Abstract:
OBJECTIVE:To characterise the complete case series of influenza A/H7N9 infections as of 27 May 2013, detected by China's national sentinel surveillance system for influenza-like illness. DESIGN:Case series. SETTING:Outpatient clinics and emergency departments of 554 sentinel hospitals across 31 provinces in mainland China. CASES:Infected individuals were identified through cross-referencing people who had laboratory confirmed A/H7N9 infection with people detected by the sentinel surveillance system for influenza-like illness, where patients meeting the World Health Organization's definition of influenza-like illness undergo weekly surveillance, and 10-15 nasopharyngeal swabs are collected each week from a subset of patients with influenza-like illness in each hospital for virological testing. We extracted relevant epidemiological data from public health investigations by the Centers for Disease Control and Prevention at the local, provincial, and national level; and clinical and laboratory data from chart review. MAIN OUTCOME MEASURE:Epidemiological, clinical, and laboratory profiles of the case series. RESULTS:Of 130 people with laboratory confirmed A/H7N9 infection as of 27 May 2013, five (4%) were detected through the sentinel surveillance system for influenza-like illness. Mean age was 13 years (range 2-26), and none had any underlying medical conditions. Exposure history, geographical location, and timing of symptom onset of these five patients were otherwise similar to the general cohort of laboratory confirmed cases so far. Only two of the five patients needed hospitalisation, and all five had mild or moderate disease with an uneventful course of recovery. CONCLUSION:Our findings support the existence of a "clinical iceberg" phenomenon in influenza A/H7N9 infections, and reinforce the need for vigilance to the diverse presentation that can be associated with A/H7N9 infection. At the public health level, indirect evidence suggests a substantial proportion of mild disease in A/H7N9 infections.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Ip DK,Liao Q,Wu P,Gao Z,Cao B,Feng L,Xu X,Jiang H,Li M,Bao J,Zheng J,Zhang Q,Chang Z,Li Y,Yu J,Liu F,Ni MY,Wu JT,Cowling BJ,Yang W,Leung GM,Yu Hdoi
10.1136/bmj.f3693subject
Has Abstractpub_date
2013-06-24 00:00:00pages
f3693eissn
0959-8138issn
1756-1833journal_volume
346pub_type
杂志文章abstract:PROBLEM:Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN:Pilot implementation of the first programme for prevention of mother to child transmission of HIV...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.329.7475.1147
更新日期:2004-11-13 00:00:00
abstract:OBJECTIVE:To evaluate the cost effectiveness of acupuncture in the management of chronic headache. DESIGN:Cost effectiveness analysis of a randomised controlled trial. SETTING:General practices in England and Wales. PARTICIPANTS:401 patients with chronic headache, predominantly migraine. Interventions Patients were ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38033.896505.EB
更新日期:2004-03-27 00:00:00
abstract:OBJECTIVES: To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN: Observational cohort study. SETTING: US Health and Retirement Study. PARTICIPANTS: 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage w...
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更新日期:2016-05-17 00:00:00
abstract::Objective To determine whether educational attainment is a causal risk factor in the development of coronary heart disease.Design Mendelian randomisation study, using genetic data as proxies for education to minimise confounding.Setting The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D an...
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doi:10.1136/bmj.j3542
更新日期:2017-08-30 00:00:00
abstract:OBJECTIVE:To quantify the impact of citalopram and other selective serotonin reuptake inhibitors on corrected QT interval (QTc), a marker of risk for ventricular arrhythmia, in a large and diverse clinical population. DESIGN:A cross sectional study using electrocardiographic, prescribing, and clinical data from electr...
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更新日期:2013-01-29 00:00:00
abstract::Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing.Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system.Setting Primary care...
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doi:10.1136/bmj.j603
更新日期:2017-02-21 00:00:00
abstract:OBJECTIVES:Analysis of incidence and characteristics of congenital abdominal wall defects, with special reference to the differences between the incidence of gastroschisis and exomphalos (omphalocele). DESIGN:Retrospective analysis using data from the Office of Population Censuses and Surveys (recoded to differentiate...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7062.903
更新日期:1996-10-12 00:00:00
abstract::Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples'...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6962.1137
更新日期:1994-10-29 00:00:00
abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6871.199
更新日期:1993-01-16 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN:Matched cohort study. SETTING:Population based, electronic primary healthcare databases before 31 December 2015 from four European coun...
