Clinical features and diagnostic approaches for abdominal tuberculosis: five-year experience from a non-tuberculosis-designated hospital in China

Background and purpose: abdominal tuberculosis (TB) is a common form of extrapulmonary TB but it is still a diagnostic dilemma in clinical practice. This study aimed to highlight the clinical features and diagnostic approaches for abdominal TB.Methods: seventy cases of diagnosed abdominal TB were retrospectively collected between August 1st, 2015 and June 30th, 2020. They were classified as peritoneal TB, lymph node TB, gastrointestinal TB, visceral TB or mixed TB.Results: eighteen patients were diagnosed with peritoneal TB, nine with lymph node TB, five with gastrointestinal TB, two with visceral TB and 36 with mixed TB. More than 65 % of the patients had tuberculosis of other sites except the abdomen. The median diagnosis time was 60 days. Ascites (58.6 %), abdominal distension (48.6 %), weight loss (44.3 %) and fever (42.9 %) were the most common symptoms. The overall microbiological and histological detection rates were 70.0 % and 38.6 %, respectively. The non-ascite samples yielded a higher microbiological confirmation rate (63.6 %) than the total samples (40.8 %). Diagnosis was confirmed histologically in 18 patients (69.2 %). Forty-five cases (64.3 %) were clinically diagnosed. Invasive procedures such as surgery (6/7), percutaneous biopsy (7/7) and endoscopy in lymph node TB (4/5) had high confirmation rates.Conclusions: the diagnosis of abdominal TB should be reached by a combination of clinical, laboratory, radiological, microbiological and pathological findings. (AU)

Clinical features and diagnostic approaches for abdominal tuberculosis: five-year experience from a non-tuberculosis-designated hospital in China.

BACKGROUND AND PURPOSE: abdominal tuberculosis (TB) is a common form of extrapulmonary TB but it is still a diagnostic dilemma in clinical practice. This study aimed to highlight the clinical features and diagnostic approaches for abdominal TB. METHODS: seventy cases of diagnosed abdominal TB were retrospectively collected between August 1st, 2015 and June 30th, 2020. They were classified as peritoneal TB, lymph node TB, gastrointestinal TB, visceral TB or mixed TB. RESULTS: eighteen patients were diagnosed with peritoneal TB, nine with lymph node TB, five with gastrointestinal TB, two with visceral TB and 36 with mixed TB. More than 65 % of the patients had tuberculosis of other sites except the abdomen. The median diagnosis time was 60 days. Ascites (58.6 %), abdominal distension (48.6 %), weight loss (44.3 %) and fever (42.9 %) were the most common symptoms. The overall microbiological and histological detection rates were 70.0 % and 38.6 %, respectively. The non-ascite samples yielded a higher microbiological confirmation rate (63.6 %) than the total samples (40.8 %). Diagnosis was confirmed histologically in 18 patients (69.2 %). Forty-five cases (64.3 %) were clinically diagnosed. Invasive procedures such as surgery (6/7), percutaneous biopsy (7/7) and endoscopy in lymph node TB (4/5) had high confirmation rates. CONCLUSIONS: the diagnosis of abdominal TB should be reached by a combination of clinical, laboratory, radiological, microbiological and pathological findings.

Characteristics and intentions of ceasing smoking among patients at a smoking cessation clinic of a Shanghai hospital / 中华全科医师杂志

To analyze the data of 284 smoking patients visiting the clinic during January 2009 to December 2011.There were 273 males and 11 females with a mean age of 49 years and an average length of 26 years of smoking 24 cigarettes per day.The average volume fraction of exhaled carbon monoxide was 16 × 10-6.The average score of Fagerstrom test of nicotine dependence (FTND) was 5.The importance,confidence and preparation of quitting smoking were graded at an average of 8.5,6.7 and 7.6 respectively.Abstinence rate was 66.1％ at 1 month and 50.9％ at 3 months.A particular focus was placed upon those smokers with more serious nicotine dependence and longer smoking years.They knew much about the importance of smoking cessation,but there was a lack of confidence.Smoking cessation improves abstinence rate via behavioral counseling,psychotherapy and medication.We should strengthen publicity of smoking cessation and smoking cessation clinic to attract more patients with heightened confidence through treatment.

The evaluation of strengthened psychological and behavioral intervention in smoking cessation clinics / 中华内科杂志

ObjectiveTo evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.