Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.801
Filter
1.
J. bras. nefrol ; 46(3): e20240012, July-Sept. 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1558249

ABSTRACT

ABSTRACT Introduction: Acute kidney injury (AKI) is an abrupt deterioration of kidney function. The incidence of pediatric AKI is increasing worldwide, both in critically and non-critically ill settings. We aimed to characterize the presentation, etiology, evolution, and outcome of AKI in pediatric patients admitted to a tertiary care center. Methods: We performed a retrospective observational single-center study of patients aged 29 days to 17 years and 365 days admitted to our Pediatric Nephrology Unit from January 2012 to December 2021, with the diagnosis of AKI. AKI severity was categorized according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The outcomes considered were death or sequelae (proteinuria, hypertension, or changes in renal function at 3 to 6 months follow-up assessments). Results: Forty-six patients with a median age of 13.0 (3.5-15.5) years were included. About half of the patients (n = 24, 52.2%) had an identifiable risk factor for the development of AKI. Thirteen patients (28.3%) were anuric, and all of those were categorized as AKI KDIGO stage 3 (p < 0.001). Almost one quarter (n = 10, 21.7%) of patients required renal replacement therapy. Approximately 60% of patients (n = 26) had at least one sequelae, with proteinuria being the most common (n = 15, 38.5%; median (P25-75) urinary protein-to-creatinine ratio 0.30 (0.27-0.44) mg/mg), followed by reduced glomerular filtration rate (GFR) (n = 11, 27.5%; median (P25-75) GFR 75 (62-83) mL/min/1.73 m2). Conclusions: Pediatric AKI is associated with substantial morbidity, with potential for proteinuria development and renal function impairment and a relevant impact on long-term prognosis.


RESUMO Introdução: Insuficiência renal aguda (IRA) é uma deterioração abrupta da função renal. A incidência de IRA pediátrica está aumentando em todo o mundo, em ambientes críticos e não críticos. Nosso objetivo foi caracterizar apresentação, etiologia, evolução e desfechos da IRA em pacientes pediátricos internados em um centro de atendimento terciário. Métodos: Realizamos estudo retrospectivo observacional de centro único de pacientes com idade entre 29 dias a 17 anos e 365 dias internados em nossa Unidade de Nefrologia Pediátrica, de janeiro de 2012 a dezembro de 2021, com diagnóstico de IRA. A gravidade da IRA foi categorizada de acordo com os critérios do Kidney Disease Improving Global Outcomes (KDIGO). Os desfechos considerados foram óbito ou sequelas (proteinúria, hipertensão ou alterações na função renal em avaliações de acompanhamento de 3 a 6 meses). Resultados: Incluímos 46 pacientes com idade mediana de 13,0 (3,5-15,5) anos. Cerca de metade (n = 24; 52,2%) apresentou um fator de risco identificável para o desenvolvimento de IRA. Treze pacientes (28,3%) eram anúricos; todos foram classificados como IRA KDIGO 3 (p < 0,001). Quase um quarto (n = 10; 21,7%) dos pacientes necessitaram de terapia renal substitutiva. Aproximadamente 60% (n = 26) apresentou pelo menos uma sequela, sendo proteinúria a mais comum (n = 15; 38,5%; mediana (P25-75) da relação proteína/creatinina urinária 0,30 (0,27-0,44) mg/mg), seguida de taxa de filtração glomerular (TFG) reduzida (n = 11; 27,5%; mediana (P25-75) da TFG 75 (62-83) mL/min/1,73 m2). Conclusões: A IRA pediátrica está associada à morbidade substancial, com potencial para desenvolvimento de proteinúria e comprometimento da função renal e impacto relevante no prognóstico de longo prazo.

2.
J. bras. nefrol ; 46(3): e20230123, July-Sept. 2024.
Article in English | LILACS-Express | LILACS | ID: biblio-1558253

ABSTRACT

Abstract In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD's etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety.


