BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cas...BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.展开更多
Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accur...Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accuracy through Meta-analysis.Methods:Studies on the diagnostic value of CRP for bacterial infections in AECOPD were searched form Web of Science,PubMed,Cochrane library,EMBASE,WANFANG DATA,CNKI and China Biology Medicine disc.The included studies were evaluated according to QUADAS-2 assessment tool.Stata 12.0 software was used for meta analyses to summarize the sensitivity and the specificity of the included studies,and the heterogeneity test was conducted.The symmetric receiver operating characteristic curves(SROC)was drawn and the area under the curve(AUC)was calculated,and the funnel plot was drawn to determine publication bias.Results:664 studies were initially identified,20 of which met the inclusion criteria(9 in English and 11 in Chinese).Meta-analysis results showed that the summary sensitivity and specificity of CRP in diagnosing bacterial infections in AECOPD were 0.84,95%CI(0.77-0.90)and 0.76,95%CI(0.67-0.82),respectively.The AUC of SROC was 0.87,95%CI(0.83-0.89).Conclusion:CRP has high accuracy,sensitivity and specificity in distinguishing AECOPD bacterial infections from non-bacterial infection.展开更多
OBJECTIVES: To determine the epidemiological features of pulmonary tuberculosis in the region of Gharb-Chrarda-Beni-Hssen in Morocco. METHODS: This is a retrospective study of pulmonary tuberculosis cases, diagnosed a...OBJECTIVES: To determine the epidemiological features of pulmonary tuberculosis in the region of Gharb-Chrarda-Beni-Hssen in Morocco. METHODS: This is a retrospective study of pulmonary tuberculosis cases, diagnosed and treated at the regional diagnostic center of tuberculosis and respiratory diseases (RDCTRD) in Kenitra between January 2010 and December 2011. RESULTS: During the study period, there were 456 cases diagnosed with pulmonary tuberculosis at the RDCTRD, accounting for 51.3% of all tuberculosis cases reported during this period. More than two-thirds were men (69%), with a male-female ratio of 2.22 and 3.3% of cases were children under the age of 15 years. The average age of the patients was 37.07 ± 0.78 years. The average body weight at diagnosis of tuberculosis was 56.20 ± 0.55 kg for all patients. According to the results, 89% of pulmonary tuberculosis cases were microscopically positive. The majority of patients (80.3%) showed signs of tuberculous impregnation. Nearly three-quarters of these cases (71%) were smokers, 21% were cannabis addicts and 7% were alcoholics. Among the 427 cases for whom the outcome was known, 3 (0.7%) of them died. CONCLUSION: Tuberculosis can be controlled by preventing transmission and infection, by stopping the progression from latent infection to active tuberculosis, and by treating active disease.展开更多
Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study i...Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.展开更多
BACKGROUND Specific pulmonary infection could seriously threaten the health of pilots and their companions.The consequences are serious.We investigated the clinical diagnosis,treatment,and medical identification of sp...BACKGROUND Specific pulmonary infection could seriously threaten the health of pilots and their companions.The consequences are serious.We investigated the clinical diagnosis,treatment,and medical identification of specific pulmonary infections in naval pilots.CASE SUMMARY We analyzed the medical waiver and clinical data of four pilots with specific pulmonary infections,who had accepted treatment at the Naval Medical Center of Chinese People’s Liberation Army between January 2020 and November 2021,including three cases of tuberculosis and one of cryptococcal pneumonia.All cases underwent a series of comprehensive treatment courses.Three cases successfully obtained medical waiver for flight after being cured,while one was grounded after reaching the maximum flight life after being cured.CONCLUSION Chest computed tomography scanning should be used instead of chest radiography in pilots’physical examination.Most pilots with specific pulmonary infection can be cured and return to flight.展开更多
目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未...目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未合并肺部感染患者作为对照组(n=104),合并肺部感染患者作为观察组(n=110)。对患者性别、年龄、发病至入院时间、合并基础疾病、鼻饲饮食、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、气管插管、呼吸机辅助通气等临床资料进行调查,分析缺血性脑卒中患者合并肺部感染的危险因素。结果观察组男56例,女54例,年龄(73.59±8.21)岁;对照组男45例,女59例,年龄(65.32±5.62)岁。单因素分析结果显示,观察组患者年龄、鼻饲饮食、NIHSS评分、GCS评分、是否气管插管、是否呼吸机辅助通气与对照组比较差异有统计学意义(t=8.511、χ^(2)=11.622、t=5.721、t=4.282、χ^(2)=6.868、χ^(2)=6.145,P均<0.05)。多因素Logistic回归分析结果显示,鼻饲饮食(OR=5.447,95%CI:2.477~11.976)、NIHSS评分(OR=8.339,95%CI:2.598~26.768)、GCS评分(OR=7.660,95%CI:3.369~17.413)、气管插管(OR=6.184,95%CI:2.447~15.628)、呼吸机辅助通气(OR=4.302,95%CI:1.830~10.110)是缺血性脑卒中患者合并肺部感染的独立危险因素。结论鼻饲饮食、病情严重程度、意识障碍、气管插管及呼吸机辅助通气是导致缺血性脑卒中患者发生肺部感染的独立危险因素,因此在患者入院时应及时评估,有针对性地实施预防措施。展开更多
文摘BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.
