潍坊市小儿腹泻状况分析

为了掌握潍坊市冬、秋季节婴幼儿腹泻的病因,在2008年10月1日~12月9日期间,对城内四所市级医疗机构的门诊和住院腹泻病人进行了统计,对住院腹泻病人采样作了检测,并对其进行分析。结果显示,潍坊市秋冬季腹泻患者主要由轮状病毒所引起,接种轮状病毒疫苗可有效预防轮状病毒腹泻。     

肩难产临床分析

目的分析肩难产发生原因,对母婴的影响,处理及预防。方法对我院1988年1月～2006年12月住院分娩产妇中出现的15例肩难产病例进行回顾性总结分析。结果肩难产虽然发生率低,但一旦发生即会造成较严重的分娩并发症,并对母婴产生严重危害,甚至新生儿死亡。结论巨大儿常发生肩难产。肩难产处理不当会发生严重的母婴并发症。产科医师除熟练掌握处理肩难产的各种方法外,更要做产前防范与助产的技巧把握。     

Does loss of heterozygosity in critical genome regions predict a local relapse in patients after laryngectomy?

BACKGROUND: Patients, who had an upper aerodigestive tract malignancy, have a high incidence of succeeding tumor development. This has been attributed to the role of "field cancerization" in carcinogenesis. The aim of this study was analysis of loss of heterozygosity (LOH) in the regions frequently lost during the course of head and neck squamous cell carcinomas (HNSCC), especially at early stages, which could answer the clinicians' question, if LOH analysis has any "predictive" value in relation to tumor occurrence. MATERIAL AND METHODS: Sixty-five larynx cancer patients were examined for loss of heterozygosity on 3p, 7q, 8p, 9p and 18q chromosomal arms with the use of 12 microsatellite markers. The material from a single patient consisted of blood, tumor, safe margin and one or two clinically unchanged mucosal samples. During follow up, the material from brush specimens (14 patients) as well as laryngeal swabs (4 patients) was also examined. RESULTS: The highest frequency of LOH was detected for marker D3S1234 in tumor tissues (29%). Analysis of margin samples (b) revealed low LOH frequencies (2-5%) and complete retention of heterozygosity for markers: D3S1234, D7S486, D8S261, D8S264, D9S171 and D18S46. Similarly, for normal appearing mucosa from upper part of larynx (c) frequencies of LOH were low (2-6%), with the complete retention of heterozygosity for markers: D3S1284, D3S1304, D3S1234, D8S264 and D9S1870. We did not detect any LOH in the material of normal appearing mucosa from tracheostoma region (d). During follow up, LOH was detected for eight markers, with the highest incidence for markers D18S46 (six cases), D7S486 (four cases) and D3S1300 (three cases). CONCLUSIONS: The data, obtained during this investigation, did not reveal the predictive value of LOH with respect to local relapse occurrence in laryngeal cancer patients. However, time of follow up did not reach 5 years, so that further clinical monitoring should be conducted.     

Attributable risk function in the proportional hazards model for censored time-to-event

Time-to-event endpoints are often used in clinical and epidemiological studies to evaluate disease association with hazardous exposures. In the statistical literature of time-to-event analysis, such association is usually measured by the hazard ratio in the proportional hazards model. In public health, it is also of important interest to assess the excess risk attributable to an exposure in a given population. In this article, we extend the notion of 'population attributable fraction' for the binary outcomes to the attributable risk function for the event times in prospective studies. A simple estimator of the time-varying attributable risk function is proposed under the proportional hazards model. Its inference procedures are established. Monte-Carlo simulation studies are conducted to evaluate its validity and performance. The proposed methodology is motivated and demonstrated by the data collected in a multicenter acquired immunodeficiency syndrome (AIDS) cohort study to estimate the attributable risk of human immunodeficiency virus type 1 (HIV-1) infections due to several potential risk factors.     

Prognostic factors for early relapse in non-metastatic triple negative breast cancer — real world data

BackgroundTriple negative breast cancer (TNBC) has the worst prognosis amongst all subtypes. Studies have shown that the achievement of pathologic complete response in the breast and axilla correlates with improved survival. The aim of this study was to identify clinical or pathological features of real-life TNBC patients with a higher risk of early relapse.Materials and methodsSingle-centre retrospective analysis of 127 women with TNBC, stage II–III, submitted to neoadjuvant treatment and surgery between January 2016 and 2020. Multivariate Cox regression analysis for disease free survival (DFS) at 2 years was performed and statistically significant variables were computed into a prognostic model for early relapse.ResultsAfter 29 months of median follow-up, 105 patients (82.7%) were alive and, in total, 38 patients (29.9%) experienced recurrence. The 2-year DFS was 73% (95% CI: 21.3–22.7). In multivariate analysis, being submitted to neoadjuvant radiotherapy [HR 2.8 (95% CI: 1.2–6.4), p = 0.017] and not achieving pathologic complete response [HR 0.3 (95% CI: 0.1–1.7), p = 0.011] were associated with higher risk of recurrence. In our prognostic model, the presence of at least one of these variables defined a subgroup of patients with a worse 2-year DFS than those without these features (59% vs. 90%, p < 0.001, respectively).ConclusionsIn this real-life non-metastatic TNBC cohort, neoadjuvant radiotherapy (performed due to insufficient clinical response to neoadjuvant chemotherapy or significant toxicity) impacted as an independent prognostic factor for relapse along with the absence of pathologic complete response identifying a subgroup of higher risk patients for early relapse that might merit a closer follow-up.     

