Partner- and partnership-related risk factors for preterm birth among low-income women in Lima,Peru

A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy. Yet, with the notable exception of intimate partner violence, there has been little previous research addressing the associations between partner- or partnership-related factors and birth outcomes. This analysis tested the hypothesis that risk factors related specifically to partner or partnership characteristics increased the risk for preterm birth. Between 2003 and 2005, a total of 580 preterm cases (20–36 weeks gestational age at delivery) and 633 term controls (≥37 weeks) were selected from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a confidential, structured interview and provided biological specimens within 48 h after delivery. Multivariable logistic regression was used to assess associations between partner and partnership characteristics and preterm birth. After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (aOR = 1.91, 95% CI 1.22–2.99), ever having had anal sex (aOR = 1.40, 95% CI 1.07–1.84), having a current partner with a history of visiting prostitutes (aOR = 1.69, 95% CI 1.22–2.33), and perceiving one's current partner as a “womanizer” (aOR = 1.34, 95% CI 1.02–1.77) were significantly associated with an elevated risk of preterm birth when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with preterm birth risk (per additional partner risk factor: aOR = 1.31, 95% CI 1.16–1.49). These results highlight the importance of considering a broader set of risk factors for preterm birth, specifically those related to a woman's partner and partnership characteristics. Further research could clarify the specific mechanisms through which these partner and partnership characteristics may increase the risk of preterm birth.     

肥胖类型与脑卒中亚型的相关性研究

目的探讨肥胖类型与脑卒中亚型的相关性。方法将573例急性脑卒中患者分为脑出血组126例,脑梗死组447例,脑梗死组再分为脑血栓形成组(215例)和腔隙性脑梗死组(232例),另外选择277例无脑卒中者为对照组。测量腰围、臀围和体重,计算体重指数和腰臀比(WHR),分析肥胖参数与脑卒中各亚组的关系。结果脑卒中各亚组与对照组肥胖发生率差异无显著性意义(P>0.05);各组WHR明显大于对照组(P<0.05)。WHR增大明显增加脑卒中各亚组的危险性(P<0.05);女性腹围增大患腔隙性脑梗死危险性升高(P<0.05);男性体重增加患脑出血的危险性升高(P<0.01)。结论腹型肥胖是脑出血、脑血栓形成和腔隙性脑梗死的危险因素之一。     

Abdominal aortic aneurysm repair and colonic infarction: a risk factor appraisal

OBJECTIVE: Colonic infarction is a recognized complication of abdominal aortic aneurysm (AAA) surgery. The clinical difficulty in establishing the diagnosis combined with the patient's poor physiological status is usually associated with a fatal outcome. We assessed our experience with this problem to identify a possible risk factor profile for these patients. METHOD: Patients records were identified from the operative logs, intensive care unit, Hospital Inpatient Enquiry system and vascular unit databases over a 6-year period. RESULTS: A total of 405 patients underwent AAA repair during this period; 140 as emergency ruptures. Nine patients were identified from the databases with known colonic infarction (2.2%). One was a woman. The mean age was 70 years. Seven patients had emergency ruptures (5%). Twenty independent risk factors were analysed using univariate and multivariate logistic regression models. Significant risk factors identified by using a multivariate analysis included the nature of the presenting patient, preoperative hypotension, prolonged cross-clamp time, intra-operative ischaemia and postoperative acidosis. Confirmatory diagnosis was made by colonoscopy in eight patients. One patient survived following the salvage surgery. The mean duration of survival was 10.5 days. The overall mortality was 89% of patients. CONCLUSION: In our unit infrarenal AAA repair has a 2.2% rate of colonic infarction. A definitive diagnosis is best made by colonoscopy. A risk factor profile for the development of colonic infarction may be constructed on the basis of specific clinical parameters. Earlier intervention on the basis of this profile may ultimately reduce the current excessive mortality.     

Peritoneal dialysis patient survival: a comparison between a Swedish and a Korean centre.

