Baseline clinical and radiographic features are associated with long-term (8 years) signs/symptoms for subjects with diseased temporomandibular joint.

OBJECTIVES: The purpose of this study was to determine the extent to which baseline clinical and radiographic features were associated with long-term outcomes in patients with temporomandibular joint disorder (TMJD). METHODS: 49 patients with unilateral radiographically proven TMJD were available in this study. Self-reported long-term (mean 96.2 months) outcomes (current joint pain, maximum mouth opening and joint noise) after TMJD treatments were assessed by questionnaire. The impact of multiple initial clinical/radiographic findings (gender, age at first visit, time interval between first visit and questionnaire survey, treatment method, disc displacement, disc morphology, disc mobility, condylar bony change and morphology of the articular eminence) on the long-term outcomes was assessed using stepwise multiple regression and logistic regression analysis. RESULTS: Patient age at the first visit was significantly correlated with current joint pain. Disc mobility and morphology of the articular eminence were significantly correlated with current range of maximal mouth opening. CONCLUSIONS: The results of this study suggest that patients who appeared symptomatic at a younger age or who initially had a fixed disc were the most likely to have recurrent or persisting clinical signs/symptoms of TMJD after 8 years.

Retrospective analysis of bacteremia because of Enterobacter cloacae compared with Escherichia coli bacteremia.

A total of 52 patients of Enterobacter cloacae bacteremia from a University hospital during the period from January 2000 to June 2005 were analysed and compared with a reference group comprising 52 patients of Escherichia coli bacteremia. Overall, E. cloacae ranked the tenth in all pathogens of bacteremia accounting for 2.8% of the total patients. Although the incidence of E. cloacae bacteremia was low, the attributable mortality rate till achieved 13.5%. Most patients (86.5%) with E. cloacae bacteremia were hospital-acquired. The overwhelming majority of patients (92.3%) were men, while almost half of the patients (48.1%) were from the Department of Urological Surgery with underlying diseases such as urinal obstruction, kidney transplantation and kidney tumours. Possible risks factors associated with E. cloacae bacteremia included immunocompromised status, long-term hospitalisation and invasive procedures or surgeries. E. cloacae bacteremia significantly differed from E. coli bacteremia in a number of clinical aspects, including underlying diseases, portal of entry, infection type, risks factors, laboratory findings and appropriateness of empirical antibiotic therapy. Besides the high prevalence of resistance to cephalosporins, most E. cloacae blood isolates were also resistant to ciprofloxacin (resistance rate, 67.3%), gentamicin (73.1%) and tobramycin (73.1%). Based on the findings of the present study, E. cloacae is probably an important pathogen of bacteremia occurring in male patients with underlying urinal system illnesses.

Fever of unknown origin: a report from China of 208 cases.

Fever of unknown origin (FUO) is a clinical dilemma in western countries and in China. To investigate the causes and prognosis of FUO, 208 patients with FUO admitted to a large university hospital in China were investigated. The final diagnoses established in 158 cases (75.96%) were: infectious disease in 66 cases (31.73%), collagen vascular disease in 46 patients (22.11%), neoplasm in 35 cases (16.83%), and other disease in 11 patients (5.29%). In 66 cases with infectious disease, tuberculosis, septicaemia and typhoid fever were the principal causes. SLE and adult Still's disease were the most important causes among collagen vascular disease. Lymphoma and malignant histiocytosis were mostly associated with FUO among neoplasms. In 50 cases (24.04%), the cause of fever was not found. On discharge from hospital, fever had subsided in 133 cases (63.94%), and had persisted in 63 cases (30.29%); 12 patients (5.87%) died. In China, infectious disease, collagen vascular disease and neoplasm are the main causes of FUO. While most patients recover, there are some differences in the distribution of causes between the West and China, and there are relatively more deaths than in previous reports.