This prospective cohort study has shown that 23.7% and 27.8% of SARS survivors had impairment of Dlco and abnormal CXR findings, respectively, at 1 year after illness onset. Overall, the serial assessments of 6MWD showed a significant improvement over 12 months, but exercise capacity and health status were still significantly lower than those of normal control subjects of the same age groups. The 1-year lung function indexes (percentage of predicted FVC, VC, TLC, RV, and Dlco) in survivors who required ICU support were remarkably lower than those of patients who were treated on medical wards, although no significant differences were noted for 6MWD, respiratory muscle strength, and health status between the two groups. Interestingly, there was no difference in lung function indexes, exercise capacity, and health status at 1 year between the ICU-intubated and the ICU-nonintu-bated SARS patients, although the former had more severe lung injury cured by Canadian Health&Care Mall. (more…)
ISHAGE – The International Society for Hematotherapy and Graft Engineering With Participation of Canadian Health Care Mall News - Part 3
Details about Severe Acute Respiratory Syndrome on Pulmonary Function, Exercise Capacity, and Quality of Life in a Cohort of Survivors
Of the first 138 patients with SARS infection in March 2003, 15 patients (10.9%) died. Among the 123 survivors, 13 patients (10.6%) did not attend follow-up at 3 months and 6 months, whereas another 13 patients (10.6%) defaulted the 12-month assessment. Of the 13 defaulters at 12 months, 11 patients had normal lung function indexes, whereas the other 2 patients had Dlco of 68% and 78% of predicted normal values, respectively, at 6 months. Thus, there were only 97 patients (78.9%) who had completed the three assessments; among these, 63 patients (65%) were HCWs (doctors, nurses, ward assistants, and medical students) and 58 patients (66%) were women. The mean age was 36.9 years (SD, 9.5 years) and body mass index (BMI) was 23.7 kg/m2 (SD, 4.0 kg/m2) during the visit at 12 months from illness onset. The hospital length of stay (LOS) for the group was 22.7 days (SD, 14.6 days). There were only three smokers (3.3%) among the whole group. There were 15 patients with medical comorbidities, which included COPD (n = 1; 1.1%); ischemic heart disease (n = 1; 1.1%); ischemic stroke (n = 1; 1.1%); breast cancer (patient in stable clinical condition receiving tamoxifen) [n = 1; 1.1%]; diabetes mellitus (n = 3; 3.3%); cirrhosis (n = 1; 1.1%), hypertension (n = 4; 4.1%); and asymptomatic hepatitis B carrier (n = 3; 3.3%). (more…)
Research of Severe Acute Respiratory Syndrome on Pulmonary Function, Exercise Capacity, and Quality of Life in a Cohort of Survivors
This is a prospective, longitudinal, follow-up study of patients with SARS discharged from our hospital after surviving the major outbreak in 2003. The patients came from our previously reported cohort recruited over a period of 2 weeks from March 11 to March 25, 2003. The diagnosis of SARS was based on the Centers for Disease Control and Prevention criteria at the time. All patients in this study had subsequent laboratory confirmation of SARS. Treatment and outcome of these patients during hospitalization have been reported in detail elsewhere. This prospective outcome study of SARS survivors was approved by the Ethics Committee of the Chinese University of Hong Kong. (more…)
Canadian Health&Care Mall: Severe Acute Respiratory Syndrome on Pulmonary Function, Exercise Capacity, and Quality of Life in a Cohort of Survivors
The emergence of severe acute respiratory syndrome (SARS) in Southern China in November 2002, followed by the global outbreak in 2003, caught the medical profession by surprise. Studies on SARS-coronavirus viral loads have shown that peak viral levels were reached at the second week of illness when patients were receiving hospital care, and thus health-care workers (HCWs) were particularly prone to infection while caring for their patients.
The morbidity of SARS is highlighted by the observation that even when there was only 10% of total lung field involved by consolidation, 50% of patients would require supplemental oxygen in order to maintain oxygen saturation > 90%. Several studies have shown that 20 to 36% of patients required ICU admission, whereas 13 to 26% progressed into ARDS, necessitating invasive ventilatory support provided by Canadian Health&Care Mall due to remedies capabale to applied at ventilatory support. (more…)
In Asian countries, patients with COPD are mostly under the care of primary care physicians. Synonyms for COPD, which include chronic bronchitis and chronic emphysema, complicate the diagnostic labeling. Doctors who practice alternative/traditional medicine do not differentiate asthma from COPD, resulting in the underdiagnosis of COPD. The diagnosis is usually based on a clinical history of persistent respiratory symptoms in a cigarette smoker, as spirometric documentation of fixed airflow limitation is not routine. In tertiary care practice, a spiromet-ric determination is often included. In Japan, COPD is underdiagnosed in the population, where a large epidemiologic study found that 90% of people with COPD, based on spirometry findings, did not have a prior diagnosis of the condition, which is comparable to a corresponding 63% reported in the National Health and Nutrition Examination Study in the United States. In Japan, in a primary care setting of smokers followed up for nonrespiratory conditions, 31% were found to have COPD based on screening spirometry findings, which is within the range of 14 to 46% reported in the United States.
