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The "timed inspiratory effort" (TIE) index, a new predictor of weaning outcome, normalizes the maximal inspiratory pressure with the time required to reach this value up to 60 s, incorporating the time domain into the assessment of inspiratory muscle function. The objective of this study was to determine whether the TIE predicts successful extubation at a similar rate as the T-piece trial with less time required. A non-inferiority randomized controlled trial was performed with ICU subjects eligible for weaning. The participants were allocated to the TIE or the T-piece groups. The primary outcome was successful weaning, and the main secondary outcome was ICU mortality. Eighty participants of each group were included in the final analysis. Time from the start of a successful test to effective extubation was significantly lower in the TIE group than in the T-piece group, 15 (10 to 24) vs 55 (40 to 75) min, P<0.001. In the Kaplan-Meier analysis, no significant differences were found in successful weaning (79.5 vs 82.5%, P=0.268) or survival rate (62.9 vs 53.8%, P=0.210) between the TIE and T-piece groups at the 30th day. In this preliminary study, the TIE index was not inferior to the T-piece trial as a decision-making tool for extubation and allowed a reduction in the decision time.
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BACKGROUND: In recent years, with the continuous progress of orthopedic surgery technology and the rapid increase in the number of orthopedic surgery, more and more attention has been paid to the postoperative rehabilitation of patients. As a common mental disorder after orthopedic surgery, the occurrence of post-traumatic stress disorder is related to demographic characteristics, psychosocial factors, trauma characteristics, past mental status and perioperative cardiovascular indicators. At the same time, previous studies have shown that postoperative post-traumatic stress disorder is closely related to the rehabilitation of patients. OBJECTIVE: By consulting the related literature of post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery in recent years, this paper analyzed the occurrence, high risk factors and the relationship between post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery, in order to guide the early diagnosis and intervention of postoperative post-traumatic stress disorder. METHODS: The first author and the second author searched the related articles in PubMed database, Embase database, China National Knowledge Infrastructure(CNKI) and Wanfang database from January 1990 to October 2019 with the English key words of “orthopedic, surgery/operation, PTSD, risk factor, rehabilitation” and the Chinese words of “orthopedics, surgery, PTSD, high risk factors, rehabilitation”. A total of 94 articles were retrieved, of which 56 met the inclusion criteria. RESULTS AND CONCLUSION:(1) According to the type of operation, about 15%-40% of orthopedic patients may have varying degrees of post-traumatic stress disorder after surgery, and the incidence of post-traumatic stress disorder after lower limb amputation is highest.(2) Youth, female, low income, low education, lack of social support, high genetic susceptibility, poor psychological state before operation, poor psychological elasticity, hypotension, high heart rate and high pain sensitivity are all high risk factors for post-traumatic stress disorder after orthopedic surgery.(3) There is no clear correlation between the severity of preoperative trauma and the trauma of the operation itself and the occurrence of postoperative post-traumatic stress disorder, but the surgery with great influence on the ability of life and work after operation easily causes post-traumatic stress disorder.(4) Patients with postoperative post-traumatic stress disorder may have poor long-term prognosis.
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Objective: To detect the expression of P53, human epidermal growth factor receptor-2 (HER-2), and tumor endothelial marker 1 (TEM1) in gastric cancer tissues, analyze their correlation with clinical efficacy, and explore their potential roles as biomarkers for neoadjuvant chemotherapy. Methods: Sixty-three patients with gastric cancer who underwent fluorouracil-based neoadjuvant che-motherapy in The First Hospital of Lanzhou University from May 2015 to May 2017 were enrolled. Using immunohistochemistry, the expression of P53, Her2, and TEM1 was detected in 63 gastric cancer specimens before neoadjuvant chemotherapy. The efficacy of neoadjuvant chemotherapy was assessed by imaging. The relationship between the expression of P53, HER-2, and TEM1 and the effi-cacy of neoadjuvant chemotherapy was analyzed. Results: The total effective rate of neoadjuvant chemotherapy in 63 patients with advanced gastric cancer was 69.8%, with 2, 7, and 35 patients achieving complete remission, partial remission, and stable disease, re-spectively. Disease progression was noted in 19 patients. Univariate analysis revealed that patients positive for TEM1 and having high T stage had a poor response to neoadjuvant chemotherapy (P<0.05); furthermore, location, differentiation, and size of tumor; P53 posi-tivity (P=0.488); and Her-2 positivity (P=0.106) were not associated with the efficacy of neoadjuvant chemotherapy for gastric cancer. Multivariate analysis revealed that TEM1 positivity and a higher T stage could be factors that predicted the response to neoadjuvant chemotherapy in patients with advanced gastric cancer. Conclusions: TEM1, as a marker of tumor stroma, may be an important molec-ular biological indicator that predicts the poor response to neoadjuvant chemotherapy in patients with gastric cancer.
