A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea

OBJECTIVE

Recent reports have suggested that patients with rosacea, a chronic inflammatory skin disorder of unknown etiology, have an increased prevalence of Helicobacter pylori infection. However, no causal relation has been identified. This study was designed to determine the prevalence of H. pylori infection and upper gastrointestinal symptoms in rosacea patients and in subjects without chronic skin disorders.

METHODS

Forty-five patients with rosacea and 43 healthy subjects underwent serological testing for H. pylori infection. Demographics, gastrointestinal symptoms, and medication use were recorded using a structured questionnaire.

RESULTS

There was no significant difference in the seroprevalence of H. pylori infection between rosacea patients and healthy subjects (26.7% vs 34.9%; p = 0.40). Significantly more patients with rosacea complained of indigestion (66.7% vs 32.6%; p = 0.001) and used antacids (60% vs 32.6; p = 0.01). There was no significant difference in the prevalence of H. pylori infection between symptomatic and asymptomatic rosacea patients, or in those using antacids. There were no differences in the frequency of heartburn, history of peptic ulcer disease, family history of peptic ulcer disease, use of H2-receptor antagonists, or use of nonsteroidal antiinflammatory drugs.

CONCLUSIONS

Patients with rosacea have similar rates of H. pylori infection as healthy subjects. Rosacea patients complain significantly more frequently of "indigestion" and use more antacids unrelated to H. pylori infection.

The EURONIC Project: a European concerted action on information to parents and ethical decision-making in neonatal intensive care

The paper presents the background, objectives and methods of a European concerted action project aimed at exploring the transmission of information to parents and the ethical decision-making process in neonatal intensive care from the perspective of health personnel, and in relation to the legal, cultural, social and ethical backgrounds of the various European countries. Eight countries are taking part in the project (France, Germany, Italy, Luxembourg, Spain, Sweden, The Netherlands and the United Kingdom), which is about to be extended also to Central and Eastern Europe (Estonia, Lithuania and Hungary). In each of them, the medical and nursing personnel of a number of randomly selected units will be interviewed through an anonymous, self-administered questionnaire. Information on the organisation and policies of the Units and on the national legislation will also be collected. The key features of the study lie in the multidisciplinary and international approach, the random selection of the sample as a guarantee of representativeness and lack of selection bias, the focus on the staff practices as well as on their attitudes and opinions.

Galactomannan from the seeds of Mimosa scabrella: a scale-up process

In view of the wide industrial applications of galactomannans as a thickening agent, those of Mimosa scabrella (bracatinga), a leguminous tree abundant in Southern Brazil, are under investigation. Seeds of bracatinga were processed on a pilot plant scale in order to obtain its galactomannan. The process consisted of successive milling, enzyme inactivation, aqueous extraction, precipitation of polysaccharide, and drying and milling. The product was obtained in 20% yield, with characteristics similar to those obtained on the laboratory scale, namely mannose:galactose ratio (M:G) 1.1:1.0 and intrinsic viscosity. Considering the seed availability in the metropolitan regions of Curitiba, it should be possible to obtain 3000 ton/year of this polysaccharide.

[Ethical decisions making in neonatal intensive care. Survey among nursing staff in 2 French centers]

A European Concerted Action, Euronic, has been set up to study the attitudes and self-reported practices of the staff working in neonatal intensive care units about parent's information and ethical decisionmaking. This paper presents the results of a preliminary qualitative survey conducted in two French units and including 23 physicians and nurses. The answers indicate that withdrawal of treatments are part of their practices. Parents are never directly involved in the decision-making process. The decision to withdraw life sustaining treatments generate psychological distress among the caregivers. Nurses consider that they are more emotionally involved with the baby and the parents. They express concerns about painful treatments and life-prolonging therapies. Most respondents believe that an ethical committee would be of little help in the decision-making process and that the actual legislation should not be modified as it gives obligation for more in-depth consideration of each case.

Risk factors for Raynaud's phenomenon among workers in poultry slaughterhouses and canning factories

BACKGROUND

Apart from the use of vibrating tools, little is known about risk factors for Raynaud's phenomenon. However, it has been hypothesized that this disorder may have a multifactorial aetiology, involving potential causal or triggering factors which can be found in the workplace. The objective of the study is to identify individual and occupational risk factors of Raynaud's phenomenon in a population of workers not exposed to vibration, but exposed to cold.