Resumo Nas últimas décadas, uma epidemia de doença renal crônica (DRC) tem sido associada a fatores ambientais e ocupacionais (estresse térmico decorrente de cargas de trabalho elevadas em altas temperaturas e exposição a produtos químicos, como agrotóxicos e metais), denominada DRC de origem não tradicional (DRCnt). Esta revisão descritiva tem como objetivo apresentar evidências recentes sobre estresse térmico, agrotóxicos e metais como possíveis causas de DRCnt e fornecer uma visão geral das estratégias brasileiras de regulamentação, fiscalização e vigilância sanitária relacionadas. Os trabalhadores brasileiros são comumente expostos a condições extremas de calor e outros fatores de risco de DRCnt, incluindo o aumento da exposição a agrotóxicos e metais. Além disso, há uma falta de regulamentação e fiscalização, políticas públicas e estratégias adequadas para proteger a saúde renal dos trabalhadores em relação aos principais fatores de risco. É provável que a DRCnt seja uma causa significativa de DRC no Brasil, uma vez que a etiologia da doença é desconhecida em muitos pacientes e diversas condições para seu desenvolvimento estão presentes no país. Estudos epidemiológicos devem ser realizados para explorar associações causais e estimar o impacto do calor, dos agrotóxicos e dos metais na DRCnt no Brasil. Além disso, as políticas públicas devem priorizar a redução da exposição dos trabalhadores e a promoção de sua saúde e segurança.

3.
Medicina (B.Aires) ; Medicina (B.Aires);84(supl.1): 31-36, mayo 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1558481

ABSTRACT

Resumen El Trastorno del Espectro Autista es una patología de base neurobiológica con alto porcentaje de hereda bilidad y amplia lista de posibles etiologías, que pre senta cambios muy heterogéneos en la arquitectura, conectividad y sinaptogénesis neuronal, con manifes taciones clínicas características, cuyo origen apunta a causas ambientales, inmunológicas, genéticas y otras, sin haberse confirmado biomarcadores específicos. El diagnóstico se sigue basando en características típicas que incluyen conductas repetitivas y comunicación e interacción social deterioradas. Se revisan sus factores de riesgo genéticos y no genéticos para avanzar en el conocimiento sobre los procesos patológicos que pueden relacionarse a su origen.


Abstract The Autism Spectrum Disorder is a neurobiological based disorder with a high percentage of heritability and a wide list of possible etiologies that presents very heterogeneous changes in neuronal architecture, con nectivity and synaptogenesis with characteristic clinical manifestations whose origin points to environmental, immunological, genetic and other causes, without hav ing been confirmed specific biomarkers. Diagnosis con tinues to be based on typical features including repeti tive behaviors and impaired communication and social interaction. Their genetic and non-genetic risk factors are reviewed to advance knowledge about the pathologi cal processes that may be related to their origin.

4.
Article in Chinese | WPRIM | ID: wpr-1006577

ABSTRACT

Cold and heat belong to the eight-principal syndrome differentiation of traditional Chinese medicine, which can reflect the rise and fall of Yin and Yang in the body and the Yin and Yang nature of the disease. At present, traditional Chinese medicine has an inconsistent understanding of cold and heat in acute coronary syndrome. The emphasis on pathogenic factors of cold and heat is biased, and the elements of cold and heat syndrome are not fully reflected in the scale. Therefore, the literature has been reviewed from the perspectives of etiology, pathogenesis, symptom elements, and test signs with drugs. From the perspective of etiology, both cold evil and heat evil can increase the risk of acute coronary syndrome. It was previously believed that acute coronary syndrome occurs frequently in cold climates such as winter and spring. Based on this understanding, hot weather can also induce acute coronary syndrome, and different temperatures have different effects on patients of different ages and with different underlying diseases. In addition, artificial pathogenic factors such as excessive consumption of cold food and refrigeration air conditioners were added. From the perspective of pathogenesis, on the basis of the traditional ''asthenia in origin and asthenia in superficiality'' and ''phlegm stagnation'', it is found that Yin-cold and fire-heat can both cause paralysis of the heart chakra and pain induced by the blockage. The pathogenesis of acute coronary syndrome characterized by heat stagnation and coldness featuring heartburn should be distinguished from gastroesophageal reflux disease. Moreover, the pathogenesis of Yin cold coagulation and pulse stagnation and wind obstruction are different. The acute coronary syndrome is in line with the wind characteristics of frequent changes and can be treated with wind medicine. From the perspective of syndrome elements, the syndrome elements such as cold condensation, heat accumulation, and toxicity are analyzed, and the use of basic syndrome elements and their combination forms facilitates clinical and scientific research. In addition, according to the test sign with the drug, it can be seen that the attributes of cold and heat of traditional Chinese medicine prescriptions for acute coronary syndrome can be explained according to the temperature-sensitive transient receptor potential (TRP) ion channel, thus proving the pathogenesis of cold and heat of acute coronary syndrome.