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Objective To analyze the correlation between the fractional exhaled nitric oxide (FeNO) levels and blood eosinophil (EOS) count and the frequency of wheeze in infants with recurrent wheezing.Methods From February 2015 to August 2016 in the General Hospital of Northern War Zone,outpatient department of Pediatrics treatment and hospitalization of age less than or equal to 3 year old children with recurrent wheezing,101 cases were induded as the research object.On the basis of asthma predictive index (API) score were divided into API positive group (n =55) and API negative group (n =46),according to the wheeze frequency of the two groups children were divided into 3 ～ 4 times wheezing groups and more than 5 times.Select 37 cases of healthy children as control group.The concentration of FeNO and blood EOS count are detected in all the children.The correlation between the three groups of children with FeNO concentration,the correlation between FeNO and blood EOS count,the correlation between the the frequency of wheeze and FeNO in experimental groups were analyzed.Results (1) API positive group mean FeNO (19.3 ± 6.2) ppb was significantly higher than API negative group (7.7 ± 2.9) ppb,there was no difference (P ＞ 0.05).API negative group mean FeNO (7.7 ± 2.9) ppb is lower than the normal control group (9.5 ± 2.0) ppb,there was no difference (P ＞0.05).(2) API positive group mean EOS count (124.7 ± 1.6) x 106/L is higher than API negative group (86.1 ± 1.9) x 106/L,there was significant difference (P ＜ 0.01);(3) There was a correlation between FeNO level and blood EOS count in API positive group,there was no correlation between FeNO level and blood EOS count in API negative group and con~ol group.(4) No statistical differences were found in ≤4 times wheezing groups and more than 5 times of the mean FeNO.Conclusion There is no significant difference in the mean value of FeNO between different times of wheezing in children with recurrent wheezing.The combination of medical history,EOS,FeNO and API might be used to predict the wheezing episode of infants.
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Objective@#To investigate the clinical significance of asthma prediction index (API), Eotaxin(Eot), interleukin-4 (IL-4), interferon-γ (IFN-γ), eosinophil (Eos) in predicting recurrent wheezing in infants.@*Methods@#Ninety-six infants with first wheezing attack due to bronchiolitis from April 2015 to April 2016 at the Department of Pediatrics, the Second Hospital of Tianjin Medical University were selected.The medical history and other clinical data were collected, and the peripheral blood samples were collected to detect Eot, IL-4, IFN-γ, Eos count and serum specific immunoglobulin E(sIgE). Then all infants were followed up by telephone until 2-year-old to find whether recurrent wheezing attack occurred and then API was calculated.According to the recurrent wheezing times during the follow-up, they were divided into 2 groups: the observation group (recurrent attacks≥2 times, 33 cases) and the control group (no recurrent wheezing during follow-up, 60 cases). The infants in the observation group were divided into the API positive group (18 cases) and the API negative group (14 cases) according to API.The differences in clinical data and peripheral blood indexes were analyzed by independent sample t test for measuring data and χ2 test for counting data.@*Results@#Thirty-three cases (35.48%) infants in the study had recurrent wheezing attacks within 2 years followed by bronchiolitis.The average age of the recurrent wheezing attack was (13.59±5.89) months.Compared with the control group, the levels of serum Eot[(135.45±44.45) ng/L vs.(110.91±22.50) ng/L, t=3.44, P<0.05], IL-4[(58.56±43.55) ng/L vs.(34.91±12.18) ng/L, t=3.78, P<0.05] and peripheral blood Eos proportion(0.034 0±0.025 6 vs.0.003 3±0.006 4, t=4.56, P<0.05) increased in the observation group, and the differences were statistically significant.The food allergy history [18.18%(6/33 cases) vs.5.00%(3/60 cases), χ2=4.23, P<0.05]and the positive proportion of sIgE allergens[38.46%(10/26 cases) vs.9.09%(2/22 cases), χ2=5.48, P<0.05] increased, and the differences were statistically significant.There was no difference between the 2 groups in IFN-γ level (P>0.05). The level of serum Eot [(146.59±59.35) ng/L vs.(114.14±13.60) ng/L, t=3.71, P<0.05], airway sIgE[45.00%(9/20 cases) vs.0(0/6 case), χ2=4.13, P<0.05]and food allergens sIgE [50.0%(10/20 cases) vs.0(0/6 case), χ2=4.88, P<0.05)] in the API positive group was higher than that in the API negative group, and the differences were statistically significant.@*Conclusions@#The elevated serum Eot levels during the first asthmatic attack of bronchiolitis in infants and food sIgE positive levels suggest an increased risk of recurrent wheezing, and the elevated serum Eot levels and sIgE positive levels are associated with API positive levels.
