医务人员呼吸道感染影响因素的巢式病例对照研究

目的 探索医务人员在院内感染呼吸道传染病的影响因素,针对性的提出院感防范重点及感染控制改进建议.方法 本研究采用巢式病例对照研究的方法.选取北京市东城区和西城区的9家二级以上医院,将符合条件的医务人员作为一个队列,对其医疗行为进行为期一个月的观察.依据咽拭子病原学检测结果判定研究对象的呼吸道感染状况,并将他们分为病例组...     

大学生神经症影响因素的病例对照研究

目的；探讨大学生神经症发病的主要危险因素。方法：采用非条件Ｌｏｇｉｓｔｉｃ回归方法对１２１例神经症患者和５１６名健康者按性别分组分析。结果：性别不同，神经症发病的主要危险因素也不同。男生：与神经质、母亲文化偏低，娱乐体育等能力不良，经济物质基础较差相关。女生与神经质，内外倾，得到社会支持系统（保护因子），母亲拒绝否认，丧失社会支持系统相关。结论：研究神经症危险因素，要控制性别影响。     

肺癌患者自杀危险因素的巢式病例对照研究

目的:识别肺癌患者中的自杀高危人群,分析自杀相关的影响因素。方法:收集美国SEER数据库中1975-2016年确诊的肺癌患者,计算患者自杀率和标化死亡比(SMR);采用巢式病例对照研究设计,纳入934例肺癌自杀患者作为病例组,按照1∶20的配比匹配同性别、同年龄的18 669例非自杀患者作为对照组,通过构建条件logistic回归模型,评估肺癌患者自杀相关危险因素。结果:肺癌患者的自杀率高于一般人群(SMR=12.00),女性、青年、确诊后1年内、肿瘤细胞未分化、远端转移和无配偶的肺癌患者SMR较高(SMR=26.55、54.10、26.68、20.04、29.67、50.90、17.71);条件logistic回归分析显示,确诊后1年内、肿瘤细胞未分化、拒绝手术、未化疗和无配偶的肺癌患者易发生自杀行为(OR=23.53、1.88、1.31、1.57、1.53)。结论:肺癌患者的自杀风险明显高于一般人群,确诊后1年内、肿瘤细胞未分化、拒绝手术、未化疗和无配偶可能是肺癌患者自杀的危险因素。     

河南林县Alzheimer病危险因素的巢式病例对照分析

目的 :探讨河南林县阿尔茨海默病 (AD)的危险因素。方法 :采用年龄 (± 2岁 )、性别和乡别匹配的巢式病例对照研究方法分析 15年前的生活习惯、心理社会因素、躯体检查史和疾病史等对AD发生的影响作用。结果 :多因素模型中 ,高血压值OR =1 971、吃发霉蔬菜OR =1 767,皮肤病和贫血的疾病史OR值分别为 0 2 2 7和 0 5 34 ,且均存在显著性意义 ;高血压值的人群归因危险度为 2 8 3% ,与AD之间趋势检验P <0 0 0 0 2。结论 :在林县地区AD的发生中 ,高血压和吃发霉蔬菜为危险因素 ,而皮肤病和贫血的疾病史为保护因素 ;血压值与AD之间存在剂量 -反应关系。吸烟和饮酒未见与AD有显著性联系     

中学生行为问题危险因素的病例对照研究

中学生行为问题危险因素的病例对照研究翟静郭传琴刘贤臣刘同洲曹会龙戴郑生山东省精神卫生中心近年来国内外许多学者对儿童行为问题进行了研究，发现儿童的行为问题与家庭、学校及儿童自身因素等有关［１］。为了探讨中学生行为问题发生的相关因素及各因素的作用，应用山...     

浙江武义地区先天性心脏病患儿影响因素的病例对照研究

目的了解影响先天性心脏病发生的危险因素,为先天性心脏病的预防及进一步研究提供理论依据。方法采用1:1配对的方法,在本院选取病例和对照各150例,采用问卷调查的形式了解母亲孕前及孕中可能与先天性心脏病有关的暴露情况,对收集到的数据采用单因素和多因素logistic回归的方法进行处理。结果调查结果表明,居前3位的先天性心脏病类型依次为:动脉导管未闭(39,26.0%)、房间隔缺损(34,22.7%)和室间隔缺损(26,17.2%);logistic回归结果表明,孕期偏食(OR=2.377,95%CI:1.015~5.566)、孕期经常饮茶(OR=10.347,95%CI:1.454~73.612)、孕早期母亲发烧(OR=16.654,95%CI:1.895~146.330)、孕早期病毒感染(OR=5.079,95%CI:1.143~22.572)、孕前母亲BMI≥24(OR=8.000,95%CI:1.517~42.175)为先天性心脏病的危险因素。结论为了预防先天性心脏病的发生,应当加强对育龄期青年的健康教育,孕前要加强体育锻炼,保持良好的体型,孕期注意合理饮食,避免病毒感染等。     

