Antiviral agents and corticosteroids in the treatment of severe acute respiratory syndrome (SARS)

published_or_final_versio

香港結核病患者的特徵與治療結果

OBJECTIVES: To identify the general characteristics of patients with tuberculosis, and to evaluate their treatment outcomes. DESIGN: Retrospective study. SETTING: Tuberculosis and Chest Service, Department of Health, Hong Kong. SUBJECTS AND METHODS: All patients with tuberculosis registered for treatment from 1 January 1996 to 31 December 1996 were included in the study. Information was extracted from their medical records at treatment commencement and at 12 and 24 months after treatment was instigated. Data gathered included demographic data, past treatment, site of disease, case category, treatment regimen, bacteriological status, and treatment outcome. RESULTS: There were 5757 patients for analysis. Approximately one third of patients were aged 60 years or older, and 69.1% were male. Pulmonary disease alone occurred in 77.7% of patients, while both pulmonary and extrapulmonary diseases occurred in 8.6%. New patients comprised 84.6% of cases, and 16.3% had concomitant illnesses. There was excess risk of disease among patients who were male, elderly, or who had silicosis. Only 0.1% of patients were co-infected with human immunodeficiency virus infection. Among the 5757 cases evaluated, 1324 (23.0%) were new patients with a positive sputum smear, 299 (5.2%) were patients who were retreated with a positive sputum smear, and 4134 (71.8%) were new or retreatment patients with a negative sputum smear. The overall treatment completion rates at 12 and 24 months were 80.4% and 84.8%, respectively. Males and patients aged 60 years or older had lower treatment completion rates. Non-adherence, transfer to other services, and mortality among the elderly were key factors influencing treatment outcomes. Co-morbidity was associated with better case-holding, and this more than compensated for its effect on prolongation of treatment and mortality. CONCLUSIONS: There was an excess risk of tuberculosis among male and elderly patients, who also had a less favourable outcome. Active screening of clearly identified risk groups may be appropriate but requires the completion of more in-depth studies and careful cost-effectiveness analyses. Further efforts with respect to case-holding are indicated to address treatment defaulting and transfer rates.published_or_final_versio

Prevalence and predictors of default from tuberculosis treatment in Hong Kong

OBJECTIVE: To determine the prevalence and risk factors of default from tuberculosis treatment in Hong Kong. DESIGN: Retrospective study. SETTING: Data were obtained from programme forms completed by physicians in the Hong Kong Government Tuberculosis and Chest Service and from medical records from Hong Kong chest clinics. PATIENTS: In all, 5917 patients registered for antituberculous drug therapy in 1996; medical records of 5757 patients were reviewed. MAIN OUTCOME MEASURES: Patients who defaulted treatment were defined as those who had failed to collect medication for more than 2 consecutive months after the date of the last attendance during the course of treatment. Demographic and clinical characteristics, including history, treatment, and outcome, were compared between defaulters and non-defaulters, both among the whole group and among those with pulmonary disease. RESULTS: There were 442 (8%) patients who defaulted from treatment. Forty-five percent of those who defaulted did so in the first 2 months of treatment. Key risk factors associated with non-compliance were a history of default, male sex, and a history of concomitant liver disease or lung cancer. Among patients with pulmonary tuberculosis (381 defaulters and 1537 non-defaulters), multiple drug resistance was also associated with default from treatment. Among defaulters with pulmonary disease, 39% were still bacteriologically positive at the time of default. CONCLUSION: Default from treatment may be partially responsible for the persistent high rates of tuberculosis in Hong Kong in the past decade. Health professionals should ensure that all barriers to treatment be removed and that incentives be used to encourage treatment compliance.published_or_final_versio

A quantitative high resolution computed tomography assessment of patients with stable bronchiectasis

published_or_final_versio

Inhaled fluticasone therapy improves quality of life in bronchiectasis

published_or_final_versio

Oral coriolus versicolor polysaccharide peptide is beneficial by slowing the progression of lung cancer

published_or_final_versio

Efficacy and safety profiles of a combination of gemcitabine and ifosfamide on Chinese patients with advanced non-small cell lung cancer

published_or_final_versio

Inhaled corticosteroid therapy in bronchiectasis - a 12-month study

published_or_final_versio

Severe acute respiratory syndrome: patients were epidemiologically linked: Letters to the editor

published_or_final_versio