5.
Article in Chinese | WPRIM | ID: wpr-1024114

ABSTRACT

Objective To investigate the current situation and influencing factors of latent tuberculosis infection(LTBI)among close contacts of positive etiology pulmonary tuberculosis(PTB)patients,provide basis for formula-ting intervention measures for LTBI.Methods A multi-stage stratified cluster random sampling method was used to select close contacts of positive etiology PTB patients from 39 districts and counties in Chongqing City as the study objects.Demographic information was collected by questionnaire survey and the infection of Mycobacterium tuberculosis was detected by interferon gamma release assay(IGRA).The influencing factors of LTBI were analyzed by x2 test and binary logistic regression model.Results A total of 2 591 close contacts were included,the male to female ratio was 0.69∶1,with the mean age of(35.72±16.64)years.1 058 cases of LTBI were detected,Myco-bacterium tuberculosis latent infection rate was 40.83%.Univariate analysis showed that the infection rate was dif-ferent among peoples of different age,body mass index(BMI),occupation,education level,marital status,wheth-er they had chronic disease or major surgery history,whether they lived together with the indicator case,and whether the cumulative contact time with the indicator case ≥250 hours,difference were all statistically significant(all P<0.05);infection rate presented increased trend with the increase of age and BMI(both P<0.001),and decreased trend with the increase of education(P<0.05).Logistic regression analysis showed that age 45-54 years old(OR=1.951,95%CI:1.031-3.693),age 55-64 years old(OR=2.473,95%CI:1.279-4.781),other occupations(OR=0.530,95%CI:0.292-0.964),teachers(OR=0.439,95%CI:0.242-0.794),students(OR=0.445,95%CI:0.233-0.851),junior high school education or below(OR=1.412,95%CI:1.025-1.944),BMI<18.5 kg/m2(OR=0.762,95%CI:0.586-0.991),co-living with indicator cases(OR=1.621,95%CI1.316-1.997)and cumu-lative contact time with indicator cases ≥250 hours(OR=1.292,95%CI:1.083-1.540)were the influential fac-tors for LTBI(all P<0.05).Conclusion The close contacts with positive etiology PTB have a high latent infection rate of Mycobacterium tuberculosis,and it is necessary to pay attention to close contacts of high age,farmers,and frequent contact with patients,and take timely targeted interventions to reduce the risk of occurrence of disease.

6.
Article in Chinese | WPRIM | ID: wpr-1026839

ABSTRACT

Immune factors play an important role in recurrent spontaneous abortion(RSA),and immune imbalance affects embryo implantation,growth,and development.There is currently no consensus on the etiology and pathogenesis of RSA caused by immune factors.Based on the theory of latent toxic in TCM and combined with the pathological mechanism of the dynamic changes of immune abnormal substances in the body,this article proposed that latent toxic is the key cause of RSA caused by immune factors.Furthermore,it expounded the pathogenic characteristics of latent toxic:combination of heat and blood stasis hidden in the womb,and latent toxic plays a role in embryo formation under qi deficiency conditions.It is established that latent toxin stagnation in the membrane is the pathogenic mechanism.Moreover,this article revealed the variable pathological changes such as the blockage of the inner membrane system and the outer membrane system.Treatment should be based on the basic methods of tonifying qi and nourishing blood,tonifying kidney to secure the Thoroughfare Vessel,clearing heat and cooling blood,promoting blood circulation and removing blood stasis.This article could provide a theoretical basis for TCM syndrome differentiation and treatment of RSA caused by immune factors.