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Objective To discuss the polymorphisms of asthma susceptibility gene ORMDL3 in infantile wheezing,in order to provide a theoretical basis for early diagnosis of asthma.Methods One hundred and fifty wheezing infants were recruited and divided into 2 groups as asthma predictive index(API) positive group(n =80) and negative group (n =70).Taqman probe was applied to detect the genotypes of 2 single nucleotide polymorphisms (SNPs)in childhood asthma susceptibility gene ORMDL3,which were rs4794820 and rs7216389.The genotype distributions were analyzed and compared between 2 groups,and the correlations among genotype distribution and tidal breath pulmonary function,fractional exhaled nitric oxide (FeNO) concentration,percentage of eosinophils (EOS％),serum immune globulin E (total IgE) levels respectively were also analyzed,respectively.Results (1) The frequencies of rs4794820 AG and rs7216389 TC heterozygotes in the API positive group were the highest,which were significantly higher than those in the negative group(58.75％ vs.31.42％,56.25％ vs.32.86％ respectively,all P ＜0.01).The frequencies of GG and TT homozygotes in the API negative group were the highest,which were significantly higher than those in the positive group (58.57％ vs.30.00％,57.14％ vs.31.25％ respectively,all P ＜0.01).(2)The time to reach the peak expiratory flow in tidal breathing over the total expiratory time (TPTEF/TE) and the volume to reach the peak expiratory flow in tidal breathing over the total expiratory volume (VPEF/VE) of the infants in the API positive group were less than those in the API negative group(16.87 ±5.31 vs.20.12 ± 5.23,20.87 ± 5.92 vs.25.56 ± 6.77,respectively),and the FeNO concentration was higher than that in the API negative group [(22.44 ± 9.77) ppb vs.(13.23 ± 7.90)ppb],and the differences were significant (t =-3.776,-4.490,6.377,respectively;all P ＜ 0.01).(3) In the API positive group,the TPTEF/TE and VPEF/VE of the infants who expressed AG/TC genotype were lower than those who expressed GG/TT genotype (14.55 ± 4.83 vs.19.91 ± 4.17,18.85 ± 4.26 vs.25.20 ± 7.06,respectively,t =-4.727,-3.976,all P ＜ 0.01);while the FeNO concentrations,EOS％ and total IgE levels were higher than those who expressed GG/TT genotype [(25.02 ± 8.77) ppb vs.(18.39 ± 6.56) ppb,7.16 ± 2.62 vs.5.50 ± 1.34,(366 727 ±275 533) IU/L vs.(166 826 ± 62 865) IU/L,respectively] (t =3.484,3.409,4.589 respectively;all P ＜ 0.01).Conclusions Childhood asthma susceptibility gene ORMDL3 SNPs rs4794820 AG and rs7216389 TC heterozygotes are the risk factors for API positive infantile wheezing.The pulmonary function damage and airway inflammation of the infants who expressed AG/TC genotype are more serious than those who expressed GG/TT genotype,and more likely to develop persistent asthma.
