Prevalence and relevant factors of positive RF in brucellosis patients with arthralgia.

BACKGROUND: Brucellosis is a critical zoonotic disease in the world, it is the non-specific arthralgia that make brucellosis patients easily misdiagnosed as rheumatoid arthritis (RA) in endemic regions. Elevated rheumatoid factor (RF) is an essential indicator of RA, and the RF in brucellosis patients is significantly higher than healthy people. Therefore, this study further explored the distribution of RF and the relevant factors of the RF positivity in brucellosis patients with arthralgia, in order to strengthen the recognition of physicians for brucellosis patients with RF positivity, especially in brucellosis-endemic areas, so as to avoid misdiagnosis and untimely treatment that may lead to malignant outcomes. METHODOLOGY AND PRINCIPAL FINDINGS: The medical records of all 572 brucellosis inpatients were collected in the Sixth People's Hospital of Shenyang, China from 2015 to 2016. After excluding 106 patients without arthralgia, 5 patients who unwilling to perform RF testing and 16 patients with diseases that may affect RF, 445 brucellosis inpatients with arthralgia were involved in this retrospective cross-sectional study. 143 (32.1%) patients with RF >10 IU/ml were classified into the RF positive group, with an average level of 16.5[12.2, 34.7] IU/ml, of which 45 (10.1%) patients were high-positive with RF >30 IU/ml. Multivariate logistic regression model was used to further analyze the relevant factors of the RF positivity and found that age, wrist joint pain and elevated C-reactive protein (CRP) were positively associated with RF positivity, with OR of 1.02 (P = 0.024), 8.94 (P = 0.008) and 1.79 (P = 0.019), respectively. CONCLUSION: The prevalence of positive RF in brucellosis patients with arthralgia was critical, nearly one-third of patients had RF positive. Elderly men brucellosis patients with arthralgia, wrist joint pain and elevated CRP were at high risk of positive RF. It is reminded that physicians should focus on differential diagnosis during clinical diagnosis and treatment, especially in brucellosis-endemic regions.

The association of depression with use of prescription drugs in adults with noncommunicable diseases: Based on NHANES in 2005-2016.

BACKGROUND: It is not clear how the noncommunicable diseases (NCDs) performed in the association of depression with use of prescription drugs. METHODS: This cross-sectional study involved 20,836 participants with at least one NCDs who aged over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2005-2016. Ordinal logistic regression under complex sampling was used to examine the association of depression with use of prescription drugs in patients with different categories of NCDs. RESULT: Among patients with respiratory diseases (OR: 1.41, 95% CI: 1.13-1.76), genitourinary diseases (OR: 1.59, 95% CI: 1.28-1.98), and cardiovascular diseases (OR: 1.43, 95% CI: 1.27-1.60), the risk of depression was higher among those who used prescription drugs than those who did not. The results showed that the association of depression with use of prescription drugs was significantly stronger, especially in patients with genitourinary diseases ≥65 years of age (OR: 1.91, 95% CI: 1.01-3.61). Trend analysis showed that the categories of prescription drugs used and the risk of depression was significantly statistically different (P for trend <0.001). LIMITATIONS: Self-reported prevalence of depression may differ from actual prevalence of depression. The categories of NCDs studied in this article are limited and the association between specific drugs and depression is not analyzed. CONCLUSIONS: In patients with NCDs, use of prescription drugs increased the risk of depression, and this risk increased significantly, especially in patients with genitourinary diseases who aged over 65 years. The risk of depression was increasing with the categories of prescription drugs used.

Brucellosis screening and follow-up of seropositive asymptomatic subjects among household members of shepherds in China.

To measure the seroprevalence of high-exposure populations in brucellosis endemic areas and report the outcome and duration of seropositive asymptomatic subjects, we screened 595 family members of shepherds in Jilin Province, China and then followed up 15 seropositive asymptomatic subjects for 18 months. We found that the seropositive rate of 15.5%. Nearly half of seropositive asymptomatic subjects (7/15) developed into brucellosis in the short term; others were still seropositive asymptomatic or had decreased SAT titer in a longer time.