7.
Article in Chinese | WPRIM | ID: wpr-1026863

ABSTRACT

Bronchiectasis has the characteristics of long course,gradual aggravation,easy recurrence and difficult to treat.The characteristics are similar to those arouse by incubative pathogenic factors.Based on the theory of incubative pathogenic factors,this disease is often related to the incubative pathogenic factors in the body's areas with deficient healthy qi,which occur at regular times.The etiology can be external,congenital,or internal.Treatment should focus on different characteristics of incubative pathogenic factors.Attention should be paid to clearing and dispersing in external pathogenic factors,while attention should be paid to supporting and promoting healthy qi in congenital pathogenic factors,and do not forget to remove internal pathogenic factors.

8.
Article in Chinese | WPRIM | ID: wpr-1027597

ABSTRACT

Acute gallstone pancreatitis (AGP) is a kind of acute pancreatitis caused by gallstones. The etiology of AGP is complex, and the anatomic basis and initiating factors have a synergistic effect on its pathogenesis, which needs to be studied jointly. The way of the confluence of pancreaticobiliary ducts, dilated main pancreatic duct, the relatively narrow opening of duodenal papilla and small stones or microlithiasis may be involved in the pathogenesis of AGP, in which small stones are the most important. Etiological diagnosis and clinical treatment of AGP should be carried out simultaneously. The timely selection of treatment methods for different causes can alleviate the patient's condition to the greatest extent and reduce the cost of treatment. At present, it is difficult to unify the prediction indexes of AGP. Meanwhile, the pathogenesis and related prophylaxis and treatment also need to be studied. In this paper, the anatomic basis, initiation factors, pathogenesis and self-defense of AGP were analyzed to provide a new perspective for its treatment.

9.
Article in Chinese | WPRIM | ID: wpr-1030200

ABSTRACT

[Objective]To summarize the characteristics and experience of Professor ZHANG Deying in treating acne from the perspective of phlegm syndrome.[Methods]By following the clinical study of Professor ZHANG's clinic,the medical records of acne treatment were sorted out,three typical cases were selected,and combined with the classical theories of traditional Chinese medicine,the unique insights and clinical experience of Professor ZHANG on phlegm syndrome theory were analyzed and summarized.[Results]According to the physical condition of people and the characteristics of acne,Professor ZHANG points out that the etiology and pathogenesis of acne are phlegm heat or phlegm fire invading the head,chest and causing local flesh rot.According to the spleen and stomach of middle-Jiao,the phlegm is a pathogenic factor of soil.In the treatment,the purpose of reducing phlegm can be achieved by reducing soil,multiplying wood to reduce soil and producing metal to eliminate soil,and then using heat-clearing drugs to clear the evil of upper-Jiao phlegm heat and cure acne.At the same time,it should be noted the relationship among the five elements,the phlegm is too excessive,easy to block the kidney water and cause kidney deficiency,the first treatment is reducing phlegm,after the removal of phlegm,tonifying the kidney can be effective,even some patients do not need to be tonified the kidney,and the kidney will slowly recover.[Conclusion]Professor ZHANG has unique understanding of the theory of phlegm syndrome,pointing out that the pathogenesis of acne is mostly phlegm fire or phlegm heat stagnation in the muscle surface,and the flesh rot.The main treatment should be to clear phlegm heat.Phlegm is the pathogenic factor of soil.Besides the method of reducing soil,according to the theory of five elements,there are also methods of multiplying wood to reduce soil and producing metal to eliminate soil.