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Introducción: En presencia de complicaciones infecciosas intrabdominales postoperatorias, la decisión de reoperar es todavía difícil para el cirujano actuante. Los modelos matemáticos representan una buena ayuda al diagnóstico en estas condiciones. Método: Estudio prospectivo observacional de 300 pacientes post-cirugía abdominal ingresados en la unidad de cuidados intensivos del Hospital Calixto García desde enero de 2008 a enero de 2010. Los pacientes fueron aleatoriamente separados (2:1) en dos grupos; estimación (GE) y validación (GV). En el GE se desarrollaron tres modelos estadísticos para la reoperación, que fueron validados en el GV .Estos modelos incluyeron variables, que en estudios anteriores demostraron su utilidad en el pronóstico, como el índice predictivo de reoperación aguda (ARPI) y la presión intrabdominal (PIA) Resultados: El modelo ARPI-PIA fue el mejor de los tres modelos, según el estadígrafo Hosmer-Lemeshow (calibración C=9,976 p=0.267, discriminación área bajo la curva ROC=0,989 IC 95 por ciento 0,976-1,000). Conclusión: La inclusión de la PIA junto al ARPI en un modelo matemático puede aumentar la certeza del pronóstico de reoperación en presencia de complicaciones infecciosas intrabdominales tras cirugía abdominal. Este modelo puede ser de utilidad en situaciones de recursos diagnósticos limitados.(AU)
Background: The decision of re-operating after abdominal surgery is still difficult, especially whenan intra-abdominal infectious complication is present. Mathematical models represent good diagnosis aid. Methods: A prospective observational study was conducted with 300 patients after abdominal surgery consecutively admitted at the intensive care unit of the "CalixtoGarcía Hospital" from January 2008 to January 2010. The patients were randomly separated (2:1) into estimation and validation groups. Three models for re-operation were developed in the estimation group by logistic regression, using some factors that demonstrated their usefulness in previous studies, for example, the acute re-operation predictive index (ARPI) and the intra-abdominal pressure (IAP). Afterwords, the models were validated on the other group. Results: Acute re-operation predictive index-intraabdominal pressure (ARPI-IAP) model was the best of the three models, with an excellent calibration by the Hossmer-Lemeshow goodness-of fit statistic (C=9,976 p=0,267), discrimination (AUC=0,989 95 percent CI 0,976-1,000). Conclusion: The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of re-operation related to intra-abdominal infectious complications in patients after abdominal surgery. This model is recommended in conditions of limited diagnostic resources. (AU)
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Humanos , Cirugía General , Modelos Anatómicos , Cuidados Posoperatorios , Presión , Índice , InfeccionesRESUMEN
Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.
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BACKGROUND: We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. METHODS: Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. RESULTS: Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. CONCLUSION: The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.
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Humanos , Masculino , Absorciometría de Fotón , Pueblo Asiatico , Densidad Ósea , Corea (Geográfico) , Tamizaje Masivo , Encuestas Nutricionales , Osteoporosis , Curva ROC , Tamaño de la Muestra , Autoevaluación (Psicología) , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. METHODS: Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. RESULTS: Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. CONCLUSION: The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.
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Humanos , Masculino , Absorciometría de Fotón , Pueblo Asiatico , Densidad Ósea , Corea (Geográfico) , Tamizaje Masivo , Encuestas Nutricionales , Osteoporosis , Curva ROC , Tamaño de la Muestra , Autoevaluación (Psicología) , Sensibilidad y EspecificidadRESUMEN
Los modelos estadísticos de clasificación se emplean cotidianamente en salud como sistemas de evaluación que permiten construir grupos homogéneos en la ayuda de pronósticos, diagnósticos, elección de terapias y cuantas situaciones requieran la discretización como herramienta para la toma de decisiones más acertadas. Su utilidad no solo se evidencia en el ámbito médico sino que muchos de ellos ayudan a mejorar actuaciones y políticas en el sector de la salud pública. Como parte de las tecnologías sanitarias, requieren de una evaluación continua en los diferentes escenarios donde se ejecuten. Por otra parte, emplearlos de manera mecánica, sin una mentalidad crítica, puede traer más riesgos que beneficios, por lo que su poder predictivo o explicativo no justifica que sus resultados se empleen de manera incuestionada.
