Gender-specific associations between activities of daily living disability and depressive symptoms among older adults in China: Evidence from the China Health and Retirement Longitudinal Study

PurposeTo evaluate the associations between BADL/IADL disability and depressive symptoms from the perspective of gender among older adults in China.MethodsThis cross-sectional study used the data from the second wave of the China Health and Retirement Longitudinal Study (CHARLS). The sample included 3463 older adults aged 60 years and older across China. Multivariable logistic regression models were conducted.ResultsAmong 3463 older adults, 1240 (35.8%) were classified as depressed, the prevalence of BADL and IADL disabilities were 756 (21.8%) and 1194 (34.5%), respectively. After controlling for covariates, BADL/IADL disability was significantly associated with an increased risk of depression prevalence both in men and women among older adults. Compared with IADL independent, IADL disability was about two times more likely to develop depressive symptoms in men (OR = 2.165, 95% CI = 1.661–2.822), which was much higher than that in women (OR = 1.748, 95% CI = 1.415–2.160). In contrast, the odds of being depressed for women with BADL disability (OR = 1.824, 95% CI = 1.447–2.299) were much higher than the odds for men with BADL disability (OR = 1.791, 95% CI = 1.348–2.379).ConclusionsOlder adults with BADL/IADL disability were more likely to have depressive symptoms both for men and women. However, the associations between depressive symptoms and BADL/IADL disability were different in gender. Our results suggest that differential institutional care service and appropriate strategies for improvement in mental health are required.     

A systematic review of ultrasound imaging as a tool for evaluating haemophilic arthropathy in children and adults

The purpose of this study was to semi‐quantitatively assess the evidence on the value of ultrasound (US) for assessment of haemophilic arthropathy (HA) in children and adults based on the following questions: (1) Does early diagnosis of pathological findings, using available US techniques, impact the functional status of the joint? (2) Do current available US techniques have the ability to accurately detect pathological changes in target joints in haemophilic patients? (3) Does treatment (prophylaxis) improve US evidence of haemophilic arthropathy in children and adults? (4) Is there any association between various US scoring systems and other clinical/radiological constructs? Of the 6880 citations identified searching databases such as MEDLINE, Embase, CENTRAL and Web of Science, 20 articles investigating either the diagnostic accuracy of US and/or US scanning protocols and scoring systems for assessment of HA met the inclusion criteria for the study. Of these, 14 articles evaluating the diagnostic accuracy of US were assessed by two independent reviewers for reporting quality using the Standards for Reporting of Diagnostic Accuracy (STARD) tool and for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS‐2) tool. Using STARD, 1/14 studies (7%) was scored as of high reporting quality and 8/14 (57%), of moderate quality. Assessment with QUADAS‐2 reported 2/14 (14%) studies as having high methodological quality and 6/14 (43%) as having moderate quality. There is fair evidence (Grade B) to recommend US as an accurate technique for early diagnosis of HA, to demonstrate that US scores correlate with clinical/US constructs and to prove an association between US findings and functional status of the joint. However, there is insufficient evidence (Grade I) to conclude that US‐detectable findings in HA are sensitive to changes in therapy.     

先天性畸形围产期干预的系统化管理

目的报告对产前诊断先天性畸形的围产期干预进行系统化管理的实践经验，并讨论相关问题。方法本管理模式由“产前诊断和分娩中心”与“新生儿治疗及随诊中心”组成，两个中心随时保持业务交流与合作。管理模式的运行：超声科及产科医生通过超声等影像学检查发现畸形，家长到新生儿外科门诊咨询，必要时学科问进行业务交流与讨论，按计划分娩，并根据病情选择：配备转运暖箱的救护车接诊、普通救护车常规转诊、或留产院观察及出院后到新生儿外科门诊。转诊患儿急诊手术、择期手术或观察。结果2003年3月至2008年12月本院共接待经产前超声诊断各种类型先天性畸形的产前咨询与诊疗共322例。其中34例（10．6％）引产或生后放弃治疗；89例通过各种方式转诊至本院；76例（23．6％）于新生儿期手术，治愈率为89．5％；212例（65.8％）继续妊娠或出生后观察。结论本管理模式为适应我国现实医疗环境和北京市医疗资源配置的具体情况而建立，可以使患儿（及准父母）得到产前诊断、咨询、监测，生后转运、治疗及随访的系统化管理，对进一步提高先天性畸形的总体治疗水平起到了积极作用。     

A brief history of photodynamic therapy in Wrocław

A brief history of photodynamic therapy in Wroclaw was presented in this paper.     

