¿Son fiables las ruedas de reconocimiento como prueba de identificación del autor de un delito? Una revisión de meta-análisis y estudios experimentales / Are police line-ups reliable as evidence of perpetrator identification? A review of meta-analyses and experimental studies / As rodas de reconhecimento são confiáveis como prova de identificação do autor do crime? Uma revisão de metanálises e estudos experimentais

La rueda de reconocimiento es una diligencia de investigación policial orientada a identificar al autor de un crimen. Se trata de una práctica relativamente frecuente que puede tener como resultado consolidar sospechas o también descartar líneas de investigación. La rueda de reconocimiento suele estar precedida de la exposición de un álbum de fotos y también es frecuente solicitar al mismo testigo que haga una descripción o un retrato robot del atacante. Existen fundadas sospechas de que la concatenación de estas diligencias policiales de identificación desvirtúa la eficacia de la declaración del testigo presencial para elegir al verdadero culpable, en caso de que esté presente en la rueda. También existen algunas controversias con respecto a la fiabilidad de la rueda de reconocimiento en función de la edad del testigo, del número de personas que la conforman, del procedimiento para llevarla a cabo, entre otras. Con el objetivo de acotar la evidencia empírica en torno a estas cuestiones, se presenta una revisión de estudios meta-analíticos y diversos estudios experimentales, desde los cuales se han podido identificar los procedimientos más adecuados para optimizar la eficacia en la precisión de la declaración de los testigos presenciales de un delito en el contexto de una rueda de reconocimiento.

The line-up is a police investigative procedure aimed at identifying the perpetrator of a crime. It is a relatively common practice that can result in consolidating suspicions or ruling out lines of investigation. The identification parade is usually preceded by the exhibition of a photo album and it is also common to ask the same witness to make a description or sketch of the perpetrator. There are strong suspicions that the concatenation of these police identification steps undermines the effectiveness of the eyewitness statement in identifying the real culprit, if present at the line-up. There is also some controversy regarding the reliability of the identification parade, depending on the age of the witness, the number of people involved, the procedure for carrying it out, among others. In order to narrow down the empirical evidence on these issues, a review of meta-analytical studies and various experimental studies is presented, based on which it has been possible to identify the most appropriate procedures to optimise the effectiveness in the accuracy of eyewitness testimony in the context of a line-up.

A roda de reconhecimento é um procedimento de investigação policial que visa identificar o autor de um crime. É uma prática relativamente comum que pode resultar na consolidação de suspeitas ou na exclusão de linhas de investigação. A roda de identificação é geralmente precedida pela exibição de um álbum de fotos e é comum pedir à mesma testemunha que faça uma descrição ou um esboço do autor do crime. Há fortes suspeitas de que a concatenação dessas etapas de identificação policial prejudica a eficácia do depoimento da testemunha ocular na identificação do verdadeiro culpado, se presente nessa fase. Há também alguma controvérsia quanto à confiabilidade da roda de reconhecimento, dependendo da idade da testemunha, do número de pessoas envolvidas, do procedimento para realizá-la, entre outros. A fim de restringir as evidências empíricas sobre essas questões, é apresentada uma revisão de estudos metanalíticos e experimentais, a partir dos quais foi possível identificar os procedimentos mais adequados para otimizar a eficácia na precisão do depoimento de testemunhas oculares no contexto de uma roda de reconhecimento.

Comparison of Contrast Sensitivity and Central Corneal Thickness in Primary Open Angle Glaucoma Suspects and Visually Normal Participants

@#Introduction: Glaucoma causes a reduction of contrast sensitivity (CS) while thinner central corneal thickness is (CCT) associated with the risk of glaucoma. Thus, in glaucoma suspect patients, CS and CCT measurements may better evaluate and monitor the disease. The purpose of this study was to compare CS and CCT between a Primary Open Angle Glaucoma (POAG) suspect group and a normal group of similar age. Methods: CS was measured with the Pelli-Robson CS chart, while CCT was measured with a hand-held pachymeter. In total, 115 glaucoma suspects and 102 normal participants were included. Results: There was a significant effect of the clinical condition on CS [F(1,209)=5.409, p=0.02]. The effect of age on CS was also significant [F(3,209)=20.419, p<0.001]. The interaction between age and clinical condition was not statistically significant [F(3,209)=0.815, p=0.49]. CS of POAG suspects was significantly lower than that of the normal group for the younger age groups (40 to 59 years old) but not for the older age groups (50 to 80 years old). There was no significant effect of clinical condition on CCT [F(3,209)=0.754, p=0.39]. However, there was a significant effect of age on CCT [F(3,209)=3.789, p=0.01]. Conclusion: Contrast sensitivity measurement is potentially useful to be integrated with routine investigations for POAG suspect patients, especially those who are younger than 60 years old. Measurements of central corneal thickness alone may not be able to differentiate between POAG suspects and visually normal individuals.