Statistical classification models are used every day in health care as evaluation systems allowing building homogeneous groups to help in prognostics, diagnostics, therapy choosing and any other situation. The usefulness of them is not only evident in the medical surroundings, but many of them tribute directly to the performance and policies improvement in the Public Health area. As part of the health technologies, they require a continuous assessment in the different environments they are performed. On the other hand, using them mechanically, without a critical mentality, could bring about more risks than benefits, so their predictive or explanatory power does not justify the usage of their outcomes in an unquestioned way.
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OBJECTIVE: To investigate the predictive index of functional recovery after primary pontine hemorrhage (PPH) using the combined motor evoked potential (MEP) and somatosensory evoked potential (SEP) in comparison to the hematoma volume and transverse diameter measured with computerized tomography. METHODS: Patients (n=14) with PPH were divided into good- and poor-outcome groups according to the modified Rankin Score (mRS). We evaluated clinical manifestations, radiological characteristics, and the combined MEP and SEP responses. The summed MEP and SEP (EP sum) was compared to the hematoma volume and transverse diameter predictive index of global disability, gait ability, and trunk stability in sitting posture. RESULTS: All measures of functional status and radiological parameters of the good-outcome group were significantly better than those of the poor-outcome group. The EP sum showed the highest value for the mRS and functional ambulatory category, and transverse diameter showed the highest value for "sitting-unsupported" of Berg Balance Scale. CONCLUSION: The combined MEP and SEP is a reliable and useful tool for functional recovery after PPH.
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Humanos , Potenciales Evocados Motores , Potenciales Evocados Somatosensoriales , Marcha , Hematoma , Hemorragia , PosturaRESUMEN
The aim of the study was to determine if diagnostic performance of CA-125 in ovarian malignancy can be improved by considering age of the patient. The study was a retrospective analysis of the medical records of 306 patients who underwent a CA-125 measurement in our Institute. Of the 306 patients, 31% had malignant ovarian diseases, 45% had benign ovarian diseases, 6% had non-ovarian gynaecological diseases and 18% had non-gynaecological diseases. A positive association was found between age and CA-125 levels in patients with ovarian diseases. Patients were divided into three age groups of 18–37 yrs, 38–56 yrs and 57–74 yrs and were given age scores as 1, 2 and 3 respectively. Biochemical predictive index (BPI) was calculated by multiplying age score and CA-125 value. Among the age groups ranging 38–56 yrs and 57–74 yrs, the CA-125 and BPI values were significantly higher in malignant ovarian diseases compared to benign ovarian diseases. ROC curve analysis revealed a cut-off of 86 for the BPI with the sensitivity, specificity, positive predictive value and negative predictive value as 58%, 78%, 56% and 80% respectively. BPI had better specificity and negative predictive value compared to CA-125, can be used in the screening of ovarian pathology.
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La lactancia materna es considerada el mejor alimento para el niño, aunque su relación con el desarrollo atopia en lactantes con sibilancias es controvertido.Objetivo: analizar la relación entre la lactancia materna, la exposición al humo de tabaco y la condición atópica en niños que presentan sibilancias persistentes en edad preescolar. Material y Métodos: Diseño retrospectivo, observacional, transversal Se incluiyeron 243 niños de entre 3 y 6 años con sibilancias persistentes estudiados en la División de Alergia e Inmunología del Hospital de Niños (2007-2011)...
Breastfeeding is considered the best food for the child, but its relationship to the development of atopy in infants with wheezing is controversial. Aim: to analyze the relationship between brestfeeding, cigarette smoke exposure and atopic status in preschool children with persistent wheezing. Material and Methods: Retrospective, observational, transversal design of 243 children aged 3 to 6 years with persistent wheezing studied in the Allergy and Immunology Division of Children's Hospital (2007-2011)...
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Niño , Lactante , Lactancia Materna , Preescolar , Estudios Transversales , Lactante , Ruidos Respiratorios , Estudios Retrospectivos , Contaminación por Humo de TabacoRESUMEN
La mayoría de casos de asma se inicia a temprana edad pese a la dificultad de establecer medidas diagnósticas especificas , eventos en el periodo postnatal son relevantes en el futuro desarrollo de reactivadas de vías aéreas y la persistencia de los síntomas. Los lactantes con sibilancias recurrentes durante los primeros años de vida es un fenómeno común y no necesariamente implica un curso prolongado de enfermedad, en muchos casos las sibilancias representan una situación transitoria la cual cesa en la edad presescolar. Pese a que estudios epidemiológicos han delineado varios genotipos, al presente no es posible asignar prospectivamente la mayoría de los infantes con sibilancias a ningún genotipo en particular.
