OBJECTIVES: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana. MATERIALS AND METHODS: A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance. RESULTS: Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions. CONCLUSION: From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.
Acquired Immunodeficiency Syndrome ; Candidiasis, Oral ; CD4 Lymphocyte Count* ; Cell Count ; Classification ; Cross-Sectional Studies ; Diagnosis ; European Union ; Female ; Ghana* ; Gingivitis ; HIV ; Hospitals, Teaching ; Humans ; Hyperpigmentation ; Immune System ; Immunosuppression ; Leukoplakia, Hairy ; Male ; Medical Records ; Opportunistic Infections ; Oral Manifestations* ; Periodontitis ; Prospective Studies ; Statistics as Topic ; Xerostomia

OBJECTIVETo investigate the etiology of severe hand-foot-mouth disease (HFMD) in children in Henan province.

METHODSA total of 244 HFMD cases admitted to a hospital in Zhengzhou from April to June of 2014 were recruited for research sampling, Real-time RT-PCR, virus isolation, VP1 sequencing and alignment methods were used to test the enterovirus-related etiology. SPSS 17.0 was used in performing statistical analysis.

RESULTSThere were 109 severe and 135 mild cases among all the 244 HFMD cases. The number of enterovirus positive stool samples was 229, with positive rate as 93.85%. EV71, Cox A16 and Cox A10 made up 83.84%, 5.68% and 8.30% of the enterovirus etiologicy, strains, respectively. EV71 infection caused 8 HFMD cases with heart-lung failure and 2 death, Cox A10 infection led to 1 HFMD case with heart-lung failure and death. There were statistically differences seen regarding the enterovirus infection rates between severe and the mild HFMD cases (χ(2)=5.312,P=0.021). Statistically significant difference was seen in the constituent ratio of EV71, Cox A16 and the others by Fisher' s exact test (P=0.048). There was statistically significant difference seen between the cardiorespiratory failure rate and the fatality rate by EV71 and Cox A10 infection (χ(2)=0.051,P=0.821; χ(2)=2.198,P=0.138). Cox A10 strains idenfied in Henan in 2014 belonged to genotype 6. The rates on homology of nucleotide and amino acid among the Cox A10 strains in Henan in 2014 were 94.3%-99.7% and 96.3%-100.0% respectively.

CONCLUSIONSEV71 still remained the most common pathogen that causing severe HFMD in children, with the increasing Cox A10 percentage in the pathogens spectrum of HFMD infection. Cox A10 strains in Henan in 2014 belonged to genotype 6. Genotype 6 Cox A10 had appeared and widely distributed in Henan for long time, but not yet variated or reconstructed. Cox A10 infection could lead to cardio-respiratory failure thus called for the monitoring program on non-EV71 and non-Cox A16 enterovirus, especially Cox A10 to be strenthened.

Amino Acids ; genetics ; Biometry ; Child ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; epidemiology ; virology ; Evolution, Molecular ; Genotype ; Hand, Foot and Mouth Disease ; epidemiology ; prevention & control ; virology ; Hospitals ; statistics & numerical data ; Humans ; Real-Time Polymerase Chain Reaction

OBJECTIVE: To determine the association between drinking patterns (the volume of drinking and frequency) and injury type (intentional injury and unintentional traffic injury).
 METHODS: A total of 1 539 patients (age≥18 years), who were treated for the first time in the emergency room within 6 h after the injury, were included. The American National Institute of Health questionnaire was used to investigate the injury type, time point of drinking, drinking volume, and drinking history in the past years and so on. The case-crossover method and logistic regression was used to analyze the data.
 RESULTS: Comparing with the control, people with alcohol consuming 6 h before the injury showed a higher risk of intentional injury (OR=3.63). Comparing with people without drinking in the past year, subjects who drank alcohol more than once in the past year displayed a higher risk of intentional injury (OR=1.986). Comparing with non-drinkers, subjects who drank alcohol 5-11 standard drinks or 12 and more drinks on one occasion in the past year had a higher risk of intentional injury (OR=1.854 or 1.572). Comparing with the non-drinkers, victims who drank alcohol 6 h before injury had a higher risk of unintentional traffic injury (OR=2.091). Comparing with non-drinkers in the past year, subjects who drank alcohol more than once in the past year had a higher risk of unintentional traffic injuries (OR=1.533). Comparing with the non-drinkers, subjects who drank alcohol 6 h before injury had a higher risk of injury (OR=5.15). Subjects who drank Less than 6 standard drinks, 6-9 standard drinks and more than 9 standard drinks of alcohol 6 h separately before injury had higher risk than non-drinkers (OR=3.83, 8.64 or 9.58). 
 CONCLUSION Drinking alcohol before injury is associated with higher risk of intentional injury and unintentional traffic injury. Over the past year, subjects who drank alcohol at least once have higher risk of intentional injuries and unintentional traffic injury. Drinking alcohol 6 h before injury is associated with higher risk of injuries. The risk is increasing with the volume of drinking before injury. The study demonstrates that drinking 6 h before injury and drinking patterns in the past year are closely associated with injuries, which provides scientific evidences for making policy relevant to alcohol consuming.
Accidents, Traffic ; statistics & numerical data ; Adult ; Alcohol Drinking ; adverse effects ; epidemiology ; Cross-Over Studies ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Hospitals, General ; Humans ; Logistic Models ; Male ; Surveys and Questionnaires ; Time Factors ; Wounds and Injuries ; classification ; epidemiology

