The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER

Vitamin D deficiency.

Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis.

Gout is a crystal-deposition disease that results from chronic elevation of uric acid levels above the saturation point for monosodium urate (MSU) crystal formation. Initial presentation is mainly severely painful episodes of peripheral joint synovitis (acute self-limiting 'attacks') but joint damage and deformity, chronic usage-related pain and subcutaneous tophus deposition can eventually develop. The global burden of gout is substantial and seems to be increasing in many parts of the world over the past 50 years. However, methodological differences impair the comparison of gout epidemiology between countries. In this comprehensive Review, data from epidemiological studies from diverse regions of the world are synthesized to depict the geographic variation in gout prevalence and incidence. Key advances in the understanding of factors associated with increased risk of gout are also summarized. The collected data indicate that the distribution of gout is uneven across the globe, with prevalence being highest in Pacific countries. Developed countries tend to have a higher burden of gout than developing countries, and seem to have increasing prevalence and incidence of the disease. Some ethnic groups are particularly susceptible to gout, supporting the importance of genetic predisposition. Socioeconomic and dietary factors, as well as comorbidities and medications that can influence uric acid levels and/or facilitate MSU crystal formation, are also important in determining the risk of developing clinically evident gout.

Global epidemiology of gout: prevalence, incidence and risk factors

OBJECTIVES: To investigate post-crash time management by police. METHODS: The retrospective study comprised data related to all road traffic crashes from March 2009 to March 2010 in Sistan and Baluchistan province of Iran. Data was retrieved from the standard national form designed for road traffic crashes completed by police officers present at the scene. SPSS 15 was used for statistical analysis. RESULTS: The median time for police to be informed in the total 2442 accidents was 10 minutes and the police response time was 15-20 minutes for non-fatal cases, while the corresponding duration for fatal cases was 15 minutes and 30 minutes (p DISCUSSION: Police arrival at the crash scene was beyond the average response time by Emergency Medical Services in Iran. It is vital to provide quicker ways of informing the police and to have more police stations along the highways. Language: en

/pdf/police-response-time-to-road-crashes-in-south-east-of-iran-36ge7umccq.pdf

Police response time to road crashes in south-east of Iran.

Background This study was carried out on Iranian female adolescents to understand health needs for the purpose of designing health promoting intervention in schools. Methods In this exploratory qualitative study, two focus group discussion (15 teachers) and 30 individual in-depth interviews were conducted among female adolescents in the eighth grade in Zahedan, Iran. Qualitative content analysis was used for data evaluation. Results The views of students and teachers demonstrated nine of needs including: informing students about the schools' health project aims, education and training all dimensions of health with an emphasis on mental health, use of experts in various fields for education from other organisations, employing capable and trusted counselors in schools, utilisation of a variety of teaching methods, activating reward systems for encouraging students' participation in group activities, teaching communication and the ability to establish good relationships with parents and strategies for resolving family conflict, teaching parents and students high-risk behaviours and strategies for handling them as well as reforming wrong attitudes and indigenous sub-culture. Conclusion This study found the different needs of Iranian female students compared to other cultures about a health promoting school programme. Therefore, their contribution can provide an insight for formulating policies and intervention in schools.

Understanding Female Students’ Needs to Develop Health Promoting School Programme: An Exploratory Qualitative Analysis

Background: Although smoking and drug use are the major causes of accidents and death of drivers, few studies have been con- ducted on the prevalence of smoking and its associated factors in this occupational group. Objectives: The current study aimed to investigate the prevalence of smoking and its relationship with blood parameters among drivers in Zahedan city, Iran. Patients and Methods: In this study, 1836 inner and intercity drivers were investigated in 2013 in terms of smoking and drug use and blood parameters. Data were obtained through in-depth interviews and necessary examinations and tests, and were analyzed by Stata.12 software using Chi-square, independent t-test, and multiple regression analysis at significance level of 0.05. Results: Generally, four drivers were addicted to drugs and smoked as well. Two-hundred and eighty eight drivers (15.8%) reported daily smoking. Variables of age, education, and type of vehicle showed a significant relationship with smoking. No significant dierence was found in blood parameters between the smokers and non-smokers. Conclusions: Despite relatively high prevalence of smoking than drug use in Zahedan drivers, there are few reports of these behav- iors. Laboratory tests cannot suitably measure substance use due to their interference with other substances. Considering adverse eects of smoking on health and driving, it is necessary to train drivers to reduce or stop smoking during driving.

