AIM： TO elucidate the age-distribution of anti-hepatitis A virus （HAY） seroprevalence across different socioeconomic status （SES） categories in Bangladesh which, despite scarce data, is generally deemed to have h...AIM： TO elucidate the age-distribution of anti-hepatitis A virus （HAY） seroprevalence across different socioeconomic status （SES） categories in Bangladesh which, despite scarce data, is generally deemed to have high endemicity. METHODS： Blood samples of 818 subjects from a stratified samp#e of schools and hospitals, comprising different age categories and SES were collected. They were assayed for total anti-HAV antibodies. Social and medical history data were obtained using a questionnaire. RESULTS： Overall anti-HAV seroprevalence was 69.6%, increasing with age from 1-5 years （40.4%） to 〉 30 years （98.4%）. Seroprevalence was lowest （49.8%） in the high SES group and highest （96.5%） in the rural lower-middle SES group. Among subjects aged 6-20 years, anti-HAV seroprevalence was lowest in urban private school children （43.0%）, followed by urban government school children （76.2%） and rural school children （96.5%） （P 〈 0.01）. Within the high SESgroup, anti-HAV seroprevalence was 32.3% in subjects 〈 10 years and 51.7% in those aged 11-20 years. Until now Bangladesh has been deemed to have high endemicity for HAV. CONCLUSION： The transition from high to intermediate HAV endemicity may be underway; high SES adolescents and adults remain particularly at risk of symptomatic illness. Preventive measures need consideration.展开更多
Non-specific arm pain is a special clinical condition that can occur in work-related activities that involve maintaining a static position for prolonged periods or repetitive and frequent movements of the hand or enti...Non-specific arm pain is a special clinical condition that can occur in work-related activities that involve maintaining a static position for prolonged periods or repetitive and frequent movements of the hand or entire arm. Such activities include typing on a keyboard, maneuvering a computer mouse, playing musical instruments （such as piano and guitar） and many forms of manual labor. The pain is dull and diffuse; It is localized in the forearm or in the hand but quickly can expand to the entire extremity. Non-specific arm pain is the most frequent type of work-related pain after lower-back pain. It thus has important socio-economic significance as a major cause of absence from work. The designation of ＂non-specific＂ originates from the fact that it has no obvious signs of tissue damage, unlike the ＂specific＂ pain accompanying carpal tunnel syndrome, tenosinovitis de Quervain, or lateral epicondylitis. Suggested causes of the pain include microtrauma of soft tissue followed by an inflammatory reaction, ischemia, fatigue, hyper-sensitization of nociceptors, focal dystonia of the hand and/or psychological stress. Treatment consists of application of NSAIDs, physical modalities, stretching and aerobic exercises. Prevention focuses on ergonomic modification during manual labor or work on a computer.展开更多
Adolescents with inflammatory bowel disease face daily and long-term challenges that may be difficult for teenagers to manage. The developmental and psychosocial changes unique to this age group include becoming more ...Adolescents with inflammatory bowel disease face daily and long-term challenges that may be difficult for teenagers to manage. The developmental and psychosocial changes unique to this age group include becoming more autonomous and being more vulnerable to peer influence. These changes may lead to problems in medical management such as poor medication adherence and risky behavior. Being aware of these issues will help the medical team provide anticipatory guidance to address these concerns.展开更多
Objective To analyze the spectrum of microbiological agents causing community-acquired pneumonia （CAP） in recent years. We also investigated the procedure of diagnosis us well as the empirical treatment for this dis...Objective To analyze the spectrum of microbiological agents causing community-acquired pneumonia （CAP） in recent years. We also investigated the procedure of diagnosis us well as the empirical treatment for this disease in OPD （ outpatient department） of pulmonary disease. Methods A total of 7097 patients from 150 hospitals in 24 provinces in China were enrolled in the study from Nov. 2002 to Mar. 2003. Every patient was diagnosed, treated and registered at the same time. Diagnostic behavior for doctors include chest radiograph and/or CT examination of the lung, as well as collecting sputum samples at the time of diagnosis for bacteria culture to identify the pathogen. Appointed staff fulfiUed the questionnaires and information sheets in each center. After that, data were computerized and analyzed. Results There were 7404 valid information sheets and 7097 questionnaires taken into count. The majority CAP patients were from cities （ 77. 3% ）, most of those who had medical insurance. Most CAP patients had productive cough （81.1% ）, and 76. 7% and 18. 2 % CAP patients received chest film and CT examination respectively for diagnosis. Only 24% patients received sputum sample tested and with 36% got positive results. Streptococcus pneumoniae remained the main pathogen of CAP （43. 2% ）. Most doctors used to prescribe β-lactam antibiotics as the first line of empirical therapy of CAP （ 51.1% ） with oral taken as the main method for drug using （66. 3% ）. Conclusion This survey provides a key point of empirical therapy in China. The procedure for diagnosing us well as the empirical treatment of CAP in OPD of pulmonary disease in China still to be improved, especially in accessing the pathogen. Guidelines developed to recognize and evaluate CAP should base on epidemiological information of the pathogen prevalence, then could offer a rational approach to the initial management of the CAP patients.展开更多
