Hospital control and multidrug-resistant pulmonary tuberculosis in female patients, Lima, Peru

We examined the prevalence of tuberculosis (TB), rate of multidrug-resistant (MDR) TB, and characteristics of TB on a female general medicine ward in Peru. Of 250 patients, 40 (16%) were positive by sputum culture and 27 (11%) by smear, and 8 (3%) had MDRTB. Thirteen (33%) of 40 culture-positive patients had not been suspected of having TB on admission. Six (46%) of 13 patients whose TB was unsuspected on admission had MDRTB, compared with 2 (7%) of 27 suspected cases (p = 0.009). Five (63%) of 8 MDRTB patients were smear positive and therefore highly infective. In developing countries, hospital control, a simple method of reducing the spread of MDRTB, is neglected.     

河南省活动性肺结核病人发现状况分析

目的　反映河南省活动性肺结核病人发现水平。方法 根据河南省2000年第四次全国结核病流行病学抽样调查数据中病人发现情况进行分析。结果 结防机构仅登记、管理了5.1%的活动性肺结核病人;88.6%的肺结核病人在非结防机构确诊,其中93.6%未转诊、登记。结论 加强各级综合医疗机构结核病归口管理是提高病人发现水平的关键。     

Prevalence of Schistosoma intercalatum and S. haematobium Infection among Primary Schoolchildren in Capital Areas of Democratic Republic Of S?o Tomé and Príncipe,West Africa

Background

A parasitological survey of Schistosoma haematobium and S. intercalatum infection among primary schoolchildren in capital area of Democratic Republic of São Tomé and Príncipe (DRSTP) was undertaken.

Methods

Subjects with positive infection were confirmed by the detection of S. haematobium ova in the urine or S. intercalatum ova in the stool by using centrifugation concentration or merthiolate-iodine-formalin concentration method. Totally, 252 urine and stool samples, respectively, were obtained from apparently healthy schoolchildren, of which 121 from boys (9.8 ± 1.4 yr) and 131 from girls (9.7 ± 1.3 yr).

Results

None of participating schoolchildren were found having S. haematobium ova in the urinary specimen. While, among 4 primary schools studied, only schoolchildren from Saint Marçal were detected with S. intercalatum ova in the fecal specimen, making the overall prevalence of S. intercalatum infection among schoolchildren was 2.4% (6/252) and girls had insignificantly higher prevalence (3.1%, 4/131) than that (1.7%, 2/121) in boys (χ² = 0.5, P = 0.5).

Conclusion

Water control and sanitation as well as snails eliminated by molluscicides are urgently needed to reduce S. intercalatum infection in DRSTP inhabitants.     

Effects of Dracaena arborea(Dracaenaceae) on sexual dysfunction in 4 weeks hyperglycemic male rats

Objective:To investigate the effects of Dracaena arborea(D.arborea) on the sexual behavior parameters in experienced type-1 diabetic rats.Methods:Aqueous and ethanol(100 and 500mg/kg respectively)extracts of dried root barks of D.arborea.sildenafil citrate(1.44 mg/kg),trimethylamine-N-oxide(TMAO,20 mg/kg)and distilled water(110 mL/kg.were orally administered to 4 weeks streptozolocin-induced diabetic rats.Mount latency and frequency(ML.MF),intromission latency and frequency(IL,IF) and post-ejaculatory interval(PEI) were measured by ejaculating series during 90 min once a week for 4 weeks.Glycemia was determined at the beginning and at the end of the treatment Results:D.arborea did not show any major antihvperglycemic effects.Compared to the control group,a significant(P0.05-0.001)increase in MF and IF was noticed in rats treated with sildenafil citrate(89.71% and 90.07% respectively),aqueous(500 mg/kg.88.08%and 88.749;respectively) and ethanol(100 mg/kg;89.53%and 89.17respectively) extracts of D.arborea after two weeks(series 1) of treatment.ML,IL and PEI were significantly(P0.05-0.001) decreased after 4 weeks of daily treatment[sildenafil citrate(96.31.96.31%and 34.98%),and D.arborea aqueous 500 mg/kg(94.33.94.33% and 66.609;i and ethanol extracts 100 mg/kg(96.98.97.089;and 64.26%)].Conclusions:These aphrodisiac potentials of D.arborea in experienced diabetic rats could be due to the antioxidant and androgenic properties of phenols,flavonoids.saponins and sterols revealed in the plant extracts.     

山东省结核病控制项目病人发现情况分析

目的：对世界银行贷款山东省结核病控制项目的病人发现工作一个全面的评析，对今后工作提出建设性意见。方法：对各市地上报到省结防中心的季度报表资料进行统计分析。结果：在项目开展的第四年项目覆盖全部人口，共发现结核病人196588例，其中143571例为涂阳肺结核病人。可疑者就诊率为1．6‰，涂阳新登记率平均为17．2／1万，涂阴涂阳比例为0．4：1。结论：病人发现成果显著，共有19万多各类病人被登记。涂阳新登记率不高，主要因可疑者就诊率及痰检率偏低而致，涂阴病人的登记也较小。     

糖尿病合并菌阳肺结核32例临床分析

目的 分析研究糖尿病合并菌阳肺结核的发病趋势,病变特点,疗效及转归。方法 对519例肺结核病人合并糖尿病51例中(9.8％)的菌阳肺结核32例进行临床分析。结果 显示糖尿病合并肺结核的例数,呈明显上升趋势,糖尿病合并菌阳肺结核比例明显高于菌阴肺结核,且糖尿病合并菌阳肺结核发病年龄,并发空洞的机会,复治比例,多耐药及持续菌阳比例均明显高于单纯菌阳肺结核。本组痰菌阴转时间平均为2.93月,较单纯菌阳肺结核痰菌阴转时间平均1.8月,明显延迟(p<0.01)。结论对于糖尿病合并菌阳肺结核病例,必须从一开始即采用强杀菌力的正规化疗方案,并确保足够疗程,根据耐药情况及时调整化疗方案,同时积极治疗控制糖尿病,才能获得满意疗效。     

Why are some doctors high-prescribers of benzodiazepines and minor opiates? A qualitative study of GPs in Norway

BACKGROUND: Registration studies have shown great variations in prescribing volume and prescribing patterns of benzodiazepines (BZDs) and minor opiates among GPs. OBJECTIVES: We aimed to form a basis for hypotheses and build theories about prescribing, in order to investigate how high-prescribing doctors can legitimize their own prescribing pattern. METHODS: A qualitative interview study of doctors with previously known high, medium and low prescribing volumes was performed. The interpretation focused on the doctors' self-explanations and how they influence their daily decision of prescribing. RESULTS AND CONCLUSIONS: It was a striking feature that many of the attitudes towards the drugs were common both within and between the three groups of prescribers. All doctors regarded the task of prescribing as difficult, and the great majority strongly advocated restriction in prescribing. In order to cope with daily practice and to live with high prescribing volumes, doctors make use of effective working strategies. These strategies, of ascribing responsibility to the previous doctor, to patient autonomy and responsibility, to the patient's age and to concomitant diseases, are described in this study. An allocation of responsibility to other persons or circumstances delimits the doctors' professional discretion in this matter. Striking differences between prescriber groups were not found in the analysis, but when all small tendencies in all steps of the decision-making process were added, a clear trend was revealed.