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Factors influencing student enrollment in clinical laboratory science programs.

The results of the phase 1 research revealed three themes concerning junior CLS students' decision to enter a single university-based CLS program: 1) influential people, 2) job characteristics, and 3) program characteristics. Phase 2 data ranked the following item descriptors as the most important motivational factors: choice of program based on geographical location; family and friends as the most influential people in making their decision; the laboratory profession as a stepping stone to other professions; and their college advisor as the most relevant information source for these students. This study provides some insight on ways to attract new people to laboratory science and as a source of information for institutions to encourage young people to enter the field of laboratory medicine. CLS programs can use the information from this study to evaluate marketing and recruiting strategies to increase enrollment. The implications of this study can be summarized as follows: Recruiters should focus marketing the program in their local geographical area. Family and friends should continue to spread the word about the profession. The ability to grow into other professions should be emphasized. College advisors should always remain visible and market the programs; and high school students should be exposed to the profession.

Career Choice↗

A social network analysis of communication about hereditary nonpolyposis colorectal cancer genetic testing and family functioning.

Hereditary cancers are relational diseases. A primary focus of research in the past has been the biological relations that exist within the families and how genes are passed along family lines. However, hereditary cancers are relational in a psychosocial sense, as well. They can impact communication relationships within a family, as well as support relationships among family members. Furthermore, the familial culture can affect an individual's participation in genetic counseling and testing endeavors. Our aims are (a) to describe the composition of familial networks, (b) to characterize the patterns of family functioning within families, (c) to analyze how these patterns relate to communications about genetic counseling and testing among family members, and (d) to identify influential family members. Specifically, we asked how the relationship between mutation status, kinship ties, and family functioning constructs, e.g., communication, cohesion, affective involvement, leadership, and conflict, was associated with discussions about genetic counseling and testing. We used social network analysis and random graph techniques to examine 783 dyadic relationships in 36 members of 5 hereditary nonpolyposis colorectal cancer (HNPCC) families interviewed from 1999-2000. Results suggest that in these five HNPCC families, two family members are more likely to discuss genetic counseling and testing if either one carries the mutation, if either one is a spouse or a first-degree relative of the other, or if the relationship is defined by positive cohesion, leadership, or lack of conflict. Furthermore, the family functioning patterns suggest that mothers tend to be the most influential persons in the family network. Results of this study suggest encouraging family members who act in the mother role to take a "team approach" with the family proband when discussing HNPCC risks and management with family members.

Adult↗

Career choice and perceptions of dental hygiene students and applicants.

PURPOSE: As the number of dental hygiene programs across the country continues to increase, educational opportunities for prospective students have flourished, resulting in increased competition among dental hygiene programs for qualified applicants. The purpose of this study was to provide a current description of dental hygiene students and applicants, assess the reasons for choosing the career, and evaluate the perceptions of both applicants and enrolled students with regard to specific aspects of the profession. METHODS: A questionnaire was mailed to 142 prospective dental hygiene students who met the minimal requirements for admission to either of the two dental hygiene programs in Arkansas. The prospective students had been invited for an admissions interview. The questionnaire also was administered during class to 80 students currently enrolled in one of the two programs. RESULTS: An overall response rate of 71% (n = 157) was achieved. The average respondent was 22 years old, female, and Caucasian with a grade point average of 3.5 and a composite ACT score of 23. Dental hygiene was also the first career choice and most respondents had prior dental assisting experience. Dental hygienists and dentists were reported as providing the most career guidance, while high school and college guidance counselors were least influential. Respondents chose the profession in order to work with and help people, have flexible work schedules, and receive good salaries. Respondents typically viewed dental hygiene as offering a bright future in terms of job security, good salaries, flexible work schedules, diverse career opportunities, and personal responsibility. No significant difference in overall perceptions of the profession was found between applicants and those enrolled in dental hygiene programs, although the strength of individual perceptions of the profession differed between applicant and first-year students compared to second-year students. CONCLUSION: Dental hygiene programs can use the findings of this study to identify influential allies in guiding prospective students toward a career in dental hygiene. The results also can be used to design recruitment strategies that incorporate aspects of the profession found to motivate students in their career choice and shape their perceptions of the profession.

