No description available.

Thesis (M. Med. Sc.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 51-54).

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.

Thesis (M.Med.Sc.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 51-54). Also available in print.

No description available.

Asthma and hayfever are common diseases in children and adults. There have been dramatic increases in the prevalence of allergic diseases over the last 25 years. Either the environment has become more toxic or the population more susceptible. Concern has been expressed that cultivation of oilseed rape leads to seasonal epidemics of respiratory symptoms in populations living near the crop. In order to investigate this apparently widespread problem a combined epidemiological and environmental study was carried out. A cross sectional study was conducted to determine the prevalence of symptoms in a rape growing area compared with a non-rape area. Detailed environmental sampling and a small case-control study to investigate atopy and bronchial reactivity were also conducted. There have been dramatic changes in the Western diet over the last 30 years, with the diet including progressively less fresh food containing antioxidants. It is possible that these changes have increased the susceptibility of the populations to potentially harmful substances. A case-control study was conducted to test the hypothesis that a diet low in antioxidants is a factor in the expression of allergic diseases. Seasonal symptoms were found to be widespread in both rape growing and non-rape growing areas, with only a very small excess of seasonal symptoms occurring in rape growing areas. Little evidence of allergy to oilseed rape, which is consistent with the low levels of pollen recorded, was found. However, there was an increase in bronchial reactivity during the flowering season, especially among cases. This could be a result of non-specific irritation due to terpenes released from the crop.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

目的: 通過搜索有關天灸治療過敏性鼻炎的臨床研究文獻，以系統評價及數據挖掘技術提取其干預措施的細節，包括敷貼藥物的組成、選用的穴位、治療時間點、治療頻率, 敷貼時長及治療次數等，並且基於此研究，從循證醫學角度提供天灸治療過敏性鼻炎干預措施的建議性方案，為進一步的臨床實踐和研究提供循證醫學依據。 方法: 選取包括中國期刊全文數據庫（ CNKI ）、中國科技期刊數據庫（ VIP ）和萬方數據庫（ Wanfang Database ）在內的中文文獻數據庫及包括EMBASE 數據庫和MEDLINE數據庫在內的英文文獻數據庫進行文獻檢索，檢索範圍為各數據庫已知收錄時間至20 1 6 年2 月的全部期刊，檢索對象為所有有關天灸治療過敏性鼻炎的臨床研究文獻，制定文獻納人和排除標準進行篩選，對所納人的文獻進行數據挖掘，並通過計算比例、百分數、平均數、中位數等數據處理方法列出相應圖表進行報告。 結果：根據檢索以及對符合納入標準的文獻進行統計、最終符合納人標準的文獻為88篇。通過干預措施數據提取分析，可知目前臨床使用率最高的四種藥物分別是白芥子（ n=85, 93 . 41 % ），緬辛（ n=85, 93 . 41 % ），甘遂（ n=72, 79.12% ）和延胡索（ n = 7 0, 76.92% ），通過將上述藥物比例換算為百分數，再計算中位數之比，得出結果為白芥子（ 28. 60% ），延胡索（ 2 0.00 % ），名田辛（ 16. 70% ），甘遂（ 16.70%) , 即白芥子： 延胡索：細辛：甘遂三7:5:4:4 的組方比例。最常用的五個穴位分別為肺俞(n=85, 96 . 5 9% ） ，大椎（ n =67, 76 . 14% ） ， 腎俞（ n =64, 72.7 3% ），脾俞( n= 56, 63 . 64 % ）和風門（ n=56, 63. 6 4% ） 。治療時間點一般分為三伏天（ n 49，53. 26% ） 與常日（ n=32 , 34. 78% ） 兩類，治療頻次及次數多為10 天貼1 次， 共 貼3次為一療程。貼敷時間一般為成人3-4h ，小兒l. 5 -2 h ， 貼藥時間以皮膚可耐受為度。 結論：通過以上數據挖掘，得出天灸治療過敏性鼻炎的建議干預措施方案為： 將白芥子、延胡索、細辛、甘遂按7: 5 : 4 : 4 的比例研組末混合，以新鮮生薑汁調成糊狀, 保鮮備用。取大椎、風門、肺俞、脾俞和腎俞，將配制好的藥物取約2 g 藥量, 置於專用敷貼繆布中央， 貼在上述穴位上。除大惟穴外，其余穴位均取雙側。 預約患者於當年三伏天當天進行治療, 1 0 天貼l 次，共貼3 次為一療程。成人一般貼敷3-4h，小兒一般貼敷1. 5-2h ， 貼藥時間可視患者具體情況而定。如發癢、灼痛感不明顯者可貼敷較長時間，如發癢、灼痛戚非常明顯者宜適當縮短貼敷時間。