Prevalence of Addiction and Smoking and Their Relationship With Blood Parameters Among Drivers in Zahedan.

Introduction: With ever improving technology and increasing the use of high-voltage power in industrial environments, concerns about the destructive effects of electromagnetic waves on human health have increased. Thus, the present study aims to evaluate the effects of electromagnetic waves on the general health of Zahedan gas power plant personnel. Materials & Methods: The present case-control study investigated the health of people at one point of time and their amount of exposure to electromagnetic waves at the same time. The data collection tool in this study was a 28item general health questionnaire (GHQ-28). After measuring the electromagnetic waves at distances of 1, 1.5, and 3 meters at high voltage power substations and data extraction, the data were fed into SPSS software and then analyzed by descriptive statistics, t-test, and chi-square. Results: In this study, the age and experience variables were not significantly different in two groups (p> 0.05). The strongest magnetic fields in high voltage power substations were at a distance of 1 meter in the substation 607 (28/1 mG) and in precision tool work units (7.03 mG). The results showed that the depressive and general health symptoms were significantly different between the exposed and unexposed groups (p = 0.04), however, the difference was not significant in terms of physical performance, anxiety, and social performance (p> 0.05). Conclusion: Although the level of exposure was lower than the standard level determined in Iran, the significant difference of the general health and depression between the two groups, explains the necessity of conducting more studies in this regard. Also by reducing the exposure time and increasing people’s awareness, it is possible to take important steps to reduce exposure and complications.

http://jhr.ssu.ac.ir/article-1-294-fa.pdf

The Effect of Electromagnetic Waves on the General Health of Zahedan Gas Power Plant Personnel

Background: In addition to the direct effect on health, high-risk behaviors expose people to a variety of disorders and affect their activities. Despite the importance of investigating the prevalence of high-risk behaviors among municipal workers, no comprehensive study has yet been conducted in this area. Objectives: The aim of the present study was to assess the predictors of high-risk behaviors among municipal workers in Zahedan city, Iran. Patients and Methods: This cross-sectional study was carried out on a total of 671 municipal workers and staff from different parts of Zahedan city in 2013. Information was collected through face to face interviews and registering answers in data forms. Data were analyzed in stata.12 software using chi-square and multivariate regression analysis at a significant level of 0.05. Results: Fifty-seven participants (8.5%) reported previous high-risk behaviors. According to the logistic regression test, only ethnicity and education variables were significantly related to the prevalence of high-risk behavior (P < 0.05). Although those with a longer work history had greater odds of high-risk behaviors than newly employed workers, this variable had no significant relationship with high-risk behaviors, and only improved the fitness and remained in the final model. Conclusions: High-risk behaviors are not highly prevalent among municipal workers and staff, and have no relationship with the occupation type. Given the higher prevalence of high-risk behaviors among more educated workers, there should be no concern about high-risk behaviors in less-educated ones. In conclusion, the ethnicity and educational level revealed as important predictors of high-risk behaviors among municipal workers.

Mahdi Mohammadi

Papers

Police response time to road crashes in south-east of Iran.

Understanding Female Students’ Needs to Develop Health Promoting School Programme: An Exploratory Qualitative Analysis

Prevalence of Addiction and Smoking and Their Relationship With Blood Parameters Among Drivers in Zahedan.

The Effect of Electromagnetic Waves on the General Health of Zahedan Gas Power Plant Personnel

Predictors of High-Risk Behaviors in Municipal Workers and Staff in Zahedan, South-East of Iran