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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(2): 124-129, 2020 Feb.
Artículo en Chino | MEDLINE | ID: mdl-32051078

RESUMEN

OBJECTIVE: To study the efficacy and safety of vitamin D as an adjuvant therapy for childhood pneumonia through a systematic review. METHODS: Cochrane Library, PubMed, EMbase, CNKI, Wanfang Data, and Weipu Data were searched for randomized controlled trials (RCTs) of vitamin D as the adjuvant therapy for childhood pneumonia published up to August 2019. Literature screening, quality assessment, and data extraction were performed based on inclusion and exclusion criteria. Revman 5.3 was used to perform the Meta analysis of outcome indicators. RESULTS: A total of 7 RCTs with 1 527 children were included, with 762 children in the vitamin D adjuvant therapy group and 765 children in the control group. The results of the Meta analysis showed that vitamin D adjuvant therapy had no effect on recovery time (P=0.67), length of hospital stay (P=0.73), and time to relief of fever (P=0.43). Furthermore, it did not reduce the recurrence rate (P=0.14), rate of adverse events (P=0.20), and mortality rate (P=0.98) of childhood pneumonia. CONCLUSIONS: Current evidence shows that vitamin D adjuvant therapy has no marked efficacy in the treatment of childhood pneumonia.


Asunto(s)
Neumonía , Vitamina D/uso terapéutico , Niño , Terapia Combinada , Fiebre , Humanos , Tiempo de Internación , Neumonía/tratamiento farmacológico
2.
Orv Hetil ; 161(3): 103-109, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31928060

RESUMEN

Introduction: Autologous hemopoietic stem cell transplantation remains a promising therapy in certain malignant and non-malignant conditions. The procedure, however, will increase the risk of complications, most notably early and late infections. Aim: To analyze the frequency and spectrum of pathogens in early (<+100 days) post-transplant infections and to evaluate risk factors for mortality. Method: Prospectively collected data from 699 patients undergoing autologous hemopoietic stem cell transplantation between 2007 and 2014 at our center were retrospectively reviewed and analyzed. Results: The median age of 699 patients was 56 (interquartile range: 43-62) years, 54% (376) were male. 25 patients have been transferred to other centers and 19 patients were lost to follow up. Neutropenic fever occurred in 69.8% (488) of patients. In addition, 102 infectious episodes in 96 patients were identified. Most commonly bacteremia occurred (49 episodes) with a median onset of 7 (5-11) days. The majority (33/49) of bacteremias have been observed during the pre-engraftment period. Their incidence proved to be higher in patients with malignant lymphoma compared to individuals with plasma cell disorders (p = 0.0005, OR: 2.41, 95% CI: 1.49-3.99). 12 episodes of viral infections and 8 cases of proven or probable invasive mycoses have been identified. Among the 655 patients with complete follow up, 16 in-hospital deaths (2.4%) occurred, 8 of them were associated with infections. Survival was adversely affected by early infections (p = 0.0001). Conclusion: In autologous stem cell transplantation, microbiologically unconfirmed neutropenic fever is common. Documented early bacteremia, however, is infrequent. Lymphoma patients have a significantly higher chance to develop bloodstream infections compared to individuals with plasma cell disorders. Early infections decrease the chance of survival; thus, an effective prophylaxis and therapy remains of paramount importance. Orv Hetil. 2020; 161(3): 103-109.


Asunto(s)
Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Fiebre/etiología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Neutropenia/microbiología , Trasplante Autólogo/efectos adversos , Adulto , Infecciones Bacterianas/mortalidad , Fiebre/epidemiología , Humanos , Hungría/epidemiología , Linfoma , Masculino , Persona de Mediana Edad , Neutropenia/epidemiología , Estudios Retrospectivos
3.
Crit Care ; 24(1): 6, 2020 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-31907075

RESUMEN

Targeted temperature management (TTM) is a complex intervention used with the aim of minimizing post-anoxic injury and improving neurological outcome after cardiac arrest. There is large variability in the devices used to achieve cooling and in protocols (e.g., for induction, target temperature, maintenance, rewarming, sedation, management of post-TTM fever). This variability can explain the limited benefits of TTM that have sometimes been reported. We therefore propose the concept of "high-quality TTM" as a way to increase the effectiveness of TTM and standardize its use in future interventional studies.