社区阿尔茨海默病危险因素病例对照研究

目的了解社区阿尔茨海默病(AD)可能的危险因素。方法将流行病学调查发现的AD患者以性别、年龄(±3岁)和文化程度按12比例与认知功能正常老人配对,部分高龄老人因无足够正常对照,则按11配对,在同村或同居委会范围内寻找正常对照。患者和正常对照危险因素调查均以询问知情者为主。结果AD患者丧偶或离异者多(OR=3.30,95％CI=1.43-7.63),出生前母亲生育子女数较少(OR=0.78,95％CI=0.62-0.98),吸烟(OR=0.52,95％CI=0.28-0.95),饮酒(OR=0.57,95％CI=0.34-0.97)者较对照组少,各项差异均显著。50岁后很少锻练身体的患者比对照组多(OR=2.56,95％CI=0.89-7.34),但差异无显著性。结论丧偶或离异、出生时母亲生育子女数较少可能是AD的危险因素。50岁后锻练身体、吸烟和饮酒对AD可能有保护作用,须进一步研究。     

新生儿颅内出血病因危险因素的病例对照研究

为了提高新生儿颅内出血的防治水平,采用回顾分析法,对150例确诊为新生儿颅内出血的新生儿患者的影响因素进行病例对照研究。结果显示：脐带绕颈、宫内窘迫、滞产、胎位异常、产钳、负压吸引、窒息、代谢性酸中毒（P均＜0．05,共9个因素对疾病的发生有明显影响。提示加强围产期保健及监护,采用正确的分娩方式是预防本病的关键。     

湖北农村妇女自杀死亡危险因素的病例对照研究

近年的研究表明中国农村妇女自杀死亡率已达到30·5/10万,远远高于城乡男性和城市女性[1]。本文报道了湖北麻城市农村15岁及以上妇女自杀死亡的影响因素。对象与方法1·1对象资料来源于湖北麻城市(县)“四报”信息管理系统。在湖北麻城市农村抽取分别代表山区、丘陵和平原的龟山、乘马岗和中驿乡,以这3个乡2000~2002年间15岁及以上自杀死亡妇女为研究对象。选择与病例同性别、年龄相差±2~3岁、与病例居住在同一生活环境的妇女1:1配对作为对照。1·2方法:采用自制问卷,由研究者(或经过培训的调查员)逐一入户,寻找知情人(家人、亲属、邻居、…     

儿童情绪障碍相关因素的病例对照研究

本文对儿童情绪障碍发生的相关因素进行病例对照调查。对象和方法1.1对象2001年1月至2003年12月在本中心门诊或住院的情绪障碍患儿。符合中国精神疾病分类方案与诊断标准第3版(CCMD-3)和ICD-10关于儿童情绪障碍的诊断标准。据Achen bach儿童行为量表(CBCL)年龄分段分为儿童组(6     

Risk Factors for Acute Hepatitis A Infection in Korea in 2007 and 2009: A Case-Control Study

This study aimed to identify the risk factors associated with acute hepatitis A virus (HAV) infection in the Korean population. Participants were recruited from five referral hospitals across the country in 2007 and from 11 hospitals in 2009. Patients with positive anti-HAV IgM antibody tests became the case group, while patients treated for non-contagious diseases at the same hospitals were recruited as controls. A total of 222 and 548 case-control pairs were studied in the 2007 and 2009 surveys, respectively. Data from the surveys were analyzed jointly. In a multivariate analysis, sharing the household with HAV-infected family members (OR, 6.32; 95% CI, 1.4-29.6), contact with other HAV-infected individuals (OR, 4.73; 95% CI, 2.4-9.4), overseas travel in 2007 (OR, 19.93; 95% CI, 2.3-174.4), consumption of raw shellfish (OR, 2.51; 95% CI, 1.8-3.5), drinking bottled water (OR, 1.64; 95% CI, 1.3-8.4), and occupation that involve handling food (OR, 3.30; 95% CI, 1.3-8.4) increased the risk of HAV infection. Avoiding contact with HAV-infected individuals and avoiding raw foods eating could help minimize the risk of hepatitis A infection. Immunization must be beneficial to individuals who handle food ingredients occupationally or travel overseas to HAV-endemic areas.     

