Objective To describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.Methods The outbreak started with a SARS patient from the community,...Objective To describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.Methods The outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29. 5±10. 3) years, 93. 8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.Results (1) The incubation period ranged from 1 to 20 (mean: 5. 9±3. 5) days. The duration of hospitalization was (17. 2±8. 0) days. (2) The initial temperature was (38. 3±0. 6)℃, while the highest was (39. 2 ±0. 6)℃( P<0. 001), with fever duration of (9. 0±4. 2) days. (3) Other most common symptoms included fatigue (93. 8%), cough (85. 4%), mild sputum production (66. 7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1. 2±0. 8 on presentation, which increased to 2. 9 ?1. 4 after admission (P<0. 001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3. 5±2. 3) days, which increased in size, extent, and severity to the maximum (6. 7±3. 5) days later. The time before the lung opacities were basically absorbed was (14.9±7.8) days. (5) Leukopenia was observed in 67. 7% of this cohort. The time between the onset of fever and leukopenia was (4. 4±2. 3) days, with the lowest white blood cell count of (2. 80±0. 72)×10~9/L (6) The lowest arterial oxygen saturation was (94.8±3.1 )% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines ( 91. 0%), aminoglycosides ( 83. 3%), quinolones (79. 2%); 18. 8% of the patients received a combination of tetracyclines and aminoglycosides, while 11. 5% received a combination of tetracyclines and quinolones, and 63. 5% received a combination of tetracyclines, amino展开更多
In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria o...In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association（DSM-IV）,we documented the atypical symptoms in 3 906 consecutive participants with bipolar disorder enrolled at 26 psychiatric services across China. We further assessed the association between atypical features and the treatment approaches,including the prescription of antidepressants. The overall point prevalence rate of atypical features was 9.1% among patients with various bipolar disorder subtypes. When the definition was broadened to include atypical features B,the overall rate increased to 11.8%. Interestingly,among patients with the mixed state and remission subtypes,there was a significant difference in the rates of antidepressant medication usage between patients who met and those who did not meet the criteria for atypical features B. These fi ndings indicate a trend of using antidepressants for these two types of patients with atypical features. Further,for both mixed state and remission patients,treatment approaches were related to atypicalfeatures B. Our findings provide evidence to assist clinicians to readily recognize atypical features in bipolar subtypes and can propose treatments based on these diagnoses.展开更多
文摘Objective To describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.Methods The outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29. 5±10. 3) years, 93. 8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.Results (1) The incubation period ranged from 1 to 20 (mean: 5. 9±3. 5) days. The duration of hospitalization was (17. 2±8. 0) days. (2) The initial temperature was (38. 3±0. 6)℃, while the highest was (39. 2 ±0. 6)℃( P<0. 001), with fever duration of (9. 0±4. 2) days. (3) Other most common symptoms included fatigue (93. 8%), cough (85. 4%), mild sputum production (66. 7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1. 2±0. 8 on presentation, which increased to 2. 9 ?1. 4 after admission (P<0. 001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3. 5±2. 3) days, which increased in size, extent, and severity to the maximum (6. 7±3. 5) days later. The time before the lung opacities were basically absorbed was (14.9±7.8) days. (5) Leukopenia was observed in 67. 7% of this cohort. The time between the onset of fever and leukopenia was (4. 4±2. 3) days, with the lowest white blood cell count of (2. 80±0. 72)×10~9/L (6) The lowest arterial oxygen saturation was (94.8±3.1 )% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines ( 91. 0%), aminoglycosides ( 83. 3%), quinolones (79. 2%); 18. 8% of the patients received a combination of tetracyclines and aminoglycosides, while 11. 5% received a combination of tetracyclines and quinolones, and 63. 5% received a combination of tetracyclines, amino
基金supported by the Science Fund of Shanghai Jiao Tong University (11XJ21006 and YG2012MS11)the Fund of Science and Technology Commission of Shanghai Municipality,China (134119a6200)+3 种基金the Overseas Talent Project of the Shanghai Health Bureau,China (GWHW201208)the "12th Five-year Plan" of the National Key Technologies R&D Program,China (2012BAI01B04)the National Natural Science Foundation of China (91232719)the National Key Clinical Disciplines at the Shanghai Mental Health Center,China (OMA-MH,2011-873)
文摘In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association（DSM-IV）,we documented the atypical symptoms in 3 906 consecutive participants with bipolar disorder enrolled at 26 psychiatric services across China. We further assessed the association between atypical features and the treatment approaches,including the prescription of antidepressants. The overall point prevalence rate of atypical features was 9.1% among patients with various bipolar disorder subtypes. When the definition was broadened to include atypical features B,the overall rate increased to 11.8%. Interestingly,among patients with the mixed state and remission subtypes,there was a significant difference in the rates of antidepressant medication usage between patients who met and those who did not meet the criteria for atypical features B. These fi ndings indicate a trend of using antidepressants for these two types of patients with atypical features. Further,for both mixed state and remission patients,treatment approaches were related to atypicalfeatures B. Our findings provide evidence to assist clinicians to readily recognize atypical features in bipolar subtypes and can propose treatments based on these diagnoses.