Adolescent↗

Does point-of-purchase nutrition labeling influence meal selections? A test in an Army cafeteria.

OBJECTIVE: This study assessed the effectiveness of nutrition labeling on sales of targeted entrees and measured the perceived influence that factors such as taste, quality, appearance, fat content, calorie content, and price had on meal selection behavior within an Army cafeteria. METHODS: A quasi-experimental design was used to compare targeted entrée sales between a 1-year baseline period and two 30-day postintervention periods, after the placement of entrée nutrition labels. A brief questionnaire, distributed to 149 patrons, measured the perceived influence of the aforementioned factors on selections. RESULTS: Analysis of variance detected no significant differences in sales between baseline and the two intervention periods; the factors of taste and quality were rated most influential to meal selection (p < 0.000). CONCLUSIONS: A marketing campaign focusing on the health attributes of targeted entrée items was not successful in boosting sales. Sensory attributes (i.e., taste, quality, and appearance) appear to be more influential to meal selection.

Adult↗

Influence of information sources on the adoption of uterine fibroid embolization by interventional radiologists.

OBJECTIVES: The purpose of the research was to (1) understand the influence of information sources on the awareness and adoption of uterine fibroid embolization (UFE) by interventional radiologists in Michigan and (2) to decipher communication relations in the social network of interventional radiologists that were most conducive to the flow of information about UFE. METHODS: Diffusion of innovations theory and constructs in social network analysis formed the basis for the development of an interview guide. Thirty-two interventional radiologists in Michigan were interviewed over the phone. Chi-square statistics were employed to analyze the awareness and adoption of UFE. Factor analysis was applied to decipher important communication relations in the social network of interventional radiologists. RESULTS: Conferences were found to be an initial source of information, creating awareness among early adopters (P < 0.05), but other individuals were found to be influential sources in the adoption of UFE by later adopters (P < 0.05). Radiologists rarely browsed Websites for information. Work relations in everyday clinical practice were the communication relations most conducive to the flow of information about UFE. Preliminary qualitative data indicated that opinion leaders in the diffusion of UFE in Michigan were located in hospitals primarily dedicated to practice rather than in hospitals affiliated with universities. CONCLUSIONS: Journals are important information sources for creating awareness and stimulating adoption of innovation among both early and late adopters of new procedures in interventional radiology. Conferences, however, are significantly more important for creating early awareness, while interactions with colleagues is the most important factor in stimulating use of the innovation among later adopters. Among colleagues, opinion leaders in nonacademic hospitals may be more influential than individuals in the academic community.

Adult↗

Factors influencing infant feeding method in an urban community.

The benefits of breastfeeding are well established. However, despite this fact, rates of breastfeeding continue to be low, falling far below the goals of Healthy People 2010. Rates are even lower among ethnic minority and low-income women. In this study, we attempt to identify the factors that most influence a mother's choice of infant feeding method in an urban predominately African-American population. Phone interviews of 70 women who delivered full-term infants at an urban tertiary care hospital were conducted in order to explore knowledge, attitudes, and beliefs about breastfeeding of the mothers and that of members of their social support network. Ten mothers (14%) exclusively breastfed. Older, caucasian, and married women were more likely to breastfeed. Breastfeeding mothers reported more partner support as well as more family knowledge about breastfeeding and had more positive attitudes about breastfeeding. Healthcare providers were not directly influential in mother's feeding choice. From this study, we conclude that in this population, the mother's partner and family are most influential in the choice of infant feeding method and, thus, should be included in breastfeeding promotion programs.

Adolescent↗

[The U-wave in ischemia and left ventricular dysfunction after myocardial infarct].