New understandings of the pathogenesis of primary angle-closure glaucoma / 中华实验眼科杂志

Primary angle-closure glaucoma (PACG) is still one of the common blinding eye diseases in China.Because of the irreversibility of the vision loss it caused, the factors affecting the early development of glaucoma are of great concern.The understanding of static anatomic structure of high-risk anterior segment, such as shallow anterior chamber, short axial length, thick iris and large anterior lens cannot fully explain the transformation process of PACG, so the specific role of dynamic changes in the development of glaucoma should be further considered.This article expounded the differences in iris volume and dynamic process of elasticity between normal people and patients with PACG, the incoordination between lens and intraocular structure during eyeball development, the dynamic block and expansion of ciliary body, vitreous and choroid, and the latest research on the relationship between the abnormal ocular nerve and vascular system adjustment and change with the onset of PACG, in order to provide guidance for understanding the pathogenesis of PACG, accurate clinical diagnosis and formulation of treatment strategies.

Lowering of intraocular pressure after phacoemulsification in primary open-angle and angle-closure glaucoma: Correlation with lens thickness

Purpose: To assess anterior chamber configuration changes during phacoemulsification in primary angle?closure suspect (PACS/PAC) and primary open?angle glaucoma (POAG). Methods: Prospective observational comparative study of anterior segment optical coherence tomography (AS?OCT) findings before and after phacoemulsification on three groups of patients (PACS/PAC, POAG, and controls). Data were collected over a period of 9 months. Main outcome measures included mean change in anterior chamber depth (ACD), angle opening distance (AOD), and trabecular iris space area (TISA). Results: 153 patients (51 PACS/PAC, 51 POAG, and 51 controls) were included in the study. Change in all parameters (ACD, AOD at 500 um, and AOD at 750 um) between the groups demonstrated a greater change in PACS/PAC as compared to POAG and controls. AOD at 750 ?m in the temporal quadrant, which has been considered to be having the highest correlation or best representation of the angle, increased in all groups after phacoemulsification (463.59 ± 10.99 vs. 656.27 ± 9.73 mm in PACS; 521.29 ± 16.36 vs. 674.37 ± 8.72 mm in POAG; 549.27 ± 12.40 vs. 702.82 ± 13.04 mm in controls, (P < 0.001). After phacoemulsification, intraocular pressure (IOP) decreased by 2.75 ± 1.17 mm Hg in PACS/PAC (P < 0.001), 2.14 ± 1.33 mm Hg in POAG and 1.90 ± 1.25 mm Hg in controls and it was statistically significant in the PACS group compared to control (P < 0.001). Conclusion: Phacoemulsification with intraocular lens implantation is associated with increase in the ACD and angle parameters and a corresponding decrease in IOP. Findings were more pronounced in PACS/PAC suggesting early phacoemulsification may be a treatment option in this group

Avaliação da relação entre a espessura da camada de fibras nervosas e variação da pressão intraocular em suspeitos de glaucoma e em pacientes com glaucoma primário de ângulo aberto / Evaluation of the relationship between nerve fiber layer thickness and intraocular pressure variation in glaucoma suspects and in patients with primary open-angle glaucoma