Asunto(s)
Paro Cardíaco , Hipotermia Inducida , Temperatura Corporal , Fiebre , Humanos , Temperatura Ambiental
4.
Medicine (Baltimore) ; 99(1): e18613, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895814

RESUMEN

Postoperative fever in pediatric patients following reconstructive hip surgery is of unknown significance. This study identifies the prevalence of postoperative fever after corrective hip surgery, its relationship to infection, and whether preventative use of anti-pyretics affects patient outcomes.Overall, 222 patients who underwent a varus derotational osteotomy (VDRO) between 11/1/2004 to 8/1/2014 with minimum 6 months follow up were retrospectively identified. Variables included diagnosis, inpatient stay, daily maximum temperature, duration of fever, fever workup, and administration of scheduled anti-pyretics. Fever was defined as temperature ≥38°C.In total, 123/222 (55.4%) and 70/222 (31.5%) had postoperative fevers of ≥38°C and ≥38.5°C, respectively. Average inpatient stay was 2.7 days postoperatively. Temperature (mean = 38.0°C) was greatest on postoperative day 1 (POD1), and 43.7% of patients had T ≥38°C on POD1. Anti-pyretics did not influence the duration of fever. Anti-pyretics on the day of surgery (POD0) did not influence the incidence of fever. Acetaminophen on POD0 significantly reduced likelihood of fever on POD1 (P = .02). Average length of fevers ≥38°C and 38.5°C were 8.4 and 4.2 hours, respectively. 3/18 (16.7%) fever workups administered were positive. Postoperative fever did not predict infection. 9/222 (4/1%) patients had postoperative infection - 5/123 (4.1%) with fever ≥38°C and 4/70 (5.7%) with fever ≥38.5°C. Rates of infection in patients with and without fevers were not significantly different (P = .97 for T ≥38°C and P = .38, for T ≥38.5°C).Though common, postoperative fever does not increase risk of infection. The low prevalence of positive cultures indicates routine fever workups can safely be avoided in most patients.Level of Evidence: III, retrospective comparative study.


Asunto(s)
Coxa Vara/cirugía , Fiebre/etiología , Osteotomía/efectos adversos , Complicaciones Posoperatorias/etiología , Niño , Fiebre/epidemiología , Humanos , Los Angeles/epidemiología , Osteotomía/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo
5.
Medicine (Baltimore) ; 99(2): e18727, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914089

RESUMEN

The current study aimed to analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) and to explore the risk factors of critical patients. From 2016 to 2018, we collected the hospitalized diagnosed cases with SFTS in Jinan infectious disease hospital of Shandong University and analyzed by the descriptive epidemiological method. According to the prognosis, they were divided into general group and severe group. The epidemiological characteristics, clinical features, and laboratory indexes of these 2 groups of patients were compared and analyzed at the first visit. The risk factors related to the severity of the disease were analyzed by univariate Logistic regression. In total, 189 cases of SFTS were treated during the period and 33 deaths occurred in the severe group, with the fatality rate of 17.46%. The patients' age (χ = 8.864, P < .01), ALT (Z = -2.304, P = .03), AST (Z = -3.361, P < .01), GLU (t = -4.115, P < .01), CK (Z = -3.964, P < .01), CK-MB (Z = -2.225, P = .03), LDH (Z = -3.655, P < .01), α-HBDH (Z = -2.040, P = .04), APTT (t = -3.355, P < .01), BUN (Z = -2.040, P = .04), Cr (Z = -3.071, P = .01), and D-dimer (Z = -2.026, P = .04) in the severe group were higher than that in the normal group, but the blood platelet (PLT) counts were significantly lower (Z = -2.778, P < .01) than that in the normal group. With the neuropsychiatric symptoms (OR = 24.083, 95% CI = 6.064-95.642), skin bleeding point (OR = 30.000, 95% CI = 6.936-129.764), multiple organ dysfunction (OR = 34.048, 95% CI = 7.740-149.782), past medical history (OR = 3.792, 95% CI = 1.284-11.200), and fasting glucose elevation (OR = 1.359, 95% CI = 1.106-1.668) could predict the severity of the SFTS. In summary, the abnormality of the laboratory index, the special clinical manifestations, and the past medical history of SFTS patients were the important basis for judging the patient's serious condition.


