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Biomedical subjects

F Pang

Publications and source records attributed to F Pang.

12 recordsLinked to original sources
PubMed2006

Preschool healthcare utilisation related to home oxygen status.

OBJECTIVE: To determine, in prematurely born children who had bronchopulmonary dysplasia (BPD), if respiratory morbidity, healthcare utilisation, and cost of care during the preschool years were influenced by use of supplementary oxygen at home after discharge from the neonatal intensive care unit. DESIGN: Observational study. SETTING: Four tertiary neonatal intensive care units. PATIENTS: 190 children, median gestational age 27 weeks (range 22-31), 70 of whom received supplementary oxygen when discharged home. INTERVENTIONS: Review of hospital and general practitioner records together with a parent completed respiratory questionnaire. MAIN OUTCOME MEASURES: Healthcare utilisation, cost of care, cough, wheeze, and use of an inhaler. RESULTS: Seventy children had supplementary oxygen at home (home oxygen group), but only one had a continuous requirement for home oxygen beyond 2 years of age. There were no significant differences in the gestational age or birth weight of the home oxygen group compared with the rest of the cohort. However, between 2 and 4 years of age inclusive, the home oxygen group had more outpatient attendances (p = 0.0021) and specialist attendances (p = 0.0023), and, for respiratory problems, required more prescriptions (p<0.0001). Their total cost of care was higher (p<0.0001). In addition, more of the home oxygen group wheezed more than once a week (p = 0.0486) and were more likely to use an inhaler (p<0.0001). CONCLUSIONS: Children with BPD who have supplementary oxygen at home after discharge have increased respiratory morbidity and healthcare utilisation in the preschool years.

Birth Weight↗
PubMed2004

A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes.

BACKGROUND & AIMS: Malnutrition is common in sick elderly people on admission to hospital and in the community. We conducted a randomised controlled trial to determine if nutritional supplementation after discharge from hospital improved nutritional status and functional outcomes, or reduced health-care costs. METHODS: Elderly malnourished subjects were randomised to 8 weeks of supplementation or no supplementation post discharge, and followed up for 24 weeks. Weight, body mass index, anthropometrics, handgrip strength, quality of life and requirements for health-care professionals' services and social services were measured throughout the study. RESULTS: Nutritional status improved significantly from baseline to week 24 in the intervention group (P<0.05), but not in the control group. There was no significant difference in nutritional status between groups at week 24. Handgrip strength improved significantly in the intervention group during supplementation, and was significantly different from that of the control group at week 8, but decreased thereafter. There was no significant difference in quality of life or health economic outcomes between groups at week 24. CONCLUSIONS: In already malnourished elderly subjects, it may be too late to expect to improve function or quality of life or to reduce health-care costs simply by providing nutritional supplements after hospitalisation. Prevention is key. All elderly patients should be nutritionally assessed as part of their routine care, and appropriate intervention initiated early.

Aged↗
PubMed2004

Health care utilisation of prematurely born, preschool children related to hospitalisation for RSV infection.

BACKGROUND: In prematurely born infants with chronic lung disease (CLD), RSV hospitalisation is associated with increased health service utilisation and costs in the first two years after birth. AIMS: To determine whether RSV hospitalisation in the first two years was associated with chronic respiratory morbidity during the preschool years in prematurely born children who had had CLD. METHODS: Retrospective review of readmissions, outpatient attendances, and community care in years 2-4 and, at age 5 years, assessment of the children's respiratory status and their health related quality of life. Comparison was made of the results of children who had had at least one hospitalisation in the first two years after birth for RSV infection (RSV group) to those of the rest of the cohort. Participants were 190 of an original cohort of 235 infants with CLD and a median gestational age 27 (range 22-33) weeks. RESULTS: The 33 children in the RSV group, compared to the rest of the cohort, had a greater duration of hospital stay and more outpatient appointments. The RSV group had required more prescriptions for all treatments and respiratory medications, and more had used an inhaler. The cost of care of the RSV group was higher (median 2630 pounds sterling [4000 Euros, US4800 dollars], range 124-18,091 pounds sterling versus 1360 pounds sterling [2500 Euros, US3000 dollars], range 5-18 929 pounds sterling ) and their health related quality of life was lower. CONCLUSION: In prematurely born children who had developed CLD, RSV hospitalisation in the first two years was associated with chronic respiratory morbidity and increased cost of care.

Ambulatory Care↗
PubMed2001

Pooling of Chlamydia laboratory tests to determine the prevalence of ocular Chlamydia trachomatis infection.

With the Global Elimination of Trachoma by 2020 program underway, it has become increasingly important to identify the prevalence of ocular chlamydia infection in communities. DNA amplification tests are the gold standard, but are prohibitively expensive. In the present paper, we investigate whether pooling multiple specimens into a single test is feasible. The conjunctivae of 170 children in western Nepal were examined and swabbed. The prevalence of chlamydial infection was estimated in two ways using the ligase chain reaction: by testing all 170 specimens individually, and by testing 34 pools of 5 specimens each. We show that the confidence interval for 34 pooled specimens approaches that of doing all 170 specimens as the prevalence decreases. We also determine the optimal number of specimens to pool into a single test to minimize the confidence interval of the estimate. If the population prevalence is expected to be around 10%, then 14 specimens should be pooled per test. Even at 50% prevalence, costs can be reduced by pooling two samples per test.

Child↗
PubMed1999

Reliability of clinical diagnosis in identifying infectious trachoma in a low-prevalence area of Nepal.

