Severe acute respiratory syndrome (SARS) has recently recognized as a new human infectious disease. A novel coronavirus was identified as the causative agent of SARS. This report summarizes the hematological findings in SARS patients and proposes a hypothesis for the pathophysiology of SARS coronavirus related abnormal hematopoiesis. Hematological changes in patients with SARS were common and included lymphopenia (68% - 90% of adults; 100% of children, n = 10), thrombocytopenia (20% - 45% of adults, 50% of children), and leukopenia (20% - 34% of adults, 70% of children). The possible mechanisms of this coronavirus on blood system may include (1) directly infect blood cells and bone marrow stromal cells via CD13 or CD66a; and/or (2) induce auto-antibodies and immune complexes to damage these cells. In addition, lung damage in SARS patients may also play a role on inducing thrombocytopenia by (1) increasing the consumption of platelets/megakaryocytes; and/or (2) reducing the production of platelets in the lungs. Since the most common hematological changes in SARS patients were lymphopenia and immunodeficiency. We postulate that hematopoietic growth factors such as G-CSF, by mobilizing endogenous blood stem cells and endogenous cytokines, could become a hematological treatment for SARS patients, which may enhance the immune system against these virus.
Adult ; Antigens, CD ; immunology ; Antigens, Differentiation ; immunology ; CD13 Antigens ; immunology ; Cell Adhesion Molecules ; Child ; Hematologic Diseases ; immunology ; physiopathology ; Hematopoiesis ; physiology ; Humans ; SARS Virus ; Severe Acute Respiratory Syndrome ; immunology ; physiopathology ; virology

INTRODUCTIONTo determine the magnitude of gender difference in paediatric hospital admissions.

MATERIALS AND METHODSWe reviewed discharge data of general medical paediatric admissions to a university teaching hospital in Hong Kong from 1984 to 2000. Based on ICD-9 codes, 9 broad categories of disease with related sub-categories were used, namely respiratory, gastrointestinal, neurological, renal, cardiac, haematological/oncological, neonatal, miscellaneous and social. Data on patients admitted to the haematological, oncological and neonatal wards were excluded from this analysis.

RESULTSThere were 92,332 patients admitted to the general paediatric wards. The 7 leading causes for admission accounted for 62% of all admissions: gastroenteritis (14%), upper respiratory tract infections (12%), asthma/wheezy bronchitis (10%), pneumonia (10%), bronchiolitis (6%), febrile convulsions (7%) and other convulsions (4%). Across almost all categories, there was a consistent excess of males (59.1% of all admissions). The male excess was even more pronounced for urinary tract infections (72%) and nephrotic syndrome (80%). The main sub-categories without this male predominance were accidents, accidental ingestion and social admissions (50% males), failure to thrive (49% males), acyanotic congenital heart disease (48%), endocrine (42%), auto-immune conditions (30%) and attempted suicide (19%).

CONCLUSIONSAlthough male vulnerability to illness has long been recognised, the consistency and magnitude of these gender differentials in admissions was impressive. More vigorous exploration of the underlying mechanisms responsible for this phenomenon is warranted.

Adolescent ; Child ; Child, Preschool ; Female ; Gastrointestinal Diseases ; epidemiology ; Heart Diseases ; epidemiology ; Hematologic Diseases ; epidemiology ; Hong Kong ; epidemiology ; Hospitals, University ; utilization ; Humans ; Infant ; Kidney Diseases ; epidemiology ; Male ; Patient Admission ; statistics & numerical data ; Respiratory Tract Diseases ; epidemiology ; Retrospective Studies ; Sex Factors

INTRODUCTIONTraditional Chinese medicine (TCM) has been used as an alternative in treating children with atopic dermatitis (AD) but its efficacy and potential side effects are debatable. We recently used a TCM capsule (PentaHerbs) on 9 children and observed significant reductions in clinical scores of disease severity. However, there have been concerns that the therapeutic effects of many forms of TCM are due to the presence of corticosteroids. The purpose of this study was to evaluate if common corticosteroids are present in PentaHerbs capsules.

MATERIALS AND METHODSPentaHerbs powder was analysed with thin-layer chromatography, infra-red spectrophotometry and liquid chromatography mass spectrometry.

RESULTSHydrocortisone, prednisolone, fludrocortisone and dexamethasone were not detected in the PentaHerbs capsules.

CONCLUSIONCorticosteroids are not present in the 5 familiar herbs that were earlier shown to have efficacy on AD.

Child ; Chromatography, Thin Layer ; Dermatitis, Atopic ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Glucocorticoids ; analysis ; therapeutic use ; Humans ; Mass Spectrometry ; Pilot Projects ; Spectrophotometry, Infrared