Introdução: Glaucoma é uma neuropatia óptica caracterizada pela perda irreversível das células ganglionares retinianas, sendo a pressão intraocular (Po) o principal fator de risco para a doença. Grandes variações da pressão intraocular durante um determinado período de tempo têm atraído a atenção como um potencial fator de risco para o desenvolvimento e progressão do glaucoma. Objetivo: Avaliar a relação entre a flutuação de 24 horas da pressão intraocular (∆Po) e a espessura da camada de fibras nervosas da retina (CFNR) medida por tomografia de coerência óptica de domínio espectral (TCO-DE). Método: O estudo incluiu 125 olhos de 65 pacientes. Sessenta e três olhos (50,4%) tiveram o diagnóstico de glaucoma primário de ângulo aberto (GPAA) e 62 (49,6%) foram considerados suspeitos de glaucoma (SG). Todos os olhos foram submetidos a imagens usando TCO-DE, juntamente com medição da Po de 24 horas e perimetria computadorizada acromática. Apenas pacientes com ∆Po anormal (>6 mmHg) foram incluídos. Correlação e modelos mistos lineares generalizados foram usados para investigar a relação entre ∆Po e a espessura da CFNR ajustando para potenciais fatores de confusão, como idade, diagnóstico de glaucoma, espessura da córnea, Po média durante 24 horas e gravidade da doença. Resultados: A idade média foi semelhante entre os grupos SG e GPAA (62,2 ± 15,6 vs. 64,6 ± 12,0, P = 0,50), enquanto o desvio médio do campo visual apresentou diferença entre SG e GPAA (0,41 ± 1,33 vs. -3,09 ± 3,23, P <0,001). A Po média também foi semelhante entre os grupos SG e GPAA (15,6 ± 3,47 vs. 15,6 ± 2,83 mmHg, P = 0,90), assim como o pico da Po às 6h (21,7 ± 3,85 vs. 21,3 ± 3,80 mmHg, P = 0,68). Correlações negativas estatisticamente significativas foram encontradas no grupo GPAA entre a Po às 6h e a espessura da CFNR global (rs = 0,543; P < 0,001), quadrantes inferior (rs = -0,540; P < 0,001), superior (rs = -0,405; P = 0,009) e nasal (rs = −0,561; P < 0,001). Correlações negativas também foram encontradas entre ∆Po e a espessura da CFNR global (rs = −0,591; P < 0,001), e todos os demais setores (P < 0,05). No SG a Po às 6h correlacionou-se apenas com a espessura da CFNR no quadrante inferior (rs = −0,307; P = 0,047). Cada 1 mmHg maior na ∆Po foi associado à afilamento de -1,44 µm na espessura global da CFNR (IC 95%: -2,77 a -0,11, P = 0,03). Além disso, cada incremento de 10 anos na idade foi associado à afilamento de -3,56 µm na espessura global da CFNR (IC 95%: -6,06 a -1,05, P = 0,006). O GPAA teve uma afilamento média de -10,91 µm na CFNR global em relação aos SG (IC 95%: -20,21 a -1,62, P = 0,02). A Po média não foi associada à espessura global da CFNR (IC 95%: -1,37 a 0,91, P = 0,69). Conclusão: Maior ∆Po foi associado à menor espessura global da CFNR medida pelo TCO-DE, em pacientes com ∆Po >6 mmHg. Esse achado corrobora um papel potencial da flutuação da Po como fator de risco para perda estrutural no glaucoma.

Introduction: Glaucoma is an optic neuropathy characterized by irreversible loss of retinal ganglion cells, with intraocular pressure (IOP) being the main risk factor for the disease. Large variations in IOP over a period of time have attracted attention as a potential risk factor for the development and progression of glaucoma. Purpose: To evaluate the relationship between 24-hour fluctuation of intraocular pressure (∆IOP) and retinal nerve fiber layer (RNFL) thickness measured by spectraldomain optical coherence tomography (SD-OCT). Material and Methods: The study included 125 eyes of 65 patients. Sixty-three eyes (50.4%) had a diagnosis of primary open angle glaucoma (POAG) and 62 (49.6%) were considered glaucoma suspects (GS). All eyes underwent imaging using SDOCT, along with 24-hour IOP measurement and standard automated perimetry. Only patients with abnormal ∆IOP (>6 mmHg) were included. Correlation and generalized linear mixed models were used to investigate the relationship between ∆IOP and RNFL thickness adjusting for potential confounding factors such as age, glaucoma diagnosis, corneal thickness, mean IOP during 24 hours, and disease severity. Results: Mean age was similar between the SG and POAG groups (62.2 ± 15.6 vs. 64.6 ± 12.0, P = 0.50), while the mean deviation of visual field showed a difference between SG and POAG (0.41 ± 1.33 vs. -3.09 ± 3.23, P < 0.001). The mean Po was also similar between GS and POAG groups (15.6 ± 3.47 vs 15.6 ± 2.83 mmHg, P = 0.90) as was IOP peak at 6 AM (21.7 ± 3.85 vs. 21.3 ± 3.80 mmHg, P = 0.68). Statistically significant negative correlations were found in POAG group between IOP at 6 AM and RNFL thickness in global (rs = −0.543; P < 0.001), inferior (rs = −0.540; P < 0.001), superior (rs = −0.405; P = 0.009), and nasal quadrants (rs = −0.561; P < 0.001). Negative correlations were also found between ∆IOP and RNFL thickness in global (rs = −0.591; P < 0.001), and all other sectors (P < 0.05). In GS IOP at 6 AM correlated only with RNFL thickness in the inferior quadrant (rs = −0.307; P = 0.047). Each 1 mmHg higher in ∆IOP was associated with thinning of -1.44 µm in global RNFL thickness (95% CI: -2.77 to -0.11, P = 0.03). Also, each 10-years increment in age was associated with thinning of -3.56 µm in global RNFL thickness (95% CI: 6.06 to -1.05, P = 0.006). POAG had on average -10.91 µm thinning in global RNFL than glaucoma suspects (95% CI: -20.21 to -1.62, P = 0.02). Mean IOP was not associated with global RNFL thickness (95% CI: -1.37 to 0.91, P = 0.69). Conclusion: Higher ∆IOP was associated with lower global RNFL thickness measured by SD-OCT, in patients with ∆IOP > 6 mmHg. This finding corroborates a potential role for IOP fluctuation as a risk factor for structural loss in glaucoma.