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
Anti-Bacterial Agents ; China ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Drug Utilization Review ; methods ; statistics & numerical data ; Geography ; Hospitals ; classification ; statistics & numerical data ; Humans ; Inpatients ; statistics & numerical data ; Outpatients ; statistics & numerical data

OBJECTIVES: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. METHODS: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. RESULTS: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. CONCLUSIONS: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.
Cesarean Section/standards/trends/*utilization ; Disclosure ; Female ; Hospitals/classification/statistics & numerical data ; Humans ; *Information Dissemination ; Logistic Models ; Pregnancy ; Program Evaluation ; *Quality of Health Care ; Republic of Korea

PURPOSE: Anterior Polar Cataract (APC) develops by a mechanism different from that of other age-related cataracts, and outside of Korea, it is an extremely rare condition. We investigated the prevalence and epidemiological characteristics of APC in Koreans. METHODS: The evaluation on the prevalence of APC in comparison to the other age-related cataracts was performed on the 2,108 cataract patients who were treated at 5 different areas in Korea from August 2003 to December 2003. The demographic characteristics of APC were studied on the, 656 cataract patients who were treated from January 2004 to January 2005 at one hospital. These patients were classified according to the type of lens opacity (nuclear, cortical, posterior subcapsular, mixed and APC). RESULTS: The prevalence of patients with APC among all the cataract patients was 6.02% during the 5 months in this hospital-based study. Eighty-seven per cent of patients with APC were male. In contrast, the proportion of female was greater than 50% in the other cataracts. The mean age of APC patients was 52.7 years. Among the APC patients, 38.9% were under 50 years of age, 42.6% in their 50s, 14.8% in their 60s, and 3.7% were in their 70s. However, 80% of patients were over the age of 60 years in nuclear, cortical, and mixed-type cataracts. CONCLUSIONS: The prevalence of APC among all cataracts was high in comparision with another country. The proportion of APC was high in individuals younger than 60 years of age, and in males.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cataract/classification/*epidemiology ; Female ; Hospitals, General/*statistics & numerical data ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Ophthalmology/statistics & numerical data ; Prevalence ; Sex Distribution

OBJECTIVETo investigate the epidemiological features of human calicivirus( HuCV) infection in children with diarrhea in a hospital in Guangzhou.

METHODSStool specimens were collected from children with viral diarrhea diagnosed between October, 2003 and January, 2004 and between October, 2004 and January, 2005. HuCV was detected by means of RT-PCR and sequence analysis of the PCR products.

RESULTSEighty specimens positive for Norwalk-like viruses (NLVs) were identified from 648 stool specimens, with a positivity rate of 12.35%, and sapporo-like viruses (SLVs) were identified in 2 specimens (0.31%). The monthly NLV positivity rate was 11.74% (Oct.), 14.16% (Nov.), 9. 09% (Dec.) and 13.95% (Jan.), respectively, showing no significant variation in these months. NLVs mainly infected children below 2 years old. Twenty-two strains of NLVs were sequenced and analyzed, and 21 of them were identified as GII and the genotype of 1 strain could not be determined. The prevalent viral population were GII-3 and GII-4 in 2003 and was GII-4 in 2004, and both of the SLVs belong to GI-1.

CONCLUSIONNLVs is one of the important pathogens causing sporadic acute gastroenteritis in children admitted in the hospital in Guangzhou, and the prevalent strains are GII-3 and GII-4 , but different prevalent strains are possible in different periods.