Asunto(s)
Fiebre/epidemiología , Fiebre/fisiopatología , Trombocitopenia/epidemiología , Trombocitopenia/fisiopatología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Glucemia , Comorbilidad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/epidemiología , Recuento de Plaquetas , Pronóstico , Factores de Riesgo , Estaciones del Año , Índice de Severidad de la Enfermedad , Trombocitopenia/mortalidad , Adulto Joven
8.
FP Essent ; 488: 25-34, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31894953

RESUMEN

Acute urinary tract infection (UTI) is among the most common bacterial infections in infants and children. Diagnosis requires evidence of infection and the presence of at least 50,000 colony-forming units (CFU)/mL of a pathogen cultured from an appropriately collected urine specimen. Febrile UTIs (ie, temperature 38°C [100.4°F] or greater) are most common during the first two years of life. Risk factors for UTI in febrile female infants are white race, age younger than 12 months, temperature 39°C (102.2°F) or greater, fever lasting 2 days or more, and absence of another source of infection. For febrile male infants, risk factors include being uncircumcised. If circumcised, risk factors include nonblack race, temperature 39°C (102.2°F) or greater, fever for more than 24 hours, and absence of another source of infection. Antibiotic treatment should be continued for 7 to 14 days. Renal and bladder ultrasonography is indicated for infants ages 2 to 24 months with a febrile UTI. If ultrasonography results are abnormal, a voiding cystourethrogram (VCUG) is indicated. VCUG also is indicated for children with recurrence of febrile UTI to identify vesicoureteral reflux and/or other anatomic findings associated with recurrent UTI. Recent studies have shown a statistically significant benefit of continuous antibiotic prophylaxis for prevention of recurrent UTI.


Asunto(s)
Infecciones Urinarias , Reflujo Vesicoureteral , Profilaxis Antibiótica , Niño , Preescolar , Femenino , Fiebre , Humanos , Lactante , Masculino , Factores de Riesgo
9.
Br J Anaesth ; 124(1): 44-62, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31653394

RESUMEN

Most cases of serotonin toxicity are provoked by therapeutic doses of a combination of two or more serotonergic drugs, defined as drugs affecting the serotonin neurotransmitter system. Common serotonergic drugs include many antidepressants, antipsychotics, and opioid analgesics, particularly fentanyl, tramadol, meperidine (pethidine), and methadone, but rarely morphine and other related phenanthrenes. Symptoms of serotonin toxicity are attributable to an effect on monoaminergic transmission caused by an increased synaptic concentration of serotonin. The serotonin transporter (SERT) maintains low serotonin concentrations and is important for the reuptake of the neurotransmitter into the presynaptic nerve terminals. Some opioids inhibit the reuptake of serotonin by inhibiting SERT, thus increasing the plasma and synaptic cleft serotonin concentrations that activate the serotonin receptors. Opioids that are good inhibitors of SERT (tramadol, dextromethorphan, methadone, and meperidine) are most frequently associated with serotonin toxicity. Tramadol also has a direct serotonin-releasing action. Fentanyl produces an efflux of serotonin, and binds to 5-hydroxytryptamine (5-HT)1A and 5-HT2A receptors, whilst methadone, meperidine, and more weakly tapentadol, bind to 5-HT2A but not 5-HT1A receptors. The perioperative period is a time where opioids and other serotonergic drugs are frequently administered in rapid succession, sometimes to patients with other serotonergic drugs in their system. This makes the perioperative period a relatively risky time for serotonin toxicity to occur. The intraoperative recognition of serotonin toxicity is challenging as it can mimic other serious syndromes, such as malignant hyperthermia, sepsis, thyroid storm, and neuroleptic malignant syndrome. Anaesthetists must maintain a heightened awareness of its possible occurrence and a readiness to engage in early treatment to avoid poor outcomes.


Asunto(s)
Analgésicos Opioides/efectos adversos , Anestesiólogos , Serotoninérgicos/efectos adversos , Síndrome de la Serotonina/terapia , Fiebre/inducido químicamente , Humanos , Complicaciones Intraoperatorias/inducido químicamente , Síndrome de la Serotonina/diagnóstico
11.
Pol Merkur Lekarski ; 47(281): 187-189, 2019 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-31812973