Caracterización clínico epidemiológica de las gestantes sospechosas y positivas a la COVID-19 / Clinical epidemiological characterization of pregnant women suspected and positive for covid-19

Introducción: El gremio médico se encuentra en función del estudio y tratamiento de la COVID-19, enfermedad producida por un nuevo coronavirus, denominado 2019-nCoV. Las gestantes son un grupo poblacional de alto riesgo para esta entidad. Objetivo: Determinar las diferencias clínico epidemiológicas de las gestantes sospechosas y positivas a la COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, de corte transversal en 56 pacientes, que fueron agrupadas en sospechosas a la COVID-19 y positivas. Las variables utilizadas fueron edad, comorbilidad asociada, edad gestacional, presencia de síntomas y fuente de infección. La información se obtuvo de las historias clínicas de las gestantes. Resultados: Las pacientes sospechosas, tenían una media de edad de 25 años, 51,0 por ciento cursaba el tercer trimestre del embarazo, el 87,7 por ciento presentaba síntomas al ingreso, el 40,8 por ciento no tenían comorbilidad, y en el 75,5 por ciento no se determinó la fuente de posible contagio. Las pacientes positivas, tuvieron una media de edad de 27 años, 66,6 por ciento estaba en el primer trimestre de la gestación, el 83,3 por ciento asintomáticas y no presentaron comorbilidad. El 50 por ciento fueron contacto de casos positivos. Conclusiones: Existieron diferencias clínicas y epidemiológicas, entre las pacientes sospechosas y positivas a la COVID-19(AU)

Introduction: The medical profession is occupied on the study and treatment of COVID-19, a disease caused by a new coronavirus, called 2019-nCoV. Pregnant women are a high-risk population group for this disease. Objective: To determine the clinical and epidemiological differences of the pregnant women suspect of and positive for COVID-19. Methods: A descriptive, observational, cross-sectional study was carried out in 56 patients, who were grouped as suspect to COVID-19 and positive. The variables used were age, associated comorbidity, gestational age, presence of symptoms and source of infection. The information was obtained from the clinical records of the pregnant women. Results: The suspect patients had a mean age of 25 years, 51.0 percent were in the third trimester of pregnancy, 87.7 percent had symptoms upon admission, 40.8 percent had no comorbidity, and in 75, 5 percent the source of possible contagion was not determined. The positive patients had a mean age of 27 years, 66.6 percent were in the first trimester of pregnancy, 83.3 percent were asymptomatic and did not present comorbidity. 50 percent were contact with positive cases. Conclusions: There were clinical and epidemiological differences between the suspect and positive patients for COVID-19(AU)

Structure-function correlation of juxtapapillary choroidal thickness with visual field analysis of patients suspected with glaucoma

Purpose@#To conduct an evaluation of juxtapapillary choroidal thickness of patients suspected with glaucoma obtained through spectral domain optical coherence tomography (SD-OCT) and correlate it with perimetry results.@*Methods@#Design: Cross-sectional Study. Population: 175 eyes diagnosed as “glaucoma suspect” had standard automated perimetry (SAP) to document the presence of functional glaucomatous damage using optimal near-point correction using the Humphrey Visual Field Analyzer II, 30-2 or 24-2 SITA-standard program. SD-OCT imaging of the retinal nerve fi ber layer (RNFL) was also done to look for structural glaucomatous damage and in using enhanced depth imaging of the optic nerve and the Cirrus caliper tool, choroidal thickness was measured at fi ve predetermined points temporal and nasal from the optic nerve. The population was classifi ed into two groups: Group 1 are those with structural or functional glaucomatous damage (n=68) and Group 2 were those without (n=107).@*Results@#One-Way Multivariate Analysis of Covariance was used in comparing the mean temporal and nasal choroidal thickness scores of the two groups. There are no statistical differences in terms of the mean temporal choroidal thickness (p=0.856) and mean nasal choroidal thickness (p=0.734) between patients with and without glaucomatous damage. The mean temporal and nasal choroidal thickness scores of the two groups at different juxtapapillary locations: 0 μm, 250 μm, 500 μm, 750 μm and 1000 μm away from the disc were also not statistically different.@*Conclusion@#Results show that from this present cohort of glaucoma suspect patients, juxtapapillary choroidal thickness is not correlated with structural and functional glaucomatous damage.

