目的根据回顾性流行病学的设计原理,探讨部分医院感染学研究运用该方法时所存在的问题,为合理运用回顾性流行病学方法开展医院感染学相关研究提供参考。方法收集近三年来发表在《中华医院感染学杂志》、《Infection Control and Hospita...目的根据回顾性流行病学的设计原理,探讨部分医院感染学研究运用该方法时所存在的问题,为合理运用回顾性流行病学方法开展医院感染学相关研究提供参考。方法收集近三年来发表在《中华医院感染学杂志》、《Infection Control and Hospital Epidemiology》等杂志上的以回顾性流行病学方法为主的医院感染学研究论文,对这些论文的设计思路、研究方法、研究对象的选择、统计学方法的运用、研究结果与结论的描述等方面进行比较和归纳,探讨部分研究在科研设计、统计分析、结果描述等方面存在的问题,并总结回顾性流行病学研究应具备的设计要素。结果目前多数医院感染学研究采用的回顾性流行病学方法主要是病例对照研究和回顾性队列研究,但部分研究存在着科研设计不严谨、科学问题不明确、研究对象无代表性,对照组选择不合理等问题。回顾性流行病学研究的设计要素应具备:明确的研究目的、合适的研究对象、适宜的样本量、合理的对照组、正确的统计学方法等。结论回顾性流行病学虽是医院感染学相关研究的主流方法,但不能盲目运用,开展研究前应当进行科学严谨的设计,充分考虑其设计要素,才能得出有说服力的结论。展开更多
Background. We undertook this study in order to determine the pattern and prevalence of childhood psoriasis in northern India and to highlight the differences and similarities with previous studies. Materials and meth...Background. We undertook this study in order to determine the pattern and prevalence of childhood psoriasis in northern India and to highlight the differences and similarities with previous studies. Materials and methods. In this retrospective epidemiologic study, the data from 419 children (less than 14 years of age) with psoriasis registered at the Psoriasis Clinic between January 1990 and December 2002 were included. Results. The 419 children registered at the Psoriasis Clinic constituted 0.3%of the dermatology outpatients and 12.5%of the total psoriasis patients seen over a period of 13 years in the department. There were 219 (52.3%) boys and 200 (47.7%) girls, with a male to female ratio of 1.09:1. The age of onset ranged from 4 days to 14 years. The mean age of onset was 8.1 ±2.1 years in boys and 9.3 ±2.3 years in girls. The peak age of onset in boys was in the 6-10-year age group, whereas the majority of girls showed an onset of psoriasis between the ages of 10 and 14 years. A positive family history was present in only 19 (4.5%) patients. The extensors of the legs were the most common initial site affected [105 (25%) cases], followed by the scalp [87 (20.7%)]. Classical plaque psoriasis was the most frequent clinical presentation [254 (60.6%) patients], followed by plantar psoriasis [54 (12.8%)]. Nail involvement was observed in 130 (31%) cases. All types of nail changes described in psoriasis were seen in these patients. Pitting was the most common nail change, followed by ridging and discoloration. Five children (1.1%) (three girls and two boys) had psoriatic arthropathy. Precipitating factors that brought about the onset of the disease or were associated with exacerbation could be recalled in only 28 (6.6%) patients. Koebnerization was observed in 27.9%of patients. Pruritus was the most frequent symptom, reported by 365 (87.1%) children. Twenty-seven (6.4%) children had other concurrent mucocutaneous diseases (vitiligo, pityriasis alba, alopecia areata, ichthyosis vulgaris, halo nevus, aphthous stomatitis, urticaria, pityriasis versicolor, nummular eczema, salmon patch, and verrucous epidermal nevus). Eighteen children had systemic disorders, including seizures, bronchial asthma, mitral regurgitation, scleroderma, Down’s syndrome, high arched palate, cholelithiasis, anterior mongoloid slant, and prognathism; however, these conditions were possibly chance findings only and no correlation with the age of onset or severity of the disease was found. Conclusions. Our findings differ from those of previous studies in showing a delayed onset, equal sex distribution, less frequent facial involvement, uncommon guttate lesions, more frequent involvement of the soles, and a less frequent history of familial occurrence.展开更多