METHODS

The survey was carried out in 1987-1988 in 17 poultry slaughterhouses and six canning factories and included 1474 employees. Data were collected at the annual visit to the occupational health physician. Finger sensitivity to cold and Raynaud's phenomenon were identified from a list of symptoms occurring from exposure to cold. The role of potential risk factors was assessed using multiple logistic regression.

RESULTS

A high prevalence of symptoms of finger sensitivity to cold was observed. Raynaud's phenomenon was more common in women than in men, was related to family history of the disease but not to smoking or alcohol consumption. After controlling for non-occupational factors, the following working conditions appeared as risk factors for Raynaud's phenomenon: use of plastic gloves, less than four rest breaks, breaks in an unheated place, continual repetition of the same series of operations, exertion of the arm or hand and being able to think of something else while working.

CONCLUSION

The study showed that a number of working conditions were associated with an increased risk of Raynaud's phenomenon and finger sensitivity to cold. Changes in working conditions might reduce the risk of this disorder in the food processing industry.

[Spontaneous liver rupture after thrombolytic therapy with streptokinase]

Two months after an osteosynthesis of a Maisonneuve-fracture a 45-year-old patient developed a thrombosis of the deep veins on the side of the fracture. Subsequent to two days of lysis with Streptokinase a rupture of the liver occurred and was treated by hemihepatectomy. A traumatic event or a tumor could be excluded as reason for the rupture. Therefore a rupture of the liver due to the application of Streptokinase has to be assumed.

Conformity of Workers' and Occupational Health Physicians' Descriptions of Working Conditions

To determine whether workers, describing their own work, and occupational physicians, describing typical workstations, would report the same working conditions, and whether the relationships between health status and working conditions described by these two sources would be similar. An epidemiologic survey was carried out in 1987-88 in 17 poultry slaughterhouses and six canneries in France. The data were collected in two ways: workers described their own working conditions, and occupational physicians described the working conditions at workstations in the same factories. The study included 507 workers who worked at fixed workstations that had been described by the 24 occupational physicians. Health data were obtained from the workers by the physicians during their annual visits. The agreement between workers and physicians in the descriptions of seven working conditions was analyzed. On the whole, the prevalences of exposures to the seven selected working conditions estimated by the two sources were similar. Nevertheless, the observed agreement was not necessarily high. When agreement existed about specific working conditions, the relationships observed between those conditions and workers' health were generally similar for the two sources. This result was stronger for physical health problems than for mental health problems. When both sources agreed that the worker was being exposed to a risk factor, the risk estimation was higher compared with the cases of discordant judgment. This study confirms the usefulness of information provided by experts but also the necessity to interview workers themselves about their working conditions.

[Psychological and social characteristics of women having repeated induced abortions. A French study in three centers]

Women having repeated induced abortions have social and affective difficulties. Pregnancy results from ineffective or erratic contraceptive practices. One woman out of two expresses the desire for a pregnancy and/or child. During childhood they frequently experienced unsatisfactory relationships with their parents and within the family.

Moderate prenatal alcohol exposure and psychomotor development at preschool age

OBJECTIVES

This study investigated the effect of moderate prenatal alcohol exposure on psychomotor development of preschool-age children in a longitudinal study.

METHODS

Pregnant women were interviewed about their alcohol consumption at their first visit to the maternity hospital in Roubaix, France. Alcohol consumption before pregnancy and during the first trimester was assessed with a structured questionnaire. The psychomotor development of 155 children of these women was assessed with the McCarthy scales of children's abilities when the children were about 4 1/2 years old.

RESULTS

Consumption of 1.5 oz of absolute alcohol (approximately three drinks) or more per day during pregnancy was significantly related to a decrease of 7 points in the mean score on the general cognitive index of the McCarthy scales, after gender, birth order, maternal education, score for family stimulation, family status, maternal employment, child's age at examination, and examiner were controlled for.

CONCLUSIONS

This study showed that moderate to heavy alcohol consumption during pregnancy, at levels well below those associated with fetal alcohol syndrome, has effects on children's psychomotor development.

Did preterm deliveries continue to decrease in France in the 1980s?

To study the trends in gestational age and birthweight in France, we compared data from three surveys that were based on representative samples of births in 10 French regions and were conducted in 1972, 1981 and 1988-89. Only single livebirths were considered in the analysis. The rate of preterm births decreased from 7.9% in 1972 to 5.8% in 1981 and 4.0% in 1988-89. The corresponding rates of children with a birthweight below 2500 g were 5.4, 4.3 and 4.7%. The mean birthweight of preterm babies born in 1988-89 was lower than the mean birthweight of those born in 1972 and 1981. The reduction in preterm births cannot be attributed to the improved accuracy of gestational age determination, but the general use of ultrasound may have played a major role in the apparent reduction of the mean birthweight of preterm babies.

