ABSTRACT
Retinoblastoma is a kind of malignant eye tumor commonly seen in children, which is one of the main causes threatening children's vision and life. The diagnosis and evaluation of retinoblastoma has always been a hot topic in clinic. In the past few years, the application of artificial intelligence(AI)technology has made significant progress in the medical field, providing new opportunities and challenges for the diagnosis and treatment of retinoblastoma, for example, the use of AI algorithms to analyze massive clinical data, which can help doctors diagnose the disease more accurately and provide personalized treatment plans. In addition, AI technology also plays an important role in medical image analysis, genomics research and other aspects, which can help the development of new drugs and improve patient prognosis. This article reviews the application progress of AI in retinoblastoma.
ABSTRACT
Objective To analyze the diagnosis cases of occupational benzene poisoning in gas station industry, and to explore the application of GC-MS technology in occupational disease diagnosis. Methods The epidemiological method was used to describe and analyze the occupational disease diagnosis of 15 gas station workers , and qualitative screening of occupational hazard factors was performed by GC-MS. Results All the 15 workers had more than one year's occupation history of oil refueling and unloading. The clinical manifestations were consistent with the characteristics of chronic benzene poisoning in diagnosis of occupational benzene poisoning. However, due to lack of evidence of occupational exposure to benzene and incomplete diagnostic data, occupational chronic benzene poisoning was not diagnosed. GC-MS technology was used to screen the occupational hazard factors in the gas station workplace, and benzene, n-pentane, n-hexane and so on were found. Conclusion GC-MS is recommended for qualitative screening of organic solvents such as benzene when diagnosing occupational diseases for gas station workers , so as to accurately identify occupational hazard factors in workplaces and provide reliable basis for diagnosis of occupational diseases.
ABSTRACT
Recently, deep learning has achieved impressive results in medical image tasks. However, this method usually requires large-scale annotated data, and medical images are expensive to annotate, so it is a challenge to learn efficiently from the limited annotated data. Currently, the two commonly used methods are transfer learning and self-supervised learning. However, these two methods have been little studied in multimodal medical images, so this study proposes a contrastive learning method for multimodal medical images. The method takes images of different modalities of the same patient as positive samples, which effectively increases the number of positive samples in the training process and helps the model to fully learn the similarities and differences of lesions on images of different modalities, thus improving the model's understanding of medical images and diagnostic accuracy. The commonly used data augmentation methods are not suitable for multimodal images, so this paper proposes a domain adaptive denormalization method to transform the source domain images with the help of statistical information of the target domain. In this study, the method is validated with two different multimodal medical image classification tasks: in the microvascular infiltration recognition task, the method achieves an accuracy of (74.79 ± 0.74)% and an F1 score of (78.37 ± 1.94)%, which are improved as compared with other conventional learning methods; for the brain tumor pathology grading task, the method also achieves significant improvements. The results show that the method achieves good results on multimodal medical images and can provide a reference solution for pre-training multimodal medical images.
Subject(s)
Humans , Algorithms , Brain/diagnostic imaging , Brain Neoplasms/diagnostic imaging , Recognition, PsychologyABSTRACT
Unclear labor relationship is the most common challenging issue in occupational disease diagnosis. At present, there are three main errors in the understanding regarding labor relationship in the process of occupational disease diagnosis. Firstly, labor relationship does not need to be considered in occupational disease diagnosis. Secondly, labor relationship must exist in order to initiate the occupational disease diagnosis procedure. Lastly, there is an overreach in handling labor relationship issues beyond one's authority. Labor relationship is the basic and antecedent problem which cannot be avoided in occupational diseases diagnosis. While officially, labor relationship issue should be considered in occupational disease diagnosis, they are not a necessary condition. The occupational diseases diagnosis requires actual labor and employment relations. If the workers with actual labor-relation are suspected to have health injuries caused by occupational hazards in the workplace, they are eligible for occupational diseases diagnosis. But it is not the responsibility of health department to judge the labor relationship. When a dispute arises between a worker and an employer regarding labor relationship, the resolution of the relevant dispute shall be submitted to the human resources and social services department or the labor and personnel arbitration committee, or submitted to the court for adjudication according to law. In the process of occupational disease diagnosis, the two reasonable disposal procedures for verifying actual labor and employment relationship involve workers submitting evidence of their labor relationship with the employer, and the employer's verification. If the employer disputes the labor relationship as presented by the worker, the occupational disease diagnosis institution should inform the worker to apply for labor dispute arbitration. However, it is important to note that arbitration or mediation documents from the court cannot be used as evidence in occupational disease diagnosis.