Personalized Medicine: A Reality Within this Decade

Personalized medicine is defined as individualized treatment based on the individual’s genetic variants. Such treatment has the potential to enable pharmacogenetics, such as the prevention of 100,000 deaths per year in the USA because of adverse drug reactions or specify treatment in heart failure such at the beta 1 adrenergic receptor polymorphisms. It is claimed that coronary artery disease (CAD) is at least 50% because of genetic predisposition. Identification of the genes predisposing to CAD would greatly facilitate prevention, early treatment, and more specific therapies. The arrival of the multimillion single nucleotide polymorphism (SNP) array provides the high throughput genotyping required to perform genome-wide Association (GWA) studies. These studies require markers (SNPs) at intervals of 6,000 bp and sample size of several thousands. Platforms are available to genotype and process millions of genotypes per day. The GWA performed by the Ottawa Heart Genomic Study identified the first deoxyribonucleic acid region (9p21) predisposing to CAD after replication in six independent populations totaling 23,000. This was subsequently confirmed in several independent studies totally more than 45,000 individuals. The region confers a risk for CAD independent of known risk factors. 9p21 occurs in heterozygous form in 40 to 50% of Caucasians with increased risk of 15 to 20% and in homozygous form in 25% of Caucasians with increased risk of 40%. Identification of the genes predisposing to CAD is a prerequisite for personalized care of these patients. It is anticipated that most of the genes predisposing to CAD will be identified in the next 5 to 8 years. The 9p21, in addition to conferring increased risk, provides the bonus of being independent of known risk factors. Thus, 9p21 is likely to provide the impetus and nidus for a major research effort over the next few years. It has the potential to not only provide for early genetic screening but also as a target for novel therapy.     

Phosphodiesterase 4D Gene and Risk of Noncardiogenic Ischemic Stroke in a Korean Population

Recently published studies from different populations provide apparently conflicting evidence on the association between the phosphodiesterase 4D (PDE4D) gene and ischemic stroke. The relationship between a representative PDE4D genotype and ischemic stroke was explored in a case-control study of 205 consecutive Korean patients with noncardiogenic ischemic stroke and 103 healthy controls who were neurologically and radiologically proven to be stroke-free. We selected and genotyped a PDE4D single nucleotide polymorphism (SNP 41, rs152312) as a candidate marker for susceptibility to ischemic stroke because SNP 41 has shown the most significant association with stroke in both a meta-analysis and the original Icelandic study of the PDE4D gene. No significant difference was observed between the cases and controls in the distribution of the PDE4D SNP 41 genotypes. The results from the adjusted conditional logistic regression analysis (adjusted for age, hypertension, diabetes and smoking status) showed no significant association between PDE4D SNP 41 genotypes and an increased risk of noncardiogenic ischemic stroke. The PDE4D gene is not a major risk factor for noncardiogenic ischemic stroke in a Korean population, which supports the recent evidence suggesting that the causative genetic variants of ischemic stroke may differ across populations.     

Comparative Update on Documentation of Trauma in Seven National Registries

Abstract Introduction: The role of trauma documentation systems for trauma research has continuously increased since the first trauma registries were developed in the late 1980s. Data acquisition and processing improved highly, partly because modern computer and network technologies offer new approaches. International comparison is important for the learning process and the investigation of differences in the mechanisms of injury, rescue systems and treatment protocols. We demonstrate keypoints of the learning curve thus supporting a further spreading of trauma registries. Methods: Seven exemplary trauma registries from the United States, Canada, Victoria (Australia), United Kingdom, France, Germany and the new European Trauma Audit and Research Network registry were analyzed according to their development until the current status. Special investigations were conducted for data acquisition, inclusion criteria and the volume and characteristics of patient data. Results: We found a clear overall beneficial influence of the documentation systems on the respective trauma system. Data acquisition displayed a wide range of difference from paper forms being entered into a centralized database by hand to direct entry of the data into the database by a local user via an Internet platform. Some systems copy computerized patient data from local hospital systems. Two registries are available in two languages. One has the option to add further languages as demanded. Datasets are comparable in terms of general data and a compulsory trauma diagnosis. Still, the details of the documented period of care and the inclusion criteria differ considerably. Discussion: We describe the important role of several trauma registries within a trauma care system. Although the success is hard to measure, related publications, continuous growth, the official use for quality control and the demand to participate by other countries stress their wide spread acceptance (secondary internationalization). These advantages make trauma registries a valuable tool in many countries.     

Role of routine coagulation studies in idiopathic epistaxis

Epistaxis, being the commonest ENT emergency requiring hospital admission, is clearly an important condition — not only to the specialist but also to any general practitioner. The role of routine coagulation studies in the management of patients suffering from epistaxis is unclear. In an attempt to address this issue, the prospective case study was carried out in the department of ENT in Government medical college and hospital Nagpur over span of 2 years from October 2001 to November 2003 in which 100 cases were studied. Coagulation studies were carried out in 100 patients but only 7 patients had abnormal coagulation profile. No other coagulation abnormalities were identified. This study supports the view that there does not appear to br role for routine coagulation studies in patients of epistaxis. The investigation for potential haemostatic disorder should be performed when clinically indicated and if necessary, in consultation with the hematology service.