The WHO Alliance for Global Elimination of Trachoma by 2020 has increased the need to identify ocular chlamydial infections by clinical examination in areas of both high and low prevalence. The relationship between clinically active trachoma (as defined by clinical examination) and chlamydial infection is known for areas with hyperendemic trachoma, but not for areas with a low prevalence of the clinical disease. In the present study, we examined, photographed, and DNA tested the conjunctivae of children in the Surkhet district of mid-western Nepal, an area known to have a low prevalence of clinically active trachoma. Although 6% of the children aged 10 years and under were found to have clinically active trachoma, none were found to have chlamydia infection by the most sensitive DNA amplification tests available. A very low prevalence of clinically active trachoma is not necessarily evidence of the presence of chlamydial infection. Therefore, the WHO policy of not recommending an intensive trachoma control effort when the prevalence of clinically active trachoma is less than 10% in children is appropriate for this area of Nepal.

Child↗
PubMed1996

Clinical neuroimmunology.

Clinical research has focused on autoimmune disease (AID) for a couple of decades. More sensitive and specific methods have been developed for neuroimmunological research. Gamma fraction bands (bands separated by electrophoresis and visualized by amino black staining) and IgG fraction bands (bands separated by iso-electric focusing and visualized by immunostaining) are used instead of oligoclonal bands. Myasthenia gravis (MG) mainly involves acetylcholine receptors of the postsynaptic membrane at the neuromuscular junction. Myasthenia gravis has been considered to be a generalized AID, because 7% of patients with myasthenia gravis associate with other AIDs and more than one autoimmune antibody is detected in 52.5% patients with myasthenia gravis. Pyramidal signs in myasthenia gravis patients are described; the possible mechanism may at least be partly due to the acetylcholine receptor antibody. P2 protein and its antibody are studied in patients with acute and chronic inflammatory demyelinating polyneuropathy.

Adolescent↗
PubMed1992

[Experimental studies on growing seedlings of Morinda officinalis How].

By using the techniques of growing seedlings in bowshaped shed covered with plastic sheeting plus treatment with plant growth regulator, vegetative and generative propagation tests have been made of Morinda officinalis. Scientific evidences have thus been provided for growing seedlings of Morinda officinalis.

Indoleacetic Acids↗
PubMed1992

[Tuberculous otitis media, mastoiditis associated with meningitis: report of one case].

Tuberculosis of the middle ear is rare; associated meningitis is even more unusual. This report contains our experience with a one and a half year old psychomotor retarded boy. He had a poor healing left postauricular abscess four months prior to admission. Also noted was postprandial vomiting and left sided involuntary movement. On admission spinal tapping was done. Results showed leukocytosis, with lymphocytes being predominant, as well as high protein and low glucose levels. A cranial CT revealed left mastoiditis, hydrocephalus, basal cistern abnormal enhancement and a prominent posterior fossa postcerebellar CSF space. Left radical mastoidectomy was performed. A biopsy showed caseous necrosis surrounded by epitheloid and Langhan's giant cells. He also received a ventriculoperitoneal shunt. The gastric and CSF were both positive for tuberculous culture.

Humans↗
PubMed1986

Use of gonozyme on urine sediment for diagnosis of gonorrhea in males.

We compared enzyme immunoassay (Gonozyme; Abbott Laboratories, North Chicago, Ill.) for detection of gonococcal antigen in urine sediments with urethral swab culture for diagnosis of gonorrhea in men attending a venereal disease clinic. The prevalence of infection was 14% by culture (27/196). The sensitivity of enzyme immunoassay was 93% (25/27) compared with the culture method, and the specificity was 99% (167/169). The ability to detect gonococcal antigen in urine sediment may provide the basis for a noninvasive method of screening for gonococcal infection.

Antigens, Bacterial↗
PubMed1985

New view of the surface projections of Chlamydia trachomatis.

Two kinds of surface specializations of chlamydiae have been described: hemispheric projections and spikelike rods. We undertook the present studies to demonstrate chlamydial ultrastructure in greater detail in conventional thin-sectioned specimens. Chlamydia trachomatis (LGV strain L2/434/Bu), cultured for 40 h in L929 mouse fibroblasts, was fixed in glutaraldehyde-acrolein, p-formaldehyde-glutaraldehyde, or glutaraldehyde-osmium tetroxide mixtures, postfixed in osmium tetroxide, stained in uranyl acetate, dehydrated in ethanols, and embedded in Epon. By the use of fixatives that penetrate and fix rapidly, chlamydial outer and plasma membranes were clearly revealed. Our results indicate that the hemispheric projections are specializations of the plasma membrane of elementary bodies. The spikelike projections are found in intermediate forms, originate beneath depressions of the plasma membrane, and extend through the periplasmic space and outer membrane to end with pointed tips. Improved preservation of chlamydiae provides a new, informative view of their complex structure. Significant interactions between chlamydiae and host cells might be influenced by the surface structures shown in this study.

Cell Membrane↗
PubMed1975

Missing medications associated with centralized unit dose dispensing.

The reasons for missing medications in a centralized unit dose system were studied, and means of improving the situation were recommended. Reasons for missing medications included: insufficient or incorrect medications dispensed by the pharmacy, differences in interpretations of orders by pharmacists and nurses, administration of extra medication or incorrect doses, waste of medication, administration of medication to patients other than for whom it was dispensed, delivery to wrong nursing unit, pilferage, and requests by nurses for medication before the orders were received by the pharmacy. A procedure for checking medications in unit dose carts by pharmacy and nursing personnel was implemented. Before this procedure, the rate of missing medications was 0.93% of the doses dispensed; after the procedure, the rate was 0.33%. Other recommendations designed to prevent missing medications in this unit dose system are presented.

Colorado↗