ABSTRACT
Nuclear magnetic resonance spectroscopy (NMRS) is a branch of spectroscopy, which can be used to determine the number, type and relative position of components in the mixture. Due to its high throughput, high sensitivity and high stability, especially its "fingerprint", non-destructive and non-biased detection of metabolites, NMRS has become one of the most commonly used analytical and detection techniques in metabolomics. Based on the research of clinical laboratory application, this review briefly expounds the technical principle of nuclear magnetic resonance spectroscopy, introduces the development and latest research results of nuclear magnetic resonance spectroscopy in biomedical application fields such as blood lipid analysis, tumor detection, prediction of mental and nervous system diseases, infectious diseases, nutrition and health management, and discusses the development prospect of clinical translational medicine.
ABSTRACT
Objective:To explore the diagnostic value of the toxicant and drug detection in clinical poisoning diseases and analyze the clinical characteristics of patients with positive poison test.Methods:This study was a multicenter retrospective cohort study. Sampling and clinical information data were collected between October 1, 2020 and September 30, 2022 from 41 tertiary hospitals in and around Jiangsu province. The clinical characteristics of patients with positive toxicology tests were analyzed, and the correlation between the drug sampling situation and the test results was analyzed..Results:A total of 895 patients with clinical diagnosis or suspected poisoning were enrolled in this study. Among them, 652 patients had positive results, accounting for 72.85%. Among all positive patients, 506 patients were exposed to a single poison and 147 patients were exposed to multiple poisons. The top three poisons were pesticide herbicides (202 cases, 30.98%), sedative and psychotropic drugs (151 cases, 23.16%), and pesticide insecticides (97 cases, 14.88%). Among 541 patients with clear exposure history, the positive rate was 78.19%, and among 354 patients with unclear exposure history, the positive rate was 64.69%. The top three poisons (drugs) of patients with unclear exposure history were sedative and psychotropic (82, 12.58%), herbicide (26, 3.99%), and rodenticide (22, 3.37%). Patients who admitted to hospital for unexplained consciousness disorder, abnormal blood coagulation function and multiple organ dysfunction were more likely to obtain positive poison test results.Conclusions:There is uncertainty in the exposure history of poisoning diseases, so it is necessary to improve the detection of toxic substances as soon as possible. Toxicant testing should be considered when patients have impaired consciousness, abnormal coagulation function and multiple organ dysfunction.
ABSTRACT
This study aims to develop a method to detect bovine multi-cytokines based on flow cytometry. Previously we have prepared and screened monoclonal antibodies against bovine cytokines IFN-γ, IL-2, TNF-α, IP-10 and MCP-1. These bovine cytokine monoclonal antibodies were fluorescently labeled, and the combination of antibody and cell surface molecules were used to develop the method for detecting bovine multi-cytokines. Subsequently, the developed method was used to determine the cytokine expression profile of Mycobacterium bovis BCG infected bovine peripheral blood mononuclear cells in vitro, and evaluate the cytokine expression level of peripheral blood CD4+ T cells of tuberculosis-positive cattle. The bovine multi-cytokine flow cytometry detection method can effectively determine the cytokine expression of BCG-infected bovine peripheral blood T lymphocytes. Among them, the expression levels of IFN-γ, IL-2, and TNF-α continue to increase after 40 hours of infection, while the expression levels of IP-10 and MCP-1 decreased. The combined detection of IFN-γ, IL-2, and TNF-α on CD4+ T lymphocytes in peripheral blood of cattle can effectively distinguish tuberculosis-positive and tuberculosis-negative samples. This method may facilitate evaluating the level of cellular immune response after bovine pathogen infection and vaccine injection.