To Study the Culture Conversion and XDR Suspect of Cat-IV Patients in DOTS Plus Site, S. N. Medical College, Agra

BACKGROUND - Multi-drug resistant tuberculosis (MDR-TB) is an increasing health problem in India. Globally,3.5% of new TB cases and 18% of previously treated cases had MDR/RR-TB.(GLOBAL TUBERCULOSIS REPORT 2018). As per the India TB Report 2018 the estimated incidence of  MDRTB/RR in India was approximately 1,47,000.Outcome of MDR patient put on MDR regime is poor due to high cost, long duration of treatment, and various side effect of second line ATT. MATERIAL & METHOD - Study comprised patients who were diagnosed MDR by culture and DST method from RNTCP accredited lab and initiated CAT–IV treatment in D.R.TB Centre, Department of Tuberculosis & Chest Diseases, S. N. Medical College, Agra. Detailed history and pre clinical evaluation as per guideline were done and at the end of 3rd ,4th,5th  and 6th month sputum  were send for AFB staining and culture. RESULT – Out of 109 MDR patient put on CAT-IV, culture conversion at 3rd month occur in 52(47.70%)  patients, at 4th month in 58 patients (53.21%), and in 5th month 66 patients (60.55%). Out of 109 MDR TB patients 12 patients (11.01%) were found suspected XDR. CONCLUSION – MDR TB is major health problem worldwide. Due to less efficacy and more side effect of second line ATT, longer duration of treatment, MDR TB is difficult to treat even with free supply of ATT through DOTS PLUS. Close attention is needed for early diagnosis  of MDR TB , and adequate clinically monitoring of during treatment is essential.

Large Unstained Cell, Blast Suspect and Delta Neutrophil Index ll Analyzed with Automated Hematology Analyzer as Parameters for the Prediction of Acute Leukemia Relapse

BACKGROUND: Here we investigated the clinical utilities of blast suspect, large unstained cell (LUC), delta neutrophil index ll (DN ll), and delta neutrophil index l (DN l), analyzed in peripheral blood samples with automated hematology analyzers to predict the relapse of acute leukemia. METHODS: We retrospectively reviewed the medical records of 112 patients, including 56 patients with acute leukemia relapse and 56 controls. Blast suspect, LUC, DN ll, and DN l were compared between the control and leukemia relapse groups. RESULTS: Significant differences in blast suspect (P<0.001), LUC (P<0.001), DN ll (P<0.001), and DN l (P=0.002) were observed between the leukemia relapse and control groups. The areas under the curve (AUC) value was 0.927 for blast suspect (95% confidence interval [CI]: 0.8750.978, P<0.001), 0.868 for LUC (95% CI: 0.794–0.941, P<0.001), and 0.900 for DN ll (95% CI: 0.841–0.960, P<0.001). Logistic regression analysis for the prediction of leukemia relapse revealed odds ratio values of 1.52 (95% CI: 1.26–1.96, P=0.0002) for blast suspect, 1.66 (95% CI: 1.27–2.42, P=0.0019) for LUC, 1.16 (95% CI: 1.08–1.29, P=0.0014) for DN ll, and 1.05 (95% CI: 1.01–1.13, P=0.0845) for DN l. CONCLUSIONS: Multiple parameters provided by automated blood cell analyzers may serve as powerful ancillary tools for the prediction and diagnosis of leukemia relapse.

