ABSTRACT
PURPOSE: Adverse drug reaction (ADR) is known to be a substantial reason for emergency departments (ED) visits. Additionally, it also is a frequent occurrence in ED. The aim of the study was to compare the characteristics between ADRs that occurred in ED and ADRs that occur elsewhere based on the spontaneous reporting system in a hospital. METHODS: In this retrospective observational study, the data was collected by the spontaneous ADR reporting system within an electronic medical record system during a 24-month period. ADR of patients aged more than 18 years were included in this study. RESULTS: Patients with ADR was older in ED (42.6±14.5 vs. 53.9±17.2, p<0.001) and they were administered with less medications (2.0±1.3 vs. 4.4±4.4, p<0.001). The proportion of ADR reported by doctors in ED was higher than that in non-ED (41.2% vs. 28.2%, p<0.001). The proportion of the severe ADR was not significantly different between the ED and non-ED groups (2.9% vs. 3.8%, p=0.701). The most common symptom of ADRs in ED and non-ED groups were cutaneous (52.9%) and gastrointestinal (42.2%), respectively; the most common implicated medication was analgesics (62.7%) and analgesics (41.5%), respectively. CONCLUSION: The characteristics of ADR in ED is different from that in non-ED locations. Further studies are needed to differentiate education and prevention strategies of ADR in ED from those in non-ED locations.
Subject(s)
Adult , Humans , Adverse Drug Reaction Reporting Systems , Analgesics , Drug-Related Side Effects and Adverse Reactions , Education , Electronic Health Records , Emergencies , Emergency Service, Hospital , Observational Study , Retrospective StudiesABSTRACT
BACKGROUND: Human papillomavirus (HPV) infection is the main cause of cervical cancer and with the advent of genotype specific vaccines, there is increased need for accurate, broad-spectrum and high-throughput methods for HPV genotyping. A MALDI-TOF mass spectrometry (MS)-based restriction fragment mass polymorphism (RFMP) assay has proven to accurately and reliably genotype a wide variety of HPV. METHODS: We evaluated the clinical utility of the RFMP assay in HPV genotyping by testing a total of 2,689 specimens taken from liquid-based cytology, which was composed of normal cytology, atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and invasive squamous cervical cancer (SCC). RESULTS: Overall HPV positive rate of total specimens was 32.5% and the high-risk positivity was 16.4%. The HPV positive rates were increased as increasing severity level of cervical lesion. Predominant high-risk HPV genotypes were found as following order; 52 (18.6%), 16 (13.7%), 18 (3.8%), 58 (3.4%), 56 (2.6%) and 31 (2.5%). The high-risk HPV positivities according to cytologic diagnosis were 10.7% (238/2229), 31.7% (76/240), 50.0% (88/176), 86.0% (37/43), 100% (1/1) in normal, ASCUS, LSIL, HSIL and SCC subgroups, respectively. The concordance rate and Kappa value between sequencing and RFMP assays were 96.6% and 0.932 (95%CI: 0.908-0.956). CONCLUSIONS: The RFMP HPV genotyping assays showed high concordance with sequencing. The assay is simple, and can accurately detect and identify HPV genotypes in samples with various levels of cytological lesions. The results demonstrated that RFMP assay should be clinically suitable for HPV genotyping in laboratories.