10.
Article in Chinese | WPRIM | ID: wpr-1030211

ABSTRACT

[Objective]To provide insights into the clinical diagnosis and treatment of infectious diseases in summer through probing into the theory of heat epidemic and its characteristics formulated by famous doctors in the past dynasties.[Methods]The etiology,pathogenesis and treatment of heat epidemic were analyzed by summarizing the discussions of various doctors from different angles and at different levels,and the differentiation and treatment rules of several common summer infectious diseases were explored on the basis of the application of heat epidemic theory.[Results]The etiology and pathogenesis of heat epidemic can be classified as excessive main Qi,evil abundance and Yin deficiency,transpiration of summer heat and diffuse ptomaine.Its treatment can be roughly divided into interior-clearing and exterior-harmonizing,blood-cooling and orifice-unblocking.On the basis,the article explored the etiology,pathogenesis and treatment of summer infectious diseases,such as hand-foot-and-mouth disease,dengue and Corona Virus Disease 2019(COVID-19),which have certain similarities with heat epidemic.[Conclusion]The theory of heat epidemic,closely related to the syndrome and treatment rules of three types of summer infectious diseases,can be the tentative basis for clinical diagnosis and treatment of summer infectious diseases with traditional Chinese medicine.

11.
Article in Chinese | WPRIM | ID: wpr-1030220

ABSTRACT

[Objective]To summarize Professor CHEN Hua's experience in treating children with recurrent respiratory tract infection(RRTI)based on"Yin deficiency,blood stasis and heat accumulation".[Methods]Through following Professor CHEN's clinical treatment and summarizing the cases information,the clinical experience and prescription characteristics of Professor CHEN in the treatment of children with RRTI were summarized and sorted out through clinical evidence.[Results]Professor CHEN considers that children with RRTI is caused by wind,phlegm,blood stasis and deficiency,and the pathogenesis is deficiency of the lung and spleen,phlegm and blood stasis obstructing venation,extending and not healing,and accumulation of blood stasis and heat.He puts forward the differentiation and treatment of RRTI from Yin deficiency,blood stasis and heat accumulation,and summarizes the diagnosis and treatment experience of paying attention to wind evil,dispelling wind and relieve symptoms;adjusting measures in accordance with three categories,nourishing Yin and clearing blood stasis;detailed differentiation of deficiency and substance,appropriate use of harmonious method;taking care of middle-Jiao and strengthening the spleen and stomach.The case involved a patient with RRTI,which was diagnosed as a condition of Yin deficiency with concurrent phlegm and blood stasis obstruction.Professor CHEN implemented a staged treatment plan,focusing on nourishing Yin,clearing stasis,which spanned the middle and later stages of the disease.During the prolonged stage,the treatment aimed at nourishing Yin and reducing fever,resolving phlegm and dispelling stasis.In the recovery stage,the focus shifted to nourishing Yin and reducing fever,invigorating the spleen and replenishing Qi.The therapeutic effect was significant.[Conclusion]Professor CHEN inherits the characteristics of pediatrics of Zhejiang school of traditional Chinese medicine,distinguishing and treating children with RRTI from"Yin deficiency,blood stasis and heat accumulation",and the curative effect is remarkable,which has high practical value in guiding clinical practice.