INTRODUCTION: The occurrence of U-wave in electrocardiogram appears after T-wave. It is period of the greatest excitability of the myocardium in heart electrical activity usually of the some direction as its own T-wave. AIM OF THE WORK ANALYSE: U-wave with ischaemia and dysfunction of the myocardium in exercise test. MATERIAL AND METHODS: The prospective study has been done for 51 patients. Electrocardiogram, exercise test vas made for all patients and immediately after test, echocardiography with Doppler and colour-Doppler. In the analysis of dysfunction of the left chamber these important parameters were followed: METS; decrease of blood pressure, devaluation of ST-segment, U-wave, heart rate, dyspnea, sweating and paleness. RESULTS: Positive U-wave was noticed in 51%, negative in 24% examinees. Sensitivity of U-wave on the base of the breakdown of segmental vall motion in echocardiography (ischaemia) is 66.67% with false negative resists of 33.33%. Systolic dysfunction with influential parameters correlates in the best way with decrease of blood pressure and regressive coefficient is 66.93, but the weabest correlation is with U-wave (0.53). Correlative coefficient for U-wave in systolic function is 0.263. Regressive coefficient with influential parameters in diastolic dysfunction is 3.34, correlative coefficient is 0.108. CONCLUSIONS: U-wave in registered at rest after exercise test when heart rate is equal or below 95 in a minute. Registration of U-wave is an additional parameter in diagnostics of ischaemia and dysfunction of the myocardium of the left chamber (small influence).

Echocardiography↗

[Sentinel lymph node identification with methylene blue in cervical cancer].

BACKGROUND & OBJECTIVE: Study of sentinel lymph node(SLN) in cervical cancer has been initiated since recent years, and there are still a lot of unknown factors about SLN identification in cervical cancer. This study was to investigate influential factors of identifying SLN with methylene blue in cervical cancer. METHODS: For 41 patients with cervical cancer enrolled from Jun. 2002 to May 2003, 2-4 ml of methylene blue was injected into cervix at 4-6 sites around the tumor about 90-400 min before operation. The blue-dyed lymph node (BDLN) was considered as SLN. HE staining in step sections, and immunohistochemistry were applied to detect SLN. The influential factors of using methylene blue to detect SLN in cervical cancer were assessed based on the identification rate of SLN, and its false negative rate. RESULTS: SLNs were detected in 31 of 41(75.6%) patients with cervical cancer of stage Ib1-IIb. A total of 85 SLNs were identified,and most frequently located in obturator fossa. SLNs were successfully detected in 20 of 23 (87.0%) patients who had no preoperative radiotherapy or chemotherapy, while in only 11 of 18 (61.1%) patients who had preoperative radiotherapy and/or chemotherapy. SLNs were detected in only 17 of 27(63.0%) patients who were injected with 2-3 ml of methylene blue, while in all of 14 patients whose dose was 3.4-4 ml. Eight patients were confirmed of lymph node metastases by pathology. CONCLUSIONS: The dose of methylene blue recommended to detect SLN in cervical cancer is 3-4 ml. SLN varies in different sites, but most frequently located in obturator fossa.

Adult↗

The importance of engaging policy-makers at the outset to guide research on and introduction of vaccines: the use of policy-maker surveys.

Face-to-face surveys of policy-makers and other influential leaders are a useful tool to identify, at an early stage, (a) major issues regarding the introduction of a new vaccine, (b) persons and groups in a country who play a major decision-making or influential role in the introduction of vaccines, (c) potential obstacles to the introduction of vaccines, and (d) data-needs of policy-makers to overcome these obstacles. By surveying the opinions and beliefs of those who will make or influence decisions on whether to introduce a new vaccine, these studies can help ensure that research activities respond to the needs of policy-makers in countries endemic for the target diseases. These surveys can also inform vaccine-introduction strategies by identifying financially and politically feasible means of distributing, targeting, and financing the vaccines. This paper describes the methodology used in conducting such surveys and discusses methodological issues. It also presents lessons learnt from two policy-maker surveys carried out in several Asian countries in regard to new-generation vaccines against cholera, typhoid fever, and shigellosis; and future vaccines against dengue fever/dengue haemorrhagic fever.

Asia↗

[Papal provisions for lesser benefices in the diocese of Breslau 1447-1471].

