Features of Asthma in Older Adults

A study compared clinical and functional features of elderly patients with asthma to younger patients at a university medical center. Older patients had a larger than predicted reduction in pulmonary function parameters even though physician-assessed severity, duration of diagnosed asthma, and smoking status were no different between groups. A significant increase in the comorbid diagnosis of chronic obstructive pulmonary disease was noted in older patients with asthma. These two points support the hypothesis that long-standing asthma may lead to irreversible airflow obstruction. Older patients reported better medication compliance and decreases in some respiratory symptoms and demonstrated lower health care utilization.     

95例发热待查病因分析

目的:总结分析最近2年住院发热待查患者的病因,为临床诊断治疗提供参考。方法:收集我院感染科2014年9月—2016年8月体温38.5℃以上、持续时间2周以上所有符合标准的患者95例,根据出院诊断和实验室检测结果,分析患者发热原因。结果:感染性疾病69例(72.63%),非感染性疾病21例(22.11%),不明原因者5例(5.26%)。感染性疾病中细菌感染最多(66.67%),病毒感染其次(21.74%),所有感染性疾病中,病原学明确者接近一半(47.83%)。非感染性疾病中,结缔组织病最多(52.63%)。所有病例中有明确实验室证据者占51.58%。结论:感染科发热待查主要病因仍然以感染性疾病为主,目前快速准确的诊断在一定程度上仍然依赖以临床综合分析为主,实验室病原学诊断方法有待提高。     

Agreement of decision analyses and subsequent clinical studies in infectious diseases

Purpose

Decision analysis techniques can compare management strategies when there are insufficient data from clinical studies to guide decision making. We compared the outcomes of decision analyses and subsequent clinical studies in the infectious disease literature to assess the validity of the conclusions of the decision analyses.

Methods

A search strategy to identify decision analyses in infectious disease topics published from 1990 to 2005 was developed and performed using PubMed. Abstracts of all identified articles were reviewed, and infectious disease-related decision analyses were retained. Subsequent clinical trials and observational studies that corresponded to these decision analyses were identified using prespecified search strategies. Clinical studies were considered a match for the decision analysis if they assessed the same patient population, intervention, and outcome. Agreement or disagreement between the conclusions of the decision analysis and clinical study were determined by author review.

Results

The initial PubMed search yielded 318 references. Forty decision analyses pertaining to 29 infectious disease topics were identified. Of the 40, 16 (40%) from 13 infectious disease topics had matching clinical studies. In 12 of 16 (75%), conclusions of at least 1 clinical study agreed with those of the decision analysis. Three of the 4 decision analyses in which conclusions disagreed were from the same topic (management of febrile children).

Conclusions

There was substantial agreement between the conclusions of decision analyses and clinical studies in infectious diseases, supporting the validity of decision analysis and its utility in guiding management decisions.