We conducted interviews on 306 histologically confirmed incident cases of nasopharyngeal carcinoma (NPC) occurring in residents of Guangzhou City, China, who were under the age of 50 years, and an equal number of age-, sex-, and neighborhood-matched controls. We also interviewed 110 mothers of patients under age 45 years and 139 mothers of controls who were matched to patients under age 45 years, to obtain information on childhood exposures of study subjects. Exposure to salted fish, whether in adulthood or in childhood, was significantly associated with an increased risk of NPC. The association was strongest for exposure during weaning, and exposures at all other periods were no longer related to NPC risk after adjustment for exposure during weaning. Besides salted fish, childhood exposure to 5 other preserved foods (fermented fish sauce, salted shrimp paste, moldy bean curd, and 2 kinds of preserved plum) was significantly related to NPC, and the effects were independent of salted fish exposure. Finally, cases ingested significantly less fresh vegetables and fruits than controls, especially during early childhood, and the differences were not explained by their differing consumption pattern of salted fish and other preserved foods.

We conducted interviews on 306 histologically confirmed incident cases of nasopharyngeal carcinoma (NPC) occurring in residents of Guangzhou City, China, who were under the age of 50, and an equal number of age-, sex-, and neighborhood-matched controls. We also interviewed 110 mothers of patients under 45 and 139 mothers of controls who were matched to patients under age 45, to obtain information on childhood exposures of study subjects. Occupational exposure to products of combustion (RR = 2.4, p = 0.001) and cotton dust (RR = 0.3, P = 0.01) was independently related to risk of NPC. Use of tobacco products showed a moderate association with NPC; a lifetime exposure of 30+ pack-year equivalents conferred a 2-fold increased risk. A history of chronic ear or nose condition (rhinitis, sinusitis, nasal polyp, otitis media) was another risk factor for NPC (RR = 2.2, p less than 0.0005), and 18 cases compared to 3 controls had a first-degree relative with NPC (RR = 6.0, p = 0.001).

Ultrasound imaging of diaphragm motion is a useful, quick, noninvasive, portable, and direct anatomic method for assessment of ET tube position. We think it should be considered the method of choice for the secondary confirmation of the ET tube position.

ABSTRACT. Objective. To evaluate the effect of treatment without aspirin in the acute phase of Kawasaki disease (KD) and to determine whether it is necessary to expose children to high-or medium-dose aspirin.Methods. A total of 162 patients who fulfilled the established criteria of acute KD between 1993 and 2003 were included in this retrospective study. All patients were treated with high-dose intravenous immunoglobulin (IVIG; 2 g/kg) as a single infusion without concomitant aspirin treatment. Low-dose aspirin (3-5 mg/kg per day) was subsequently prescribed when fever subsided. Patients who had defervescence within 3 days after the completion of IVIG treatment were classified as the IVIG-responsive group, and those whose fever persisted for >3 days were classified as the IVIG-nonresponsive group. The 162 patients were divided further into 2 groups: those who were treated with IVIG before illness day 5, and those who were treated after illness day 5. We compared the response rate of IVIG therapy, duration of fever, and incidence of coronary artery abnormalities (CAAs) between these groups.Results. A total of 153 patients were classified into the IVIG-responsive group, and 128 (83.66%) of them had defervescence within 24 hours after completion of IVIG therapy. Nine (5.56%) patients were classified into the IVIG nonresponsive group, and all received additional IVIG (2 g/kg) without aspirin. Six (66.67%) had defervescence within 3 days after additional therapy. Patients in the IVIG-nonresponsive group had a significantly higher incidence of CAAs than those in the IVIG-responsive group (25% vs 2.92%). In the group that was treated before illness day 5 (n ‫؍‬ 16), all patients had defervescence within 3 days after IVIG therapy and 13 (81.25%) had defervescence within 24 hours. In the group that was treated after illness day 5 (n ‫؍‬ 146), 137 (93.84%) patients had defervescence within 3 days and 115 (78.77%) had defervescence within 24 hours. One (6.67%) patient in the group that was treated before illness day 5 got a new onset of CAAs, as did 5 (3.85%) in the group that was treated after illness day 5. There was no statistically significant difference in the response rate of IVIG therapy, duration of fever, and incidence of CAAs between these 2 groups. Conclusion.The results of our study indicate that the treatment without aspirin in acute stage of KD had no effect on the response rate of IVIG therapy, duration of fever, or incidence of CAAs when children were treated with high-dose (2 g/kg) IVIG as a single infusion, despite treatment before or after day 5 of illness. We conclude that it seems unnecessary to expose children to high-or medium-dose aspirin therapy in acute KD when the available data show no appreciable benefit in preventing the failure of IVIG therapy, formation of CAAs, or shortening the duration of fever. K awasaki disease (KD) is an acute systemic vasculitis of unknown origin that occurs predominantly in children who are Ͻ5 years old. The most significant complication is coronary arteritis, and an...