Corelation of Cardiac Arhythmias with

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Experiences of living with asthma – a focus group study with adolescents and parents of children with asthma

Objective: The goal for asthma treatment is that every individual, so far as possible, shall live without symptoms and exacerbations. Patients and health care professionals sometimes have different perceptions of what is important for achieving good quality of life. This work aims to describe the experiences among adolescents as well as those of parents with young children living with asthma. Methods: Four focus group interviews were performed, two with parents of young children and two with adolescents. The data were qualitatively analyzed, using Systematic Text Condensation. Result: Three themes relevant to the participants’ experiences of living with asthma were presented; strategies, frustrations and expectations. The adolescents wanted to be like their peers and developed their own strategies for self-management of asthma, which included not always taking medication as prescribed. The parents emphasized frustration regarding not being believed, lack of understanding feelings of loneliness, or anxiety. One identified expectation was that the participants wanted to be met with competence and understanding in asthma care from health care professionals. Another expectation expressed among parents was that teachers in nursery and primary schools should have more knowledge and understanding on how to care for children with asthma. Conclusion: Living with asthma leads to developing personal strategies in self-management of asthma. Moreover both parents and adolescents had expectations of being met by competent and understanding health care professionals. Developing a partnership between patients and health care professionals could be a successful way to improve the care of patients with asthma.     

Correlation of tumor-positive ratio and number of perigastric lymph nodes with prognosis of patients with surgically-removed gastric carcinoma

AIM:To evaluate the tumor-positive ratio and number ofperigastric lymph nodes as prognostic factors of gastriccarcinoma in surgically-treated patients.METHODS:The postoperative survival of 169 patients withgastric cancer who were performed D_2 curative gastrectomywas analyzed with regard to its lymph node metastasis ratioand number.Meanwhile correlation of tumor-positive ratioand number of perigastric lymph nodes with pathologicalparameters of these patients was studied.RESULTS:The overall 5-year survival rate of all the patientsstudied was 29.6%.The 5-year cumulative survival rate inpatients with 1%-20% and more than 20% of tumor-positivelymph nodes was 70.6% and 12.0% respectively,and 46.6%and 17.4% in those with 1-5 and more than 5 of tumor-positive lymph nodes respectively,which were significantlydecreased with the increment of involved lymph nodesassessed by either numbers or ratio (P<0.05).Multiplestepwise regression analysis showed that both the positiveratio and number of tumor-involved lymph nodes weresensitive prognostic factors in these surgically-treatedpatients,which were also significantly correlated with tumorsize and depth of submucosal invasion (P<0.05).CONCLUSION:Tumor-positive ratio and number of perigastriclymph nodes are associated with cancer progression andfive-year survival rate,and may serve as valuable prognosticfactors of gastric cancer in surgically-treated patients.     

Restoration of quality of life of patients with inflammatory bowel disease after one year with antiTNFα treatment

BackgroundInflammatory bowel disease impairs patients' health related quality of life (HRQOL). AntiTNFα agents control disease activity effectively. An ambitious goal of treatment is to achieve the normalization of health. This can be assessed by using a cut-off scoring threshold of the IBDQ-36 questionnaire. It has not been established if antiTNFα treatment is able to restore to normal patients' HRQOL.AimsTo determine whether patients with Crohn's disease (CD) and ulcerative colitis (UC) in clinical remission after one year treatment with antiTNFα agents achieve normalization of their HRQOL.MethodsObservational and cross-sectional study in patients treated with antiTNFα for one year and in sustained clinical remission. Patients completed the specific questionnaire IBDQ-36. Complete restoration of health was considered achieved when global score of IBDQ-36 was higher than 209 points.Results54 patients (43 with CD and 11 with UC) were included. Thirty patients received adalimumab and 24 infliximab. Median global score of the IBDQ-36 was 231, without differences between CD and UC (228 vs 235 respectively, p = ns). Normalization of HRQOL was achieved in all 11 UC patients and in 29 out of 43 CD patients (67%). In our sample population, restoration of health was significantly more frequent in UC than in CD (p < 0.05).ConclusionsOne-year clinical remission induced by antiTNFα treatment restores perception of health to normal in most patients with IBD.     

How does quality of life of patients with systemic lupus erythematosus compare with that of other common chronic illnesses?

