Advances in myelin oligodendrocyte glycoprotein antibody-associated disease / 国际儿科学杂志

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is one of inflammatory demyelinating disorders of the central nervous system.Due to the diverse and atypical clinical manifestations, positive rate of current detection methods is not high, and early diagnosis is difficult.This review aims to elucidate the research progress of the epidemiology, pathogenesis, clinical characteristics, diagnostic criteria, biological markers, treatment and prognosis of MOGAD, in order to improve the understanding of MOGAD for clinicians, so as to identify, treat and reduce the recurrence of MOGAD as early as possible.

Single Stage Repair for Aortic Coarctation associated with Intracardiac Defects Using Extra-Anatomic Bypass Graft in Adults

BACKGROUND AND OBJECTIVES: Coarctation of the aorta in adulthood is generally associated with other cardiovascular disorders requiring surgical management. An extra anatomic bypass grafting from the ascending to descending aorta by posterior pericardial approach via median sternotomy could be a reasonable single stage surgical strategy for these patients. SUBJECTS AND METHODS: Seven male patients aged between 14-41 years underwent an extra anatomic bypass grafting for coarctation repair concomitantly with the surgical management of the associated cardiovascular disorders via median sternotomy. Preoperative mean systolic arterial blood pressure was 161.8±24.5 mmHg, although the patients were under treatment of different combinations of antihypertensive agents. Additional surgical procedures were: aortic valve replacement (n=4), ventricular septal defect (VSD) closure (n=2), ascending aortic replacement (n=3) and Bentall procedure (n=1). None of our patients have been previously diagnosed or operated on for coarctation. Data were evaluated during their hospital stay and in post-operative follow-up. RESULTS: The post-operative course was uneventful in all but one patient was re-operated on due to bleeding. There was neither mortality nor significant morbidity during the in-hospital period and all patients were discharged within 5-9 (mean: 6.3±1.5) days. The mean follow up period was 71.83±23 months (range: 23-95 months). Unfortunately one of our patients could not be contacted for a follow up period because of invalid personal data. CONCLUSION: Coarctation of the aorta in adulthood associated with other cardiovascular disorders can be operated on simultaneously via an extra anatomic bypass grafting technique with low morbidity and mortality.

Enfermedad asociada a Clostridium difficile: prevalencia y diagnóstico por laboratorio / Clostridium difficile associated disease: Prevalence and diagnostic laboratory

Clostridium difficile es un bacilo gram positivo, anaerobio estricto, capaz de formar esporas que le permiten su supervivencia en aguas, suelos y en ambientes hospitalarios, donde puede permanecer hasta años. Inicialmente, fue descrito en 1935 como un agente normal de la microbiota intestinal de recién nacidos sanos. El presente escrito pretende revisar las generalidades del microorganismo y de la enfermedad asociada a C. difficile , enfatizando la prevalencia de ambos en nuestro medio, la problemática, el vacío del conocimiento que se presenta y los métodos de laboratorio que permiten su diagnóstico y estudio.

Clostridium difficile is a gram-positive, strictly anaerobic, bacillus capable of forming spores that enable it to survive in waters, soils, and in hospital environments, where it can remain for years. It was initially described in 1935 as a normal microorganism of the intestinal microbiota of healthy newborns. This article reviews the general features of the microorganism and the disease associated with C. difficile , emphasising the prevalence of both in our environment, the problems, the lack of knowledge on it, and the laboratory methods that help in its diagnosis and study.

Caracterización de ancianos con neumonía extrahospitalaria en un servicio de geriatría / Characterization of elderly people with community-acquired pneumonia in a geriatric service

Se realizó un estudio observacional, descriptivo y prospectivo en 80 ancianos con neumonía adquirida en la comunidad, ingresados en el Servicio de Geriatría del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero hasta diciembre del 2008, a fin de caracterizarlos. En la serie predominaron el sexo masculino (53,7 por ciento), el grupo etario de 80-89 años (38,7 por ciento), los procedentes de domicilios en la ciudad (90,0 por ciento) y los que residían en los distritos 1 y 3 (39,0 y 29,0 por ciento, respectivamente). Asimismo, la hipertensión arterial, la cardiopatía isquémica y la insuficiencia cardíaca fueron las enfermedades asociadas prevalentes y en la totalidad de los afectados se siguió una terapia empírica

An observational descriptive and prospective study was conducted in 80 elderly people with community-acquired pneumonia, admitted to the Geriatrics Department of Saturnino Lora Provincial Teaching Clinical Surgical Hospital of Santiago de Cuba, from January to December 2008 to characterize them. Males (53.7 percent), the age group of 80-89 years (38.7 percent), those from homes in the city (90.0 percent), and those living in the districts 1 and 3 (39.0 percent and 29.0 percent respectively) predominated in the series. Also, arterial hypertension, ischemic heart disease and heart failure were the prevalent associated diseases, and in all the patients an empiric therapy was continued

Patient Characteristics and Treatment of Hallux Polydactyly Associated with Varus Deformity / 대한정형외과학회잡지