During the fifteenth century the popes were severely criticized for problems allegedly created by their provisions for benefices: prolonged law-suits, immense costs, and absenteeism of priests. Papal provisions for higher benefices, bishoprics and monasteries, were usually a political compromise. For lesser benefices, i.e. canonries or vicaries in cathedral or collegiate churches, parishes or altars in towns or villages, the background is seldom clear. Sometimes influential people at the papal curia strove to secure their livings, sometimes local princes, lords or towns provided their servants with incomes, sometimes ambitious clerics sought papal protection against local rivals. The extent to which the papacy was involved in appointments to lesser benefices varied throughout Europe and can only be studied in the regional archives. For the diocese of Breslau this has not been done so far, but the Repertorium Germanicum published by the German Historical Institute in Rome provides the data extant in the papal registers and account-books. The present study sums up these sources from the accession of Nicholas V in 1447 to the death of Paul II in 1471, a period, during which Silesia and especially its capital Breslau held close contact with Rome in order to fight the heretic Bohemian king George of Podiebrad. Nevertheless, the proportions of papal involvement in appointments for lesser benefices in the dioceses were apparently small. The cathedral of St John at Breslau had to admit papal exspectanices and provisions. But only half of the collegiate churches in Silesia were affected to some degree, especially Holy Cross at Breslau and St Mary at Grob-Glogau. Very few important town parishes were concerned, for example St Mary Magdalene at Breslau, the parishes at Neisse and at Neumarkt. It is not possible to say how many papal provisions were successful; those that were usually favoured men with influential friends in Silesia. If Rome introduced foreigners at all, they came from neighbouring courts (Habsburg, Poland, Brandenburg). Many clerics who sought papal provisions had studied at universities (including three doctors of medicine). ALthough provisions by papal legates in Breslau, whose registers are lost, may slightly alter the picture, it is clear that in general the papacy was not an important factor for the appointment to lesser benefices in late medieval Silesia, despite an impressive number of papal documents concerning Silesia and despite some spectacular cases (e.g. Paul Stange von Legendorf, later bishop of Ermland, and his nephew Adam Stange von Pfeildorf). The local authorities themselves were responsible for obvious deficiencies of the pre-Reformation church owing to bad training of clerics or the accumulation of benefices which led to the installation of badly paid vicars.

Catholicism↗

[Dilemmas of contemporary epilepsy pharmacotherapy].

The last decade was characterized by an enormous progress in all fields of epilepsy. The availability of a relatively great number of drugs that can be categorized into standard and new antiepileptic drugs (AEDs) has made individualization of therapy possible, but has challenged the clinician to answer many questions in everyday clinical routine that are not even theoretically satisfactorily solved. Among other questions, it refers to the choice of the most appropriate AED for specific therapeutic situations. Certainly, clinical trials that are harmonized with the principles of evidence-based medicine (EBM) constitute the basis for the evaluation of AEDs. In the forming of value judgments concerning new AEDs, the most influential were clinical trials with these drugs tested as add-on therapy in pharmacoresistant epilepsy. However, many relevant clinical questions have remained unanswered by these studies, primarily because the design of these trials was more appropriate for the licensing of new drugs than for clinical practice. As far as such a complex clinical condition as epilepsy is concerned, it is difficult to define the design for clinical drug trials that might be considered generally acceptable. Nevertheless, randomized controlled studies in newly diagnosed epilepsy, where the main outcome variable is the seizure absence, constitute the main methodological standard. The disproportion between the enormous quantity of easily accessible information about epilepsy therapy and the individual capability to meaningfully process that information is certainly one of the main challenges faced by a clinician. One of the solutions offered lately by some respectable professional organizations might be the implementation of treatment guidelines made on the basis of available studies that satisfy the standards of EBM. It can be assumed that the existing guidelines, and the guidelines that are yet expected, will be very influential. However, there is a prevailing consensus that therapy should be definitely individualized. Based on the contemporary level of knowledge, it means that it should be the result of dynamic interaction between the seizure type and epileptic syndrome, specific features of AEDs, and individual characteristics of the patient.

Anticonvulsants↗

Survival analysis for adult glioma in England and Wales.