A Study on Incidence of Leprosy among Children in Five High Prevalence Districts of West Bengal

A descriptive observational study was conducted in five high prevalent districts of West Bengal with an objective to estimate incidence of new cases of leprosy among children. A total 441,954 children were examined from October 2013 to September, 2014 by conducting a house-hold as well as school surveys in five endemic districts of West Bengal namely Kolkata, Burdwan, Paschim Midnapur, Bankura & Purulia. A total 248 suspected child leprosy cases were identified. The male/female sex ratio of suspects was 1:1. Clinically confirmed leprosy child cases ware 17/248.The overall incidence of leprosy suspects and clinically confirmed leprosy cases was 56.11 and 3.85 per 100,000 children screened, respectively. District-wise difference in incidence of leprosy suspects was found to vary from 23.53 per 100,000 in Purulia to 91.01 per 100,000 in Paschim Midnapur district. Of the 248 suspected cases in the child population, 17 cases were confirmed as leprosy by the CHC and PHC medical officers of NLEP and the State Health Services. All these cases were put on treatment. The incidence of new child cases during this 1 year period was observed to be 3.85/100,000 of examined child population. All these cases resided in Burdwan, Kolkata as well as Paschim Midnapur districts. No cases were confirmed in the suspected cases in Bankura and Purulia districts. One child in Kolkata district also had Grade 2 disability. The incidence of suspected leprosy cases among adult contacts of suspected leprosy children in the study is 33.01/100,000 population (23 suspected to have leprosy in a population of 69655). Among these, 8 cases were confirmed as leprosy cases, by the NLEP and State health services staff. It appears that transmission of leprosy is still high in some geographical areas/pockets and active search in addition to IEC on signs, symptoms and treatment of leprosy is required for the general population as well as other health care workers for effective & early treatment as well as to block transmission of leprosy in the community. While for leprosy programme confirmed cases are relevant, need to strengthen the capacity of health services to differentiate and treat other conditions which created suspicion of leprosy will be equally important.

The values of SOFA score, qSOFA score and SIRS criteria in predicting the prognosis of adult patients with suspect infection / 中华急诊医学杂志

Objective To investigate the clinical values of SOFA score,qSOFA score and SIRS criteria in predicting the prognosis of patients with suspected infection in the emergency department.Methods From January 2015 to April 2017,487 patients aged over 18 years were suspected to be infected and admitted to hospital.SOFA,qSOFA,and SIRS scores were calculated.The mortality and the requirement of ICU treatment were used as prognostic factors for evaluating the validity of each score.The prognostic value of each scoring system was evaluated by the area under the receiver operating characteristic curve (AUROC).Results In 487 patients,the hospital mortality rate was 4.9％,and requirement of ICU treatment rate was 17％.SOFA score predicting hospital mortality and requirement of ICU treatment (AUROC 0.905) were superior to other scores (qSOFA-WBC:AUROC 0.778,qSOFA:AUROC 0.769,SIRS:AUROC 0.64).Compared with the SIRS criteria,patients with a score of ＞1 had higher qSOFA scores (94.47％),but lower sensitivity (44.86％);although SIRS criteria had a higher sensitivity (77.57％),they were less specific (42.63％).When qSOFA was added to the condition of leukocyte abnormalities (＜4× 109/L or ＞ 10× 109/L),the prognosis was improved and the sensitivity and specificity for prognosis were 73.83％ and 71.84％ (qSOFA-WBC score,＞1),respectively.In patients with qSOFA-WBC score,only 6 patients (negative predictive value of 94.2％) died or required ICU treatment.Conclusion The SOFA score is superior to qSOFA and SIRS in predicting the prognosis of patients with suspect infection,and qSOFA-WBC is superior to qSOFA and SIRS in predicting low risk.

Efficacy of laser peripheral iridotomy for different type of primary angle closure suspect based on UBM / 局解手术学杂志

Objective This thesis is aimed to compare and analyze the effectiveness of laser peripheral iridotomy ( LPI) in treating pu-pillary block primary angle-closure suspect ( PACS) and multimechanism PACS in eyes .Methods A total of 85 eyes of 75 patients with PACS in ophthalmology department of Daping hospital affiliated to army medical university were divided by using ultrasound biomicroscopy (UBM) into two groups:pupillary block PACS group(36 eyes) and multimechanism PACS group(49 eyes).All patients received LPI treat-ment,and the images of anterior chamber angle were collected by anterior segment optical coherence tomography (AS-OCT) at the time of be-fore,1 week and 3 months after treatment.Then,the parameter values (AOD500,AOD750,TISA500,TISA750,ACV,ACD,ACW,CCT)of an-terior chamber in AS-OCT images were recorded .Results Comparing to the parameter values before treatment ,AOD500,AOD750,TISA500, TISA750,ACV and ACD significantly increased at the time of 1 week and 3 months after LPI in both groups(P<0.05),while ACW or CCT remain unchanged(P>0.05).Moreover,the increasement in AOD500,AOD750,TISA500 and TISA750 in pupillary block group was more significant than that in multimechanism group 1 week and 3 months after treatment(P<0.05).The differences of AOD500,AOD750,TI-SA500 and TISA750 between pre-operation and post-operation(1 week and 3 months after treatment) in pupillary block group were more sig-nificantly increased than those in multimechanism group (P<0.05).Conclusion LPI can significantly increase the angle width in PACS , which is more effective for pupillary block group than multimechanism group .