Subject(s)
Cattle , Animals , Cytokines , BCG Vaccine/metabolism , Tumor Necrosis Factor-alpha/metabolism , Interleukin-2 , Flow Cytometry/methods , Chemokine CXCL10/metabolism , Leukocytes, Mononuclear , CD4-Positive T-Lymphocytes/metabolism , Tuberculosis , Antibodies, Monoclonal/metabolismABSTRACT
OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics.
ABSTRACT
Objective@#To investigate the epidemiological characteristics of suspected cases with occupational diseases and analyze the quality of occupational diseases report in Huzhou City from 2016 to 2020, so as to provide insights into supervision and early warning of occupational diseases.@*Methods@#The epidemiological data pertaining to suspected cases with occupational diseases reported in Huzhou City from 2016 to 2020 were retrieved from the Occupational Disease and Health Risk Factors Monitoring Information System of China Disease Prevention and Control Information System, including gender, age, type of job, industry category, enterprise size and diagnosis. The percentages of identification, diagnosis and definitive diagnosis were calculated, and the distribution and diagnosis of suspected cases with occupational diseases were descriptively analyzed among different regions, industry categories and enterprise sizes.@*Results@#A total of 264 398 people underwent occupational health examinations in Huzhou City from 2016 to 2020, and 322 suspected cases with occupational diseases were detected (12.18/104), including 179 cases with suspected pneumoconiosis (55.59%), 78 cases with suspected occupational ear, nose, throat and oral diseases (24.22%), 54 cases with suspected occupational poisoning (16.77%), 6 cases with suspected occupational skin diseases (1.86%), 3 cases with suspected occupational diseases caused by physical factors (0.93%) and 2 cases with other suspected respiratory diseases (0.62%). The 322 cases with suspected occupational diseases included 290 men (90.06%) and 32 women (9.94%), and had a mean age of (53.28±9.20) years. A total of 207 cases underwent occupational diseases diagnosis (64.29%), and 155 cases were definitively diagnosed with occupational diseases (74.88%). Among different counties (districts) in Huzhou City, the highest number of suspected cases with occupational diseases was reported in Changxing County (101 cases, 31.37%), with a diagnostic rate of 88.12%, and among all enterprises, the highest number of suspected cases with occupational diseases was reported in small enterprises (220 cases, 68.32%), with a diagnostic rate of 68.64%, while among all industry categories, the highest number of suspected cases with occupational diseases was reported in manufacture industry (228 cases, 70.81%), with a diagnostic rate of 56.14%. In addition, there was no suspected case with occupational diseases detected in agriculture, forestry, animal husbandry, fishery, wholesale/retail trade industry, or public administration, social security or social organizations.@*Conclusion@#Pneumoconiosis was the predominant type of suspected occupational diseases in Huzhou City from 2016 to 2020, and a low diagnostic rate was found. Improved supervision of occupational diseases control is strongly recommended among small enterprises to standardize the reporting system of suspected occupational diseases.
ABSTRACT
@#Artificial intelligence is described as the“fourth industrial revolution”. Driven by the development of the Internet and big data, ophthalmology has become a frontier discipline in this wave, showing a good prospect of vigorous development. Artificial intelligence has been applied to the auxiliary screening, diagnosis and treatment of a variety of eye diseases, and assisted in the completion of corneal, refractive, cataract and other related operations; Help realize graded diagnosis and treatment, telemedicine and improve the training mode of ophthalmic talents, and participate in eye health management and ophthalmic education. While artificial intelligence brings benefits to mankind, it also brings a number of ethical problems, among which the contradictions related to medical ethics, such as the division of responsibility for diagnosis and treatment errors, the protection of patient information privacy, humanistic care and its fairness, the contradiction between the growing artificial intelligence and imperfect ethics and laws are particularly prominent. Artificial intelligence must be guided by the correct value and abide by the corresponding ethical norms to continue to mature and improve in clinical practice. This paper summarizes the development status and ethical dilemma of ophthalmology under the background of artificial intelligence to provide reference for promoting its healthy development in the field of ophthalmology.
