Journal of the Chinese Medical Association : JCMA
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Low back pain (LBP) is very common in the general population. Most patients with LBP will receive an X-ray examination on lumbar spine; however, the results are likely to show a negative finding or degenerative joint disease, which are not truly pathological factors. Among various imaging diagnostic tools for active bony lesions of lumbar spine, planar bone scintigraphy has a higher sensitivity, but its ability to locate anatomic lesions is less satisfactory. The purpose of this study was to investigate the role of SPECT for evaluation of LBP. ⋯ SPECT was more sensitive and located more lesions than planar bone scintigraphy, especially when the lesions were located at posterior element of vertebrae. Most of the lesions were distributed at the 4 th and 5 th lumbar vertebral segments. There was no significant statistical difference of abnormal SPECT related to X-ray finding. The use of SPECT was the first choice among all image modalities when cause of low back pain was assumed to arise from bone and joint disorder at clinical evaluation.
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Review Case Reports
Severe hypophosphatemia in a patient with diabetic ketoacidosis and acute respiratory failure.
Although hypophosphatemia is a common complication during therapy of diabetic ketoacidosis, it is seldom severe and rarely causes clinical manifestations. We report a 39-year-old woman with diabetic ketoacidosis who developed acute respiratory failure after therapy. Although hyperglycemia and acidosis were corrected after treatment, respiratory distress and weakness still persisted. ⋯ The patient's clinical condition improved steadily over the next few days, and after 4 weeks of hospitalization, she was discharged home without obvious long-term sequelae. In a critically ill patient, the symptoms of hypophosphatemia are not apparent and may mimic the symptoms of other underlying disease. Although phosphate replacement is not recommended routinely in diabetic ketoacidosis, if the patient develops cardiopulmonary distress, anemia or severe hypophosphatemia, phosphate therapy under close surveillance is indicated.
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Procalcitonin (PCT) represents a new marker of systemic inflammatory reactions to bacterial infections. The main aim in this study was to determine the diagnostic value of PCT in predicting the clinical severity of febril neutropenic attacks, compare it with that of C-reactive protein (CRP), and clarify its importance in culture-positive attacks. ⋯ PCT and CRP are comparable with each other in prediction of the clinical severity of febrile neutropenic attacks. Furthermore, serum CRP levels correlate with the duration of fever.
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It has been pointed out that longitudinal rather than cross-sectional growth standards should be used to assess individual linear growth. The purpose of this study is to investigate the growth characteristics of school boys and girls living in Shih-Pai district in Taipei. ⋯ Our preliminary results were actually calculated from the combination of longitudinal data and cross-sectional data pools. Since this is only a pilot study design, we expect that a longer follow-up period of the same cohorts would give more exact growth characteristics.
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Oral anticoagulants have an expanding role in cardiovascular and thrombotic disorders. Few data are available describing their safety among Chinese patients. We aim to evaluate the incidence of major and minor bleeding complications among Chinese patients receiving long term anti coagulants in community practice. ⋯ Among Chinese patients receiving long-term warfarin, major hemorrhage occurred at an acceptable range in clinical practice, while considerable minor bleeding was observed. Utilization of oral anticoagulants in Chinese patients appears safe and should be advocated in situations with appropriate indications.