12.
Article in Chinese | WPRIM | ID: wpr-1030248

ABSTRACT

[Objective]To introduce the clinical experience of Director ZHANG Guoliang,a famous and highly-experienced traditional Chinese medicine practitioner,in treating cough in convalescent period of Corona Virus Disease 2019(COVID-19)with exterior and interior differentiation therapy.[Methods]Based on the relevant discussions on epidemic diseases and coughs by doctors of all ages and the experience of more than 300 COVID-19 patients treated by Director ZHANG himself,the understanding of Director ZHANG on the etiology and pathogenesis of cough in convalescent period of COVID-19 was expounded,and his experience in treating cough in convalescent period of COVID-19 with exterior and interior differentiation therapy was summarized,and a typical case was interpreted.[Results]Director ZHANG believes that treatment of cough in convalescent period of COVID-19 should start from the disease location.The disease is located in the nose and pharynx,and the exterior treatment method is adopted,focusing on ventilating the lung and dissolving phlegm,dispelling wind and relieving cough.In clinical practice,a combination of Banxia Houpu Decoction and Zhisou Powder is commonly used,added or subtracted according to the symptoms.The disease is located in the trachea and lungs,and the interior treatment method is adopted,and the phlegm turbidity(phlegm heat)accumulation in lung syndrome focuses on clearing the lungs and dissolving phlegm,relieving cough and asthma,added or subtracted Maxing Shigan Decoction,Qianjin Weijing Decoction combined with Tingli Dazao Xiefei Decoction are often used.Qi and Yin deficiency syndrome should clear the lungs and dissolve phlegm,invigorate Qi and nourish Yin,generally use added or subtracted Zhuye Shigao Decoction combined with Shengmai Drink.The medical case attached belonged to the phlegm and pharyngeal syndrome,Director ZHANG first treated with ventilating the lung and resolving phlegm,dispelling wind and relieving cough,then strengthening the spleen and invigorating Qi,drying dampness and resolving phlegm,and finally achieved good results.[Conclusion]Director ZHANG's unique opinion and clinical experience in the treatment of cough in convalescent period of COVID-19 with exterior and interior differentiation therapy are worth learning and promoting.

13.
Article in Chinese | WPRIM | ID: wpr-1031068

ABSTRACT

Children with cerebral palsy (CP) frequently experience secondary musculoskeletal issues, with a high incidence of fractures and severe symptoms. These factors cannot be overlooked in the rehabilitation process for children with CP. This article examines the causes of fractures in children with CP, including low bone mineral density, abnormal training, premature delivery, and falls. Furthermore, it outlines intervention measures to improve bone mineral density and exercise training, in order to assist in the prevention and treatment of fractures in children with CP.

14.
Article in Chinese | WPRIM | ID: wpr-1031509

ABSTRACT

Syndrome differentiation and treatment is a traditional Chinese medicine (TCM)-featured concept and method in diagnosis and treatment, which needs to be combined with the intelligent diagnosis of TCM in the future. At present, the intelligent diagnosis of TCM has gradually changed from the simple data-driven primary intelligence to the knowledge-driven advanced intelligence that integrates professional knowledge. Although syndrome element differentiation breaks down the elements of TCM diagnostic knowledge to form syndrome elements, which makes the original vague knowledge information more specific, the relationship between syndrome elements is not well classified and sorted out, resulting in the lack of hierarchical relationship and connection between syndrome elements, and thereby causing obstacles to the application of intelligent technology. Based on the understanding of etiology and pathogenesis from TCM, this paper concretized the syndrome element set of etiology, disease location and disease nature in TCM syndrome differentiation and treatment, and formed a knowledge framework system of syndrome elements with clear logical relationship, clear hierarchy and good explanation, thereby providing certain reference for realizing knowledge-driven advanced intelligence syndrome differentiation in the future.

