Objective: to evaluate the additional value of funduscopy in the routine manag ement of patients with hypertension. Design: Systematic review. Participants: Ad ults aged 19 or more with hypertensive retinopathy. Data ...
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Objective: to evaluate the additional value of funduscopy in the routine manag ement of patients with hypertension. Design: Systematic review. Participants: Ad ults aged 19 or more with hypertensive retinopathy. Data sources: Medline, Embas e, and the Cochrane Library from 1990. Review methods: Studies were included tha t assessed hypertensive retinopathy with blinding for blood pressure and cardiov ascular risk factors. Studies on observer agreement had to be assessed by two or more observers and expressed as a κstatistic. Studies on the association betwe en hypertensive retinopathy and hypertensive organ damage were carried out in pa tients with hypertension. the association between hypertensive retinopathy and c ardiovascular risk was carried out in unselected normotensive and hypertensive p eople without diabetes mellitus. Results: the assessment of microvascular change s in the retina is limited by large variation between observers. the positive an d negative predictive values for the association between hypertensive retinopath y and blood pressure were low (47%to 72%and 32%to 67%, respectively). Associ ations between retinal microvascular changes and cardiovascular risk were incons istent, except for retinopathy and stroke. the increased risk of stroke, however , was also present in normotensive people with retinopathy. these studies did no t adjust for other indicators of hypertensive organ damage. Conclusion: Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients.
Background:Given the restricted distribution of Schistosoma mekongi in one province in Lao People’s Democratic Republic(Lao PDR)and two provinces in Cambodia,together with progress of the national control programmes ...
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Background:Given the restricted distribution of Schistosoma mekongi in one province in Lao People’s Democratic Republic(Lao PDR)and two provinces in Cambodia,together with progress of the national control programmes aimed at reducing morbidity and infection prevalence,the elimination of schistosomiasis mekongi seems ***,sensitive diagnostic tools will be required to determine whether elimination has been *** compared several standard and novel diagnostic tools in ***-endemic ***:the prevalence and infection intensity of *** were evaluated in 377 study participants from four villages in the endemic areas in Lao PDR and Cambodia using Kato-Katz stool examination,antibody detection based on an enzyme-linked immunosorbent assay(ELISA)and schistosome circulating antigen detection by lateral-flow *** highly sensitive test systems for the detection of cathodic and anodic circulating antigens(CCA,CAA)in urine and serum were ***:Stool microscopy revealed an overall prevalence of *** of 6.4%(one case in Cambodia and 23 cases in Lao PDR),while that of Opisthorchis viverrini,hookworm,trichuris trichiura,Ascaris lumbricoides and taenia *** 50.4%,28.1%,3.5%,0.3%and 1.9%,*** the urine samples,the tests for CCA and CAA detected *** infections in 21.0%and 38.7%of the study participants,*** the serum samples,the CAA assay revealed a prevalence of 32.4%,while a combination of the CAA assay in serum and in urine revealed a prevalence of 43.2%.there was a difference between the two study locations with a higher prevalence reached in the samples from Lao ***:the CCA,CAA and ELISA results showed substantially higher prevalence estimates for *** compared to Kato-Katz thick *** schistosomiasis mekongi in Lao PDR and Cambodia might thus have been considerably underestimated ***,sustained control efforts are still needed to break transmission of ***
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