Epidemiological Characteristics and Spatiotemporal Trend Analysis of Human Brucellosis in China, 1950-2018.

The rate of brucellosis, a zoonotic disease, has rapidly increased in humans brucellosis(HB) in recent years. In 1950-2018, a total of 684,380 HB cases (median 2274/year (interquartile range (IQR) 966-8325)) were reported to the National Infectious Disease Surveillance System in mainland China. The incidence of HB peaked in 2014 (4.32/100,000), and then showed a downward trend; we predict that it will maintain a steady downward trend in 2019-2020. Since 2015, the incidence of HB has shown opposite trends in the north and south of China; rates in the north have fallen and rates in the south have increased. In 2004-2018, the most significant increases in incidence of HB were in Yunnan (IQR 0.002-0.463/100,000), Hubei (IQR 0.000-0.338/100,000), and Guangdong (IQR 0.015-0.350/100,000). The areas where HB occurs have little overlap with areas with high per capita GDP in China. The "high-high" clusters of HB are located in northeastern China (Inner Mongolia, Heilongjiang, Jilin, Liaoning, Ningxia, Shanxi, and Gansu), and the "low-low" clusters of HB are located in southern China (Yunnan, Jiangxi, Shanghai, Guangxi, Guangdong, Zhejiang, Guizhou, and Hunan). In recent years, the incidence of HB in China has been controlled to some extent, but the incidence of HB has increased in southern China, and the disease has spread geographically in China from north to south. Further research is needed to address this change and to continue to explore the relationship between the incidence of HB and relevant factors.

Associated factors in distinguishing patients with brucellosis from suspected cases.

BACKGROUND: To investigate the risk factors for brucellosis in suspected cases of the disease. METHODS: A self-designed questionnaire was developed to collect data from 3557 people whose initial visit site was the Songyuan Center for Disease Control and Prevention (CDC) from January 1st, 2009 to December 31st, 2012. After collecting blood samples, a plate agglutination test (PAT) and serum agglutination test (SAT) were used to distinguish the patients with brucellosis from the suspected cases. RESULTS: Sex, occupation (farmers and herdsmen), contact with abortion products, and contact with feces were the main risk factors for brucellosis in the suspected cases (all P < 0.05). No difference existed between the confirmed cases and suspected cases in the demographic characteristics, contact with animals (except swine), contact with substances, or clinical symptoms (except fever). However, the confirmed cases showed significant differences from people without brucellosis in demographic characteristics, contact with animals (except cattle and swine), contact with substances, and clinical symptoms. Suspected cases exhibited significant differences from people without brucellosis in the demographic characteristics (except education), contact with animals (except swine), contact with substances (except dust), and clinical symptoms (except chills and acratia). Brucella was cultured from the blood samples of three of 30 suspected cases with fever. Using AMOS-PCR and agarose electrophoresis, the detailed species of Brucella strain was identified as Brucella melitensis. CONCLUSIONS: Abortion products and feces are the main risk factors for brucellosis in suspected cases of the disease. Pyrexia in suspected cases with a history of contact with abortion products or feces should raise suspicion for the disease.

A cost-function approach to rival penalized competitive learning (RPCL).

Rival penalized competitive learning (RPCL) has been shown to be a useful tool for clustering on a set of sample data in which the number of clusters is unknown. However, the RPCL algorithm was proposed heuristically and is still in lack of a mathematical theory to describe its convergence behavior. In order to solve the convergence problem, we investigate it via a cost-function approach. By theoretical analysis, we prove that a general form of RPCL, called distance-sensitive RPCL (DSRPCL), is associated with the minimization of a cost function on the weight vectors of a competitive learning network. As a DSRPCL process decreases the cost to a local minimum, a number of weight vectors eventually fall into a hypersphere surrounding the sample data, while the other weight vectors diverge to infinity. Moreover, it is shown by the theoretical analysis and simulation experiments that if the cost reduces into the global minimum, a correct number of weight vectors is automatically selected and located around the centers of the actual clusters, respectively. Finally, we apply the DSRPCL algorithms to unsupervised color image segmentation and classification of the wine data.