PURPOSE: To evaluate patient characteristics such as deformity type, associated disease, and family history, and results of treatment of pre-axial polydactyly with hallux varus deformity. MATERIALS AND METHODS: We carried out a retrospective study of 5 patients who presented with preaxial polydactyly with hallux varus deformity, and were treated between 2003 and 2010 at the authors' hospital. Surgeries including extra digit excision, local flap, osteotomy, and interphalangeal joint fusion were performed taking into consideration the deformity types and patient's age. Family history, associated disease, and types of duplication were assessed, and the outcomes of surgery were evaluated with radiographs and appearances of foot. The mean follow-up period was 34 months. RESULTS: All 5 patients had one or more associated anomalies such as congenital anterolateral tibial bowing and polydactyly in three, translocation of chromosome 2 : 13 associated with cryptorchidism in one, pes planovalgus in one, residual poliomyelitis in one, syndactyly of the foot in two, and leg length discrepancy in one patient. There was no family history of hallux polydactyly in any of the cases. All five patients had duplication of the distal phalanx and one of them had a blocked proximal phalanx. The extra digit was completely removed and the varus deformity was corrected in all cases. CONCLUSION: There was a high incidence of associated diseases in patients with hallux polydactyly and varus deformity. Deformity correction could be obtained by surgeries chosen according to the individual deformity type and patient age.

Clinical analysis of mvcoplasma infection and female associated diseases / 中国医师进修杂志

ObjectiveTo study the pathogenicity of mycoplasma and damage on female's health.Methods The type of infection,symptoms and complications of 128 female patients of mycoplasma infection were counted.The correlation of the disease causing by mycoplasma and other diseases was summarized.Results Among of the 128 patients,there were 78 patients(60.94％) of Mycoplasma urealytium infection,22 patients (17.19％) of Mycoplasma hominis infection,18 patients (14.06％) of Mycoplasma genitalium infection,10 patients(7.81％) of Mycoplasma urealytium and Mycoplasma hominis mixed infection.The disease causing by mycoplasma and associated diseases including 66 patients (51.56％ )of non-gonococcal urethritis,48 patients (37.50％) of mucopurulent cervicitis,32 patients (25.00％) of pelvic inflammatory disease,8 patients (6.25％) of bacterial vaginosis,38 patients (29.69％) of adverse consequences of pregnancy,8 patients(6.25％) ofdysgenesia.ConclusionsMycoplasma urealytium is the major cause of non-gonococcal urethritis,and abortion,stillbirth,premature delivery,early delivery,such as pregnancy-related adverse effects.Mycoplasma genitalium is correlated with pelvic inflammatory disease,mucopurulent cervicitis; Mycoplasma hominis is correlated with bacterial vaginosis; Mycoplasma genitalium and Mycoplasma hominis are likely to lead to tubal infertility.

Dermatologic Diseases Associated with Atopic Dermatitis in Koreans: Multicenter Study / 대한피부과학회지

BACKGROUND: Dermatological diseases can occur with atopic dermatitis. OBJECTIVE: The purpose of this study was to analyze diseases associated with atopic dermatitis in Koreans. METHODS: From November, 2007, to May, 2008, 948 patients with atopic dermatitis who visited the department of dermatology at 19 hospitals were evaluated for associated diseases. RESULTS: Of 948 patients, 53.8% (510) had symptoms associated with other dermatological diseases. In order of frequency, diseases associated with atopic dermatitis included acne, hand/foot eczema, seborrheic dermatitis, urticaria, warts, and recurrent herpes simplex. The number of associated diseases did not change significantly with the severity of atopic dermatitis. However, the incidence of hand/foot eczema and eczema herpeticum correlated significantly with the severity of atopic dermatitis. CONCLUSION: There is a distinct pattern of diseases associated with atopic dermatitis in Koreans.

Management of Antibiotics-Associated Diarrhea / 대한소화기학회지

Antibiotics-associated diarrhea (AAD) is defined as unexplained diarrhea that occurs with the administration of antibiotics. Approximately 20% AAD cases are due to Clostridium difficile. Over the last decade, the incidence of Clostridium difficile-associated disease (CDAD) has progressively increased, and now a significant clinical problem. Recent change in the epidemiology of CDAD and the emergence of an epidemic hypervilruent strain suggest the need for greater attention for infection control, early diagnosis, and more effective treatment modality. However, since most cases of CDAD are both iatrogenic and nosocomial, careful selection of antibiotics, combined with proper hand hygiene and precaution by medical staffs are required.