ABSTRACT
@#Improving the efficiency of occupational disease diagnosis and verification is conducive to protecting the rights and interests of workers, better realizing the legislative value pursuit of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases, and truly demonstrating the spirit of legal fairness and justice. In 2021, the Administration Measures for the Diagnosis and Verification of Occupational Disease was revised and implemented. The working procedures of occupational disease diagnosis are adjusted and optimized, and the efficiency of diagnosis of occupational disease is greatly improved. They include items such as new provisions specifying working time limits; optimize the working mode; the diagnosis of occupational disease attribution applies to presumptive causality is emphasized and the logical thinking of inversion of burden of proof is carried out. However, the work efficiency of occupational disease diagnosis does not make a great breakthrough in quality, mainly manifests in three aspects: difficult to confirm labor relationships, raising the threshold of occupational disease diagnosis, the administrative field investigation is empty and the diagnosis of occupational disease is complicated. There are many pre-procedures in occupational disease diagnosis, which restrict the efficiency of diagnosis. In the future, attention needs to be paid to promote the independent work of occupational disease diagnosis institutions, and through the revision of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases. Occupational disease diagnosis institutions should be empowered to confirm labor relationship, so as to lower the threshold of diagnosis of occupational disease and maximize the protection of the rights and interests of workers.
ABSTRACT
Alzheimer's disease(AD)represents the main form of dementia;however,valid diagnosis and treatment measures are lacking.The discovery of valuable biomarkers through omics technologies can help solve this problem.For this reason,metabolomic analysis using ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS)was carried out on plasma,hippocampus,and cortex samples of an AD rat model.Based on the metabolomic data,we report a multi-factor combined biomarker screening strategy to rapidly and accurately identify potential bio-markers.Compared with the usual procedure,our strategy can identify fewer biomarkers with higher diagnostic specificity and sensitivity.In addition to diagnosis,the potential biomarkers identified using our strategy were also beneficial for drug evaluation.Multi-factor combined biomarker screening strategy was used to identify differential metabolites from a rat model of amyloid beta peptide 1-40(Aβ1-40)plus ibotenic acid-induced AD(compared with the controls)for the first time;lysophosphati-dylcholine(LysoPC)and intermediates of sphingolipid metabolism were screened as potential bio-markers.Subsequently,the effects of donepezil and pine nut were successfully reflected by regulating the levels of the abovementioned biomarkers and metabolic profile distribution in partial least squares-discriminant analysis(PLS-DA).This novel biomarker screening strategy can be used to analyze other metabolomic data to simultaneously enable disease diagnosis and drug evaluation.
ABSTRACT
@#Positron emission tomography (PET) has been used for the diagnosis of gynecological malignancies and is superior to conventional imaging tools in detecting metastatic lesions, diagnosing local recurrence, and evaluating treatment outcome. Compared with the in vitro assessment of tumor biopsy materials, PET imaging has advantages in measuring <i>in vivo</i> tumor behaviors, characterizing overall tumor burden, and capturing the phenotypic heterogeneity of tumors. PET imaging provides precision data on tumor staging and recurrence through integrating the anatomic and functional data of metabolic features, thereby achieving the high-quality assessment of gynecological malignancies. This article reviews the advances in the application of PET imaging in the diagnosis and treatment of cervical cancer, ovarian cancer, and endometrial carcinoma.
ABSTRACT
In recent years,scientific researchers have increasingly become interested in noninvasive sampling methods for therapeutic drug monitoring and disease diagnosis.As a result,dried saliva spot(DSS),which is a sampling technique for collecting dried saliva samples,has been widely used as an alternative matrix to serum for the detection of target molecules.Coupling the DSS method with a highly sensitive detection instrument improves the efficiency of the preparation and analysis of biological samples.Furthermore,dried blood spots,dried plasma spots,and dried matrix spots,which are similar to those of the DSS method,are discussed.Compared with alternative biological fluids used in dried spot methods,including serum,tears,urine,and plasma,saliva has the advantage of convenience in terms of sample collection from children or persons with disabilities.This review aims to provide integral strategies and guidelines for dried spot methods to analyze biological samples by illustrating several dried spot methods.Herein,we summarize recent advancements in DSS methods from June 2014 to March 2021 and discuss the advantages and disadvantages of the key aspects of this method,including sample preparation and method validation.Finally,we outline the challenges and prospects of such methods in practical applications.