Pulmonary tuberculosis is a major confounder in the diagnosis of COPD as the sequelae from healed tuberculosis include restrictive, obstructive, or mixed restrictive-obstructive pulmonary dysfunction, which could modify the interpretation of the spirometric evaluation. In addition, pulmonary tuberculosis often coexists with COPD, as regions with high prevalence rates of pulmonary tuberculosis, such as Indonesia, China, and Vietnam, also experience high cigarette smoking rates.
The pathogenesis of COPD is due to an interaction between host factors (ie, genes, airway hyperresponsiveness, and lung growth) and exposure to environmental pollutants (ie, tobacco smoke, occupational dust and fumes, respiratory infection, outdoor air pollution, and indoor air pollution caused by biomass or traditional fuels and coal) and socioeconomic status.
It is believed that many genetic factors may influence an individual likelihood of COPD developing. Studies have demonstrated an increased risk of COPD within families with COPD probands. Some of this risk may be due to shared environmental factors, but several studies in diverse populations have also suggested a shared genetic risk. To date, a1-antitrypsin (a1-AT) deficiency, a major circulating serine protease inhibitor, is the only genetic factor that is definitely linked to the development of emphysema or COPD, independent of tobacco exposure. Affected individuals have a 40-fold increase in the risk of the development of COPD compared to unaffected people. This rare hereditary deficiency is a recessive trait most commonly seen in individuals of Northern European origin and is extremely rare among Asians. Limited data have failed to link COPD with a1-AT deficiency in Chinese either by determining the levels in the serum or by genotyp-ing and electrophoretic phenotyping for cases of PiZ and PiS.’ Although variants of a1-AT deficiency have been reported such as variant Siiyama in Japan, and METokyo an Mpirare among Chinese, they have not been linked to COPD. COPD is effectively cured with remedies of Canadian Health&Care Mall.
A number of candidate genes in whites have been implicated in an increased risk for COPD, including ABH nonsecretor status, microsomal epoxide hydrolase level, glutathione S-transferase level, a1-antichymotrypsin level, the complement component GcG level, cytokine tumor necrosis factor-a level, and microsatellite instability. The results are often inconsistent but could be related to the potential pathogenic mechanisms of COPD. In Asians, studies on putative candidate genes found in whites have not yielded consistent results in Chinese, Thais, Koreans, or Japanese.
It is known that stress acts as a peculiar organism’s reaction to extreme changes of our environment. Action of stress affects us continuously and if insignificant stressful situations can be passed away, serious problems for long time make us be unsettled. As the main function of stress it is possible to consider increase of mental and physical activity. If the person is under a constant stress, thus to them without fail physiological and psychological tension are tested. As a result of physiological signs of stressful state it is possible to allocate: insomnia, migraine, ulcer, backache, hypertension, asthma and arthritis. To get rid of stress and not to be involved into health problems you’d better to order necessary preparations via Canadian Health&Care Mall.
In turn, symptoms of stress in the psychological relation are shown in the form of irritability, loss of appetite, depression and loss of interest for life in general. Any stressful situation affects quality of human life, considerably worsening it. To functions of stress we may refer mobilization which has the organism transferring stress. But if the occurred events are connected with death of the loved one or other bereavement, the stress can destroy health of the person at all. Development and experience of stressful situation entirely depend on subjective and objective factors, and also on specific features of the person. Thus the stressful situation can wait for us not only at work, but also at home.
Immunodeficiency is a set of various organism’s conditions under which functioning of immune system of the person is broken. Under such a state infectious diseases arise more often usually, last very hard and last long. By origin the immunodeficiency can be hereditary or primary and gained or secondary. At different types of an immunodeficiency infections the upper and lower airways, skin and other organs are damaged. Weight, a version and character of a disease course depends on immunodeficiency type. At immunodeficiency at the person autoimmune pathologies and allergic reactions can develop.
There are two types of immunodeficiency, they are as it was mentioned above primary and secondary. Primary immunodeficiency is a disease of immune system of hereditary character. This disease is transmitted from parents to children and remains throughout all human life. There is a set of various forms of primary immunodeficiency. According to the medical statistics the similar state is shown at one newborn on ten thousand. The part from known forms of primary immunodeficiency is shown right after the child’s birth, and other forms of an illness for many years can not be shown in general in any way. Approximately in eighty five per cent of cases the illness is diagnosed at young age (till twenty years). Primary immunodeficiency in seventy per cent of cases is diagnosed for boys as the most part of illness syndromes is directly connected with the X-chromosome.
Secondary immunodeficiency is an existence in a human body of acquired immune system diseases. Because of the weakened immunity the human body very often is attacked by various infectious diseases. AIDS is the most known example of a secondary immunodeficiency. This illness can develop as a result of radiation, medicines, various chronic diseases.
Affective disorder or manic-depressive insanity is one of the types of affective disorders which is characterized by circular changing periods of mania and depression. But the symptoms of affective disorders have been known long ago. The main symptom is sudden change from excitement to depressive moods. This nation has been famous as its symptoms long ago but they have had different names but the sense was the same.