Nutritional Survey Analysis of Vitamin A in 2 000 Children Aged 2-6 Years Old / 沈阳医学院学报

Objective:To investigate the serum Vitamin A level of 2-6 years old children in Shenyang kindergarden. Method:A total of 2 000 children aged 2-6 years old in Shenyang kindergarden were selected. And fluorescence micro spectrophotometry was used to detect. Results:Serum Vitamin A level of 2 000 children fluctuated at 0.700-1.751μmol/L,the mean was (1.074±0.257)μmol/L. There was no vitamin A deficiency (VAD) and sub-Vitamin A deficiency (SVAD) . The incidence of suspect SVAD was 52.7%. Conclusions:VAD and SVAD may be eradicated in 2-6 years old in Shenyang kindergarden, but there is increasing tendency in suspect SVAD. Decreasing and eradicating susptect SVAD is important work of our current and next step.

Early detection of multi-drug resistance and common mutations in Mycobacterium tuberculosis isolates from Delhi using GenoType MTBDRplus assay.

Purpose: There is scarcity of prevalence data of multi-drug–resistant tuberculosis (MDR-TB) data and common mutations responsible in North India. This study aimed to detect MDR-TB among MDR-TB suspects from Delhi and mutation patterns using GenoType MTBDRplus assay. Materials and Methods: All MDR suspects in fi ve districts of New Delhi were referred to the laboratory from 1st October 2011 to 31st December 2012 as per criterion defi ned by Programmatic Management of Drug Resistant Tuberculosis (PMDT). GenoType MTBDRplus assay was performed on 2182 samples or cultures and mutations in the rpoB gene for rifampicin (RIF) and katG and inhA genes for isoniazid (INH) were analyzed. Results: A total of 366 (16.8%) MDR-TB cases were diagnosed. MDR rate was found to be 32%, 16.6% and 10.2% during criterion A, B and C respectively. The most common mutation detected for RIF was S531L (59.0%) and for INH was S315T1 (88.3%). Mutations S531L and S315T1 occurred signifi cantly higher in MDR strains as compared to RIF mono-resistant and INH mono-resistant strains, respectively. Average laboratory turn-around time (TAT) for dispatch of result to districts for test conducted on samples was 4.4 days. Conclusion: GenoType MTBDRplus is a useful assay for rapid detection of MDR-TB. The common mutations for RIF and INH were similar to those seen in other regions. However, mutations determining MDR strains and mono-resistant strains differed signifi cantly for both RIF and INH.

Evaluation of the change of anterior chamber parameters before and after laser peripheral iridectomy in primary angle -closure suspetive with Pentacam anterior segment analysis system / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM:To investigate the sensitive parameters of the anterior chamber changes with Pentacam anterior segment analysis system before and after laser peripheral iridectomy (LPl) in primary angle-closure suspetive (PACS). ? METHODS: Sixty eyes of 33 PACS patients were enrolled in this study. Pentacam examination was performed before and 1d after LPl to measure the central anterior chamber depth ( CACD ) , the peripheral anterior chamber depth ( PACD ) , the anterior chamber volume ( ACV) and the peripheral anterior chamber angle ( ACA) . Statistical analysis used paired t test. ?RESULTS: There was no statistical significance on the changes of ACD. PACD and ACV increased significantly between before and 1d after LPl. ACA was widened from (22. 26o±5. 18o) to (26. 42o±5. 20o), which were increased significantly between before and 1d after LPl. ?CONCLUSlON: LPl can deepen the PACD and increase the ACV in PACS. PACD and ACV are the sensitive parameters of the anterior chamber changes with Pentacam anterior segment analysis system.

Depression and Anxiety in Patients with Glaucoma or Glaucoma Suspect

PURPOSE: To investigate depression and anxiety in patients with glaucoma or glaucoma suspect. METHODS: Seventy-two patients with glaucoma, 72 patients with glaucoma suspect and 26 controls comprised the study population. Anxiety and depression was evaluated by hospital anxiety and depression scale (HADS) questionnaire. In this study, scores higher than 10 on the HADS-A and HADS-D were defined as anxiety and depression, respectively. The relationship between HADS and mean deviation (MD) of visual field tests or visual acuity of the better eye was analyzed in glaucoma patients. RESULTS: Three (11.5%) controls, 11 (15.3%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had anxiety. One (3.8%) control, 5 (6.9%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had depression. In glaucoma patients, the number of anxiety patients was higher in patients who had MD of less than -6 dB and the numbers of anxiety and depression patients were higher in patients who had visual acuity of lower than 20/40. CONCLUSIONS: The rate of depression in patients with glaucoma is higher than that of glaucoma suspect and controls. There is no significant difference between the three groups in rate of anxiety. Clinicians are advised to not only offer medical treatment but also should monitor for mood disturbances like anxiety and depression to ensure compliance and quality of life of patients.

