Objective To determine the validity of the diagnostic evidence for deceased cases in hospitals. Methods All information collected from medical records of the deceased cases in tertiary care health facilities was input...Objective To determine the validity of the diagnostic evidence for deceased cases in hospitals. Methods All information collected from medical records of the deceased cases in tertiary care health facilities was input into ottr database. Four diagnosis levels were determined based on level of diagnostic evidence： level Ⅰ was based on autopsy, pathology or operative exploration, level Ⅱ on physical and laboratory tests plus expert clinical judgment, level Ⅲ on expert clinical judgment, level Ⅳ on postmortem assumptions. After the diagnostic evidence of each deceased case was reviewed by a panel of three experts, the diagnostic level of each diagnosis was determined. Results Among the 2102 medical cases for verbal autopsy study, only 26 （1.24%） afforded diagnostic evidence for level Ⅲ Among the level Ⅲ evidence-based cases of death, the major causes of death were cardiovascular diseases, respiratory diseases, and gastroenterological diseases. According to some special symptoms and medical histories, these cases could be diagnosed by comprehensive clinical judgment. Only one case met the criteria for level Ⅳ. Conclusion Level Ⅰ diagnostic evidence is hard to attain in China because of the traditional concept and economic restriction. The causes for 2101 deaths can be validated by level Ⅱ or Ⅲ diagnostic evidence.展开更多
Post-polio syndrome(PPS)is a neurologic disorder characterized by an accumulation of symptoms,most often muscle weakness,fatigue,and pain,decades after the initial polio.Diagnosis of PPS is based on the presence of a ...Post-polio syndrome(PPS)is a neurologic disorder characterized by an accumulation of symptoms,most often muscle weakness,fatigue,and pain,decades after the initial polio.Diagnosis of PPS is based on the presence of a lower motor neuron disorder which is supported by neuro-physiological findings,as well as exclusion of other disorders as causes of new symptoms.The pathogenesis of PPS is still disputed.Rehabilitation for patients with PPS should take a comprehensive approach.Evaluation of the need for orthoses is often required.展开更多
Tumefactive demyelinating lesions （TDLs）,[1-3] previously named as tumor-like inflammatory demyelinating disease[4,5] or demyelinating pseudotumor,[6] are relatively special type of immune-mediated inflammatory demy...Tumefactive demyelinating lesions （TDLs）,[1-3] previously named as tumor-like inflammatory demyelinating disease[4,5] or demyelinating pseudotumor,[6] are relatively special type of immune-mediated inflammatory demyelinating lesions in the central nervous system （CNS）,[7] which mainly occur within cerebrum,but rarely in spinal cord.TDLs are so named because it mimics brain tumors with such characteristics as less severe symptoms,large lesions with perilesional edema,mass effect and/or enhancement on neuroimaging,and easily misdiagnosed as brain tumors.[8,9]展开更多
基金This work was sponsored by the National Institute of Aging Grant (No. 1-PO1-AG17625)
文摘Objective To determine the validity of the diagnostic evidence for deceased cases in hospitals. Methods All information collected from medical records of the deceased cases in tertiary care health facilities was input into ottr database. Four diagnosis levels were determined based on level of diagnostic evidence： level Ⅰ was based on autopsy, pathology or operative exploration, level Ⅱ on physical and laboratory tests plus expert clinical judgment, level Ⅲ on expert clinical judgment, level Ⅳ on postmortem assumptions. After the diagnostic evidence of each deceased case was reviewed by a panel of three experts, the diagnostic level of each diagnosis was determined. Results Among the 2102 medical cases for verbal autopsy study, only 26 （1.24%） afforded diagnostic evidence for level Ⅲ Among the level Ⅲ evidence-based cases of death, the major causes of death were cardiovascular diseases, respiratory diseases, and gastroenterological diseases. According to some special symptoms and medical histories, these cases could be diagnosed by comprehensive clinical judgment. Only one case met the criteria for level Ⅳ. Conclusion Level Ⅰ diagnostic evidence is hard to attain in China because of the traditional concept and economic restriction. The causes for 2101 deaths can be validated by level Ⅱ or Ⅲ diagnostic evidence.
基金This work was supported by the Fundamental Research Funds for Central Public Welfare Research Institutes(2019-CZ-17,2020-CZ-12).
文摘Post-polio syndrome(PPS)is a neurologic disorder characterized by an accumulation of symptoms,most often muscle weakness,fatigue,and pain,decades after the initial polio.Diagnosis of PPS is based on the presence of a lower motor neuron disorder which is supported by neuro-physiological findings,as well as exclusion of other disorders as causes of new symptoms.The pathogenesis of PPS is still disputed.Rehabilitation for patients with PPS should take a comprehensive approach.Evaluation of the need for orthoses is often required.
文摘Tumefactive demyelinating lesions （TDLs）,[1-3] previously named as tumor-like inflammatory demyelinating disease[4,5] or demyelinating pseudotumor,[6] are relatively special type of immune-mediated inflammatory demyelinating lesions in the central nervous system （CNS）,[7] which mainly occur within cerebrum,but rarely in spinal cord.TDLs are so named because it mimics brain tumors with such characteristics as less severe symptoms,large lesions with perilesional edema,mass effect and/or enhancement on neuroimaging,and easily misdiagnosed as brain tumors.[8,9]