Clinical Characteristics and Changing Epidemiology of Clostridium difficile-Associated Disease (CDAD) / 대한소화기학회지

BACKGROUND/AIMS: The spectrum of Clostridium difficile-associated disease (CDAD) ranges from mild diarrhea to life-threatening colitis. Recent studies reported an increase in incidence and severity of CDAD and the presence of severe community-acquired CDAD (CA-CDAD). The aims of this study were to investigate the incidence of CA-CDAD and non-antibiotics-associated CDAD, and to compare the clinical characteristics between hospital-acquired (HA) and CA-CDAD. METHODS: The medical records of 86 patients who were diagnosed as CDAD in Hanyang University Guri Hospital between January 2005 and October 2007 were retrospectively reviewed. RESULTS: Of the 86 patients (mean age 64 years), 53 patients were women. The most frequently prescribed antibiotics were cephalosporins (67.4%), followed by aminoglycosides (38.4%) and quinolones (14%). Of the 86 patients, the average duration of treatment and recovery time of symptoms were 11.5 days and 4.6 days, respectively. Seven percent of patients experienced relapse treatment. The overall incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD group had lower rate of antimicrobial exposure whilst showing higher rate of complications compared to HA-CDAD group. Three patients in the CA-CDAD progressed towards a severe complicated clinical course, including septic shock. CONCLUSIONS: The incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD tends to have a higher complication rate compared to HA-CDAD. Community clinicians needs to maintain a high level of suspicion for CDAD, whilst coping with the ever evolving epidemiologic change.

Prevalence of the Associated Diseases in Patients with Snoring and Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many reports have been made regarding the association between snoring and sleep apnea with systemic diseases such as hypertension, ischemic heart disease, and cerebrovascular disease. The aim of this study is to evaluate and analyze the prevalence of such associated diseases in Korean patients with snoring and sleep apnea diagnosed by polysomnography. MARERIALS AND METHODS: 462 Korean patients (395 males and 67 female, aged 6 to 75) on whom polysomnography were performed were included in this study. Retrospective review of the medical records of these patients was done and the prevalence of the associated diseases were surveyed according to severity of respiratory disturbance index (RDI) and minimal O2 saturation (Min. SaO2). RESULTS: The prevalence of hypertension was 31.2% and it was correlated with severity of RDI. The prevalence of ischemic heart disease was 9.3% and it was associated with the severity of RDI and Min. SaO2. Endocrine diseases with the exception of DM was significantly correlated with the severity of Min. SaO2. The prevalence of chronic pulmonary disease was highly associated in patients with Min. SaO2 <65. CONCLUSION: Snoring and sleep apnea are not simple problems of localized obstruction of an airway but should be considered and managed as generalized diseases involving an array of organs.

Associated Diseases in Inpatients with Dementia

OBJECTIVES: Patients with dementia are accompanied with poor autonomy and multiple disability. Therefore moer cost and medical service are required than non-dementia patients. In order to insure comprehensive, systematic care for dementia patients, knowledge of the associated disease of different types of dementia is warranted. This study evaluate the characteristics of associated disease in inpatients with dementia, to be used as basic reference for effective treatment. METHODS: The study popultion consist of 92 patients with dementia admitted between January 1, 1996 and September 30, 1997 to geriatric department, Yosei University Kwangju Severance Psychiatric Hospital. Diagnoses were based on DSM-IV and NINCDS. Severity of dementia was evaluated by GDS (Global Deterioration Scale). Associated diseases was recorded in separated checklist. chi-test, Fisher's exact test, ANOVA, T-test, Wilcoxon rank sum test, Kruskal-Wallis test were used to determine statistical differences among the dementia subgroup. RESULTS: The mean age was 71.8+/-9.2 with 31 male (33.7%) subjects and 61 female subject (66.3%). The types of dementia among the 92 demented patients were as follows:50 (54%) with Alzheimer's disease, 30 (33%) with vascular dementia, 12 (13%) with unclassified dementia. Mean GDS score was 5.4+/-1.1. The mean duration of admission was 66.9+/-88.9 days. Types of discharge were normal discharge 33 (35.9%), discharge against doctors' advice 28 (30.4%), transfer 23 (25.0%). The average number of diagnoses was 4.9+/-2.4. (4.5+/-2.4 in Alzheimer's disease, 6.1+/-2.4 in vascular dementia, 5.3+/-2.1 in unclassified dementia in respectively (p<0.05). The most common associated disease were gastrointestinal disorders (24.8%), cardiovascular disorders (11.8%), urinary tract infection (6.8%), musculoskeletal disorder (6.6%), diabetes mellitus (4.5%). Associated diseases that their frequency showed significant differences in different types of dementia were hypertension, diabetes mellitus, urinary incontinence, oral cavity disease, anemia (p<0.01). CONCLUSIONS: Associated disease are different in different type of dementia. Patients with vascular dementia had more associated disease and received more drugs for associated disease than Alzheimer's disease. Our data emphasize comprehensive and systematic treatment plan according to type of dementia.

Human Genne Myo-Inositol Monophosphatase 2 Gene and Clinical Disease / 实用儿科临床杂志

Human genne myo-inositol monophosphatase 2(IMPA2) was recently a novel and promising gen that was associated with disease,especially in mental and neuro diseases.Its locus is in chromosome 18p11 2,about 15 kb.It encodes IMPA2 enzyme.IMPA2 enzyme as a mainly and catalytic inositol plays an important role in cell signaling system.The mechanism of action of IMPA2 gene is still unclear.But in basic research on genetic structure and IMPA2 product,the biochemical functions and crystal structure have gradually been recognized;In the clinical application,the association with disease has been detected in manic depression,schizophrenia and febrile seizuers.IMPA2 even has been a susceptible gene to certain diseases.IMPA2 has increasingly been the hotspot in gene research.