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更新日期:2019-10-08 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38404.650208.AE
更新日期:2005-04-16 00:00:00
abstract::An association between vasectomy and the development of testicular tumors, and the importance of testicular examinations both before and after a vasectomy is discussed. Patients diagnosed with testicular tumors within the last ten years were examined at Bangour General Hospital in Scotland. From 1977-87, 37 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6721.370
更新日期:1990-02-10 00:00:00
abstract:OBJECTIVE:To determine whether short-term, oral low dose prednisolone (< or = 15 mg daily) is superior to placebo and non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN:Meta-analysis of randomised trials of oral corticosteroids compared with placebo or a non-steroidal anti-inflammatory...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.316.7134.811
更新日期:1998-03-14 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of interventions designed to improve outcomes in patients with multimorbidity in primary care and community settings. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, CINAHL, CAB Health, Cochrane central register of controlled trials, the database of abstracts of review...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.e5205
更新日期:2012-09-03 00:00:00
abstract:OBJECTIVES:To determine the accuracy and acceptability to patients of non-endoscopic screening for Barrett's oesophagus, using an ingestible oesophageal sampling device (Cytosponge) coupled with immunocytochemisty for trefoil factor 3. DESIGN:Prospective cohort study. SETTING:12 UK general practices, with gastroscopi...
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c4372
更新日期:2010-09-10 00:00:00
abstract:OBJECTIVE:To synthesise the views of patients and carers in decision making regarding treatment for chronic kidney disease, and to determine which factors influence those decisions. DESIGN:Systematic review of qualitative studies of decision making and choice for dialysis, transplantation, or palliative care, and them...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.c112
更新日期:2010-01-19 00:00:00
abstract::Many clinicians remain unsure of the relevance of measuring quality of life to their clinical practice. In health economics quality of life measures have become the standard means of assessing the results of health care interventions and, more controversially, the means of prioritising funding; but they have many othe...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6861.1074
更新日期:1992-10-31 00:00:00
abstract:OBJECTIVE:To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. DESIGN:Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7097.1791
更新日期:1997-06-21 00:00:00
abstract::The numbers of patients being admitted to hospital with aortic aneurysms have increased recently. A study was carried out to try to find out whether this was a true increase in incidence or whether it could be attributable to more accurate diagnosis and better surgical techniques. From analyses of routine statistics i...
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pub_type: 杂志文章
doi:10.1136/bmj.298.6665.33
更新日期:1989-01-07 00:00:00
abstract:OBJECTIVES:To assess the experiences of obstetricians in England and Wales of serum screening for Down's syndrome. DESIGN:Postal questionnaire survey. SUBJECTS:Questionnaires were sent to all practising obstetricians in England and Wales with nonacademic appointments who had not participated in an earlier (randomly s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6957.769
更新日期:1994-09-24 00:00:00
abstract:OBJECTIVE:To investigate the long term effects of continuous subcutaneous insulin infusion (insulin pump therapy) on cardiovascular diseases and mortality in people with type 1 diabetes. DESIGN:Observational study. SETTING:Swedish National Diabetes Register, Sweden 2005-12. PARTICIPANTS:18,168 people with type 1 dia...
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更新日期:2015-06-22 00:00:00
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pub_type: 杂志文章
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更新日期:1988-08-13 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.f521
更新日期:2013-02-14 00:00:00
abstract:OBJECTIVES:To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN:Randomised c...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38558.393669.E0
更新日期:2005-09-03 00:00:00
abstract:OBJECTIVE:To determine whether tobacco smoking causes increased DNA modification (adducts) in human cervical epithelium. DESIGN:Comparison of DNA adducts measured by the technique of postlabelling with phosphorus-32 in normal ectocervical epithelium of smokers and non-smokers. A questionnaire on smoking habit and a ur...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6890.1444
更新日期:1993-05-29 00:00:00
abstract:OBJECTIVE:To test whether the relation between income inequality and mortality found in US states is because of different levels of formal education. DESIGN:Cross sectional, multiple regression analysis. SETTING:All US states and the District of Columbia (n=51). DATA SOURCES:US census statistics and vital statistics...
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pub_type: 杂志文章
doi:10.1136/bmj.324.7328.23
更新日期:2002-01-05 00:00:00
abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
abstract:OBJECTIVES:To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design T...
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pub_type: 杂志文章
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更新日期:2010-04-20 00:00:00
abstract:OBJECTIVE:To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at increased risk of becoming infected with...
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pub_type: 杂志文章
doi:10.1136/bmj.m1328
更新日期:2020-04-07 00:00:00
abstract:OBJECTIVE:To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN:11 year longitudinal clinical and laboratory study. SETTING:A haemophilia centre. PATIENTS:111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES:Symptoms of HI...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6810.1093
更新日期:1991-11-02 00:00:00