OBJECTIVE: Comparison of health related quality of life (HRQOL) of patients with systemic lupus erythematosus (SLE) with other common chronic illnesses. METHODS: Responses from self-administered Medical Outcomes Study Short Form-36 (SF-36) questionnaires from 90 patients with SLE, recorded in the lupus database at the University of Chicago Hospital, were analyzed. Comparative norms and domain scores for patients with other chronic diseases [hypertension, congestive heart failure (CHF), adult onset diabetes mellitus, myocardial infarction, and depression] were used and are based on the general US population. T tests were used to make comparisons. RESULTS: Patients with SLE were younger than patients with most reference chronic conditions except for depression. Their Physical Component Scores and Mental Component Scores were 30 +/- 10.5 and 45.1 +/- 11, respectively. SLE patients fared significantly worse than age matched norms from the general US population for women (p = 0.0001) in all 8 domains. Their quality of life was significantly worse than for those with hypertension, diabetes, or myocardial infarction in all domains (p < 0.004). Patients with CHF were no worse than those with SLE in regard to physical function, role-physical, role-emotional, and vitality. CHF patients fared significantly better in mental health, bodily pain, social functioning, and general health, compared to patients with SLE. Patients with depression were significantly impaired in role-emotional and mental health domains (p = 0.0001) compared to SLE patients, but were no worse (role-physical, vitality, and social functioning) and even better (physical function, bodily pain, and general health) in some. General health of SLE patients was significantly lower than all comparative groups. CONCLUSION: HRQOL of patients with SLE seems to be significantly worse and affects all health domains at an earlier age in comparison to patients with some other common chronic diseases.     

Quality of Life of Pakistani Children with β-Thalassemia Major

Abstract

Compromised quality of life (QoL) has been reported in individuals suffering from β-thalassemia major (β-TM) in Pakistan. However, insufficient data of its associated psychosocial, physical and other disease-related determinants is available. In an observational analytical study, 200 subjects aged between 5-25 years, were examined using a transfusion-dependent QoL (TranQoL) questionnaire. Clinical records and other related data were also gathered from transfusion center databases. The TranQoL mean score was 48.33?±?5.6, ranging from 53.86?±?13.6 for family functioning and support domain to 39.70?±?18.4 for school and career functioning domain. Age, income, education, pre transfusion hemoglobin (Hb), serum ferritin level, pain, death due to β-thal, monetary issues and pain were significantly associated with TranQoL scores. It was not only the clinical conditions but life alterations, social relationship and psychological events also loomed in improvement of treatment outcomes. Therefore, a tetra-cone of patient, school representatives, family and physicians are needed for better patient prospective.     

Incidence of toxoplasmosis in patients with cirrhosis

AIM:It is known that toxoplasmosis rarely leads to variousliver pathologies,most common of which is granulomatosehepatitis in patients having normal immune systems.Patientswho have cirrhosis of the liver are subject to a variety ofcellular as well as humoral immunity disorders.Therefore,itmay be considered that toxoplasmosis can cause morefrequent and more severe diseases in patients with cirrhosisand is capable of changing the course of the disease.Theaim of this study was to investigate the frequency oftoxoplasmosis in patients with cirrhosis.METHODS:Serum samples were taken from 108 patientswith cirrhosis under observation in the Hepatology Polyclinicof the Gastroenterology Clinic,and a control group madeup of 50 healthy blood donors.IFAT and ELISA methodswere used to investigate the IgG and IgM antibodies,whichhad developed from these sera.RESULTS:Toxoplasma IgG and IgN antibody positivity wasfound in 74 (68.5%) of the 108 cirrhotic patients and 24(48%) of the 50 people in the control group.The differencebetween them was significant (P<0.05).CONCLUSION:In conclusion,it was found that thetoxopiasma sero-prevalence in the cirrhotic patients in thisstudy was higher.Cirrhotic patients are likely to form atoxoplasma risk group.More detailed studies are neededon this subject.     

Clinical manifestations of patients with chronic pancreatitis

BACKGROUND: Recent advances in molecular and genomic technologies and pancreatic imaging techniques provided some insights into genetic, environmental, immunologic, and pathobiological factors for chronic pancreatitis (CP). This study was undertaken to investigate the clinical manifestations of patients with chronic pancreatitis at our hospital. METHODS: The data of the patients with CP who had been treated at our hospital between 1997 and 2004 were analyzed. RESULTS: The major symptoms of the patients with CP were abdominal pain, dyspepsia, loss of weight, diabetes mellitus, pancreatic pseudocyst, steatorrhea, and calcification. Biliary diseases were found to be the first cause of CP in this study; but alcohol abuse was the major cause of CP in men and biliary diseases were the first etiological factors for CP in women. The etiological difference of constituent ratio between men and women was related to alcohol comsumption (P<0.01). CONCLUSIONS: During the past 8 years, biliary diseases have been the major etiological factors for CP, but their constituent ratio is decreasing, and the constituent ratio of alcohol abuse is increasing gradually. Alcohol tends to replace biliary diseases as the primary etiological factor for CP.     

Detection of malaria antibodies with ELISA.