RESUMEN

The prevalence of heart failure (HF) in developed countries exceeds 10% in adults over 70 year old. At the following report we aim to present a case of HF worsening complicated by gout attack. CASE REPORT: 80-year old patient was admitted to the hospital, with the suspicion of pneumonia, because of 3-day history of dyspnoe, cough and fever. Patient reported redness, swelling and pain in the area of left elbow. Prior to admission patient was diagnosed with bursitis and treated with antibiotic without symptoms resolution. There was past medical history of atrial fibrillation, hypertension, intermittent claudication, COPD. One month before, patient was hospitalized due to HF worsening. Diuretics' dosage was increased at that time and symptoms resolved. On admission: blood pressure 145/88 mm Hg, HR 96/min irregular, saturation O2 88% without oxygen therapy. On physical examination, bilateral pulmonary crackles, redness, tenderness of left elbow were found. Laboratory tests demonstrated elevated parameters of inflammation - leukocytosis 13.4G/L, neutrophilia 11G/L, CRP 142.5 mg/L, but normal procalcitonin 0.27 ng/ml. Moreover, high NTproBNP 8573 pg/ml and hyperuricemia 13.1 mg/dl were detected. Chest X-ray indicated pulmonary venous congestion. ECG revealed atrial fibrillation with QRS rate of 100/min, left axis deviation. Therefore, gout attack was diagnosed and after colchicine administration symptoms resolved quickly. CONCLUSIONS: Clinical signs including fever, elevated parameters of inflammation and dyspnoe justify pneumonia consideration in differential diagnosis. Importantly, non-infectious causes of inflammatory conditions, like gout must be also considered. Patients with HF often develop hyperuricemia due to diuretic treatment, aggravated catabolism and often co-prevalent chronic kidney disease.


Asunto(s)
Insuficiencia Cardíaca , Anciano de 80 o más Años , Enfermedad Crónica , Tos , Fiebre , Gota , Humanos
12.
Acta otorrinolaringol. esp ; 70(6): 348-357, nov.-dic. 2019. tab, graf, ilus
Artículo en Español | IBECS | ID: ibc-184880

RESUMEN

Antecedentes y objetivo: El objetivo del estudio ha sido describir los resultados del tratamiento de sinusitis fúngica invasiva con cirugía endoscópica nasal en una población oncológica pediátrica con inmunosupresión e informar sobre la seguridad, la eficacia y las complicaciones del procedimiento. Métodos: Se realizó un estudio retrospectivo de la totalidad de los pacientes con diagnóstico de sinusitis fúngica invasiva operados en la Unidad Nacional de Oncología Pediátrica entre los años 2012 y 2016. Los datos tomados de su historial médico incluyeron: características epidemiológicas, diagnóstico oncológico, datos hematológicos, síntomas, estudios tomográficos, intervenciones quirúrgicas, resultados de enfermedad y cultivos, medicamentos recibidos, complicaciones, evolución y supervivencia. Los datos fueron analizados utilizando estadística descriptiva, las variables continuas con medidas de tendencia central y las variables categóricas de forma porcentual. Resultados: Se identificó a 18 pacientes, 7 de sexo masculino y 11 de sexo femenino. El promedio de edad fue de 12 años, 13 tuvieron diagnóstico de leucemia linfoide aguda y 5 de leucemia mieloide aguda; 17 pacientes presentaron neutropenia severa en el momento del diagnóstico. El agente etiológico más frecuentemente identificado fue Aspergillus en 13 pacientes. En 16 pacientes (89%) se controló la enfermedad con cirugía endoscópica nasal. Diez pacientes fallecieron por causas no relacionadas a lo largo del estudio. Discusión y conclusiones: La sinusitis fúngica invasiva es una enfermedad cuya incidencia va en aumento entre pacientes con inmunosupresión y debe de considerarse una urgencia médica debido a su alta mortalidad. El diagnóstico se basa en un alto índice de sospecha en pacientes con factores predisponentes (leucemia, neutropenia, fiebre persistente, sonda nasogástrica) y la evaluación endoscópica nasal. El tratamiento médico antifúngico y cirugía endoscópica nasal agresiva está indicado independientemente del estado del paciente para disminuir la carga fúngica y la alta mortalidad asociada. El tratamiento debe de ser suministrado por un equipo multidisciplinario que incluye pediatría, hemato-oncología, infectología y otorrinolaringología


Background and objective: to describe the results of the treatment of invasive fungal sinusitis with nasal endoscopic surgery in an immunocompromised paediatric oncological population. Methods: retrospective study of all patients diagnosed with invasive fungal sinusitis operated in the National Paediatric Oncology Unit between 2012 and 2016. Data taken from their medical history included: epidemiological characteristics, oncological diagnosis, haematological data, symptoms, tomographic studies, surgical interventions, results of pathology and cultures, medications received, complications, evolution and survival. Results: 18 patients were identified, 7 male and 11 female. The average age was 12 years, 13 had a diagnosis of acute lymphocytic leukemia and 5 of acute myeloid leukemia. Seventeen patients presented severe neutropenia at the time of diagnosis. The most frequently identified aetiological agent was Aspergillus in 13 patients. In 16 patients (89%) the disease was controlled with nasal endoscopic surgery. Ten patients died due to unrelated causes throughout the study. Discussion and conclusions: Invasive fungal sinusitis should be considered a medical emergency due to its high mortality. The diagnosis is based on a high index of suspicion in patients with predisposing factors (leukaemia, neutropenia, persistent fever, nasogastric tube) and endoscopic nasal evaluation. Antifungal medical treatment and aggressive nasal endoscopic surgery is indicated regardless of the patient's condition to reduce the fungal burden and associated high mortality. The treatment must be provided by a multidisciplinary team that includes paediatrics, haemato-oncology, infectology and otorhinolaryngology