Background Hay fever is typically poorly managed, particularly in adolescents, in whom it is responsible for considerable morbidity and impairment in educational performance. Evidence-based training of professionals has the potential to improve outcomes, but it can be expensive and so warrants formal evaluation. This trial sought to evaluate the effectiveness of a training intervention for primary care-based health care professionals on adolescent disease-specific quality of life. Methods A cluster randomised controlled trial was conducted in UK general practices. Practices were centrally randomised to a short, intensive training course on the evidence-based management of hay fever (intervention arm) or distribution of guidelines (control arm). The primary outcome measure was the change in the validated Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQ(S)) score in adolescents with hay fever between baseline and six weeks post-intervention (minimal clinically important difference = 0.5). Secondary outcome measures included health care professionals’ knowledge and confidence in managing hay fever, number of hay fever-related consultations, relevant treatments prescribed and symptom scores. Multi-level modelling using a random effects model was used to take account of between and within cluster variation, adjusting for strata, individual covariates and year of study. Results Thirty-eight general practices were randomised (20 in the intervention arm) and 246/341 patients (50.2% male, mean age 15 years) were included in the primary outcome analysis. Health care professionals’ self-assessed knowledge and confidence improved (prescribing/recommending treatment mean score 95% CI 1.4, 2.8), and the training was perceived to be of value. This did not however result in clinically or statistically significant improvements in RQLQ(S): -0.15, 95% CI -0.52 to +0.21. There were no differences in consultation frequency (95% CI -0.02, +0.63), treatments issued for hay fever (95% CI -0.24, +0.08) or symptom scores (95% CI - 1.03, +0.54). Conclusions Although attendance on this short, intensive hay fever training course was associated with professionals’ increased self-assessed confidence and understanding of the clinical management of hay fever, this did not translate into improvements in disease-specific quality of life or reduction in rhinitis symptoms in adolescents with hay fever.

M.Tech. / Allergic rhinitis is on the increase around the world affecting between 15-20% of the global population and is the most common chronic condition of children in South Africa. Luffeel® is a propriety complex homeopathic product manufactured by Biologische Heilmittel Heel. It is available in nasal spray and tablet form. These two forms are designed to work in combination with each other in the treatment of allergic rhinitis. The aim of this study is to determine the effect of a combination of Luffeel® nasal spray and Luffeel® tablets on allergic rhinitis using Phadiatop® tests, RAST Inhalant screens and subjective evaluation on symptoms such as nasal itching, sneezing, congestion, discharge, ocular redness and itching as indicators. This study was a double-blind, placebo-controlled study conducted at the University of Johannesburg, Doornfontein campus over a period of eight weeks. Thirty participants were recruited by poster advertisement. It can be concluded that Luffeel® nasal spray and Luffeel® tablets decrease the symptoms of allergic rhinitis, when compared to the placebo, thus giving persons suffering from allergic rhinitis an alternative treatment with no rebound or lethargic effects. It can also be concluded that this study that Luffeel® nasal spray and Luffeel® tablets has no significant effect on Phadiatop® and RAST inhalant screens over an eight week period. The results are inconclusive due to the small sample size and short time frame of the study.