ABSTRACT
Background China is facing enormous challenges of occupational disease prevention and control and high incidences of occupational diseases. Occupational disease diagnosis is an important part of occupational disease prevention and control. However, the current situation of occupational disease diagnosis service system in China is not optimistic. Relevant national laws, regulations, policies, and plans require to improve the current technical support system of occupational disease diagnosis and treatment, and to establish a sound occupational disease diagnosis, treatment, and rehabilitation network on the foundation of existing medical and health institutions. Objective To analyze the development status and existing problems of occupational disease diagnosis institutions in China, and propose countermeasures and suggestions. Methods All occupational disease diagnosis institutions in China were surveyed by questionnaire using comprehensive census. The Occupational Health Center of the National Health Commission organized the preparation of the questionnaire and the participation of all relevant institutions in the survey. All data collected in the survey were for the year 2020 and available as of December 31, 2020. The questionnaire covered the overall situation, service provided, staffing of certified physicians for providing occupational disease diagnosis, and instruments in selected categories of occupational disease diagnosis institutions. Results As of December 2020, there were 587 occupational disease diagnosis institutions in China; the highest average number of enterprises served by an occupational disease diagnosis institution was 39000, and that of employees served by an occupational disease diagnosis institution was 2.15 million in Chongqing. There were a total of 5809 physicians certified to diagnose occupational diseases in China, with 20.4 doctors per specified occupational disease prevention and treatment hospital, 9.5 doctors per general hospital, and 8.3 doctors per disease control and prevention center. Only 87.7% of the institutions were equipped with digital radiography (DR), 58.1% with computed tomography (CT), and 96.4% with pulmonary function meters; the equipment rate of computed radiography (CR) was only 6.5%, and that of CT was only 14.6% in all-level disease control and prevention centers; 45 disease control and prevention centers were not equipped with any common x-ray machine, CR, DR, or CT. Conclusion In the face of the still serious situation of prevention and treatment of occupational diseases, the overall distribution of institutions is uneven around China, the number of institutions in some regions is relatively insufficient, and the comprehensive capacity of centers for disease control and prevention at all levels needs to be improved. Strengthening comprehensive capacity building of occupational disease diagnosis institutions and training of relevant physicians would be helpful to ensure the accuracy and scientificity of diagnosis. At the national level, further increasing policy guidance and financial input would help occupational disease diagnosis institutions upgrade their techniques and service capacity, and protect workers' occupational health rights.
ABSTRACT
ABSTRACT Mutations in the ABCA4 gene are a common cause of Stargardt disease; however, other retinal phenotypes have also been associated with mutations in this gene. We describe an observational case report of an unusual clinical phenotype of Stargardt disease. The ophthalmological examination included best corrected visual acuity, color and autofluorescence photography, fluorescein angiography, optical coherence tomography, and electrophysiology tests. Targeted next-generation sequencing of 99 genes associated with inherited retinal dystrophies was performed in the index patient. A 48-year-old woman presented with a best corrected visual acuity of 20/25 and 20/20. Fundoscopy revealed perifoveal yellow flecked-like lesions. Fluorescein angiography and fundus autofluorescence findings were consistent with pattern dystrophy. Pattern electroretinogram demonstrated bilateral decrease of p50 values. Genetic testing identified two heterozygous missense mutations, c.428C>T, p.(Pro143Leu) and c.3113C>T, p.(Ala.1038Val), in the ABCA4 gene. Based on our results, we believe that these particular mutations in the ABCA4 gene could be associated with a specific disease phenotype characterized by funduscopic appearance similar to pattern dystrophy. A detailed characterization of the retinal phenotype in patients carrying specific mutations in ABCA4 is crucial to understand disease expression and ensure optimal clinical care for patients with inherited retinal dystrophies.