15.
Article in Chinese | WPRIM | ID: wpr-1032316

ABSTRACT

ObjectiveTo analyze the epidemiological characteristics and etiology of clustered outbreaks of hand, foot, and mouth disease (HFMD) in Pudong New Area, Shanghai from 2017 to 2022, and to provide a scientific basis for the prevention and control of HFMD in the area. MethodsThe data related to HFMD clustered outbreaks from 2017 to 2022 were obtained from the Pudong New Area HFMD outbreak database. Descriptive analysis was conducted to explore the outbreak scope, seasonal characteristics, distribution of occurrence settings, and etiological composition. ResultsFrom 2017 to 2022, Pudong New Area reported a total of 2 547 HFMD clusters, involving 8 884 cases, with an average of 3.49 cases per event. The majority of events (78.52%) had between 2 and 4 cases. The peak reporting periods for clustered HFMD from 2017 to 2019 and in 2021 were during the summer (May‒July) and autumn (September‒November). The seasonal pattern was less distinct in 2020 and 2022, likely due to the impact of the COVID-19 pandemic. The majority of clustered outbreaks occurred in childcare facilities (44.64%), followed by households/neighborhood committees (44.21%), with schools accounting for a smaller proportion (12.39%). The etiology revealed the coexistence of multiple enterovirus genotypes, with a positive detection rate of 60.46%, and CoxA6 being the dominant strain. ConclusionHFMD clustered outbreaks in Pudong New Area show fluctuating trends, with significant yearly differences in the number of incidents. The predominant seasons for outbreaks are summer and autumn, with CoxA6 identified as the dominant strain. The implementation of prevention and control measures for COVID-19 significantly reduced the occurrence of HFMD outbreaks. Continuous monitoring and focus on large-scale clustered outbreaks in key institutions are essential for the future.

16.
Article in Chinese | WPRIM | ID: wpr-1032336

ABSTRACT

Objective To investigate the pathogenic distribution characteristics and drug resistance of opportunistic Candida in patients with pulmonary tuberculosis on the Qinghai-Tibet Plateau. Methods 3 012 hospitalized cases of pulmonary tuberculosis at Qinghai Province Fourth People’s Hospital from March 1, 2020 to December 31, 2020 were analyzed, sputum samples were collected, Candida identification was carried by VITEK-32-YBC automatic bacterial analysis system, and the detected Candida was tested for drug sensitivity. Results Among the 3 012 cases of pulmonary tuberculosis in this investigation, 283 cases of pulmonary tuberculosis patients with Candida infection, accounting for 9.40%. Among them, Candida albicans was the main type of Candida, accounting for 79.86% of the total. Conclusion The prevalence rate of pulmonary tuberculosis complicated with Candida infection was high in Qinghai-Tibet Plateau. Therefore, the selection of antimicrobial drugs should be based on a comprehensive analysis of the patient's condition, in order to select the best and most effective drugs for treatment.

17.
Article in Chinese | WPRIM | ID: wpr-1018733

ABSTRACT

Objective To explore the differential diagnostic indicators of adult-onset Still's disease(AOSD)from other fever of unknown origin(FUO).Methods The clinical data and laboratory indicators of 177 AOSD patients and 163 FUO patients who were hospitalized in the First Affiliated Hospital of Army Medical University from January 2010 to May 2021 were collected,and the patients were randomly divided into training group and verification group.Statistically significant variables were extracted from univariate analysis for receiver operating characteristic(ROC)curve analysis and the best cut-off value of the variables was obtained.The differential diagnostic indicators were extracted by multivariate logistic regression analysis and nomogram model was constructed.ROC curve,calibration curve,and decision curve analysis were used to evaluate the accuracy and stability of nomogram.Results Univariate analysis revealed that there were significant differences in 4 clinical features(arthralgia,rash,pharyngeal pain,myalgia)and 14 laboratory parameters[white blood cell count(WBC),monocyte percentage,neutrophil percentage,lymphocyte percentage,platelet count,C-reactive protein,interleukin-6(IL-6),ferritin,globulin,immunoglobulin A,and immunoglobulin G(IgG),creatine kinase,creatinine and complement C3].Multivariate analysis suggested that arthralgia,WBC≥9.995×109/L,IL-6≥98.13 ng/L,ferritin≥507.37 ng/ml,globulin≤36.58g/L,IgG≤13.59g/L,complement C3≥1.27 g/L were related with AOSD.The area under curve(AUC)values of training group and verification group were 0.917(95%CI 0.883-0.951)and 0.869(95%CI 0.802-0.936),respectively.The calibration curves showed good consistency.The decision curve analysis showed that training group and verification group had a large positive rate of return in the wide risk range of 5%-85%and 10%-85%,respectively.Conclusions This study has established a relatively accurate AOSD differential diagnosis model.The combination of arthralgia,WBC,IL-6,ferritin,globulin,IgG and complement C3 may help to distinguish AOSD from other causes of FUO.

