A nation wide survey of blood pressure (BP) and high BP was carried out in China in 1991, using standardized methods and covering 950356 men and women ages 15 years and above, from 30 provinces, autonomous regions, an...A nation wide survey of blood pressure (BP) and high BP was carried out in China in 1991, using standardized methods and covering 950356 men and women ages 15 years and above, from 30 provinces, autonomous regions, and municipalities. The purpose of this part of the study was to estimate the prevalence and the status of awareness,treatment, and control of hypertension. The overall prevalence rate of hypertension defined as systolic BP≥140 mmHg or diastolic BP≥90 mmHg or currently on antihypertensive medication was \{13.6\}%, and was higher in urban (16.3%) than in rural (\{11.1\}%) setting. The rate was 6.6% if a BP cut point of 160/95 was used. Rates were low in younger age groups but rose sharply after age 45.The total number of hypertensives in 1990 was estimated to be close to 90 millions.Of all hypertensives.about 1/4 were aware of their high BP,half of these were on medication, and only 3% had their BP controlled. In conclusion, hypertension was found to be common in China, and the rates of awareness,drug treatment, and controlled BP were low,indicating an urgent need for developing a national program of treatment and prevention of high BP on a community basis.展开更多
Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a...Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.展开更多
Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as...Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic,radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. In this literature review, we summarize the evidence for initial management of acute LGIB. Assessing various clinical factors,including comorbidities, medication use, presenting symptoms, vital signs, and laboratory data is useful for risk stratification of severe LGIB, and for discriminating upper gastrointestinal bleeding. Early timing of colonoscopy had the possibility of improving identification of the bleeding source, and the rate of endoscopic intervention, compared with elective colonoscopy. Contrast-enhanced computed tomography before colonoscopy may help identify stigmata of recent hemorrhage on colonoscopy, particularly in patients who can be examined immediately after the last hematochezia. How to deal with nonsteroidal antiinflammatory drugs(NSAIDs) and antithrombotic agents after hemostasis should be carefully considered because of the risk of rebleeding and thromboembolic events. In general, aspirin as primary prophylaxis for cardiovascular events and NSAIDs were suggested to be discontinued after LGIB. Managing acute LGIB based on this information would improve clinical outcomes. Further investigations are needed to distinguish patients with LGIB who require early colonoscopy and hemostatic intervention.展开更多
文摘A nation wide survey of blood pressure (BP) and high BP was carried out in China in 1991, using standardized methods and covering 950356 men and women ages 15 years and above, from 30 provinces, autonomous regions, and municipalities. The purpose of this part of the study was to estimate the prevalence and the status of awareness,treatment, and control of hypertension. The overall prevalence rate of hypertension defined as systolic BP≥140 mmHg or diastolic BP≥90 mmHg or currently on antihypertensive medication was \{13.6\}%, and was higher in urban (16.3%) than in rural (\{11.1\}%) setting. The rate was 6.6% if a BP cut point of 160/95 was used. Rates were low in younger age groups but rose sharply after age 45.The total number of hypertensives in 1990 was estimated to be close to 90 millions.Of all hypertensives.about 1/4 were aware of their high BP,half of these were on medication, and only 3% had their BP controlled. In conclusion, hypertension was found to be common in China, and the rates of awareness,drug treatment, and controlled BP were low,indicating an urgent need for developing a national program of treatment and prevention of high BP on a community basis.
文摘Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.
文摘Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic,radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. In this literature review, we summarize the evidence for initial management of acute LGIB. Assessing various clinical factors,including comorbidities, medication use, presenting symptoms, vital signs, and laboratory data is useful for risk stratification of severe LGIB, and for discriminating upper gastrointestinal bleeding. Early timing of colonoscopy had the possibility of improving identification of the bleeding source, and the rate of endoscopic intervention, compared with elective colonoscopy. Contrast-enhanced computed tomography before colonoscopy may help identify stigmata of recent hemorrhage on colonoscopy, particularly in patients who can be examined immediately after the last hematochezia. How to deal with nonsteroidal antiinflammatory drugs(NSAIDs) and antithrombotic agents after hemostasis should be carefully considered because of the risk of rebleeding and thromboembolic events. In general, aspirin as primary prophylaxis for cardiovascular events and NSAIDs were suggested to be discontinued after LGIB. Managing acute LGIB based on this information would improve clinical outcomes. Further investigations are needed to distinguish patients with LGIB who require early colonoscopy and hemostatic intervention.