RESUMO Mutações no gene ABCA4 são causa comum da doença de Stargardt, mas outros fenótipos da retina também foram associados a mutações nesse gene. Apresentamos um relato de caso observacional de um fenótipo clínico incomum da doença de Stargardt. O exame oftalmológico incluiu a acuidade visual com melhor correção, fotografia em cores e com autofluorescência, angiofluoresceinografia, tomografia de coerência óptica e testes de eletrofisiologia. Na paciente em questão, realizou-se o sequenciamento de próxima geração de 99 genes associados a distrofias retinais hereditárias. Tratava-se de uma mulher de 48 anos com melhor acuidade visual corrigida de 20/25 e 20/20. A fundoscopia revelou lesões puntiformes amarelas perifoveais. Os resultados da angiofluoresceinografia e da autofluorescência do fundo de olho foram consistentes com distrofia em padrão. A eletrorretinografia por padrões mostrou diminuição bilateral dos valores de p50. Os testes genéticos revelaram duas mutações missense heterozigóticas, c.428C>T, p. (Pro143Leu) e c.3113C>T, p. (Ala.1038Val), no gene ABCA4. Nossos resultados nos fazem pensar que essas mutações específicas em ABCA4 talvez possam estar associadas a um fenótipo específico da doença, caracterizado por uma aparência fundoscópica semelhante à da distrofia em padrão. Uma caracterização detalhada do fenótipo da retina em pacientes portadores de mutações específicas em ABCA4 é crucial para compreender a expressão da doença e para garantir o tratamento clínico ideal para pacientes com distrofias retinais hereditárias.
ABSTRACT
Introducción: La fiebre se considera uno de los primeros síntomas registrados en pacientes hospitalizados y se ha convertido en un importante marcador de enfermedad. La presente revisión buscó recopilar evidencia en torno a la fiebre y su importancia en los diferentes escenarios clínicos que se presentan en el paciente neurológico, ya que en los últimos años se ha logrado comprender mejor el papel que desempeña el sistema nervioso central dentro de la termorregulación. Metodología: Búsqueda de la literatura en bases de datos como Pubmed, OVID, Epistemonikos, SciELO y Google Scholar, durante los años 2009 al 2019 en español e inglés, sobre fiebre e implicaciones en pacientes neurológicos, usando palabras clave como fiebre, sensibilidad, especificidad, likelihood ratio, enfermedades del sistema nervio-so, neurología, encefalitis, neuritis y traumatismo del sistema nervioso. Resultados: Se encontraron 374 artículos, de los cuales 48 cumplieron con los criterios de inclusión. Se incluyeron libros de texto, como metaanálisis, revisiones sistemáticas, revisiones scoping, artículos de revisión y estudios ob-servacionales. Se analizaron y subdividieron en 8 apartados con temáticas en común para su estudio. Conclusiones: En etapas tempranas de eventos cerebro-vasculares isquémicos o hemorrágicos la fiebre se com-porta como una respuesta sistémica secundaria al daño de base, y es crucial corregirla tempranamente. Al mismo tiempo, en traumatismos del sistema nervioso central, la fiebre en las primeras 72 horas se identifica como un marcador de mal pronóstico
Introduction: Fever is considered one of the first symptoms registered in hospitalized patients, beco-ming an important marker of disease. The present review sought to collect evidence on fever and its importance in the different clinical scenarios that occur in neurological patients, since in recent years it has been possible to better understand the role of the central nervous system within the thermo-regulation. Methodology: A literature search was carried out in databases such as Pubmed, OVID, Epistemoni-kos, SciELO and Google Scholar during the years 2009 to 2019 in Spanish and English languages, on fever and implications in neurological patients, using keywords such as fever, sensitivity, specificity, likelihood ratio, diseases of the nervous system, neurology, encephalitis, neuritis and trauma of the nervous system. Results: A total of 374 articles were found, of which 48 articles met the inclusion criteria, for the construction of this review article. Textbooks, as well as meta-analyzes, systematic reviews, scoping reviews, and review articles were included. They were analyzed and subdivided into 8 sections with common themes for their study. Conclusions: In early stages of ischemic or hemorrhagic CVD, fever behaves as a systemic response secondary to the underlying injury, and it is crucial to correct it early. At the same time, in CNS trauma, fever in the first 72 hours is identified as a poor prognostic marker