BACKGROUND AND PURPOSE: To investigate factors influencing survival for adult glioma at the national population level, data from the Cancer Registry in England and Wales were analyzed. Glioma was diagnosed in 32,267 patients during 1971-1990 and follow-up data were available for these patients until 1995. METHODS: Median survival and crude survival rates (CSR) for 8 variables (age, gender, International Classification of Diseases for Oncology [ICD-O] morphology, World Health Organization [WHO] grade, tumor site, deprivation, geographical region, and period of diagnosis) were calculated and tested using the Kaplan-Meier method and the log-rank test. Relative survival rates (RSR) were calculated using the life table of 1981. Cox multivariate regression was performed for estimating hazards ratios (HR) and tested using the log likelihood ratio test. RESULTS: The median survival and the 1-, 5-, and 10-year CSR for this population were 0.42 years, 29.1%, 12.0%, and 7.7%, respectively. The 1- and 5-year RSR were 29.6% and 12.3%, respectively. Survival was influenced by all 8 variables tested (p </= 0.025). Age at diagnosis was the most influential factor (HR, 1.22/5 years). Females had better survival than males (HR, 0.94). Patients with unspecified gliomas had the worst survival, while those with ependymoma had the best survival. Tumors in the posterior fossa were associated with better survival than those in the cerebral hemisphere. Survival was associated with the WHO grade and the level of deprivation, and had regional differences. Survival improved by 16% between 1971-1975 and 1986-1990. CONCLUSION: Survival in adult glioma is influenced by multiple factors, including socioeconomic background. However, age at diagnosis and tumor characteristics are the most influential factors.

Age Factors↗

[Natural history of acute symptomatic hepatitis C in Korea].

BACKGROUND/AIMS: Acute hepatitis C (AHC) has a high chronicity rate of up to 85%. Recently, several studies have demonstrated AHC has a self-limited course in about 50% especially in symptomatic cases. However, there is no investigation about the natural course of AHC in Korea. We intended to define the natural course of AHC and the influential factors on it. METHODS: We enrolled the patients with AHC from 2001 to 2004. The diagnosis of AHC was based on seroconversion to anti-HCV antibodies or the clinical and biochemical diagnostic criteria satisfactory to AHC and on the presence of HCV RNA in first serum sample. The self-limited course of AHC was defined as permanent (>6 months) loss of HCV RNA in serum and normalization of ALT. RESULTS: Eighteen patients presented with AHC. Seventeen out of eighteen was symptomatic. Twelve out of eighteen (66.7%, 95% CI 41.7-84.9%) showed spontaneous remissions. Presence of anti-HCV on first serum samples predicted chronic courses. Antibody to HCV was not detected during follow-up periods in nine patients, who all showed spontaneous viral clearance. CONCLUSIONS: AHC has a high rate of spontaneous viral resolution. Further study is needed to define the influential factors on the viral clearance in AHC.

Acute Disease↗

Wüsteria.

The last two decades have seen considerable efforts directed towards making electronic health records interoperable through improvements in medical ontologies, terminologies and coding systems. Unfortunately, these efforts have been hampered by a number of influential ideas inherited from the work of Eugen Wüster, the father of terminology standardization and the founder of ISO TC 37. We here survey Wüster's ideas - which see terminology work as being focused on the classification of concepts in people's minds - and we argue that they serve still as the basis for a series of influential confusions. We argue further that an ontology based unambiguously, not on concepts, but on the classification of entities in reality can, by removing these confusions, make a vital contribution to ensuring the interoperability of coding systems and healthcare records in the future.

Computer Systems↗

Factors influencing the selection of dental hygiene as a profession.

Since the mid-1970s, the dental hygiene profession has experienced a decline in the number of applicants. Reasons cited for this decline are fewer traditional college-age students, an increase in the career opportunities available to women, and a decrease in student financial aid. Four-year dental hygiene programs have experienced applicant decline faster than two-year programs. The purpose of this study was to determine factors that influenced university freshmen to designate dental hygiene as a career choice. Factors examined included reasons for choosing or not choosing a career in dental hygiene, and retention in the college major chosen. A questionnaire was mailed to three groups of students who entered the University of North Carolina-Chapel Hill as freshmen from 1985 through 1987: (1) all students who designated dental hygiene as a major on their entrance application; (2) a random sample who did not; and (3) all the freshman during that time period who subsequently matriculated into the dental hygiene program. The overall response rate was 78% (n = 80). Subjects began to explore career opportunities at a mean age of 16. Having a family member/friend in the selected field was found to be the most influential factor in career selection. Among dental hygiene students, contact with a dental hygienist was perceived to be influential in their career choice. Entering college freshmen exhibited a lack of knowledge about the dental hygiene profession, and most had not received any information about dental hygiene in high school. These findings can be used to develop recruitment strategies.