OBJECTIVE:To evaluate the efficacy and safety of treatment based on syndrome differentiation ofTraditional Chinese Medicine(TCM) for community-acquired pneumonia(CAP).METHODS:A total of 240 CAP patients were randomly ...OBJECTIVE:To evaluate the efficacy and safety of treatment based on syndrome differentiation ofTraditional Chinese Medicine(TCM) for community-acquired pneumonia(CAP).METHODS:A total of 240 CAP patients were randomly divided into the following two groups:thecontrol group was treated by anti-infection plus conventional medicine treatment;and the trial group was treated by TCM plus the above-mentioned treatment given to the controls.The course of treatment was 14 days,and the patients were followed up for 7 days.RESULTS:Of the 240 patients,235 accomplished the whole process of treatment.The five patients who withdrew from the study were brought into an intent-to-treat analysis.The therapeutic effects of the trial group were superior to those of the control group(P<0.01).The trial group took less time to become clinically stable,with a higher score in the quality of life(P<0.01).There were no significant differences in mortality rate(P>0.05),white blood cell count(P>0.05),bacterial clearance rate(P>0.05),and adverse reactions between the two integrated groups.CONCLUSION:Treatment based on TCM syndrome differentiation for CAP has the advantages of resulting in less time to achieve a stable clinical condition,improvement of clinical symptoms and quality of life,and is comparatively safe.展开更多
OBJECTIVE:To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia(CAP) who underwent integrated interventions involving traditional Chinese medicine(TCM) and modern medicin...OBJECTIVE:To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia(CAP) who underwent integrated interventions involving traditional Chinese medicine(TCM) and modern medicine.METHODS:Patients aged ≥45 years and diagnosed with CAP were divided into a middle-aged cohort(45-59 years) and an elderly cohort(≥60 years),and clinical data comprising 75 predictor variables in seven classes were collected.After replacing missing data,calibrating multicenter differences and classifYing quantitative data,univariate and multivariate analysis were performed.RESULTS:On multivariate analysis,eight independent risk factors-respiration rate,C reactive protein(CRP),cost of hospitalization,anemia,gasping,confusion,moist rales and pneumonia severity index(PSI)-were correlated with the outcome "not cured" in the elderly cohort.Nine factors-neutrophil percentage(Neu%),blood urea nitrogen(BUN),time to clinical stability,appetite,anemia,confusion,being retired or unemployed,Gram-negative bacterial infection and educational level-were correlated with not cured in the middle-aged cohort.CONCLUSION:Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate,CRP≥four times the mean or median for the patient's center,cost of hospitalization>11,323 RMB and PSI>II,plus anemia,gasping,confusion and moist rales;those in middle-aged patients were higher Neu%,BUN≥mean or median,loss of appetite,anemia,confusion,being retired or unemployed and lower educational level.Gram-negative bacterial infection and time to clinical stability>9 days were protective factors.展开更多
OBJECTIVE:To evaluate school success in pediatric patients undergoing acupuncture treatment for variousindications.METHODS: The grades achieved during both school terms by children undergoing acupuncture treatment for...OBJECTIVE:To evaluate school success in pediatric patients undergoing acupuncture treatment for variousindications.METHODS: The grades achieved during both school terms by children undergoing acupuncture treatment for various indications at the pediatric out patient clinic of Ulus State Hospital were analyzed. Exam grades in mathematics, social studies,and Turkish was compared between the first and the second terms. Forty children were included in thestudy,with 22 male and 18 female,and their average age was 11.1 years. These patients were undergoing acupuncture treatment for attention deficit-hyperactivity disorder(ADHD), enuresis nocturna, migraine, obesity, atopic dermatitis, alopecia areata, and Tourette's syndrome. Treatments were done at the beginning of the second term. Four of the 25 patients with ADHD had borderline intelligence quotients.The report cards of all 40 patients were examined, and their grades in the first and these condschool term were compared.RESULTS: There was a statistically significant increase in the grades obtained in mathematics, social studies, and Turkish(P<0.005) by the students from the first to the second school term. When 4 ADHD patients with borderline deficiency in intelligence were excluded, and the grades among the 21 patients with ADHD were compared for both terms, there was also a statistically significant increase in mathematics, social studies, and Turkish grades(P<0.05).CONCLUSION: Acupuncture contributed to the academic success of the children who under went acupuncture treatment for their primary symptoms.展开更多
