Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report.

RATIONALE: Reversible splenial lesion syndrome (RESLES) is a recently identified clinico-radiological syndrome, the etiology is miscellaneous. Atrial septal defect (ASD) as an underlying etiology for RESLES has not been reported. We first report a rare case of RESLES associated with ASD. The clinical, radiological, and ultrasonic profiles were presented and the pathophysiological mechanism was analyzed. PATIENT CONCERNS: A 23-year-old man presented with headache, drowsiness, occasional paraphasia, and paroxysmal dry cough. Brain magnetic resonance imaging (MRI) on admission showed an ovoid isolated lesion in the splenium of corpus callosum, which exhibited hyperintensity on diffusion-weighted imaging and hypointensity on apparent diffusion coefficient, and completely disappeared on the follow-up MRI 14 days later. ASD was found by transthoracic echocardiography, Right-to-left shunts were detected on color Doppler of transesophageal echocardiography, and microemboli were captured by transcranial Doppler ultrasound. DIAGNOSES: According to his clinical history and imaging results, we confirmed the diagnosis of RESLES associated with ASD. INTERVENTIONS: The patient was treated by oral aspirin and lopidogrel sulfate to inhibit platelet aggregation. In addition, oral nimodipine to suppress vasoconstriction. OUTCOMES: After 14 days treatment, all the symptoms presenting on admission resolved completely. Subsequently, a repair surgery of ASD under thoracoscopy was successfully performed. LESSONS: To our knowledge, this is the first reported case of ASD may be an underlying etiology for RESLES and need require an etiotropic treatment.

Knowledge, attitudes and practices towards avian influenza among live poultry market workers in Chongqing, China.

BACKGROUND: Live poultry market (LPM) workers are at high risk of infection with avian influenza virus due to frequent occupational exposure to poultry. This study aims to assess the knowledge, attitude and preventive practice regarding avian influenza among LPM workers in Chongqing, the largest municipality directly under the central government of China. METHODS: 216 LPM workers were recruited by two-stage cluster sampling and interviewed face-to-face using a structured questionnaire. Hierarchical logistic regression analysis was performed to explore factors associated with preventive practices against avian influenza and views on government control measures. RESULTS: Nearly half of respondents failed to recognize contact with sick birds or excrement as a risk of infection. Less than half the respondents perceived themselves to have a personal susceptibility to be infected or would like to enhance personal protection. Respondents did not pay sufficient attention to wearing preventive clothing such as gloves (43.1%), aprons/garments (33.3%) and face masks (26.9%) when handling live poultry. Few respondents were supportive to market control measures such as a ban on birds' overnight storage (26.8%) or a regular rest day (32.4%). Being older, being more highly educated, having worked longer with poultry, having better knowledge, having more access to information, and perceiving more personal susceptibility to the disease were positively associated with preventive practices. Having higher personal income, longer engagement with poultry work, better knowledge, more awareness of personal protection were positively associated with agreement with government control measures. CONCLUSIONS: LPM workers in Chongqing showed low level of knowledge, weak perception of susceptibility to avian influenza and inadequate preventive behaviors. Health education campaigns need to better target the knowledge on transmission routes and potential outbreak threat of avian influenza. More attention should be paid to LPM workers who are younger, less educated, with shorter occupational years and lower personal income.