Acute rheumatic fever in adult patients

Acute rheumatic fever (ARF) is considered as a disorder of children, and attacks in adults are usually a recurrence of disease acquired in the child’s life. Although the incidence of ARF in children has a decreasing trend in developed countries, resurgent and sporadic epidemics still occur in adults. The first attacks of ARF in adult patients without a childhood history can lead to a diagnostic dilemma.A medical record review in adults at least 18 years of age with an arthralgia complaint fulfilling 2015 revised Jones criteria was performed from January 1, 2000 to December 31, 2019.Eleven ARF patients were identified, including 8 with initial attacks (6 females aged 26–42 years, 33.9 ± 5.3) and 3 pre-existing valvular heart disease with recurrent attacks (2 females aged 38–52 years, 45.0 ± 7.0). In addition to febrile pharyngitis and migratory polyarthritis in initial attacks, pericarditis was encountered in 1, valvulitis in 2, prolong PR interval in 3 and skin involvement in 2 patients with erythema marginatum and IgA vasculitis. All responded to antibiotics and nonsteroidal anti-inflammatory drugs therapy with normalized clinical and laboratory abnormalities, no new-onset carditis, and no recurrent disease during a long-term follow-up (3.8–19.8 years, 12.7 ± 5.4).A sporadic occurrence of adult ARF is observed in southern Taiwan. This disease should be considered by physicians for the differential diagnosis of febrile pharyngitis with arthritis and/or carditis in adults, even in areas with a low incidence of ARF.     

Reference equations of the impulse oscillatory in healthy Thai adults

BackgroundThe ethnicity is significantly under-reported and this may limit the applicability of current impulse oscillometry (IOS) equations to heterogeneous patient populations. Establishing predictive equations for the IOS in the Thai adult population is still required. Therefore, this study aimed to establish reference equations for the IOS in the Thai adult population.MethodsThis retrospective cross-sectional study of IOS parameters in healthy adults aged greater than 20 years old with normal spirometry and who had no chronic respiratory diseases. Pre-bronchodilator (BD) IOS was performed in all subjects. Reference equations were calculated separately for men and women using multivariable linear regression analysis.ResultsA total of 127 subjects (87 men and 40 women) with a mean age of 48.7±17.2 (range, 22–92) years were included. The resistance at 5 Hz (R5), resistance at 20 Hz (R20), and area under reactance curve between 5 Hz and resonant frequency (AX) were significantly higher in women compared to men. The reference equations of the IOS parameters were established for men and women. Age, height, and bodyweight were shown to be the influential predictor as they contributed to the most of IOS indices except for the R5–R20 in men equations. Bodyweight was shown to be the influential predictor as it contributed to the most IOS indices except for the X5 in women’s equations.ConclusionsWe provided the reference equations for the IOS indices in Thai adults. IOS indices including R5, R20, and AX were significantly higher in women compared to men.     

自身免疫多内分泌腺病综合征与成人隐匿性自身免疫性糖尿病

成人隐匿性自身免疫性糖尿病(LADA)可同时伴有肾上腺、甲状腺、性腺等其他内分泌腺的自身免疫性疾病,而成为自身免疫多内分泌腺病综合征(APS)中的一个表现,其共同土壤为免疫耐受的破坏。文章从APS的角度探讨LADA的研究价值。     

Reimagining care for young adults living with type 1 diabetes

Young adults living with type 1 diabetes often struggle to achieve what clinicians consider to be optimal levels of metabolic control. Despite the impact that this can have on a young person''s future risk of complications, there are relatively few studies reporting new ways of organizing or delivering care to this cohort. In this article, we explore some of the reasons why young adult diabetes care is challenging, and describe approaches to “re‐imagining” how care might be improved. The work is informed by the ‘Making Care Fit’ collaborative and by a program of research, entitled D1 Now, involving co‐design of a complex person‐centered intervention with young adults.     

NCCN老年肿瘤临床指引(2005.1版)

1 目录 NCCN老年肿瘤专家组成员（附后） 筛选、评估和结果（SAO—1） 特别需要考虑的问题（SAO-2） 特定年龄组患者的期望寿命的上、中、下四分位数分布情况（SAO—A）     

成人型呼吸窘迫综合征的胸部x线表现

本文对10例 ARDS 病人的胸部甲片进行回顾性分析。发现当临床出现呼吸困难时,7例24小时内所照的胸部平片上,肺部均已出现异常 x 线征象。因此认为胸部 x 光片有助于 ARDS 的早期诊断。发现 PaO_2/FiO_2比值的下降或升高与肺部 x 线的恶化或改善平行.部分患者出现肺部感染(2例),纵隔气肿(2例),等并发症。认为系列胸部照片可判断 ARDS 的改善或进展,并能发现胸部并发症的发生。     

Food Sales and Adult Weight Status: Results of a Cross-Sectional Study in England

Ecological studies often use supermarket location as a proxy measure of the food environment. In this study, we used data on sales at a leading mainstream supermarket chain to explore how area-level supermarket use is associated with overweight and obesity in English adults. Sales data were aggregated to local authority level and joined to a national dataset describing self-reported height and weight and fruit and vegetable consumption. Regression models showed a modest association between higher levels of unhealthy food sales relative to health food sales and increased odds of being overweight and obese. Although effect sizes were small, they persisted after adjustment for area-level deprivation. Supermarket sales data provide additional understanding in the study of food environments and their impact on increasing weight status. Future health policies should consider using ‘big data’ combined with other research methods to address the increasing consumption of unhealthy and highly processed foods.     

成人输尿管结石治疗中小儿输尿管镜的应用

目的探讨分析成人输尿管结石治疗中小儿输尿管镜的应用。方法随机选取我院收治的2012年3月到2014年3月患200例成人输尿管结石,并且将这些患者可以依据随机分配方法将患者分两组,即研究组（100例）和对照组（100例）。给予对照组患者治疗中,采取成人输尿管镜治疗方案,研究组患者治疗中,给予小儿输尿管镜治疗方案,对两组患者临床效果进行观察评定。结果研究组患者经治疗后,其患者临床病情得到明显改善,效果明显,显著高于对照组（P〈0.05）。结论在临床中,对于成人输尿管结石治疗中应用小儿输尿管镜治疗手段,改善患者临床疗效,应用该方法进行治疗,对于输尿管开口狭窄较小、输尿管粘连狭窄、输尿管迂曲的患者,可明显提高输尿管镜碎石成功率,安全、高效,有效治疗疾病。     

双向排斥反应联体动物模型的建立

目的 探讨在异基因成年小鼠之间建立联体模型用以研究双向排斥反应。方法 54只雄性C57BL/6(H-2b,C57)小鼠和54只雌性Balb/c(H-2d)小鼠配对分为3组:1组(注射生理盐水)、2组(注射脾细胞+环磷酰胺)、3组(注射脾细胞+环磷酰胺+环孢素A)。于术中经尾静脉注入对方的脾细胞;术前3d和术后1周每日分别腹腔注射环孢素A(30mg·kg·d^-1);术后2d腹腔注射环磷酰胺(150mg/kg)1次。对经以上处理的部分联体小鼠在术后1周后分开,相互植皮。观察联体维持时间,并分别检测其混合淋巴细胞反应和诱导迟发型超敏反应(DTH)。结果 第3组联体时间明显延长;第3组联体小鼠DTH,2、3组显示明显抑制,但3组小鼠抑制程度明显比第2组小鼠深。结论 应用免疫抑制剂,可成功建立双向排斥反应联体动物模型。     

Services for the Danish Elderly

No abstract available for this article.