文摘Objective:The clinical diagnostic accuracy of C-reactive protein(CRP)for bacterial infections in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is still controversial.This study evaluated its accuracy through Meta-analysis.Methods:Studies on the diagnostic value of CRP for bacterial infections in AECOPD were searched form Web of Science,PubMed,Cochrane library,EMBASE,WANFANG DATA,CNKI and China Biology Medicine disc.The included studies were evaluated according to QUADAS-2 assessment tool.Stata 12.0 software was used for meta analyses to summarize the sensitivity and the specificity of the included studies,and the heterogeneity test was conducted.The symmetric receiver operating characteristic curves(SROC)was drawn and the area under the curve(AUC)was calculated,and the funnel plot was drawn to determine publication bias.Results:664 studies were initially identified,20 of which met the inclusion criteria(9 in English and 11 in Chinese).Meta-analysis results showed that the summary sensitivity and specificity of CRP in diagnosing bacterial infections in AECOPD were 0.84,95%CI(0.77-0.90)and 0.76,95%CI(0.67-0.82),respectively.The AUC of SROC was 0.87,95%CI(0.83-0.89).Conclusion:CRP has high accuracy,sensitivity and specificity in distinguishing AECOPD bacterial infections from non-bacterial infection.
文摘OBJECTIVES: To determine the epidemiological features of pulmonary tuberculosis in the region of Gharb-Chrarda-Beni-Hssen in Morocco. METHODS: This is a retrospective study of pulmonary tuberculosis cases, diagnosed and treated at the regional diagnostic center of tuberculosis and respiratory diseases (RDCTRD) in Kenitra between January 2010 and December 2011. RESULTS: During the study period, there were 456 cases diagnosed with pulmonary tuberculosis at the RDCTRD, accounting for 51.3% of all tuberculosis cases reported during this period. More than two-thirds were men (69%), with a male-female ratio of 2.22 and 3.3% of cases were children under the age of 15 years. The average age of the patients was 37.07 ± 0.78 years. The average body weight at diagnosis of tuberculosis was 56.20 ± 0.55 kg for all patients. According to the results, 89% of pulmonary tuberculosis cases were microscopically positive. The majority of patients (80.3%) showed signs of tuberculous impregnation. Nearly three-quarters of these cases (71%) were smokers, 21% were cannabis addicts and 7% were alcoholics. Among the 427 cases for whom the outcome was known, 3 (0.7%) of them died. CONCLUSION: Tuberculosis can be controlled by preventing transmission and infection, by stopping the progression from latent infection to active tuberculosis, and by treating active disease.
文摘Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.
基金Supported by Key Project of Medical Service Scientific Research of Navy Medical Center,No.20M2302.
文摘BACKGROUND Specific pulmonary infection could seriously threaten the health of pilots and their companions.The consequences are serious.We investigated the clinical diagnosis,treatment,and medical identification of specific pulmonary infections in naval pilots.CASE SUMMARY We analyzed the medical waiver and clinical data of four pilots with specific pulmonary infections,who had accepted treatment at the Naval Medical Center of Chinese People’s Liberation Army between January 2020 and November 2021,including three cases of tuberculosis and one of cryptococcal pneumonia.All cases underwent a series of comprehensive treatment courses.Three cases successfully obtained medical waiver for flight after being cured,while one was grounded after reaching the maximum flight life after being cured.CONCLUSION Chest computed tomography scanning should be used instead of chest radiography in pilots’physical examination.Most pilots with specific pulmonary infection can be cured and return to flight.
文摘目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未合并肺部感染患者作为对照组(n=104),合并肺部感染患者作为观察组(n=110)。对患者性别、年龄、发病至入院时间、合并基础疾病、鼻饲饮食、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、气管插管、呼吸机辅助通气等临床资料进行调查,分析缺血性脑卒中患者合并肺部感染的危险因素。结果观察组男56例,女54例,年龄(73.59±8.21)岁;对照组男45例,女59例,年龄(65.32±5.62)岁。单因素分析结果显示,观察组患者年龄、鼻饲饮食、NIHSS评分、GCS评分、是否气管插管、是否呼吸机辅助通气与对照组比较差异有统计学意义(t=8.511、χ^(2)=11.622、t=5.721、t=4.282、χ^(2)=6.868、χ^(2)=6.145,P均<0.05)。多因素Logistic回归分析结果显示,鼻饲饮食(OR=5.447,95%CI:2.477~11.976)、NIHSS评分(OR=8.339,95%CI:2.598~26.768)、GCS评分(OR=7.660,95%CI:3.369~17.413)、气管插管(OR=6.184,95%CI:2.447~15.628)、呼吸机辅助通气(OR=4.302,95%CI:1.830~10.110)是缺血性脑卒中患者合并肺部感染的独立危险因素。结论鼻饲饮食、病情严重程度、意识障碍、气管插管及呼吸机辅助通气是导致缺血性脑卒中患者发生肺部感染的独立危险因素,因此在患者入院时应及时评估,有针对性地实施预防措施。
