Biomedical subjects

S J Lin

Publications and source records attributed to S J Lin.

205 records · Page 12Linked to original sources

PubMedDate not supplied

Comparison of the genetic knowledge among nurses, students, and general public after ten years of implementation of genetic health program in Taiwan.

This study aims to explore the genetic knowledge of different health professional, and non-professional populations after ten years of implementation of genetic health program in Taiwan. A self-administered questionnaire was developed to test the genetic knowledge of 885 respondent who included 361 community health nurses, 74 maternal-child nurses, 364 college students, and 86 members of the general public. The questionnaire included 33 questions which were divided into 4 categories (1) basic genetic knowledge, (2) Mendel's Law and probability, (3) prenatal diagnosis, (4) identification of common genetic disorders. The responses were scored and analyzed statistically with ANOVA tests. Community health nurses had the highest scores of genetic knowledge. However, they need more practice in the application of Mendel's Law and probability. Maternal-child nurses should be involved in genetic education programs and improve their ability to identify common genetic disorders and thus increase their ability to identify cases and provide better information to patients and families. Compared to other groups, college students had lower scores in prenatal diagnosis and identification of common genetic disorders. Therefore, college curricula in genetics need to emphasize more on these subjects. From the study, it was concluded that community health nurses are effective and competent to continue the genetic education as supported by the government in the past ten years. Maternal-child nurses are inevitably involved in genetic service, and they should be provided with suitable continuing education programs. The general public should strengthen their knowledge of prenatal diagnosis and common genetic disorders. Prenatal diagnosis should be added in the school curriculum of college students to expand their knowledge. New genetic technology, such as DNA analysis, should be added in the content of genetic education programs.

Adult↗

PubMedDate not supplied

Acetaminophen overdose in children and adolescents.

From 1982 to 1997, 12 Chinese children were admitted to Chang Gung Memorial Hospital with acetaminophen overdose. Six subjects (one young child, and five adolescents) developed liver damage which was severe in three cases (AST > 1000 IU/L). Acetaminophen-induced liver function abnormalities were characterized by elevation of transaminase levels with ALT higher than AST(6/6), coagulopathy(5/6), thrombocytopenia (1/6), but absence of jaundice(6/6). Fortunately, none of the six patients with liver damage developed fulminant liver failure, and all recovered completely. Acetaminophen overdose can cause significant morbidity in children and adolescents. Caretakers should be well instructed to give the drug correctly. So far, acetaminophen is still considered as the drug-of-choice for antipyresis in pediatric practice. However, multicentered collaborative study is necessary to determine whether acetaminophen intoxication causes less hepatic failure in Chinese children than in Western children.

Acetaminophen↗

PubMedDate not supplied

Clinical and laboratory correlation of acute Henoch-Schönlein purpura in children.

The clinical and laboratory features of 72 children with Henoch-Schönlein purpura (HSP) were examined to determine if there were associations between the laboratory indices--including white blood cell (WBC) counts, serum C-reactive protein (CRP) levels, platelet (PLT) counts--and the clinical manifestations of acute HSP. Marked leukocytosis (WBC > 15,000/mm3), elevation of serum CRP levels (> 10 mg/L) and thrombocytosis (PLT > 400 x 10(3)/mm3) were associated with gastrointestinal (GI) bleeding, but not associated with abdominal pain in the absence of GI bleeding. None of the three parameters was associated with arthritis and nephritis. Elevated serum CRP levels alone was associated with prolonged hospital course, and may serve as an indicator of disease severity in patients with HSP. GI bleeding did not occur in patients with normal WBC counts, serum CRP levels, PLT counts (0/19), but occurred in 21.7% (5/23), 50% (8/16), and 85.7% (12/14) in patients with only one, two of the three and all three laboratory abnormalities, respectively. Patients with GI bleeding had higher mean WBC, PLT counts and serum CRP levels than those with abdominal pain in the absence of GI bleeding, and than those without abdominal pain. Routine measurement of these parameters is warranted to monitor children with acute HSP.

Adolescent↗

PubMedDate not supplied

Gastrointestinal involvement as the initial manifestation in children with Henoch-Schönlein purpura--clinical analysis of 27 cases.

