Internal medicine journal
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Internal medicine journal · Jul 2008
Comparative StudyPrevalence and associated factors of overweight and obesity in older rural Chinese.
The elderly obese are at increased risk of mortality and morbidity of many obesity-related chronic diseases, such as hypertension, diabetes and coronary heart disease. This study was designed to investigate the epidemiological features of overweight and obesity in older rural Chinese. ⋯ Although the prevalence of obesity was low, the prevalence of overweight was relatively high in older rural Chinese, especially in female adults. Unfavourable lifestyles, gender, age, ethnicity, education levels and physical activity were associated with the prevalence of these health conditions.
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Internal medicine journal · Jun 2008
Comparative StudyPrevalence of the JAK2-V617F mutation in Taiwanese patients with chronic myeloproliferative disorders.
The Janus kinase-2 (JAK-2) V617F mutation has been recently reported in patients with myeloproliferative disorders (MPD), which is believed to underlie growth factor hypersensitivity displayed by haematopoietic progenitors in these disorders. However, its frequency has been rarely determined in Taiwanese patients. ⋯ The JAK2-V617F mutation can be frequently detected in the Taiwanese patients with MPD disorders and therefore should be incorporated into the initial evaluation of patients suspected of MPD.
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Internal medicine journal · Jun 2008
Practice GuidelineDiagnostic and therapeutic approach to persistent or recurrent fevers of unknown origin in adult stem cell transplantation and haematological malignancy.
Persistent or recurrent fevers of unknown origin (PFUO) in neutropenic patients on broad-spectrum antibiotics have traditionally been treated with empirical antifungal therapy (EAFT). The lack of survival benefit seen with the use of amphotericin B deoxycholate (AmB-D) as EAFT has been attributed to its toxicities. More recently, newer, less toxic and more expensive antifungal agents such as the lipid formulations of AmB, the newer azoles (fluconazole, itraconazole and voriconazole) and caspofungin have been analysed in a number of EAFT trials. ⋯ The pre-emptive approach has been shown to be safe and feasible but its impact on clinically important patient outcomes such as survival is less clear. Other advances include the introduction of effective, non-toxic mould-active antifungal prophylaxis and patient risk-group stratification. In this paper we provide new evidence-based algorithms for the diagnosis and treatment of PFUO in adult patients undergoing stem cell transplantation and chemotherapy for haematological malignancy which incorporate these newer diagnostic tests and are directed by the risk category of the patient and type of antifungal prophylaxis the patient is receiving.