18.
Article in Chinese | WPRIM | ID: wpr-1018943

ABSTRACT

Objective:To analyze the causes of out-of-hospital cardiac arrest (OHCA) and the differences in outcomes of pre-hospital first-aid measures and cardiopulmonary resuscitation for different etiologies, improved the success rate of rescue.Methods:A retrospective study was conducted on OHCA patients admitted to Beijing Emergency Medical Centre from January to December 2021. The pre-hospital emergency medical records and rescue results within medical institutions were collected. Compared the basic situation between patients with cardiogenic and non-cardiogenic cardiac arrest, the differences of rescue measures and CPR outcomes between the groups were compared by non-parametric test and χ 2 test. Results:A total of 7 517 patients were included in this study. Cardiogenic arrest patients were older, more underlying diseases (84.2%), and cardiac arrest mainly occurred at home. The cause of non-cardiogenic arrest included disease (85.1%), trauma (2.9%), suicide (5.0%), traffic accidents (1.7%), poisoning (1.1%), and so on. In terms of first-aid measures, after the emergency doctor arrived at the scene, the proportion of first-aid measures used for cardiogenic patients was high (22.3%), and the first aid measures include cardiopulmonary resuscitation, tracheal intubation, defibrillation, oxygen inhalation, injection of adrenaline and use of other drugs. All the proportions of first-aid measures for cardiogenic patients were significantly higher than non-cardiogenic patients (all P<0.001). In terms of clinical outcomes, there were no statistical differences in return of spontaneous circulation ( P=0.072) and 24-hour survival ( P=0.093) between cardiogenic and non-cardiogenic patients. Conclusions:Cardiogenic cardiac arrest was the main cause of OHCA. Cardiogenic arrest patients were more underlying diseases, and older in age, the main clinical feature was onset at home. The comprehensive treatment measures for pre-hospital first-aid cardiac arrest should continue to be strengthened to improve the success rate of rescue for OHCA.

19.
Article in Chinese | WPRIM | ID: wpr-1019237

ABSTRACT

Objective To investigate the etiology and outcome of elderly patients with new-onset status epilepticus(NOSE).Methods According to the electronic medical record,the keywords"Epilepsy"and"Status epilepticus"were searched for elderly patients with status epilepticus admitted to Sichuan Provincial People's Hospital between January 2018 and June 2023.Elderly patients with NOSE were strictly screened according to inclusion and exclusion criteria,and etiology were analyzed according to medical history and ancillary examinations,and factors related to prognosis of epilepsy were analyzed by Logistic regression.Results There were 63 elderly NOSE patients,including 38 males and 25 females,with an average age of(72.71±7.45)years old.Cerebrovascular disease(21%)was determined as the major cause of NOSE in elderly patients,followed by central nervous system infection(17%).Logistic regression analysis of prognostic factors showed that co-infection(OR = 11.67,95%CI:1.391-97.850,P =0.024)and renal insufficiency(OR =18.90,95%CI:3.522-101.43,P = 0.001)were associated with poor patient prognosis.Conclusions Cerebrovascular disease is the main known cause of NOSE in elderly patients.Prevention of infection and improvement of renal function may improve prognosis.

20.
Article in Chinese | WPRIM | ID: wpr-1020064

ABSTRACT

Tic disorder (TD) is one of the typical neurodevelopmental disorders in childhood.More studies have confirmed that the etiology and pathogenesis of TD are related to genetics, environment, immunology, and psychology, etc.Identifying the etiology and pathogenesis helps to guide the treatment of TD.This paper reviews the research progress in the etiology and pathogenesis of pediatric TD in recent years.

SELECTION OF CITATIONS
SEARCH DETAIL