文摘目的根据回顾性流行病学的设计原理,探讨部分医院感染学研究运用该方法时所存在的问题,为合理运用回顾性流行病学方法开展医院感染学相关研究提供参考。方法收集近三年来发表在《中华医院感染学杂志》、《Infection Control and Hospital Epidemiology》等杂志上的以回顾性流行病学方法为主的医院感染学研究论文,对这些论文的设计思路、研究方法、研究对象的选择、统计学方法的运用、研究结果与结论的描述等方面进行比较和归纳,探讨部分研究在科研设计、统计分析、结果描述等方面存在的问题,并总结回顾性流行病学研究应具备的设计要素。结果目前多数医院感染学研究采用的回顾性流行病学方法主要是病例对照研究和回顾性队列研究,但部分研究存在着科研设计不严谨、科学问题不明确、研究对象无代表性,对照组选择不合理等问题。回顾性流行病学研究的设计要素应具备:明确的研究目的、合适的研究对象、适宜的样本量、合理的对照组、正确的统计学方法等。结论回顾性流行病学虽是医院感染学相关研究的主流方法,但不能盲目运用,开展研究前应当进行科学严谨的设计,充分考虑其设计要素,才能得出有说服力的结论。
文摘Background. We undertook this study in order to determine the pattern and prevalence of childhood psoriasis in northern India and to highlight the differences and similarities with previous studies. Materials and methods. In this retrospective epidemiologic study, the data from 419 children (less than 14 years of age) with psoriasis registered at the Psoriasis Clinic between January 1990 and December 2002 were included. Results. The 419 children registered at the Psoriasis Clinic constituted 0.3%of the dermatology outpatients and 12.5%of the total psoriasis patients seen over a period of 13 years in the department. There were 219 (52.3%) boys and 200 (47.7%) girls, with a male to female ratio of 1.09:1. The age of onset ranged from 4 days to 14 years. The mean age of onset was 8.1 ±2.1 years in boys and 9.3 ±2.3 years in girls. The peak age of onset in boys was in the 6-10-year age group, whereas the majority of girls showed an onset of psoriasis between the ages of 10 and 14 years. A positive family history was present in only 19 (4.5%) patients. The extensors of the legs were the most common initial site affected [105 (25%) cases], followed by the scalp [87 (20.7%)]. Classical plaque psoriasis was the most frequent clinical presentation [254 (60.6%) patients], followed by plantar psoriasis [54 (12.8%)]. Nail involvement was observed in 130 (31%) cases. All types of nail changes described in psoriasis were seen in these patients. Pitting was the most common nail change, followed by ridging and discoloration. Five children (1.1%) (three girls and two boys) had psoriatic arthropathy. Precipitating factors that brought about the onset of the disease or were associated with exacerbation could be recalled in only 28 (6.6%) patients. Koebnerization was observed in 27.9%of patients. Pruritus was the most frequent symptom, reported by 365 (87.1%) children. Twenty-seven (6.4%) children had other concurrent mucocutaneous diseases (vitiligo, pityriasis alba, alopecia areata, ichthyosis vulgaris, halo nevus, aphthous stomatitis, urticaria, pityriasis versicolor, nummular eczema, salmon patch, and verrucous epidermal nevus). Eighteen children had systemic disorders, including seizures, bronchial asthma, mitral regurgitation, scleroderma, Down’s syndrome, high arched palate, cholelithiasis, anterior mongoloid slant, and prognathism; however, these conditions were possibly chance findings only and no correlation with the age of onset or severity of the disease was found. Conclusions. Our findings differ from those of previous studies in showing a delayed onset, equal sex distribution, less frequent facial involvement, uncommon guttate lesions, more frequent involvement of the soles, and a less frequent history of familial occurrence.