A retrospective study was conducted to analyze the clinical and laboratory features, results of imaging studies, and course and treatment in 27 children with Henoch-Schönlein purpura (HSP) who initially presented with only abdominal symptoms. There were 17 boys and 10 girls, aged 6.7 +/- 0.5 years. The abdominal symptoms preceded the purpura for 10.2 +/- 1.9 days, ranging from 3 to 48 days. The main abdominal symptoms were periumbilical pain (77.8%); vomiting (51.9%); diarrhea (29.6%); pain mimicking appendicitis (22.2%) and bloody stool (14.8%). Laboratory findings revealed leukocytosis (88.9%), thrombocytosis (77.8%), positive stool guaiac tests (77.8%), and elevation of serum C-reactive protein (71.4%). Plain film is of limited use, but emergent abdominal sonography can be helpful in patients suspected of appendicitis. Unnecessary laparotomy was performed in three patients, whose pain persisted after the operation. Corticosteroid, given upon the appearance of rash, alleviated the abdominal pain in 2.4 +/- 0.2 days. All patients had recovered completely at six-month follow-up, except that three had persistent microscopic hematuria. A high index of suspicion and early diagnosis of HSP based on clinical features, laboratory data and the findings from diagnostic imaging may avoid unnecessary surgery. Early use of corticosteroid may reduce the suffering in these children.

Abdominal Pain↗

PubMedDate not supplied

Successful treatment of Sjögren's syndrome with cyclophosphamide pulse therapy: report of one case.

The treatment of Sjögren's syndrome (SS) is very controversial, though several therapeutic regimens have been proposed. Cyclophosphamide pulse therapy has been widely used in many disease entities. However, reports concerning its clinical application in SS were very rare. We report a 17-year-old girl presenting with lupus nephritis and SS, which was refractory to corticosteroid therapy but successfully treated with cyclophosphamide pulse therapy. The improvement of clinical features was confirmed by Schirmer's test and minor salivary gland biopsy.

Adolescent↗

PubMedDate not supplied

Orthopedic manifestation in a child with hyperimmunoglobulin E syndrome.

We report a 12-year-old girl with hyperimmunoglobulin E (HIE) syndrome who presented with genu vulgus of left knee, joint deformities involving both hands, and frequent fractures. She had had chronic eczema and recurrent skin and soft tissue infections since infancy, and was found to have a pneumatocele during admission. Immunologic abnormalities included extremely elevated serum IgE levels (18989 IU/ml) and cutaneous anergy to candida, purified protein derivative, and tetanus toxoid. The results of polymorphonuclear leukocyte function tests including the nitroblue tetrazolium test and chemotaxis were normal. A high index of suspicion for HIE syndrome should be given in patients with recurrent skin infections and orthopedic complaints. The physician should anticipate orthopedic problems in caring for patients with HIE syndrome, and optimal antibiotics prophylaxis should be used.

Arthrography↗

PubMedDate not supplied

Circulating interleukin (IL)-1 beta, IL-6 and tumor necrosis factor-alpha in children with febrile infection--a comparison with C-reactive protein.

Circulating interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha were examined in 42 febrile children with fever lasting more than 4 days. Their diagnosis were probable viral syndrome in 22, urinary tract infection (UTI) in 10, and probable bacterial pneumonia in 10. None of our study patients had detectable serum IL-1 beta. TNF-alpha levels were significantly higher in children with pneumonia than in those with viral syndrome (p < 0.01). Children with UTI and pneumonia had significantly higher IL-6 and CRP, compared to those with probable viral syndrome (p < 0.01 for both IL-6 and CRP). When appropriate cutoff values are chosen, IL-6 had greatly improved specificity (86.4%, > 20 pg/ml) to demonstrate UTI and pneumonia, as compared to that using CRP (48%, > 40 mg/l). After three days' antibiotic treatment, IL-6 fell to control levels in children with UTI and pneumonia, while CRP remained elevated. There was no difference in TNF-alpha values before and after treatment. Thus, IL-6, rather than IL-1 beta and TNF-alpha, may be a helpful diagnostic tool for evaluation of pediatric febrile infection. Sequential studies involving more patients are needed to determine whether IL-6 is better than CRP in this clinical setting.

Adolescent↗