Caliciviridae ; classification ; genetics ; isolation & purification ; Caliciviridae Infections ; epidemiology ; virology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; virology ; Diarrhea, Infantile ; epidemiology ; virology ; Feces ; virology ; Female ; Genotype ; Hospitals ; statistics & numerical data ; Humans ; Infant ; Male ; Molecular Epidemiology ; methods ; Molecular Sequence Data ; Norwalk virus ; genetics ; isolation & purification ; Phylogeny ; Prevalence ; RNA, Viral ; genetics ; Seasons ; Sequence Analysis, DNA

PURPOSE: The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. METHOD: Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. RESULT: As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was 'activity and exercise management', followed by 'physical comfort promotion', 'community health promotion', 'life span care', 'coping assistance', 'Self care facilitation', 'information management', 'nutrition support', 'community risk management' and 'patient education'. One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were the physical complex domain. CONCLUSION: In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.
Hospitals, Community ; Humans ; Nursing Care/*classification/*statistics & numerical data ; *Nursing Informatics ; Public Health Nursing/*statistics & numerical data ; Terminology as Topic

OBJECTIVETo explore the epidemiological characteristics of Norwalk-like virus (NLVs) infection in children with diarrhea and to study the genotype and predominant cluster at a hospital in Guangzhou city.

METHODSFecal specimens from 358 children with acute gastroenteritis from October 2003 to January 2004 and information about the cases were collected. NLVs was detected from the specimens by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were purified and sequenced.

RESULTSForty-two positive specimens were detected from the 358 fecal specimen with a positive rate of 11.73% (42/358). Of these, 40 specimens were obtained from infants younger than 3 years of age. The youngest infant infected with NLVs in this study was only 25 days. The positive rate in November (17.27%) was the highest. Eleven positive PCR products were selected and sequenced. Nucleotide sequence analysis revealed that 11 strains all belong to genogroup II (G II), and of these, 5 strains belonged to G II-3 cluster, with another 5 strains belonged to G II-4 cluster. However, one strain with its cluster could not be determined.

CONCLUSIONNLVs served as one of the important pathogens causing sporadic acute gastroenteritis among children at a hospital in Guangzhou. The predominant strains were identified as G II-3 and G II-4 cluster.

Age Distribution ; Caliciviridae Infections ; complications ; epidemiology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; complications ; epidemiology ; Feces ; virology ; Female ; Hospitals ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Molecular Epidemiology ; Norovirus ; classification ; genetics ; physiology ; Phylogeny ; RNA, Viral ; genetics ; Seasons ; Sequence Homology, Nucleic Acid ; Sex Distribution

OBJECTIVETo study the epidemiological status on rotavirus diarrhea in Kunming to improve the rotavirus vaccine immunization program.

METHODSA hospital-based sentinel surveillance program for rotavirus was set up among children less than 5 years old with acute diarrhea in Kunming Children's Hospital. Clinical information and fecal specimens were collected and rotavirus were detected by polyacrylamide gel electrophoresis (PAGE) and/or enzyme linked immunosorbent assay (ELISA). Positive specimens were further serotyped or genotyped by ELISA and/or RT-PCR.

RESULTSDuring the three years of surveillance, 466 specimens were collected. Rotavirus were detected on 246 (52.8%) specimens. 97% of the rotavirus diarrhea cases occurred among children less than 2 years old. There was a peak of admissions for rotavirus diarrhea cases between October and December which accounted for 48% of all the rotavirus hospitalizations each year. Among 204 specimens with G serotyping, the predominant strain was serotype G1 (47.5%) followed by G2 (17.6%), G3 (15.7%), G9 (4.9%) and G4 (1.0%). Mixed infection (2.5%) were rare and 22 specimens (10.8%) remained non-typeable. P genotyping showed P[4], P[8] and P[6] were the most common strains, accounting for 29.3%, 27.6% and 13.8% respectively. P[4]G2 was the most common strain which accounted for 34.1% (14/41) followed by P[8]G1 (29.3%) and P[6]G9 (12.2%). Another 7 uncommon P-G combinations were also identified.

CONCLUSIONRotavirus was the major cause of acute diarrhea in Kunming. An effective rotavirus vaccine for prevention and control of rotavirus diarrhea should be developed.

Child, Preschool ; China ; epidemiology ; Diarrhea ; virology ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Female ; Genotype ; Hospitals, Pediatric ; statistics & numerical data ; Humans ; Infant ; Male ; Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus ; classification ; genetics ; isolation & purification ; Rotavirus Infections ; epidemiology ; Sentinel Surveillance ; Serotyping