A PRE‐TRAINING ASSESSMENT TOOL FOR HOME DIALYSIS (JPAT)

A tool for assessing the suitability of candidates for home dialysis (Jo‐Pre‐training Assessment Tool version 2.1 — JPAT) was developed, pilot‐tested at one hospital and field‐tested at two major teaching hospitals in Sydney. JPAT acts as a screening instrument to distinguish suitable candidates for the home dialysis programme, identifying patients with the greatest chance of learning to manage the programme. This study included an interview/test of home dialysis patients based on the Medical Outcomes Study Short‐Form 36‐Item Health Survey (SF‐36). JPAT version 2.1 is in the form of an interview questionnaire consisting of 38 assessment items in six domains: physical stability, nutritional status, communication ability, ability to maintain self‐care, psychological suitability and social support. Overall, results suggest that JPAT version 2.1 is sufficiently reliable to be used as a tool for assessing patients who suffer from end‐stage renal disease (ESRD), and to identify patients most likely to succeed in a home dialysis programme.     

中国初期防疟工作简史

中国的防疟工作开始于 194 0年 ,由云南遮放疟疾研究所施行。虽然规模很小 ,但进行得较有系统。该所名义上是前中国卫生署与美国罗氏基金社 (Rock-feller Foundation)合办 ,实际是后者负责一切 ,并由该社驻沪的远东代表 (M.C.Balfour)筹设 (为省篇幅 ,本文中的姓名皆未加称谓 ,并无不敬之意 )。抗日战争开始后 ,我国大部分海岸线被日军封锁 ,为从仰光输入物资 ,遂修筑一条长约 10 0 0 km由昆明到畹町 (中缅边界 )的滇缅公路。云南疟疾为患 ,在唐朝白居易“新丰折臂翁”诗提及 :“闻道云南有泸水 ,椒花落时瘴烟起 ,大军徒涉水如汤 ,未过十…     

The association between HLA genes and radiological erosions in Malaysian patients with rheumatoid arthritis

Objective: To assess the relationship between the HLA-DRB1 genes with disease severity as assessed by radiological erosions in Malaysian patients with rheumatoid arthritis (RA).

Methods: In this cross-sectional study, we studied 61 RA patients who fulfilled the ACR criteria for the diagnosis of RA. HLA-DRB1 genotyping was performed by sequence specific primer (SSP)—PCR. Radiological grading and erosive score of the hands and wrists was calculated according to the Larsen–Dale method. Demographic data and treatment given to the patients were obtained from their case records.

Results: Fifty-six females and five males were studied from three ethnic groups. In 57 patients with erosions, rheumatoid factor was detected in 80%, HLA-DR4 in 40%, HLA-DRB1*0405 in 24% and shared epitope (SE) in 31%. The median delay in starting DMARDs was 24 months. The presence of rheumatoid factor, HLA-DR4 and HLA-DRB1*0405 were not significantly associated with a worse erosive score. Patients who possessed the SE had a higher erosive scores, compared to those who did not (p = 0.05). Concurrently, a delay in starting DMARD was associated with a high erosive score (p = 0.023, r = 0.348). However, after adjustment for the delay in starting DMARD, SE was no longer significantly associated with the erosive score.

Conclusions: In these patients, the delay in starting DMARDs had a greater influence on the erosive score than SE alone. Whilst we cannot discount the contribution of the SE presence, we would advocate early usage of DMARDs in every RA patient to reduce joint erosions and future disability.