿道,行病理组织学观察证实。后置入人工合成生物可降解尿道内支架,置入术后2、4、8、12周分别行逆行尿道造影、尿道镜检查以及尿流动力学检测。并在以上各时间点处死5只动物,取狭窄处尿道组织,观察组织学修复重建情况。对照组(n=8):于实验组爆炸处理后4周和支架置入12周,分别取对照组4只动物与实验组对比观察。结果实验组所有动物爆炸后4周在尿道球部狭窄形成稳定狭窄模型(狭窄段长5～10 mm,尿道腔缩窄50%以上)。尿道内支架置入后2周,组织学观察见黏膜上皮新生迹象,并有炎性细胞浸润;4周时上皮新生明显,炎性细胞消失;8周时出现尿道平滑肌细胞再生,12周时见损伤后尿道组织结构完全修复,与正常尿道组织比较差异无统计学意义(P>0.05)。。同时间点尿道镜检查证实尿道腔隙、黏膜形态结构无异于正常对照组。尿流动力学检测显示两组间差异无统计学意义(P>0.05)。。结论应用成功建立的战伤性尿道狭窄动物模型,证实生物可降解性尿道内支架能作为修复战伤性尿道狭窄的理想材料,具有损伤小,易操作,功能恢复快的特点。     

平时罕见,特殊情况下发生的几种伤病

一些损伤和疾病平时罕见，特殊情况下可以发生，造成严重危害。特殊情况主要包括严重事故、灾害、战争、恐怖主义活动以及特殊环境与特殊作业的危害等。本阐述了现代战争中发生的贫铀武器伤害、燃料空气炸弹伤害、微波武器伤害和战时精神疾病；可能源于恐怖主义活动的炭疽、天花；严重事故性伤害中的核事故、化学事故和煤矿事故伤害；严重灾害中的地震、海难(海战)落海伤害。中介绍了这些伤病的发生情况、伤害特点与医学救治。     

Treatment of Status Epilepticus in Adults: Guidelines of the Italian League Against Epilepsy

Summary:  Status epilepticus (SE) is a medical emergency which can lead to significant morbidity and mortality and requires prompt diagnosis and treatment. SE is differentiated into generalized or partial SE on the basis of its electro-clinical manifestations. The guidelines for the management of SE produced by the Italian League against Epilepsy also distinguish three different stages of SE (initial, established and refractory), based on time elapsed since the onset of the condition and responsiveness to previously administered drugs. Treatment should be started as soon as possible, particularly in generalized convulsive SE, and should include general support measures, drugs to suppress epileptic activity and, whenever possible, treatments aimed at relieving the underlying (causative) condition. Benzodiazepines are the first line antiepileptic agents, and i.v. lorazepam is generally preferred because it is associated with a lower risk of early relapses. If benzodiazepines fail to control seizures, i.v. phenytoin is usually indicated, though i.v. phenobarbital or i.v. valproate may also be considered. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. In refractory SE, general anesthesia may be required. Propofol and thiopental represent first line agents in this setting, after careful assessment of potential risks and benefits.     

伊曲康唑不良反应的国内文献综述

目的：了解伊曲康唑的不良反应及安全性。资料与方法：手工检索《中华皮肤科杂志》等3种中文专业期刊，从对照试验的文献中提取治疗例数和各种不良反应例数，计算发生率。结果：共有14725例涉及有关安全性的报道。伊曲康唑不良反应总的发生率约为1．57％。结论：伊曲康唑较为安全。     

Detection of human papillomavirus types 6 and 11 E4 gene products in condylomata acuminatum.

Polyclonal antiserum to an Escherichia coli-produced beta-galactosidase/E4 fusion protein of human papillomavirus type 6b (antiserum 256), and affinity purified HPV 11 anti-E4 antibodies were tested for reactivity in Western blots with bacterially expressed trpE/E4 fusion proteins of HPV types 6b, 11, 16, and 18. To further characterize the affinity purified anti-E4 antibodies, a dot-immunobinding assay was performed using overlapping synthetic HPV 11 E1E4 peptides as antigens. Protein extracts of condylomata acuminatum from 18 patients containing HPV type 6 or 11 DNA sequences were tested in Western blots using antiserum 256 or affinity purified HPV 11 anti-E4 antibodies. In the Western blots of the trpE proteins, antiserum 256 identified the HPV types 6b and 11 fusion proteins; the affinity purified HPV 11 anti-E4 antibodies identified only the HPV 11 fusion protein. In the dot-immunobinding assay, three HPV 11 peptides were recognized, each containing a shared 8 amino acid sequence that differs significantly from the corresponding sequences of HPV types 6b, 16, or 18. In the Western blots of protein extracts from 18 condylomata acuminatum samples shown to contain HPV types 6 or 11 DNA, putative E4 gene products were identified in six samples by antiserum 256. The affinity purified HPV 11 anti-E4 antibodies identified putative E4 gene products in one of these same six lesions, which was shown to contain HPV 11 sequences by the Southern blot method. All six samples containing E4 gene products were from women. Three of these women were pregnant, one had serum antibodies to the human immunodeficiency virus, and one was a renal transplant recipient receiving glucocorticoids.(ABSTRACT TRUNCATED AT 400 WORDS)     

唐山大地震所致截瘫患者远期心身健康状况调查研究

目的 :研究唐山大地震所致截瘫患者远期心身健康状况。方法 :6 4例唐山大地震所致截瘫患者和 6 4例对照组完成了唐山大地震心身健康调查问卷和标准化评定工具的调查、评定和诊断。结果 :6 4例截瘫患者中有 6例患延迟性应激障碍 (posttraumaticstressdisorder ,PTSD)。PTSD现患率为 9 38%,显著高于正常人群中PTSD的抽样调查结果。 6 4例截瘫患者有 32例地震后发生急性应激性反应 (acutestressreaction ,ASR)。目前截瘫患者心身健康程度显著低于对照组 ,表现在SCL -90中的总分和部分因子分 ,SDS总分和标准分 ,SAS总分和标准分 ,CMI中部分因子分均显著高于对照组 (P均 <0 0 1～ 0 0 0 1)。结论 :心理创伤的严重程度与人类的心身健康之间存在着密切的关系。     

Immune response of adults to sequential influenza vaccination

Annual immunization against influenza is recommended for numerous individuals, but the antibody response to sequential vaccination has not been well characterized. Levels of hemagglutination-inhibition antibody were measured in adults given either two or three doses of trivalent influenza vaccine at six-month intervals. A significant rise in the number of individuals with antibody titers of greater than or equal to 40 was seen for all three antigens only after initial vaccination. Repeated vaccination was necessary to maintain adequate antibody levels only to the A/Brazil (H1N1) antigen; it did not significantly affect the proportions of individuals with protective levels of antibody to either the A/Bangkok (H3N2) or the B/Singapore 222/79 antigens. These findings do not support the current recommendation for annual immunization when the vaccine formulation has not changed.