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Sinusitis/diagnóstico , Sinusitis/cirugía , Inmunosupresión , Endoscopía/métodos , Evaluación de Resultados de Intervenciones Terapéuticas , Estudios Retrospectivos , Neutropenia/complicaciones , Aspergillus/aislamiento & purificación , Micosis/complicaciones , Fiebre/etiología , Senos Paranasales/diagnóstico por imagen , Complicaciones Posoperatorias
13.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3869-3875, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31872717

RESUMEN

Mahuang Fuzi Xixin Decoction recorded in Treatise on Febrile Diseases by Zhang Zhongjing in the Han Dynasty have been widely used in treating Yang deficiency and exogenous wind-cold syndrome by traditional Chinese medicine physicians for thousands of years. The indications of Mahuang Fuzi Xixin Decoction include bradyarrhythmia,sinus bradycardia,sick sinus node syndrome,senile exogenous,asthmatic cold,rhinitis,bronchial asthma,optic neuritis,optic atrophy,sudden blindness,sudden onset of cough,laryngeal obstruction,migraine,joint pain,low back pain,insomnia,shock,heart failure,renal failure,accompanied by fever or nosocomial infection,and hyperpyrexia after tracheotomy; dark complexion,chills,cold limbs,listlessness,fatigue,insomnia,lack of thirst,liking hot drinks,slightly swollen limbs or whole body,pale fat tongue,greasy fur,and deep pulse. Mahuang Fuzi Xixin Decoction is a potential drug for Shaoyin disease complicated with fever and pain. Tracheal intubation is an artificial ephedrine syndrome. It is necessary to distinguish Yin and Yang syndrome in treating hyperpyrexia after tracheotomy. However,it belongs to Yin syndrome,which could be treated by Mahuang Fuzi Xixin Decoction. Mahuang Fuzi Xixin Decoction is effective in the treatment of sick sinus syndrome,second degree atrioventricular block and third degree atrioventricular block. It can significantly alleviate symptoms,improve heart rate,and heart rhythm in a short period of time. However,after one year of drug withdrawal,the diseases may recur,indicating that Mahuang Fuzi Xixin Decoction may not improve the long-term prognosis of slow arrhythmia. Mahuang Fuzi Xixin Decoction is often used for fever or nosocomial infection in critical care medicine. In the treatment of critical care medicine complicated with high fever,Mahuang Fuzi Xixin Decoction is often taken continuously by stomach tube.


Asunto(s)
Infección Hospitalaria/tratamiento farmacológico , Neuropatías Diabéticas/complicaciones , Medicamentos Herbarios Chinos/farmacología , Fiebre/tratamiento farmacológico , Infarto del Miocardio/complicaciones , Dolor Postoperatorio/tratamiento farmacológico , Traqueotomía/efectos adversos , Cuidados Críticos , Diabetes Mellitus , Humanos , Medicina China Tradicional , Fitoterapia , Síndrome
14.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3876-3882, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31872718

RESUMEN

Chaige Jieji Decoction recorded in Six Books of Exogenous Febrile Disease could be used to treat exterior syndrome due to wind-cold and heat caused by stagnation. The indications of Chaige Jieji Decoction include acute exogenous febrile diseases,such as influenza,upper respiratory tract infection,nosocomial infection; symptoms and signs,such as headache,eye pain,orbital pain,dizziness; fever,cold and hot exchanges; dry mouth,thirst,cold drinks,bitter mouth,dry throat; dry nose,stuffy nose,runny nose; poor appetite,silent appetite; strong neck,stiff back; insomnia,difficulty in sleeping; cough and sputum; abdominal pain,limb twitching;slightly torrent pulse. Disease involving all three Yang channels is very common in acute exogenous febrile diseases; the pathogenesis of exogenous diseases is quite different between cases in South China and North China. Most of the exogenous diseases in North China involves all three Yang channels. Disease involving all three Yang channels is the core of the pathogenesis of Chaige Jieji Decoction syndrome,in which headache is the key indications. Chaige Jieji Decoction can not only treat exogenous diseases,but also treat nosocomial infections in critically ill patients during hospitalization. Although Chaige Jieji Decoction,Xiaochaihu-Maxing Shigan Decoction,and Xiaochaihu-Daqinglong Decoction could be used to treat disease involving all three Yang channels,there are differences in indicators among them.