BACKGROUND: Dialysis patient mortality remains high, and this high mortality may be due to many factors. In peritoneal dialysis (PD) patients, old age, co-morbid diseases, malnutrition, low residual renal function (RRF) and a high peritoneal transport rate have been shown to influence survival, but the relative importance of these factors may differ between different patient populations. Besides, centre practice patterns may differ between centres and may influence patient survival. In addition, the literature suggests that dialysis patient survival may be better in Asian than in Caucasian patients. METHODS: The influence of centre and patient characteristics on patient survival was investigated in 132 Korean and 106 Swedish incident PD patients, who underwent initial biochemical measurements and assessment of adequacy of dialysis, nutritional status, RRF and peritoneal transport characteristics. RESULTS: At the start of PD, Korean patients had a higher prevalence of diabetes, peritoneal Kt/V(urea), peritoneal creatinine clearance and peritoneal fluid removal, and lower body mass index, RRF and dialysate to plasma creatinine concentration ratio (D/P Cr) compared with Swedish patients. Significantly more patients from Korea were placed on temporary haemodialysis before PD (100 out of 132) when compared with Swedish patients (21 out of 106). During the follow-up, there was a significantly higher rate of transfer to other units in Korea and a significantly higher rate of kidney transplantation in Sweden. On Kaplan-Meier analysis, overall patient survival did not differ and relative risk for death was also not different between the two centres even after adjustment for age, diabetes, cardiovascular disease, RRF and D/P Cr. On Cox proportional hazards multivariate analysis, age, diabetes, RRF and D/P Cr were found to be independent predictors of mortality in the combined cohort of patients. While age, diabetes and D/P Cr were independent predictors of mortality in Korean patients, age and RRF independently predicted mortality in Swedish patients. CONCLUSION: Although there were significant differences in centre and patient characteristics, we were unable to confirm a survival advantage for Korean over Swedish PD patients. The results of this study suggest that the reported difference in survival between Asian and Caucasian dialysis patients may have been due, in part, to differences in centre and patient characteristics rather than to race as such. The genetic influence on patient characteristics remains, however, to be elucidated.     

脐血铅水平与妊娠结局及影响因素的关系

目的 :了解本地区脐血铅水平现状及其妊娠结局与妊娠并发症 ,新生儿体格发育及神经行为发育的关系 ,并探讨脐血铅与环境因素的关系。方法 :采用 HB2 10 0原子吸收光谱仪用原子吸收法测定 178例经剖宫分娩的新生儿脐带血水平 ,同时观察孕妇妊娠与分娩期有无合并症与并发症 ,并于新生儿出生后即刻测量体重、身长 ,2 4 h内测量头围、胸围和腹围 ,采用神经行为发育量表 ,对出生后 4 2 d的 5 0例婴儿进行神经行为发育评分。同时对产妇家庭环境等相关因素进行问卷调查。结果 :178例脐血铅最高值 12 2 μg/ L,最低值 1μg/ L,中位数 36 μg/ L,脐血铅≥ 10 0 μg/ L 者 6例 ,占3.33%。脐血铅水平与妊娠并发症无明显相关性 ,与新生儿体格发育及神经行为发育评分无明显相关性。新生儿血铅水平与环境因素 (家庭住址、居室新旧、家庭经济情况、职业等 )差异有显著性 ,P<0 .0 5。结论 :本组脐血铅水平与孕期并发症及新生儿体格发育及神经行为发育评分无明显关系。脐血铅水平与环境因素有关。     

高度近视的病因学研究进展

高度近视发生的内因、外因，包括遗传倾向，相关基因定位，巩膜胶原白体免疫学说，视网膜生物活性物质失调学说，环境因素等，本研究就这些因素对高度近视发病的影响做一综述。现统一的认识有：①高度近视具有明显的遗传倾向。②迄今为止，已找到4个高度近视相关基因，它们的遗传方式均为常染色体显性遗传。③高度近视的巩膜组织病理改变和胶原代谢障碍引发了人们对高度近视免疫相关基因的深入研究。已发现HLAⅡ类基因与部分高度近视具有相关性。④视网膜中存在的生物活性物质直接或间接参与了形觉剥夺性近视的形成。⑤环境因素并非高度近视发病的决定因素，它仅起一定程度的促进作用。将今后的工作重点放在高度近视基因定位的研究，基因表达的调控及巩膜胶原代谢、网膜生物活性物质之间的关系研究上，无疑会进一步揭示高度近视的病因，为防治高度近视开辟新途径。     

