<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:&...<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.展开更多
Asthma is a chronic inflammatory disease that affects 300 million people worldwide. Its prevalence rangesfrom 1% to 18% of the population in different countries. The World Health Organization has estimated that 15 mil...Asthma is a chronic inflammatory disease that affects 300 million people worldwide. Its prevalence rangesfrom 1% to 18% of the population in different countries. The World Health Organization has estimated that 15 million disability-adjusted life years are lost annually due to asthma. Worldwide deaths from asthma are estimated at 250 000 per year. Furthermore, asthma is a major cause of absence from work in many countries, including United States .展开更多
Background Several children are affected by airway foreign body aspiration(FBA)resulting from life-threatening conditions.Choking has been considered the major symptom and is defined as airway blockage by a foreign bo...Background Several children are affected by airway foreign body aspiration(FBA)resulting from life-threatening conditions.Choking has been considered the major symptom and is defined as airway blockage by a foreign body(FB),leading to marked morbidity or mortality.This retrospective study indicates the possibility of misdiagnosis or rigid bronchoscope(RB)failure,which is the standard gold method for extracting FB in the airway.Methods Six children with airway FBA who failed treatment using RB between 2018 and 2019 were retrospectively studied.The inclusion criterion was a history of failure to extract FB using RB followed by flexible fiberoptic bronchoscopy(FFB).Results In the present study,among 63 patients who had undergone rigid bronchoscopy,airway FBs were successfully removed in 57(90.48%).Rigid bronchoscopy failed in 6(9.52%)patients.The age of cases at the time of bronchoscopy ranged from 11 months to 13 years.FFB was performed to extract missing or remaining FBs and was done successfully in all patients.The patients made an uneventful recovery following FB extraction using the FFB method.Conclusions It is not easy to diagnose and treat airway FB in children.Rigid bronchoscopy has been approved as a method to manage airway FB,but a negative bronchoscopy result must usually be interpreted carefully.FFB is applicable as a proper and relatively safe diagnostic and therapeutic tool in managing airway FBs among the pediatric population,especially in cases where rigid bronchoscopy was performed but missed or failed to extract the FB.展开更多
Precision medicine requires coordinated and integrated evidence-based combinatorial approaches so that diagnosis and treatment can be tailored to the individual patient.In this context,the treatment approach to mild o...Precision medicine requires coordinated and integrated evidence-based combinatorial approaches so that diagnosis and treatment can be tailored to the individual patient.In this context,the treatment approach to mild obstructive sleep apnea(OSA)is fraught with substantial debate as to what is mild OSA,and as to what constitutes appropriate treatment.As such,it is necessary to first establish a proposed consensus of what criteria need to be employed to reach the diagnosis of mild OSA,and then examine the circumstances under which treatment is indicated,and if so,whether and when anti-inflammatory therapy(AIT),rapid maxillary expansion(RME),and/or myofunctional therapy(MFT)may be indicated.展开更多
文摘<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.
文摘Asthma is a chronic inflammatory disease that affects 300 million people worldwide. Its prevalence rangesfrom 1% to 18% of the population in different countries. The World Health Organization has estimated that 15 million disability-adjusted life years are lost annually due to asthma. Worldwide deaths from asthma are estimated at 250 000 per year. Furthermore, asthma is a major cause of absence from work in many countries, including United States .
文摘Background Several children are affected by airway foreign body aspiration(FBA)resulting from life-threatening conditions.Choking has been considered the major symptom and is defined as airway blockage by a foreign body(FB),leading to marked morbidity or mortality.This retrospective study indicates the possibility of misdiagnosis or rigid bronchoscope(RB)failure,which is the standard gold method for extracting FB in the airway.Methods Six children with airway FBA who failed treatment using RB between 2018 and 2019 were retrospectively studied.The inclusion criterion was a history of failure to extract FB using RB followed by flexible fiberoptic bronchoscopy(FFB).Results In the present study,among 63 patients who had undergone rigid bronchoscopy,airway FBs were successfully removed in 57(90.48%).Rigid bronchoscopy failed in 6(9.52%)patients.The age of cases at the time of bronchoscopy ranged from 11 months to 13 years.FFB was performed to extract missing or remaining FBs and was done successfully in all patients.The patients made an uneventful recovery following FB extraction using the FFB method.Conclusions It is not easy to diagnose and treat airway FB in children.Rigid bronchoscopy has been approved as a method to manage airway FB,but a negative bronchoscopy result must usually be interpreted carefully.FFB is applicable as a proper and relatively safe diagnostic and therapeutic tool in managing airway FBs among the pediatric population,especially in cases where rigid bronchoscopy was performed but missed or failed to extract the FB.
基金Supported by NIH grants HL130984,HL140548,and AG061824,a Tier 2 grant from the University of Missourithe Leda J.Sears Foundation.In addition,PEB was supported by FONDECYT grant number 1180397.
文摘Precision medicine requires coordinated and integrated evidence-based combinatorial approaches so that diagnosis and treatment can be tailored to the individual patient.In this context,the treatment approach to mild obstructive sleep apnea(OSA)is fraught with substantial debate as to what is mild OSA,and as to what constitutes appropriate treatment.As such,it is necessary to first establish a proposed consensus of what criteria need to be employed to reach the diagnosis of mild OSA,and then examine the circumstances under which treatment is indicated,and if so,whether and when anti-inflammatory therapy(AIT),rapid maxillary expansion(RME),and/or myofunctional therapy(MFT)may be indicated.