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

OBJECTIVE:

The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue.

METHODS:

The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue.

RESULTS:

Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death.

CONCLUSIONS:

The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.     

Lack of awareness of Hepatitis B screening and vaccination in high-risk groups

Background/aim Hepatitis B virus (HBV) vaccination rates are insufficient in high-risk patients worldwide. This study aimed to investigate the screening, immunization, and vaccination rates in three high-risk groups for HBV infection: allogeneic hematopoietic stem cell transplantation (AHSCT), renal transplantation (RT), and chronic hepatitis C (CHC) groups. Materials and methods The serological data of consecutive patients between 2014 and 2019 were reviewed using the hospital database. Results The HBV screening rates were 100.0%, 90.4%, and 82.4% in the AHSCT, CHC, and RT groups, respectively (p = 0.003). The immunization rates against HBV through either previous exposure or vaccination were 79.5%, 71.7%, and 46.5% in the AHSCT, RT, and CHC groups, respectively (p < 0.001). The HBV vaccination rate was significantly low in the CHC group (71.5%, 69.0%, 34.6% in the AHSCT, RT, and CHC groups, respectively, p < 0.001). If patients lost their immunity due to immunosuppressive therapy were accounted, the vaccination rates increased to 95.2% in the AHSCT group and 72.9% in the RT group. The rate of annual screening for HBV status was 97.9% in the AHSCT group, but it was only 23.9% in the RT group. Conclusion HBV screening and vaccination rates were significantly lower in the RT and CHC groups than in the AHSCT group.     

A retrospective cohort study on obesity and hypertension risk among Korean adults

A retrospective cohort of adult Korean males and females was conducted to evaluate the influence of obesity on the development of hypertension and to determine the level of the body mass index at which the risk of hypertension significantly increases. The subjects of this study were 1,467 men and 944 women aged 20 to 75 yr who were normotensive at the time of their initial examinations from 1990 to 1991, who had a follow-up examination at least 1 yr after their initial examinations, or whose blood pressure status could be confirmed by reviewing their medical records until June 2000. During an average follow-up period of 6.2 yr, 234 new cases of hypertension were identified. An analysis using the Cox proportional hazards model showed that the risk of developing hypertension increased with increasing age, body mass index, and amount of daily alcohol consumption in men; and with increasing age and body mass index in women. Comparing men and women whose body mass indices were smaller than 23 kg/m(2), the relative risks of hyper-tension were 2.56 times greater in men and 3.17 times greater in women, whose body mass indices were greater than 27 kg/m(2). Our study confirmed that obesity is a strong risk factor for hypertension among Korean adults. In addition, high alcohol consumption may be a significant risk factor for men.     

Hepatitis B vaccination in children: The Taiwan experience

The world's first nationwide hepatitis B virus (HBV) universal vaccination program for infants was launched in Taiwan in July, 1984. All infants received three to four doses plasma or recombinant HBV vaccines. In addition, infants of HBeAg-positive mothers received 0.5 ml of hepatitis B immunoglobulin within 24 hours after birth. The vaccination coverage rate is as high as 97%. Seroprevalence of hepatitis B surface antigen (HBsAg) declined from 9.8% (prevaccination period) to 0.6% in children in Taipei City after 20 years of mass vaccination. The seropositive rates for HBsAg, antibody to HBsAg, and antibody to hepatitis B core antigen were 1.2%, 50.5%, and 3.7%, respectively, in those born after the vaccination program (< 20 years old) in 2004. In line with the decrease of chronic HBV infection, the incidence of hepatocellular carcinoma (HCC) also decreased in children in Taiwan. From 1981 to 1994, the incidence of HCC in 6- to 9-year-olds declined from 0.52/100,000 for those born between 1974 and 1984 to 0.13 for those born between 1984 and 1986 (p < 0.001). We extended the observation to 2000, the incidence of HCC per 100,000 children declined from 0.54 to 0.20. The prevalence of a determinant mutants (amino acids 121–149 of HBsAg) in Taiwanese carrier children was 7.8% (eight out of 103) in 1984, increased to 19.6% (10 out of 51) in 1989, peaked at 28.1% (nince out of 32) in 1994, and remained stationary at 23.1% (three out of 13) and about 25% in 1999 and 2004, respectively; it was higher in those fully vaccinated compared with those not vaccinated. The other group of subjects who are susceptible to vaccine failure is the immunocompromized hosts. We observed some de novo HBV infection in children after liver transplantation. Despite of the success of hepatitis B immunization, childhood chronic HBV infection and HCC were not eliminated by the universal vaccination program. Among those HBsAg carriers born after the vaccination program, 89% of their mothers were found to be positive for HBsAg, indicating the importance of maternal transmission. This was also true in the mothers of children with HCC, of them 96% were HBsAg positive. After two decades of universal infant HBV vaccination, we found this program provides long-term protection for up to more than 20 years, and a universal booster is not required for the primary HBV vaccinees before adulthood. Mother-to-child transmission, although largely diminished, is still the main cause for immunoprophylaxis failure. The emergence of escape mutant did not impose increased risk of chronic infection at present. Nevertheless, development of new vaccines may overcome the vaccine failure.     