文摘AIM： TO elucidate the age-distribution of anti-hepatitis A virus （HAY） seroprevalence across different socioeconomic status （SES） categories in Bangladesh which, despite scarce data, is generally deemed to have high endemicity. METHODS： Blood samples of 818 subjects from a stratified samp#e of schools and hospitals, comprising different age categories and SES were collected. They were assayed for total anti-HAV antibodies. Social and medical history data were obtained using a questionnaire. RESULTS： Overall anti-HAV seroprevalence was 69.6%, increasing with age from 1-5 years （40.4%） to 〉 30 years （98.4%）. Seroprevalence was lowest （49.8%） in the high SES group and highest （96.5%） in the rural lower-middle SES group. Among subjects aged 6-20 years, anti-HAV seroprevalence was lowest in urban private school children （43.0%）, followed by urban government school children （76.2%） and rural school children （96.5%） （P 〈 0.01）. Within the high SESgroup, anti-HAV seroprevalence was 32.3% in subjects 〈 10 years and 51.7% in those aged 11-20 years. Until now Bangladesh has been deemed to have high endemicity for HAV. CONCLUSION： The transition from high to intermediate HAV endemicity may be underway; high SES adolescents and adults remain particularly at risk of symptomatic illness. Preventive measures need consideration.
文摘Non-specific arm pain is a special clinical condition that can occur in work-related activities that involve maintaining a static position for prolonged periods or repetitive and frequent movements of the hand or entire arm. Such activities include typing on a keyboard, maneuvering a computer mouse, playing musical instruments （such as piano and guitar） and many forms of manual labor. The pain is dull and diffuse; It is localized in the forearm or in the hand but quickly can expand to the entire extremity. Non-specific arm pain is the most frequent type of work-related pain after lower-back pain. It thus has important socio-economic significance as a major cause of absence from work. The designation of ＂non-specific＂ originates from the fact that it has no obvious signs of tissue damage, unlike the ＂specific＂ pain accompanying carpal tunnel syndrome, tenosinovitis de Quervain, or lateral epicondylitis. Suggested causes of the pain include microtrauma of soft tissue followed by an inflammatory reaction, ischemia, fatigue, hyper-sensitization of nociceptors, focal dystonia of the hand and/or psychological stress. Treatment consists of application of NSAIDs, physical modalities, stretching and aerobic exercises. Prevention focuses on ergonomic modification during manual labor or work on a computer.
文摘Adolescents with inflammatory bowel disease face daily and long-term challenges that may be difficult for teenagers to manage. The developmental and psychosocial changes unique to this age group include becoming more autonomous and being more vulnerable to peer influence. These changes may lead to problems in medical management such as poor medication adherence and risky behavior. Being aware of these issues will help the medical team provide anticipatory guidance to address these concerns.
文摘Objective To analyze the spectrum of microbiological agents causing community-acquired pneumonia （CAP） in recent years. We also investigated the procedure of diagnosis us well as the empirical treatment for this disease in OPD （ outpatient department） of pulmonary disease. Methods A total of 7097 patients from 150 hospitals in 24 provinces in China were enrolled in the study from Nov. 2002 to Mar. 2003. Every patient was diagnosed, treated and registered at the same time. Diagnostic behavior for doctors include chest radiograph and/or CT examination of the lung, as well as collecting sputum samples at the time of diagnosis for bacteria culture to identify the pathogen. Appointed staff fulfiUed the questionnaires and information sheets in each center. After that, data were computerized and analyzed. Results There were 7404 valid information sheets and 7097 questionnaires taken into count. The majority CAP patients were from cities （ 77. 3% ）, most of those who had medical insurance. Most CAP patients had productive cough （81.1% ）, and 76. 7% and 18. 2 % CAP patients received chest film and CT examination respectively for diagnosis. Only 24% patients received sputum sample tested and with 36% got positive results. Streptococcus pneumoniae remained the main pathogen of CAP （43. 2% ）. Most doctors used to prescribe β-lactam antibiotics as the first line of empirical therapy of CAP （ 51.1% ） with oral taken as the main method for drug using （66. 3% ）. Conclusion This survey provides a key point of empirical therapy in China. The procedure for diagnosing us well as the empirical treatment of CAP in OPD of pulmonary disease in China still to be improved, especially in accessing the pathogen. Guidelines developed to recognize and evaluate CAP should base on epidemiological information of the pathogen prevalence, then could offer a rational approach to the initial management of the CAP patients.
