ABSTRACT
@#BACKGROUND: Diarrhea is frequently seen in developed and developing countries, and severe diarrhea is characterized by the high risk of death. Thus, it is very important to assess the severity of diarrhea early. We conducted a multi-center study to identify risk factors for the severity of diarrhea in adult patients and formulate an adult diarrhea state score (ADSS) for out-patient clinicians. METHODS: A total of 219 adult patients with acute diarrhea were divided into two groups: 132 patients with mild diarrhea and 87 with severe diarrhea. Logistic regression was used to determine risk factors for the severity of diarrhea. The risk factors were assessed and an ADSS was formulated. Receiver operating characteristic (ROC) analysis was made to evaluate the diagnostic accuracy of ADSS, and the Kappa test was used to confirm the diagnostic reliability. RESULTS: Five risk factors for evaluating the severity of diarrhea in adults included age (P<0.05), axillary temperature (P<0.01), mean arterial pressure (P<0.01), white blood cell count (WBC; P<0.01), and WBC in stool (P<0.01). The area under the ROC curve for ADSS was 0.958 when the cut off value was 4 (a sensitivity of 0.909; a specificity of 0.874), and the Kappa value was 0.781 (P<0.05). CONCLUSION: The risk factors associated with the pathogenic condition of diarrhea were identified, quantified and formulated into an ADSS, which has high diagnostic accuracy and reliability for the early identification of patients with severe acute diarrhea.
ABSTRACT
<p><b>OBJECTIVE</b>To provide scientific basis for angiostrongyliasis cantonensis control and prevention in Beijing.</p><p><b>METHODS</b>Descriptive epidemiological method was used to analyze angiostrongyliasis cantonensis reported from June to September in 2006.</p><p><b>RESULTS</b>141 cases were treated at the Beijing Friendship Hospital with the peak in July (61 cases) and August (68 cases). All patients had dined at the same restaurant in Beijing city and they ate undercooked Pomacea canaliculata or related eatables. The source of Pomacea canaliculata was from Guilin in Guangxi. Major manifestations would include fever (56.79%), headache (93.83%), neck stiffness (100%), and skin paresthesia (77.78%). Some cases had significant eosinophil increase in peripheral blood picture and cerebrospinal fluid respectively.</p><p><b>CONCLUSION</b>The source of infection related to angiostrongyliasis cantonensis was clear, suggesting that the improvement of restaurant sanitation and on awareness of personal hygiene were important preventive and control measures on angiostrongyliasis cantonensis.</p>