A clinico-demographic analysis of maxillofacial trauma in the elderly

doi: 10.1111/j.1741‐2358.2010.00431.x A clinico‐demographic analysis of maxillofacial trauma in the elderly Introduction: The elderly represent an increasing proportion of society. Management of maxillofacial trauma in this population may be complicated by coexisting medical conditions, requiring multi‐disciplinary care. Methods: This retrospective audit assesses the incidence and pattern of maxillofacial trauma in elderly patients (≥60 years) presented to the Merseyside Regional Maxillofacial Unit. Over the time period of 2003, 2004 and 2005, 7905 trauma patients presented to the accident and emergency department, of whom 757 were elderly (10%). Results: Results indicated that the male to female ratio was 1:1.4. The commonest cause of injury was a fall (83%) followed by an assault (6%); the majority of falls occurring in the home. Conclusion: Management of maxillofacial injuries in this population should focus on targeted prevention programmes, which address known risk factors for falling. We believe that this is a public health issue. Members of the maxillofacial team should be aware of common risk factors of falls in elderly. Better collaboration with the Medicine for Elderly team should be considered at an early stage on managing these patients.     

Theileria,Babesia, and Anaplasma detected by PCR in ruminant herds at Bié Province,Angola

Distribution of Anaplasma spp., Babesia spp., Theileria spp., and Ehrlichia ruminantium, was for the first time studied in Bié Province, central Angola. We examined 76 blood samples of cattle originated from seven farms, and 13 blood samples of goats from two farms employing molecular genetic tools (PCR). Most prevalent was A. ovis-infection in goats (100%) and A. marginale-infection in cattle (38% of examined animals, and six out of seven farms). B. bigemina-infection was detected in only one specimen at Andulo, whereas B. bovis was not detected in Bié. We did not detected T. parva, the causative agent of serious diseases in cattle; nevertheless, infection by T. velifera was quite frequent (14% of examined animals, and five out of seven farms). Causative agent of heartwater disease – E. ruminantium, was not detected. Taking into account short-term perspective of PCR methods in monitoring of epidemiological status in herds, the number of infected animals and distribution of detected pathogens should not be ignored.     

新生儿呼吸机相关性肺炎临床分析与防治对策

目的探讨新生儿呼吸机相关性肺炎的临床特点以及防治措施。方法59例患儿使用呼吸机机械通气进行治疗,分析与呼吸机相关性肺炎发生率情况、病原学检查结果、药敏试验结果以及转归情况。结果与呼吸机相关性肺炎者有30例,发生率为50．85％。从下呼吸道分泌物培养或管端培养出细菌29例。分析了病原菌种类与所占的比例,并给出了药敏试验结果。两组患儿治愈率相比具有统计学差异。结论采取综合的防治措施是降低呼吸机相关性肺炎发生的最佳方法。     

Diagnostic tools for atrial tachyarrhythmias in implantable pacemakers: a review of technical options and pitfalls

Background. Correct pacemaker (PM) diagnosis of paroxysmal atrial tachyarrhythmias is crucial for their prevention and intervention with specific atrial pacing programmes. The PM mode switch to only ventricular pacing after detection of atrial tachyarrhythmias is often used as the parameter to quantify the ‘burden’ of atrial tachyarrhythmias. Objectives. This review addresses potential errors in the detection and diagnosis of atrial tachyarrhythmias, sometimes resulting in incorrect mode switches. The interpretation of PM-stored data of patients with atrial tachyarrhythmias and the results of trials of pace prevention and intervention can be better appreciated with more insight into the technical options and pitfalls. Results. Literature and clinical experience demonstrate that the correctness of PM-derived diagnosis of atrial tachyarrhythmias depends on 1) the sensitivity setting to detect the onset and perpetuation of atrial tachyarrhythmias frequently characterised by variable and low-voltage signals, 2) the rejection of far-field R wave sensing by the atrial sense amplifier, 3) the facility for verification of mode switches by a high-quality intracardiac registration of the nonmodified atrial electrogram. The configuration of the atrial lead also contributes to the diagnostic performance of the PM. Conclusion. Not only pacing algorithms and diverse technical PM features but also the atrial lead configuration are currently the limiting factors to the fully reliable, automated detection and diagnosis of atrial tachyarrhythmias. If these technical shortcomings can be improved, better signal processing will result. Then atrial pacing to prevent or suppress atrial tachyarrhythmias will be more justified. (Neth Heart J 2008;16:201-10.)     

Preventive strategies for frequent outbreaks of Japanese encephalitis in Northern India

Japanese encephalitis (JE) remains the most important cause of acute viral encephalitis and continues to spread to hitherto unaffected regions like Indonesia, Pakistan and Australia. Approximately 60% of the world population inhabits JE endemic areas. Despite its restricted range mostly in the developing countries, a high annual incidence of 50,000 cases and about 10,000 deaths has been reported. Disease can be fatal in 25% cases. Magnitude of the problem is even more alarming since the survivors are left with serious long-term neuropsychiatric sequelae. Almost every two years, epidemics of JE occur in Indian subcontinent with a high mortality. JE virus infection results in different disease manifestations in host from mild subclinical febrile illness to clinical infections leading to encephalitis. No antiviral treatment is so far available for JE. The prevention of JE can be achieved by controlling the vector or by immunization regime. The vector control in the rural areas, which are the worst affected ones, is practically almost impossible. Three vaccines that have been implicated against JE include inactivated mouse brain derived, inactivated cell culture derived and cell culture derived live attenuated JE vaccine. But each has its own limitation. Currently, attempts to synthesize recombinant DNA vaccine are being made. New therapeutics are on the way of development like use of minocycline, short interfering RNA, arctigenin, rosmarinic acid, DNAzymes etc. However, the immune mechanisms that lead to JE are complex and need to be elucidated further for the development of therapeutics as well as safe and efficacious JE vaccines.