Adult↗

Managing primary care using patient satisfaction measures.

Our study aimed to identify which attributes of a primary healthcare experience have the most impact on patient satisfaction as well as which aspects of each attribute are most significant in patients' response to the services they receive. The three attributes examined in this study were access, staff care, and physician care. Analyses of the aspects of each attribute controlled for age, gender, and race. Data used in this study were obtained through a survey questionnaire with random sampling, resulting in the sample size of 8,465. The psychometric properties of the questionnaire were also examined and showed appropriate reliability and validity. The multiple regression analysis showed that among the three attributes, physician care was most influential, closely followed by staff care, with access having much less influence. Further analyses revealed that specific aspects of each attribute were more influential on patient satisfaction. Within the physician care attribute, patients were found to be rational consumers who were looking for surrogate indicators of correct diagnosis and treatment options among the measures available to them. They were much less likely to be influenced by so-called bedside manner. Within the staff care attribute, willingness and compassionate behaviors of staff and prompt service were most important. Within the access attribute, patients sought caring interaction with appointment personnel. After considering the findings, we discuss possible actions for healthcare managers.

Adult↗

[Lymphatic metastasis intensity of and lymphadenectomy for thoracic esophageal squamous cell carcinoma].

BACKGROUND & OBJECTIVE: The intensity of lymphatic metastasis consists of lymph node metastasis number (LMN) and lymph node metastasis ratio (LMR). LMR is the ratio of positive nodes to dissected nodes. LMN and LMR are 2 important prognostic factors of esophageal cancer, and are adopted in tumor staging. This study was to assess the lymphatic metastasis intensity of thoracic esophageal squamous cell carcinoma (ESCC), and explore the influential factors and lymphadenectomy pattern. METHODS: A total of 120 patients with ESCC had been operated in the Second Affiliated Hospital of Sun Yat-sen University from 1998 to 2000. The lymph nodes were dissected according to the mapping scheme of the American Thoracic Society (ATS) modified by Casson et al. RESULTS: A total of 2 631 lymph nodes were dissected with an average of 22 lymph nodes in each case. The cervical LMR was significantly higher in the upper thoracic ESCC than in the middle and lower thoracic ESCC (20.9% vs. 12.9% and 6.8%, P<0.05). The left gastric LMR was significantly higher in the lower thoracic ESCC than in the middle and upper thoracic ESCC (37.5% vs. 17.5% and 7.1%, P<0.05). Subcarinal metastatic lymph nodes were often found in the middle thoracic ESCC. T stage, histological differentiation, and circum wall involvement degree were correlated to lymphatic metastasis intensity (P<0.05); the length of esophageal lesion had no correlation to lymphatic metastasis intensity (P>0.05). The survival time of the patients received the right thoracic esophagectomy with 3-field lymphadenectomy (3-FL) was significantly longer than that of the patients received the left thoracic esophagectomy with 2-FL (P<0.05). CONCLUSIONS: During the operation on ESCC, the regions with high lymphatic metastasis intensity should be dissected. T stage, histological differentiation, and circum wall involvement degree are important influential factors of lymphatic metastasis intensity. The right thoracic esophagectomy with 3-FL is superior to the left thoracic esophagectomy with 2-FL.

Adult↗

[Clinical analysis of 942 cases of Kawasaki disease].