The ELISA test for detecting malaria antibodies using the FCC-2 strain of Plas-modium falciparum grown in vitro and prepared on microscopic slides as an antigen wasdescribed. Serum samples obtained from 270 normal subjects and 404 Datients with P.falciparum or P. vivax infections 1-4 months before were tested.     

Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice?

BACKGROUND: Gastroduodenal obstruction is a common preterminal event for patients with gastric and pancreatic cancer who often undergo palliative surgical bypass. Endoscopic palliation with self-expanding metallic stents has emerged as a safe and an effective alternative to surgery, but experience with the technique remains limited. METHODS: Twenty-eight patients hospitalized with GI obstruction because of incurable gastric or pancreatic cancer were recruited for a prospective study of palliation with self-expanding metallic stents. Complications and clinical outcomes were assessed. OBSERVATIONS: Stent insertion was technically successful in 26 patients. Thereafter, 24 patients resumed an adequate liquid or semisolid diet. Stent insertion facilitated hospital discharge for 20 patients. Occlusion of the stent because of tumor ingrowth occurred in 3 patients, but there was no complication related to stent insertion or the stent itself. CONCLUSIONS: Endoscopic placement of a self-expanding metallic stent is a simple, effective means of palliation for patients with malignant gastroduodenal obstruction.     

Time course of total cysteine,glutathione and homocysteine in plasma of patients with chronic hepatitis C treated with interferon-α with and without supplementation with N-acetylcysteine

Background/Aims: Glutathione depletion might be one reason for the low rate of response of patients with chronic hepatitis C to treatment with interferon. The aim of the present study was to document the thiol status of patients with chronic hepatitis C and the effects of N-acetylcysteine, a precursor for glutathione synthesis, on the concentrations of total cysteine, glutathione and homocysteine during treatment of chronic hepatitis C with interferon.Methods: Total cysteine, glutathione and homocysteine in plasma were measured by high performance liquid chromatography, following reduction of disulfides and derivatization of thiols with monobromobimane in a group of 36 patients with chronic hepatitis C, who participated in a multicenter, double-blind, randomized, placebo-controlled clinical trial studying the effect of supplementation with N-acetylcysteine (600 mg three times daily) on the response to treatment with interferon-α (3 MU three times per week) for 6 months.Results: The concentrations of total cysteine (367.0±43.9 vs 360.4±33.5 nmol/ml, mean±95% confidence interval), glutathione (12.5+1.6 vs 14.1+1.3 nmol/ml) and homocysteine (21.2±4.5 vs 19.6±5.2 nmol/ml) were similar in patients with chronic hepatitic C and healthy control subjects. Supplementation with N-acetylcysteine resulted in measurable concentrations of N-acetylcysteine in plasma, but did not significantly increase the concentrations of cysteine, glutathione or homocysteine. There was no difference between the two treatment groups with regard to transaminases and clearance of HCV RNA.Conclusions: Circulating concentrations of total cysteine, glutathione and homocysteine are normal in patients with chronic hepatitis C. Supplementation with N-acetylcysteine did not increase the circulating concentrations of total cysteine, glutathione and homocysteine.     

Treatment of duodenal ulceration with Furazolidine in China preceded the discovery of its association with H pylori

TO THE EDITOR It is not generally known that patients with duodenal ulceration were being treated with an antibiotic, Furazolidone, in China f ive or more years before Marshall and Warren[1] published their seminal paper in 198     

Clinical features of infection with different genotypes of hepatitis C virus

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Can Agitated Behavior of Nursing Home Residents with Dementia Be Prevented with the Use of Standardized Stimuli?

OBJECTIVES: To assess the relative effect of different types of stimuli on agitated behaviors of nursing home residents with dementia. DESIGN: Repeated‐measures design with randomized assignment of conditions. SETTING: Seven Maryland nursing homes. PARTICIPANTS: One hundred eleven nursing home residents with a diagnosis of dementia who exhibited agitation. INTERVENTION: Different types of stimuli (music, social stimuli, simulated social stimuli, and individualized stimuli based on the person's self‐identity) were presented. MEASUREMENTS: Agitation was directly observed and recorded using the Agitation Behavior Mapping Instrument. RESULTS: All stimulus categories were associated with significantly less physical agitation than baseline observations, and all except for manipulative stimuli were associated with significantly less total agitation. Live social stimuli were associated with less agitation than music, self‐identity, work, simulated social, and manipulative stimulus categories. Task and reading stimulus categories were each associated with significantly less agitation than work, simulated social, and manipulative stimulus categories. Music and self‐identity stimuli were associated with less agitation than simulated social and manipulative stimuli. CONCLUSION: Providing stimuli offers a proactive approach to preventing agitation in persons with dementia, with live social stimuli being the most successful.     