Most of cases of asthma begin to early age in spite of the difficulty of establishing measured specific. In the postnatal period it is probable the future development of reactivity of airway rand the persistence of the symptoms. The child with recurrent wheezing during the first years of life is a common phenomenon and it not necessarily implies a lingering course of illness, in many cases the wheezing represents a transitory situation which ceases in the childhood age. In spite of the fact that epidemic studies have delineated several phenotypes, to the present is not possible to assign most of the infants prospectively with wheeze to any phenotypes in particular.
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PURPOSE: We compared the asthma predictive index(API) and the modified asthma predictive index (mAPI) of the Tuscon Children's Respiratory Study Group in Korean children with recurrent wheezing. We investigated the atopic profiles and presence of allergen sensitization of each risk group, and ascertained the significant clinical risk factors. METHODS: Two hundred and sixty two children, who visited for recurrent wheezing from 1998 to 2005, were enrolled and divided into groups by API and mAPI. We investigated the history of the patients and their families, atopic profiles, and sensitization to aeroallergen and food allergens. Twenty nine children were followed up to 6 years of age and we evaluated the sensitivity, specificity and positive and negative predictive value of both indices. RESULTS: The high risk group of API were of older age, were more likely to be sensitized to aeroallergen(P=0.001) and food allergen(P=0.034) and had higher levels of total eosinophil count, eosinophil percent, serum ECP, total IgE, and D.p-, D.f-specific IgE. High risk group of mAPI showed higher levels of atopic markers such as egg-, milk-, D.p- and D.f-specific IgE. Even though API did not include allergen sensitization, the high risk group was more significantly sensitized to common allergens than the low risk group. Twenty nine children were followed up until 6 years of age; therefore 15 children were diagnosed as asthma, clinically. The sensitivity, specificity, positive and negative predictive values of mAPI were higher than API. CONCLUSION: Both high risk groups of API and mAPI had higher levels of atopic markers and were more sensitized to common allergens. These findings suggest that sensitization to aeroallergens and food allergens are more objective markers as asthma predictive indices. In addition, mAPI is a more reliable index in predicting asthma in Korean children with recurrent wheezing than is API. But only 29 patients were followed until the age of 6, so we need to include more children with long term follow up for future study.
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Niño , Humanos , Alérgenos , Asma , Proteína Catiónica del Eosinófilo , Eosinófilos , Estudios de Seguimiento , Inmunoglobulina E , Ruidos Respiratorios , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
PURPOSE: Penile size has been a focus of interest in the life and the culture throughout human history. It has been a longstanding question whether there is any relation between penile size and the dimensions of body extremities. We measured the standard length of the penis and investigate whether any body extremity is a predictive index of penile size in Korea men. PATIENTS AND METHODS: A series of 655 males above 17 years of age were examined during a 4-month period. Stretched penile length, penile circumference, and length and characteristics of various body parts and features (1st finger, 2nd finger, 3rd finger, 1st toe, 2nd toe, 3rd toe, ear, mouth, nose, height, weight, and baldness) were investigated by one examiner. To see the relation among the penile length and circumference and various body dimensions, univariate and multivariate statistical methods such as correlation analysis and multiple linear regression were applied. RESULTS: The mean values standard deviations were 46.6 +/- 18.4 for age, 10.0 +/- 2.0 cm for the length of the penis, and 8.5 +/- 1.0 cm for the circumference of the penis. In a correlation coefficient analysis, the length of the penis was slightly correlated with penile circumference. Additionally, the circumference of the penis was slightly correlated with penile length, patient height, weight, and 3rd toe and 1st toe length, in decreasing order. In a multivariate analysis, the coefficients of determination from multiple linear regression were 13% and 15% for the length and the circumferences of the penis, respectively. CONCLUSIONS: Human body index including the size or characteristics of body extremities is not enough to predict the penile size.