青少年心理健康素质状况及影响因素的研究

目的 探讨青少年心理健康素质的差异和影响因素,为心理健康教育和素质教育的开展提供理论和实践依据.方法 采用青少年心理健康素质调查表对338名大中学生的心理健康素质状况进行调查研究.结果 ①除自我维度外,大、中学生[适应(64.17±7.12)分,(68.27±5.86)分;人际(58.70±7.13)分,(64.78±5.25)分;个性(127.72±14.41)分,(135.72±10.52)分;动力系统(109.34±11.76)分,(129.79±10.12)分;认知风格(61.19±5.35)分,(71.57±5.84)分;归因风格(43.76±4.24)分,(49.86±4.70);应付方式(106.14±10.33)分,(124.77±9.80)分]、男女生、城市学生和农村学生、不同家庭收入水平、不同父母受教育水平学生的心理健康素质各维度及其子维度均存在显著差异.②相关和回归分析表明,心理健康素质的形成和发展受多种因素影响.结论 青少年心理健康素质状况良好;各类学生心理健康素质的发展模式不同.     

A prospective study of Toxoplasma-positive pregnant women in southern Brazil: a health alert

We evaluated anti-Toxoplasma gondii IgM-reactive pregnant women seen at a high-risk pregnancy outpatient clinic. From March 2005 to January 2008 in Paraná, Brazil, pregnant women seen by the Brazilian Public Health System, in any gestational period, who were anti-T. gondii IgM-positive, were followed. Clinical symptoms were noted, and tests performed including IgA, IgG avidity, ultrasonogram, and amniocentesis (PCR/inoculation in mice). Of 75 patients, 8 showed low, 3 intermediate and 31 high IgG avidity. Of those who underwent the avidity test, 31 (70.5%) were in the second trimester of pregnancy. Thirty-two (42.7%) pregnant women received specific treatment. Six received triple combination treatment; in three, tachyzoites were isolated, although only one was PCR-positive, showing changes in the cerebral sonogram, borderline IgA, and the Sabin tetrad. One fetus died, and one non-reactive IgM pregnant woman showed ocular recurrence. The municipality of residence, contact with cats during adulthood, and ingestion of unpasteurized milk were shown to be important risk factors. Congenital toxoplasmosis was observed in a pregnancy referred late for treatment. Follow-up of children born to mothers with diagnosed or suspected acute toxoplasmosis is crucial in the management of the changes that toxoplasmosis may cause.     

社区人群痛风危险因素的病例对照研究

目的 探讨社区人群(20岁以上)痛风的危险因素。方法 采用1：3病例对照研究方法，进行单因素与多因素与多因素logistic回归分析。结果 经单因素筛选和多因素分析，在P=0．05水平，高尿酸(OR=8．601)、肥胖(OR=2．910)、伴有高血压病史(OR=2．330)是痛风的独立危险因素。结论 痛风是一种在遗传基础上的与环境和生活方式有关的疾病，改变生活方式、控制相关疾病可能预防或减少高尿酸血症的发生，进而减少痛风的发生。     

Soluble CD14 at 2 yr of age: Gender-related effects of tobacco smoke exposure, recurrent infections and atopic diseases

The endotoxin receptor soluble CD14 (sCD14) has been implicated in the 'hygiene hypothesis' suggesting reduced allergic sensitization with bacterial stimulation. However, the relationship between early life sCD14 and allergic diseases is conflicting. We aimed to investigate whether possible risk factors for allergic diseases were associated with sCD14 levels at 2 yr of age. In the nested case-control study of the birth cohort studies 'Environment and Childhood Asthma study in Oslo' 411 children selected with recurrent bronchial obstruction (rBO) (n=241) and no bronchial obstruction (n=170) by 2 yr were investigated with skin prick test and structured parental interview at age 2 yr. Exposure to tobacco smoke, pets and infections was recorded semi-annually by questionnaires (0-2 yr). The sCD14 was analysed from frozen, stored serum by ELISA technique. Regression analyses were performed in all subjects with complete data (n=406, 180 girls), and in girls and in boys separately. Mean sCD14 (ng/ml) was significantly higher among girls 2035 (1973-2096) vs. 1947 (1890-2004) (boys). The sCD14 was significantly reduced among girls exposed to antenatal maternal smoking and with parental asthma, after adjusting for age, parental rhino-conjunctivitis, pet keeping and childhood infections. Recurrent otitis media (OM) increased and common colds significantly decreased sCD14 levels in girls. Boys with atopic dermatitis and rBO had reduced sCD14. Pet exposure was not significantly associated with sCD14. We report novel gender-related effects of sCD14 in early life and suggest that gender, tobacco smoke exposure, age and middle ear disease in particular should be accounted for when assessing the role of sCD14 in childhood allergic diseases.