基金Supported by the National Program on Key Basic Research Project(973 Program)(Grant NO.2006CB504605)the Program for New Century Excellent Talents at the University of Henan Province(Grant NO.006HANCET-05)
文摘OBJECTIVE:To evaluate the efficacy and safety of treatment based on syndrome differentiation ofTraditional Chinese Medicine(TCM) for community-acquired pneumonia(CAP).METHODS:A total of 240 CAP patients were randomly divided into the following two groups:thecontrol group was treated by anti-infection plus conventional medicine treatment;and the trial group was treated by TCM plus the above-mentioned treatment given to the controls.The course of treatment was 14 days,and the patients were followed up for 7 days.RESULTS:Of the 240 patients,235 accomplished the whole process of treatment.The five patients who withdrew from the study were brought into an intent-to-treat analysis.The therapeutic effects of the trial group were superior to those of the control group(P<0.01).The trial group took less time to become clinically stable,with a higher score in the quality of life(P<0.01).There were no significant differences in mortality rate(P>0.05),white blood cell count(P>0.05),bacterial clearance rate(P>0.05),and adverse reactions between the two integrated groups.CONCLUSION:Treatment based on TCM syndrome differentiation for CAP has the advantages of resulting in less time to achieve a stable clinical condition,improvement of clinical symptoms and quality of life,and is comparatively safe.
基金Supported by the National Basic Research Program(973 Program) [No.2006CB504605]the Program for New Century Excellent Talents in Universities in Henan Province (No.2006HANCET-05)
文摘OBJECTIVE:To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia(CAP) who underwent integrated interventions involving traditional Chinese medicine(TCM) and modern medicine.METHODS:Patients aged ≥45 years and diagnosed with CAP were divided into a middle-aged cohort(45-59 years) and an elderly cohort(≥60 years),and clinical data comprising 75 predictor variables in seven classes were collected.After replacing missing data,calibrating multicenter differences and classifYing quantitative data,univariate and multivariate analysis were performed.RESULTS:On multivariate analysis,eight independent risk factors-respiration rate,C reactive protein(CRP),cost of hospitalization,anemia,gasping,confusion,moist rales and pneumonia severity index(PSI)-were correlated with the outcome "not cured" in the elderly cohort.Nine factors-neutrophil percentage(Neu%),blood urea nitrogen(BUN),time to clinical stability,appetite,anemia,confusion,being retired or unemployed,Gram-negative bacterial infection and educational level-were correlated with not cured in the middle-aged cohort.CONCLUSION:Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate,CRP≥four times the mean or median for the patient's center,cost of hospitalization>11,323 RMB and PSI>II,plus anemia,gasping,confusion and moist rales;those in middle-aged patients were higher Neu%,BUN≥mean or median,loss of appetite,anemia,confusion,being retired or unemployed and lower educational level.Gram-negative bacterial infection and time to clinical stability>9 days were protective factors.
文摘OBJECTIVE:To evaluate school success in pediatric patients undergoing acupuncture treatment for variousindications.METHODS: The grades achieved during both school terms by children undergoing acupuncture treatment for various indications at the pediatric out patient clinic of Ulus State Hospital were analyzed. Exam grades in mathematics, social studies,and Turkish was compared between the first and the second terms. Forty children were included in thestudy,with 22 male and 18 female,and their average age was 11.1 years. These patients were undergoing acupuncture treatment for attention deficit-hyperactivity disorder(ADHD), enuresis nocturna, migraine, obesity, atopic dermatitis, alopecia areata, and Tourette's syndrome. Treatments were done at the beginning of the second term. Four of the 25 patients with ADHD had borderline intelligence quotients.The report cards of all 40 patients were examined, and their grades in the first and these condschool term were compared.RESULTS: There was a statistically significant increase in the grades obtained in mathematics, social studies, and Turkish(P<0.005) by the students from the first to the second school term. When 4 ADHD patients with borderline deficiency in intelligence were excluded, and the grades among the 21 patients with ADHD were compared for both terms, there was also a statistically significant increase in mathematics, social studies, and Turkish grades(P<0.05).CONCLUSION: Acupuncture contributed to the academic success of the children who under went acupuncture treatment for their primary symptoms.