Introdução: A febre é considerada um dos primeiros sintomas registrados em pacientes hospitaliza-dos e tornou-se um importante marcador de doença. A presente revisão procurou reunir evidencias em torno da febre e sua importância nos diferentes panoramas clínicos no paciente neurológico, uma vez que nos últimos anos foi possível compreender melhor o papel do sistema nervoso central no processo de termo regulação. Metodologia: Foi realizada uma pesquisa de literatura em bases de dados como Pubmed, OVID, Epis-temonikos, SciELO e Google Acadêmico, durante os anos 2009 a 2019 em espanhol e inglês, sobre febre e suas implicações em pacientes neurológicos, utilizando palavras-chave como febre, sensibili-dade, especificidade, likelihood ratio, doenças do sistema nervoso, neurologia, encefalite, neurite e trauma do sistema nervoso. Resultados: Foi encontrado um total de 374 artigos, dos quais 48 abrangiam os critérios de inclusão. Foram incluídos livros de texto, como meta-análises, revisões sistemáticas, revisões Scoping, artigos de revisão e estudos observacionais. Foram analisadas e subdivididas em 8 secções com assuntos comuns para seu estudo. Conclusões: Em fases iniciais de eventos cerebrovasculares isquêmicos ou hemorrágicos, a febre se comporta como uma resposta sistêmica secundária ao dano de base, e é crucial corrigi-la precoce-mente. Enquanto, em traumatismos do sistema nervoso central, a febre nas primeiras 72 horas é identificada como um marcador de mau prognóstico
Subject(s)
Fever , Diagnosis , Nervous System Diseases , NeurologyABSTRACT
Point-of-care testing (POCT) has the characteristics of convenient carrying, fast detection, convenient operation, high applicability to detection conditions and personnel, and can be carried out next to patients. In recent years, POCT has developed rapidly and has been widely used. The clinical value of POCT is reflected in emergency medicine, clinical front-line, primary medical care, public health prevention and control, out-of-hospital management of patients, consumer self-test and many other scenarios. With more and more extensive attention and applications, POCT is also facing challenges in its supervision and management, product quality and new scene requirements. However, with its rapid development, more advanced technologies like mobile smart devices, 5G communication technology, wearable devices, molecular and mass spectrometry detection technology, artificial intelligence are now further integrated with POCT. POCT is expected to be used for clinical diagnosis and treatment, public health prevention and control, and large-scale application. It will be widely used in health management.
ABSTRACT
As occupational health work enters a new era, the diagnosis and identification of occupational diseases, that are closely related to the protection of workers′ health rights, require higher and newer standards. In 2021, the National Health Commission of the People′s Republic of China revised and issued the Administrative Measures for the Diagnosis and Verification of Occupational Diseases to improve and perfect the original diagnosis and verification system of occupational diseases. These measures clarify the time limit for diagnosis of occupational diseases and shorten the time limit for identification of occupational diseases; and strengthen the main responsibility of the employer. This new system design is more operable. It embodies the management idea of Streamline administration, delegate power, combine decentralization, and optimize services. The language expression is more accurate and standardized. The revision of the Administrative Measures for Diagnosis and Verification of Occupational Disease is conducive to improving the efficiency of occupational disease diagnosis and protecting the rights and interests of workers. It is conducive to strengthening the supervision and management of occupational disease diagnosis institutions and occupational disease verification offices by administrative supervision and management departments. It is conducive to strengthening the responsibilities of employers. However, there are some problems: Article No. 28 sets up obstacles to the realization of legal value, which does not clearly stipulate the concept of new evidence. The effective time of this regulation has caused difficulties for occupational disease diagnosis institutions and occupational disease verification offices. It is recommended that this regulation can be further improved in the future revisions.