A case series of 8 children supported with extracorporeal membrane oxygenation

<正>Objective The use of extracorporeal membrane oxygenation (ECMO) as a treatment for the failure of cardiopulmonary function after cardiac surgery is increasing and has been reported to be 3% to 5% in the cases with congenital heart disease. We reviewed our experience with ECMO in children who     

Causes and outcome of bacterial meningitis in Malawian children

598 children with bacterial meningitis were admitted to the paediatric wards of the Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi from July 1997 – March 2001. Patients were followed up at 1 and 6 months after hospital discharge when physical, neurological, developmental and hearing assessments were made. The most common causes of pyogenic meningitis were Streptococcus pneumoniae (40%), Haemophilus influenzae type b (28%), Neisseria meningitidis (11%), Salmonella species (5%). There was no growth on culture in 13% of cases. The overall mortality was 31% and 38% were left with significant sequelae. Indicators for a poor prognosis were younger age, lower coma score on admission, bacterial cause, nutritional status and HIV positivity.     

脑脓肿的诊断及治疗

目的：进一步探讨脑脓肿发病情况，影像学表现，选择最佳治疗方法，提高治疗效果。方法：回顾分析１４７裂离脓肿的发病，病因，影像学表现，治疗方法及死亡率下降因素，结果：脑脓肿发病年龄较年青，血源性及隐源性脑脓肿发病率升高，ＣＴ结合ＭＲＩ可明确诊断，选择最佳手术方法。ＣＴ应用后死亡率由２３．８％下降到７．５％，结论：ＣＴ为脑脓肿最主要的诊断方法，ＣＴ定位下穿刺排脓可治愈大部分脑脓肿。     

脑脓肿20例临床分析

目的探讨脑脓肿的临床特点和诊治方法。方法对20例脑脓肿患者的临床资料及治疗方法进行回顾性分析。结果脑脓肿病因以血源性和隐源性为主;经CT及MRI诊断脑脓肿的准确率达90%;手术或保守治疗,治愈15例,好转4例,复发1例。结论脑脓肿血源性和隐源性发病率上升,CT及MRI是早期明确诊断的重要方法,早期诊断及治疗能提高治愈率、降低死亡率。     

93例春季角结膜炎患者的睫毛较长

目的：春季角结膜炎（VKC）是一种主要发生在温带地区儿童的慢性结膜炎，春夏季病情加重。睫毛为眼睛提供天然防护，可阻挡阳光、风和异物，这些因素可加剧VKC患的症状和体征，而对眼睛的机械性保护可使症状减轻。本研究旨在探究VKC患的睫毛长度并同年龄性别相匹配的健康儿童相比较。方法：用数码卡尺测量93例VKC患（4～18岁，平均年龄：8.7岁）的上睑睫毛长度。     

A case series of acanthamoeba keratitis in Singapore

Acanthamoeba keratitis has become an important cause of severe ocular inflammation and visual loss in the past two decades. Its prevalence has been linked to the increasing use of contact lens. Early diagnosis, effective treatment regimes and education on proper contact lens wear are important in the management and prevention of visual loss from this debilitating disease. We described a series of two cases of culture positive acanthamoeba keratitis and their subsequent management.     

93例春季角结膜炎患儿的睫毛变长

目的：春季角结膜炎（VKC）是气候温和区域的儿童罹患的一种慢性结膜炎，该疾病常在春季和夏季加重。睫毛为眼睛提供了对阳光、风沙和异物的自然防护。以上这些因素会加重VKC的症状及体征，而眼睛的机械防护功能可减轻症状。该研究的目的在于比较多例VKC患儿与年龄及性别匹配健康儿童的睫毛长度。方法：使用电子卡钳测量93例VKC患儿（x^-=8．7岁；极差4～18岁）的上睑睫毛长度。评估患儿的病史、临床分类、临床表现类型、疾病严重程度及药物治疗情况。进行皮肤试验及常见过敏原血清特异性免疫球蛋白E、血清总免疫球蛋白E水平、外周血嗜酸性细胞计数及血清嗜酸红阳离子蛋白水平测量。     

