目的探讨治疗前天冬氨酸转氨酶与淋巴细胞比值指数(AST to lymphocyte ratio index,ALRI)对聚乙二醇干扰素/利巴韦林(Peg-IFN-α/RBV,PR)治疗慢性丙型肝炎(chronic hepatitis C,CHC)疗效的预测价值。方法 85例CHC患者行PR治疗,采用Pear...目的探讨治疗前天冬氨酸转氨酶与淋巴细胞比值指数(AST to lymphocyte ratio index,ALRI)对聚乙二醇干扰素/利巴韦林(Peg-IFN-α/RBV,PR)治疗慢性丙型肝炎(chronic hepatitis C,CHC)疗效的预测价值。方法 85例CHC患者行PR治疗,采用Pearson或Spearman分析治疗前ALRI与CHC患者临床特征的相关性,用受试者工作特征曲线分析其对PR治疗CHC的疗效的预测价值。结果治疗前ALRI与HCV RNA呈正相关性(r=0.746,P=0.000),对PR治疗后的持续病毒应答有预测价值(曲线下面积为0.664,95%CI:0.514~0.815,P=0.030),其最佳截断值为27.005。结论 CHC患者治疗前ALRI对PR治疗的持续病毒应答有预测价值,可为CHC的PR治疗提供依据。展开更多
Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a c...Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.展开更多
Human rhinovirus (HRV) must be viewed as a significant etiological agent of acute low respiratory tract infections (ALRIs) in infants and young children. The present study has been carried out to investigate the preva...Human rhinovirus (HRV) must be viewed as a significant etiological agent of acute low respiratory tract infections (ALRIs) in infants and young children. The present study has been carried out to investigate the prevalence of recently identified respiratory viruses and determine the phylogenetic composition of HRV strains. In total, 923 nasopharyngeal aspirates (NPAs) collected from hospitalized patients with ALRIs between January and December 2010 (453 females and 470 males) at five referral hospitals in Seoul were tested for respiratory viruses. Viruses were detected by RT-PCR (Reverse transcription polymerase chain reaction) in 501 (54.3%) of the 923 positive samples obtained. Overall, HRV was detected in 7.9%, ADV in 10.2%, IFV in 21.9%, RSV in 3.6%, hMPV in 2.7%, HCoV in 2.5%, HEV in 1.6%, HBoV in 1.6%, and PIV in 2.4% of the samples. HRV infections occurred throughout the year, with peaks in January, May, July, and November of 2010. Phylogenetic analyses using the VP4/VP2 cording region showed that among the 27 isolates with HRV, 14 (52%) were infected with species A, 2 (7%) were infected with species B, and 11 (41%) were infected with the strains from HRV-C. HRV-C sequences are genetically distinct, sharing only 32% to 33% of their amino acids with HRV-A and HRV-B, while retaining 46% to 100% identity with each other. HRV-A, B, and C were co-circulating in children hospitalized with ALRIs in Korea in 2010. These findings indicated that HRV-C was the important causative agent of HRV associated with ALRIs.展开更多
文摘目的探讨治疗前天冬氨酸转氨酶与淋巴细胞比值指数(AST to lymphocyte ratio index,ALRI)对聚乙二醇干扰素/利巴韦林(Peg-IFN-α/RBV,PR)治疗慢性丙型肝炎(chronic hepatitis C,CHC)疗效的预测价值。方法 85例CHC患者行PR治疗,采用Pearson或Spearman分析治疗前ALRI与CHC患者临床特征的相关性,用受试者工作特征曲线分析其对PR治疗CHC的疗效的预测价值。结果治疗前ALRI与HCV RNA呈正相关性(r=0.746,P=0.000),对PR治疗后的持续病毒应答有预测价值(曲线下面积为0.664,95%CI:0.514~0.815,P=0.030),其最佳截断值为27.005。结论 CHC患者治疗前ALRI对PR治疗的持续病毒应答有预测价值,可为CHC的PR治疗提供依据。
文摘Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.
文摘Human rhinovirus (HRV) must be viewed as a significant etiological agent of acute low respiratory tract infections (ALRIs) in infants and young children. The present study has been carried out to investigate the prevalence of recently identified respiratory viruses and determine the phylogenetic composition of HRV strains. In total, 923 nasopharyngeal aspirates (NPAs) collected from hospitalized patients with ALRIs between January and December 2010 (453 females and 470 males) at five referral hospitals in Seoul were tested for respiratory viruses. Viruses were detected by RT-PCR (Reverse transcription polymerase chain reaction) in 501 (54.3%) of the 923 positive samples obtained. Overall, HRV was detected in 7.9%, ADV in 10.2%, IFV in 21.9%, RSV in 3.6%, hMPV in 2.7%, HCoV in 2.5%, HEV in 1.6%, HBoV in 1.6%, and PIV in 2.4% of the samples. HRV infections occurred throughout the year, with peaks in January, May, July, and November of 2010. Phylogenetic analyses using the VP4/VP2 cording region showed that among the 27 isolates with HRV, 14 (52%) were infected with species A, 2 (7%) were infected with species B, and 11 (41%) were infected with the strains from HRV-C. HRV-C sequences are genetically distinct, sharing only 32% to 33% of their amino acids with HRV-A and HRV-B, while retaining 46% to 100% identity with each other. HRV-A, B, and C were co-circulating in children hospitalized with ALRIs in Korea in 2010. These findings indicated that HRV-C was the important causative agent of HRV associated with ALRIs.