Prevalence and risk factors of Hepatitis D virus antibody among asymptomatic carriers of Hepatitis B virus: a community survey

BackgroundHepatitis D virus (HDV) can cause a chronic infection in the presence of hepatitis B surface antigen and contribute to the burden of chronic liver disease especially in regions where chronic hepatitis B virus (HBV) infection is endemic.AimTo determine the prevalence and risk factors of HDV among asymptomatic carriers of HBsAg in Cross River State, Nigeria.MethodsThis was a cross-sectional study conducted among apparently healthy adults resident in Cross River State, Nigeria. A structured questionnaire was used to collect socio-demograhic data and risk factors for HBV/HDV infection. Participants blood samples were screened for HBsAg. Samples that were HBsAg positive were further screened for anti-HDVIgM. Statistical analysis was performed using statistical package for social sciences (SPSS) version 20.ResultsA total of 90 HBsAg positive samples were assayed. The prevalence of anti-HDV IgM was 5.6% (95% CI 1.1–10.1). The HDV positive subjects were mostly females (80%), reported family size of >5 members (80%), had female circumcision (75%) and took injections from Non-certified health care practitioners (NCHCPs). None of the assessed risk factors were significantly associated with HDV infection (p >0.05).ConclusionHepatitis D virus is moderately prevalent amongst asymptomatic HBsAg carriers in Cross River State, Nigeria.     

Seroprevalence and risk factors of Hepatitis B and Hepatitis C infections among pregnant women in the Asante Akim North Municipality of the Ashanti region,Ghana; a cross sectional study

BackgroundViral hepatitis is a serious public health problem affecting billions of people globally with maternal-fetal transmission on the rise.ObjectivesThis study sought to determine the prevalence and factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among pregnant women in the Asante Akim North Municipality, in the Ashanti region of Ghana.MethodsIn this cross-sectional study 168 pregnant women were recruited from the Agogo Presbyterian hospital. Blood samples were collected for the detection of Hepatitis B Surface Antigen (HBsAg) and anti-HCV antibodies. A pretested questionnaire was used to obtain demographic data and identify the risk factors associated with the two infections.ResultsOf the 168 participants studied, 16 (9.5%) tested positive for HBV and 13 (7.7%) tested positive for HCV representing 9.5% and 7.7% respectively. A participant tested positive for both HBV and HCV co-infection representing 0.6%. Undertaking blood transfusion, tattooing and sharing of needles were associated with hepatitis C infection (P=0.001). HBV was not associated with any of the risk factors (P>0.05).ConclusionOur findings suggest a high prevalence of hepatitis B and hepatitis C among pregnant women; blood transfusion, tattooing and sharing of hypodermic needles were associated with hepatitis C infection. Measures to reduce the disease and transmission burden must be introduced.     

我国九个地区丁型肝炎病毒感染状况及其与乙型肝炎病毒复制指标关系的研究

对１５４５例各类乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阳性肝病和无症状ＨＢｓＡｇ携带者的血清进行了乙型肝炎病毒（ＨＢＶ）与丁型肝炎病毒（ＨＤＶ）感染标记物的测定。结果表明，ＨＤＶ感染率为１３．０１％，其中ＨＤＡｇ和抗－ＨＤ阳性率分别为２．９１％和１０．０９％。而且在全国九个地区均有ＨＤＶ感染者存在，说明其分布是较为广泛的。同时还表现出，男性高于女性，慢性肝炎、重型肝炎及原发性肝癌高于急性肝炎和无症状ＨＢｓＡｇ携带者。提示ＨＢＶ与ＨＤＶ合并感染或重叠感染可能导致病情加重和感染的慢性化。本项研究结果还揭示，在ＨＢＶ与ＨＤＶ合并或重叠感染时，可能对ＨＢＶ的复制指标（ＨＢｅＡｇ·ＨＢＶＤＮＡ）有一定的抑制现象。