小儿急性咽后脓肿的诊断与治疗

目的总结小儿急性咽后脓肿的诊治体会。方法回顾性分析8例小儿急性咽后脓肿患者的临床表现及治疗经过。结果5例首诊儿科并延误诊断。5例进行了颈部影像学检查，诊断准确率为100％。8例中6例经口内脓肿切开引流治愈；2例脓肿突然破裂，1例抢救后治愈，1例因全身感染中毒症状重而死亡。结论小儿急性咽后脓肿易被误诊，影像学检查有助提高诊断准确率，脓肿切开引流是最直接有效的治疗手段，倒提患儿是脓肿突然破裂时实用有效的急救措施。对于全身感染中毒症状较重的患儿，应及早行对症治疗。     

Subcutaneous and brain abscesses caused by Nocardia farcinica in China

ＴｈｅｇｅｎｕｓＮｏｃａｒｄｉａｏｆａｃｔｉｎｏｍｙｃｅｔｅｓｉｓｆｉｌａｍｅｎｔｏｕｓ ,ｂｒａｎｃｈｅｄｂａｃｔｅｒｉａ ,ｆｏｕｎｄｗｏｒｌｄｗｉｄｅｉｎｓｏｉｌｉｎｎａｔｕｒｅ ,ａｎｄａｂｏｕｔ10 0ｓｐｅｃｉｅｓｉｎｔｏｔａｌｗｅｒｅｆｏｕｎｄｕｎｔｉｌｎｏｗ Ｆｏｕｒｍａｉｎｓｐｅｃｉｅｓｗｅｒｅｆｏｕｎｄｔｏｈａｖｅｐａｔｈｏｇｅｎｅｓｉｓｔｏｈｕｍａｎ ,ｔｈａｔｉｓＮｏｃａｒｄｉａａｓｔｅｒｏｉｄｅｓ ,Ｎ ｂｒａｓｉｌｉｅｎｓｉｓ,Ｎ ｏｔｉｔｉｄｉｓｃａｖｉａｒｕｍａｎｄＮ ｆａｒｃｉｎ…     

Biopsy case mix and diagnostic yield at a Malawian central hospital

Cancer is a major disease burden worldwide resulting in high morbidity and mortality. It is the leading cause of mortality in developed countries and is one of the three leading causes of death for adults in developing countries. Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific pathologic diagnosis, effective treatment cannot be planned or delivered. In addition, there are marked geographical variations in incidence of cancer overall, and of the specific cancers seen. Much of the published literature on cancer incidence in developing countries reflects gross estimates and may not reflect reality. Performing baseline studies to understand these distributions lays the groundwork for further research in this area of cancer epidemiology. Our current study surveys and ranks cancer diagnoses by individual anatomical site at Queen Elizabeth Central Hospital (QECH) which is the largest teaching and referral hospital in Malawi. A retrospective study was conducted reviewing available pathology reports over a period of one full year from January 2010 to December 2010 for biopsies from patients suspected clinically of having cancer. There were 544 biopsies of suspected cancer, taken from 96 anatomical sites. The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in biopsies of the oesophagus biopsies (squamous cell carcinoma, 65.1%; adenocarcinoma, 11.6%), breast (57.5%), bladder (squamous cell carcinoma, 53.1%) and stomach (37.6%). Our study demonstrates that the yield of biopsy for clinically suspected malignancy was greater than 50% for the 11 most common sites and provides a current survey of cancer types by site present in the population reporting to our hospital.     

Ankylosing spondylitis in a Malawian

I report a case of ankylosing spondylitis in a Malawian patient. I believe this is the first reported case of ankylosing spondylitis in a Malawian. Ankylosing spondylitis is rare in black Africans when compared with the Caucasian population. The clinical features of this disease are also different in these different racial groups. I will present a brief clinical history and a review of ankylosing spondylitis with special reference to the black African.