Asunto(s)
Infección Hospitalaria/tratamiento farmacológico , Medicamentos Herbarios Chinos/farmacología , Fiebre/tratamiento farmacológico , China , Cuidados Críticos , Humanos , Medicina China Tradicional , Síndrome
15.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3890-3894, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31872720

RESUMEN

The theory of " treating same syndrome with different methods" has been widely used in traditional Chinese medicine( TCM). It originated from Treatise on Febrile and Miscellaneous Diseases,and had objective formation factors. The " syndrome" in TCM was a comprehensive manifestation of etiology,characteristics,disease location and trend of disease. Considering the rich connotation of " syndrome",the diverse treatment methods,and the complex ingredients in prescriptions,different specific methods or prescriptions have been often applied to treat the same syndrome. Therefore,based on the theory of " treating same syndrome with different methods",the concept of " prescriptions corresponding to syndromes" was extended,suggesting one syndrome treated with several different prescriptions. Moreover,the concept of " prescription corresponding to syndrome" doesn't refer to a random match between the " syndrome" and the " prescription". Instead,it would refine and objectify the " same syndrome" and seek subtle differences in symptoms,signs and chemical indicators of different diseases and individuals. It further embodied the new diagnosis and treatment model of " pathogenesis combined with pathology,drug properties combined with pharmacology". As a result,the nature of " treating same syndrome with different methods" lies in different microscopic pathological changes or trends,which traditionally expressed as the same syndrome with different symptoms,the same syndrome with different trends,and the same syndrome with different diseases and the same syndrome with different physiques. Therefore,by enriching the connotation of " syndrome",and further defining its objective pathology and development trend,the correspondence between " syndrome" and " prescription" became more precise. By carefully identifying the different characterizations,trends and prognosis in same syndrome,medical practitioners could give individual and dynamic prescriptions,so as to improve the clinical efficacy.


Asunto(s)
Medicamentos Herbarios Chinos/uso terapéutico , Fiebre/tratamiento farmacológico , Medicina China Tradicional , Humanos , Prescripciones , Síndrome
16.
Zhonghua Xue Ye Xue Za Zhi ; 40(11): 962-964, 2019 11 14.
Artículo en Chino | MEDLINE | ID: mdl-31856450
17.
Acta Neurol Taiwan ; 28(2): 52-56, 2019 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-31867707

RESUMEN

Although it is known that Fabry disease should be included in the differential diagnosis of young stroke and fever of unknown origin, it has not been reported in the literature of stroke with fever as the presentation of Fabry disease. This is relevant because stroke with fever may misguide the differential diagnosis. Here we present a young stroke patient with fever. DWI of brain MRI revealed acute multiple infarctions. Due to the fever, infectious and inflammatory origins such as infective endocarditis and autoimmune diseases were examined first. However, we could not identify the source of fever after fever workup. The fever did not respond to one week of acetaminophen and antibiotics, but responded promptly to steroid. Our patient is also a case of de novo mutation rather than being inherited that further complicates the diagnosis of this patient. Because of the rare combined presentation of stroke with fever, Fabry disease should also be considered in stroke with fever, even without family history of Fabry disease.


Asunto(s)
Enfermedad de Fabry , Accidente Cerebrovascular , Diagnóstico Diferencial , Fiebre , Humanos , Imagen por Resonancia Magnética
18.
Afr J Reprod Health ; 23(3): 30-41, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31782629

RESUMEN

Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention. Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156-4.174], p=.016); within 7 days (OR=1.972, 95% CI: [1.102-3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082-4.172], p=.029) among reproductive health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038- 3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060-3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192-3.366], p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand washing, prevention of malaria.


Asunto(s)
Servicios de Salud Materna/estadística & datos numéricos , Atención Posnatal/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , República Democrática del Congo/epidemiología , Femenino , Fiebre/epidemiología , Encuestas de Atención de la Salud , Humanos , Malaria/epidemiología , Matrimonio , Persona de Mediana Edad , Hemorragia Posparto/epidemiología , Periodo Posparto , Embarazo , Atención Prenatal/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
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