Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health最新文献

Influenza virus infection and disease historically contribute to widespread cases of seasonal morbidity and in some cases mortality. Prompt and accurate diagnosis is crucial for optimal patient management. Rapid influenza direct antigen testing (RIDT) offers a faster turn-around-time for results but test performance (ie, sensitivity and specificity) varies widely. Nucleic acid amplification testing (NAAT) can offer a viable alternative. The objective of this retrospective study was to compare the test performance of RIDT with NAAT. RIDT testing included the Directigen EZ Flu A+B or the Veritor System for Rapid Detection of Flu A+B. NAAT employed the SimplexaTM Flu A/B™ RSV assay. A total of 5,795 specimens collected from October to March for the 2012/2013 (n=953), 2013/2014 (n=2060) and 2014/2015 (n=2783) seasons were co-tested by RIDT and NAAT. Using NAAT as the gold standard, RIDT tests had a sensitivity range of 0 to 15.7% and a specificity of 98.2 to 100% for influenza type A. For influenza type B, RIDT tests had a sensitivity of 0 to 33.3% and a specificity of 98.9 to 100%. These findings suggest that RIDT has unacceptably low sensitivity for both influenza A and influenza B, despite high specificity. The key advantage of RIDT in previous years (faster turnaround time) has been challenged by newer NAAT technology that provides results in a turn-around-time comparable to RIDT, but with superior test performance.

The Maori of New Zealand have been identified as a high-risk population for slipped capital femoral epiphysis (SCFE). This study assessed whether the burden of disease from SCFE in the American Territory of American Samoa is similar to that identified in the Maori. This was a retrospective review of children from American Samoa treated for SCFE at a tertiary care pediatric hospital between 2005-2014. Demographic, clinical, and radiographic information was collected. All patients were followed for at least one year after surgery and prophylactically pinned hips were not included. Data for determining incidence was obtained from the United States Census Bureau. Between 2005-2014, 55 American Samoan youth were treated for 73 SCFE. The incidence in the "at-risk" population 5-14 years of age was 53.1 per 100,000. Patients had a mean BMI of 29.5 (19.4-46.4) and mean weight of 76.7 kg (45.9-139 kg). Southwick angle was a mean 40.6°+/- 20.4° (6-83°). Overall, 82.2% of hips were treated with in-situ cannulated screw fixation. At a minimum one-year after initial surgery, 22 hips (30.1%) required major surgery including intertrochanteric osteotomy, osteochondroplasty, or total hip replacement. The incidence of SCFE in American Samoa is extremely high, 53.1 per 100,000 of "at-risk" population 5-14 years old. The mean weight and BMI in SCFE patients from American Samoa is substantially higher than previously published reports. Furthermore, morbidity from SCFE in this population is substantial with 30.1% requiring major surgery either at the time of physeal stabilization or in subsequent years.

The Kona WIC oral health pilot project was developed to assess the oral health beliefs and behaviors of parents of children and pregnant women at the Kona WIC site and to demonstrate the ease of providing oral health education to families in order to improve oral health behaviors. Data were collected from 50 families about the oral health behaviors and dental care of a total of 73 children, including 5 pregnant women, four of whom had a child enrolled in WIC and one pregnant woman without any previous children. Data revealed that 68% of children with teeth had been seen by a dentist within 6 to 12 months of the study visit. Mothers were seen less often, with 55% stating that they had not been seen for a dental visit for over one year. Parental knowledge about the effects of fluoride on teeth was limited; however, 90% of the parents would allow fluoride varnish applied to their child's teeth, 88% would give daily fluoride drops/tablets to their child, and 78% would support water fluoridation if it would help to improve their children's oral health. Additionally, for children old enough to receive fluoride supplementation, 60% were not given a prescription by their health care providers, and 58% had not received any fluoride varnish applications. By offering oral health education in a WIC clinic and assisting clients to seek out comprehensive care within a dental home, children and caregivers can be provided essential education and resources early in a child's life or women's pregnancies to reduce poor oral health outcomes.