Survival of patients with stomach cancer in Changle city of China

AIM: The survival rate of patients with stomach cancer isused to evaluate the effects of treatments.The short- andmid-term survival of patients on the present level of treatmentscan be described by calculating 1- to 5-year survival rates.The aims of this study were to document patterns of survivalafter treatments for stomach cancer in Changle city and analyzewhether the stage of cancer and the way of treatmentimpacted on survival of patients or not.METHODS: A total number of 745 patients with stomachcancer reported in the Changle Cancer Registry from 1993to 1998 were investigated with respect to the diseasecondition,the way of treatment and survival time.1- to 5-year survival rates were estimated by using life-tablemethod.RESULTS: The 1- to 5-year survival rates in the patientswith stomach cancer in Changle city were 54.23%,41.77%,37.95%,33.98% and 30.47%,respectively.The 1- to 5-yearsurvival rates in stageIor Ⅱ group were 3,6.1,7.4,8.9and 9.8 times as high as those in stage Ⅲ or Ⅳ group,respectively.The 1- to 5-year survival rates in operationgroup were 3.5,8.7,11.2,11.7 and 19 times as high as thosein no operation group,respectively.For the patients with stageⅢ or Ⅳ stomach cancer the 1-year survival rate in operationgroup was 3 times as high as that in no operation group and 2-year survival rate in operation group was 11.9 times as high asthat in no operation group.For the patients with stage Ⅲ or Ⅳstomach cancer,the differences of the survival rates averagesurvival times between total gastrectomy and partialgastrectomy were not significant and the median survival timesin these 2 groups were 8 mo and 9 mo,respectively.CONCLUSION: Mid-term survival rates of patients withstomach cancer in Changle city are low.Stage of cancer isan important factor influencing survival of patients withstomach cancer.Surgery is an effective treatment for thepatients with stage Ⅳ cancer and can raise short- andmid-term survival rates.Total gastrectomy should not beencouraged for the patients with late stage of cancer.     

Association of urotensin Ⅱ with angiographic severity of coronary artery disease

Objective The goal of this study was to examine the association between urotensin Ⅱ (U Ⅱ) concentration and the severity of coronary artery disease (CAD). Methods We studied U Ⅱ concentrations in 100 patients with known or suspected CAD referred for cardiac catheterization. Based on coronary angiograms, subjects were classified as having no or mild CAD (stenosis ＜50%) and significant CAD (stenosis=50%). Micheal score system was used to estimate the severity of CAD. Result U Ⅱ concentration in the significant CAD group had no difference compared with the no or mild CAD group (1.95±1.18 pmol/L vs 2.04±1.47 pmol/L, P＞0.05),but higher in the severe group (score =9) than in the normal or nearly normal group (score＜3)( 2.50±1.62 pmol/L vs 1.61±1.05 pmol/L,P=0.03). U Ⅱ concentration had no relationship with other known risk factors, but it correlated with CAD severity (r=0.213, P=0.034).In multiple regression analysis, U Ⅱ is one of the determinants of the severity of CAD, other than age, abnormal glucose, hypertension and gender. Conclusios U Ⅱ is elevated in severe CAD and there is a significant relationship between U Ⅱ concentration and CAD severity.     

Association of CT perfusion imaging with plasma levels of TGF-β1 and VEGF in patients with NSCLC

Objective: To study the association of CT perfusion imaging parameters with plasma level of transforming growth factor-β1(TGF-β1) and vascular endothelial growth(VEGF) in patients with non small cell cancer(NSCLC). Methods: A total of 67 patients with NSCLC(NSCLC group) and 64 patients with benign lesion(control group) were given with CT perfusion imaging to obtain blood flow, blood volume, mean transit time, time to peal and permeability surface through CT perfusion software. The plasma levels of TGF-β1 and VEGF were tested by ELISA. The relationship between plasma levels of TGF-β1, VEGF and CT perfusion imaging parameters were analyzed. Results: CT perfusion imaging parameters and the plasma levels of TGF-β1 and VEGF of NSCLC group were significantly higher than the control group(P0.05), while CT perfusion parameters and the levels of TGF-β1 and VEGF in NSCLC group showed significant difference in different tumor node metastasis stages(P0.05). Correlation analysis showed that the level of plasma TGF-β1 and VEGF were positively correlated with blood flow, blood volume, and mean transit time(P0.05), and negatively correlated with time to peal(P0.05). There was no significant correlation between TGF-β1 and VEGF with the permeability surface. Conclusions: CT perfusion imaging parameters in patients with NSCLC is closely associated with plasma TGF-β1, VEGF and its biological characteristics. CT perfusion imaging is a convenient method to detect tumor blood perfusion.