OBJECTIVE: The study was designed to investigate the clinical characteristics and the effects of therapeutic proposal on Kawasaki disease (KD). METHODS: Clinical features, diagnosis and treatment for totally 942 patients with KD hospitalized during Jan, 2000 to Dec, 2004 were reviewed. Clinical features of typical and incomplete KD were compared. Also, influential factors for KD resistant to intravenous immune globulin (IVIG) therapy were analyzed. Five hundred and ten cases were followed up for analyzing the prognosis of coronary artery lesion (CAL). RESULTS: (1) 774 cases were diagnosed as typical KD, and 168 cases as incomplete KD. The incidence of infants with incomplete KD was higher than that of infants with typical KD (18.5% vs. 10.1%, P < 0.01). As compared with typical KD, the cases of incomplete KD had a long duration of fever before final diagnosis [(7.7 +/- 2.9) d vs. (7.0 +/- 2.4) d, P < 0.01], high hemoglobin level [Hb, (106.6 +/- 13.4) g/L vs. (103.5 +/- 12.3) g/L, P < 0.01], high hematocrit [Hct, (32.0 +/- 4.3)% vs. (31.0 +/- 4.0)%, P < 0.01], and high prevalence of CAL (23.8% vs. 16.8%, P < 0.05), respectively. The occurrence rate and emerging time of clinical manifestations in incomplete KD and in typical KD were presented, respectively: non-exudative conjunctivitis [occurrence rate, 64.9% vs. 93.5%; emerging time, (4.4 +/- 1.4) d vs. (4.0 +/- 1.6) d, respectively (P < 0.05 or P < 0.01)], erythema and cracking of lips [occurrence rate, 50.6% vs. 94.8%; emerging time, (4.9 +/- 1.4) d vs. (4.5 +/- 1.6) d, respectively (P < 0.05 or P < 0.01)], rash [occurrence rate, 35.1% vs. 87.7%; emerging time, (3.9 +/- 1.9) d vs. (3.4 +/- 1.7) d, respectively (P < 0.05 or P < 0.01)], erythema and edema of extremity [occurrence rate, 26.8% vs. 71.4%; emerging time, (6.7 +/- 1.5) d vs. (5.3 +/- 1.7) d, respectively (P < 0.01)], cervical lymphadenopathy [occurrence rate, 34.5% vs. 68.0%; emerging time, (4.3 +/- 2.5) d vs. (3.6 +/- 2.2) d, respectively (P < 0.05 or P < 0.01)], strawberry tongue [occurrence rate, 31.0% vs. 59.8%; emerging time, (5.6 +/- 2.2) d vs. (4.9 +/- 1.8) d, respectively (P < 0.05 or P < 0.01)], membranous desquamation of fingertips [occurrence rate, 34.5% vs. 56.3%; emerging time, (11.7 +/- 3.3) d vs. (10.3 +/- 2.7) d, respectively (P < 0.01)], and desquamation peri-anus [occurrence rate, 42.9% vs. 50.0%; emerging time, (6.7 +/- 2.7) d vs. (6.9 +/- 2.5) d, respectively (P > 0.05)]. Except for peri-anus desquamation, other clinical manifestations in incomplete KD were sporadical as compared to typical KD. (2) Six per cent (51/857) of cases were resistant to the IVIG therapy. As compared to the group responding to IVIG therapy, high prevalence of CAL (31.4% vs. 17.1%, P < 0.05), long fever duration [(10.6 +/- 3.9) d vs. (7.5 +/- 2.3) d, P < 0.01], low Hb level [(99.9 +/- 14.1) g/L vs. (104.3 +/- 12.4) g/L, P < 0.01], low Hct [(30.1 +/- 4.5)% vs. (31.2 +/- 4.0)%, P < 0.05], low platelet [PLT, (256.9 +/- 142.4) x 10(9)/L vs. (309.7 +/- 131.5) x 10(9)/L, P < 0.05], and low albumin level [ALB, (27.8 +/- 8.4) g/L vs. (33.5 +/- 6.7) g/L, P < 0.01] were found in the group resistant to IVIG therapy, respectively. (3) In patients who received IVIG 1 g/kg and 2 g/kg, the recovery rates from CAL were 83.1% and 89.7% (P > 0.05), respectively. The prevalence of CAL in those without CAL in acute and subacute stages was 0.9% and 3.5% (P > 0.05), respectively, during 2 year-follow-up period. CONCLUSION: (1) Infants appeared to have more chances to suffer from incomplete KD. Incomplete KD had high prevalence of CAL. The peri-anus desquamation might be an important clue for early diagnosis of incomplete KD. (2) In acute stage, the influential factors for KD resistance to IVIG therapy included prolonged fever, non-elevated PLT, and persistent decrease in Hb, Hct and ALB levels. (3) Children receiving IVIG 1 g/kg and 2 g/kg had the similar effects on recovery and prevention from CAL within the first two years after KD onset.

Adolescent↗