Depression and Anxiety in Patients with Glaucoma or Glaucoma Suspect

PURPOSE: To investigate depression and anxiety in patients with glaucoma or glaucoma suspect. METHODS: Seventy-two patients with glaucoma, 72 patients with glaucoma suspect and 26 controls comprised the study population. Anxiety and depression was evaluated by hospital anxiety and depression scale (HADS) questionnaire. In this study, scores higher than 10 on the HADS-A and HADS-D were defined as anxiety and depression, respectively. The relationship between HADS and mean deviation (MD) of visual field tests or visual acuity of the better eye was analyzed in glaucoma patients. RESULTS: Three (11.5%) controls, 11 (15.3%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had anxiety. One (3.8%) control, 5 (6.9%) patients with glaucoma suspect, and 15 (20.8%) patients with glaucoma had depression. In glaucoma patients, the number of anxiety patients was higher in patients who had MD of less than -6 dB and the numbers of anxiety and depression patients were higher in patients who had visual acuity of lower than 20/40. CONCLUSIONS: The rate of depression in patients with glaucoma is higher than that of glaucoma suspect and controls. There is no significant difference between the three groups in rate of anxiety. Clinicians are advised to not only offer medical treatment but also should monitor for mood disturbances like anxiety and depression to ensure compliance and quality of life of patients.

A cross sectional survey on the prevalence of active pulmonary tuberculosis in three‘key’ elderly population / 中华流行病学杂志

Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts. Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects,patients with diabetes,TB close contacts in the past 2 years,from January to September,2013. Results 82 active pulmonary TB cases were identified among 9 041 cases who received the examination,with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms,patients with diabetes or having suspicious symptoms of TB,the prevalence rates of active TB were 115‰,3.4‰,0.9‰respectively. No active pulmonary TB case was found in the TB close contacts,patients with diabetes,or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different(χ2=697.478, P=0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times(RR=17.951)higher than those non-diabetic patients,and 2 times higher than those with suspicious symptoms (RR=3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ2=46.637,P=0.000),the longer duration of diabetes and the higher risk of tuberculosis (RR>1). Conclusion Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that‘Key crowd screening program’should be introduced into case-finding strategy on TB,with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.

A cross sectional survey on the prevalence of active pulmonary tuberculosis in three‘key’ elderly population / 中华流行病学杂志

Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts. Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects,patients with diabetes,TB close contacts in the past 2 years,from January to September,2013. Results 82 active pulmonary TB cases were identified among 9 041 cases who received the examination,with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms,patients with diabetes or having suspicious symptoms of TB,the prevalence rates of active TB were 115‰,3.4‰,0.9‰respectively. No active pulmonary TB case was found in the TB close contacts,patients with diabetes,or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different(χ2=697.478, P=0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times(RR=17.951)higher than those non-diabetic patients,and 2 times higher than those with suspicious symptoms (RR=3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ2=46.637,P=0.000),the longer duration of diabetes and the higher risk of tuberculosis (RR>1). Conclusion Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that‘Key crowd screening program’should be introduced into case-finding strategy on TB,with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.

Internal Carotid Artery Aneurysm Presenting with Unilateral Nasal Hemianopsia

PURPOSE: To report a case of unilateral nasal hemianopsia caused by a large internal carotid artery aneurysm. CASE SUMMARY: A 56-year-old female presented with large cupping in the left optic nerve head detected incidentally during a routine check-up. She had no underlying systemic disease except hypertension. The best corrected visual acuity was 20/20 in both eyes and a slit-lamp examination showed no abnormal findings. Ophthalmoscopy showed cup/disc ratios of 0.6 in the right eye and 0.75 in the left eye. Relative afferent papillary defect or color vision defect was not observed. A Humphrey visual-field test indicated unilateral nasal hemianopsia in the left eye. Brain CT and angiography revealed a large 2.2-cm aneurysm on the left internal carotid artery. CONCLUSIONS: Internal carotid artery aneurysm should be considered as a possible cause of unilateral nasal hemianopsia in patients without intraocular lesion.