Change in alcohol, tobacco and coffee consumption in pregnant women: evolution between 1988 and 1992 in an area of high consumption

OBJECTIVE

Analyse the evolution of alcohol, tobacco and coffee consumption during pregnancy in a population characterized by a high level of consumption and a low socioeconomic situation.

STUDY DESIGN

Data were obtained from two studies done with the same protocol and questionnaire in the Roubaix Public Maternity Hospital in 1988 (176 women) and 1992 (235 women); the two periods were compared using univariate tests and multiple logistic regression to control for social factors.

RESULTS

Between 1988 and 1992, there was a clear decrease in alcohol consumption, a slight decrease in coffee consumption and an increase in tobacco use. These changes affected usual consumption as well as consumption during pregnancy. The increase in tobacco use was no longer significant after controlling for social factors. However, the decrease in alcohol consumption affected all women regardless of sociodemographic characteristics, and remained significant after controlling for these characteristics.

CONCLUSION

Several factors support the hypothesis that the decrease in the reported alcohol consumption is real, for consumptions in the low to moderate range. However, it is difficult to identify the role of the several factors involved in this evolution: behaviour of the general population, attitude among pregnant women, information and sensitization of prenatal care providers. Besides, one negative aspect needs to be considered: the stability of the incidence of fetal alcohol syndrome, probably reflecting the stability of the proportion of very heavy consumers.

The circadian rhythm in activity of the periodic acid Schiff reaction and of the Mg and Ca content in rat liver in relation to age and season of the year

The experiments were carried out on male Wistar rats aged 6, 12 and 24 months, over the four seasons of the year. Analysis of the results obtained in all age groups disclosed that changes in activity of the p.a.S (periodic acid Schiff) reaction and in concentrations of Mg and Ca in the liver showed rhythmic oscillations with a period of 12 hours. The maximal p.a.S reaction activity and of Ca and Mg levels were generally found to coincide throughout all seasons and in all age groups. The rhythms of change in these parameters in 12- and 24-month-old rats showed a phase shift as compared to the 6-month-old animals.

Attitudes and behavior of pregnant women and health professionals towards alcohol and tobacco consumption

The objective of this study was to identify those factors that influence pregnant women's behavior towards alcohol consumption, so that they could be taken into account when developing alcohol prevention programs in prenatal care. Tobacco use was also studied to identify similarities and differences in attitudes and behavior. A sample of 176 women was interviewed using a structured questionnaire in the prenatal clinics or post-partum wards. Most women were aware that alcohol and tobacco could be harmful to their babies; however heavy drinkers recognized the influence of alcohol in pregnancy less often than the others. Sixty percent of the women, even among the light drinkers, thought that two drinks per day was a reasonable level of consumption during pregnancy. When asked who could be helpful in decreasing their alcohol consumption, most women mentioned their husband, and the doctor or midwife. This is in contrast to our finding that less than 20% of heavy drinkers were advised to reduce alcohol consumption, as compared to 70% of heavy smokers. The results point to the potential for more active interventions on alcohol reduction by health personnel during prenatal care.

Risk factors for high blood pressure among workers in French poultry slaughterhouses and canneries

The aim of the present study is to examine the relationship between the working conditions of employees in the food industry and blood pressure. An epidemiological survey was conducted between 1987 and 1988 in 17 poultry slaughterhouses and 6 canneries in the French regions of 'Bretagne' and 'Pays de Loire'. One thousand, four hundred and seventy-four workers were included in the study. Data was collected in the course of the medical visit organized annually for employees. Mean diastolic (DBP) and systolic blood pressure (SBP) were analyzed separately for male and female workers. The results indicate a significant relationship between blood pressure, and age and obesity. Amongst the various features of working condition studies, loud noise and the number of work breaks were found to be associated with heightened mean values of DBP or SBP in men only. Type and size of the factory was found to be associated with blood pressure readings for both sexes. A number of working conditions giving rise to heightened mental strain were found to be related to a lowering in mean blood pressure: for example, irregular work finishing times for men and production-line work for women. A discussion of these results reveals the complexity of the relationships which exist between physical and environmental factors in this type of setting and blood pressure of employees.