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1.
Lima; Perú. Ministerio de Salud; 20200900. 30 p.
Monography in Spanish | LILACS (Americas), LIPECS | ID: biblio-1118686

ABSTRACT

El documento contiene los criterios administrativos para el adecuado tratamiento de los datos personales relacionados con la salud o datos personales en salud.


Subject(s)
Information Systems , Medical Records , Computer Security , Guidelines as Topic
2.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 53-61, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090553

ABSTRACT

Abstract Introduction The increase in life expectancy is an incentive to the development of researches with the elderly population aiming at actions that may ensure healthy and active aging. Objective To analyze the profile of laryngeal microsurgery performed in patients > 60 years old. Methods A retrospective observational study, with a cross-sectional design. A retrospective analysis of the medical records of elderly patients submitted to laryngeal microsurgery was performed at a private hospital in Curitiba, state of Paraná, Brazil, between January 2004 and December 2016. Were included all of the patients > 60 years old that underwent laryngeal microsurgery during this period. Results During the studied period, 213 laryngeal microsurgeries were performed in 181 patients > 60 years old. There was a preponderance of male patients. The mean age was 67.6 years old. Squamous cell carcinoma (SCC) was the most prevalent disorder (26%), followed by Reinke edema (20%), papillomatosis (14%), polyps (11%), leukoplakia (8%), minor structural alterations (8%), associated lesions (9%), and others (4%). Men presented a higher probability of SCC diagnosis, regardless of the age group, while Reinke edema was more frequently observed in women. A directly proportional relation between the frequency of laryngeal cancer and age increase was also observed. No significant differences were observed in professional voice users. Conclusion Further researches are required to properly comprehend the factors associ- ated with laryngeal lesions and determine prevention and treatment approaches.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Laryngeal Diseases/surgery , Laryngeal Diseases/epidemiology , Larynx/surgery , Microsurgery , Papilloma/surgery , Occupational Risks , Aging/physiology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/epidemiology , Sex Factors , Laryngeal Edema/surgery , Laryngeal Edema/epidemiology , Laryngeal Neoplasms/surgery , Laryngeal Neoplasms/epidemiology , Medical Records , Cross-Sectional Studies , Retrospective Studies , Age Factors
3.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 31-37, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090554

ABSTRACT

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Salivary Gland Diseases/diagnosis , Salivary Gland Diseases/pathology , Salivary Gland Diseases/therapy , Salivary Gland Diseases/epidemiology , Parotitis/epidemiology , Sialadenitis/epidemiology , Magnetic Resonance Spectroscopy , Salivary Gland Calculi/epidemiology , Tomography, X-Ray Computed , Medical Records , Incidence , Prevalence , Retrospective Studies , Longitudinal Studies , Ultrasonography , Biopsy, Fine-Needle , Germany
4.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 18-23, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090550

ABSTRACT

Abstract Introduction Cholesteatomas are benign tumors consisting of skin, and growing inside a retraction pocket in the tympanic membrane. Cholesteatomas can occupy the entirety of the middle ear, and are known for their osteolytic capabilities. Surgery is the only curative treatment for cholesteatomas. Objective To describe the risk of recurrence after first-time surgically-treated middle- ear cholesteatoma (STMEC1) on the island of Funen from 1983 to 2015. Methods Cases of STMEC1 were identified in the Danish National Hospital Register. The medical records were reviewed. Time-to-event analyses were applied. The ears were followed from STMEC1 to a secondary cholesteatoma, emigration, death, or end of follow-up. Results Records from 1,006 patients with STMEC1 were reviewed. A total of 54 patients were submitted to surgery on both ears. The total sample consisted of 1,060 ears with STMEC1; 300 were children's (< 16 years) ears, and 760 were adult's ears. The total observation time was of 12,049 years. The overall estimated proportion with recurrence 5 years after surgery was of 37% in children and of 15% in adults. The older the child was at the first surgery, the risk decreased by 7% per year. In children, canal wall up (CWU) mastoidectomy without obliteration was associated with a hazard ratio for recurrence of 1.9 (95% confidence interval [95%CI]: 1.2-3.0) compared with CWU with obliteration. Conclusion Compared with adults, children were had 2.6 times more risk of recurrence. Procedures performed without mastoidectomy had the lowest risk of recurrence. In children, obliteration was associated with a significantly lower risk of recurrence. However, patients were not randomized regarding the surgical approach; thus, the association between approach and risk of recurrence was likely influenced by confounding factors.


Subject(s)
Humans , Child , Adolescent , Adult , Ear Neoplasms/surgery , Cholesteatoma, Middle Ear/surgery , Neoplasm Recurrence, Local/epidemiology , Time Factors , Proportional Hazards Models , Survival Analysis , Medical Records , Multivariate Analysis , Retrospective Studies , Second-Look Surgery , Denmark , Mastoidectomy/methods
5.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 107-111, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090552

ABSTRACT

Abstract Introduction Obstructive sleep apnea syndrome (OSAS) is a multifactorial disease characterized by episodes of partial or complete collapse during sleep of different regions of the upper airway. Surgery for OSAS evolved with the introduction of different techniques, considering new surgical concept of reconstruction of the upper airway. Objective To retrospectively evaluate the effectiveness of a new approach aimed at reducing pharyngeal collapse by combining two surgical techniques: lateral and expansion pharyngoplasty. Methods We reviewed the medical records of 38 patients with OSAS undergoing lateral/expansion pharyngoplasty from January 2012 to December 2016. The following data were collected: patient age, gender, and pre- and postoperative body mass index (BMI), Epworth sleepiness scale (ESS) scores, snoring visual analogue scale (VAS) scores, and polysomnography (PSG) results. Results The PSG results showed a significant reduction in the apnea/hypopnea index (AHI) from 22.4 ± 27.3 events/h preoperatively to 13.6 ± 17.9 events/h postoperatively (p = 0.009), with postoperative AHI reduction greater than 50% in 63.2% of the patients. There was also a significant reduction in the microarousal index (19.5 ± 22.6 vs 11.0 ± 13.4 events/h; p = 0.001) and in the minimum oxygen saturation (82.6 ± 10.3 vs 86.9 ± 11.1; p = 0.007). Conclusions Lateral-expansion pharyngoplasty represents a new surgical strategy for the treatment of OSAS in patients with palatal collapse by combining two different techniques: lateral and expansion pharyngoplasty. The two techniques, performed as a one-stage procedure, led to improvements in excessive daytime sleepiness, snoring, and PSG respiratory parameters by acting on lateral and retropalatal collapse, produc- ing favorable results with good applicability in otolaryngology clinical practice.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pharynx/surgery , Otorhinolaryngologic Surgical Procedures/methods , Reconstructive Surgical Procedures/methods , Sleep Apnea, Obstructive/surgery , Pharyngeal Muscles/surgery , Medical Records , Retrospective Studies , Longitudinal Studies , Treatment Outcome
7.
J. Health Biol. Sci. (Online) ; 8(1): 1-4, 01/01/2020. ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1104329

ABSTRACT

Objetivo: descrever a aceitabilidade do Registro de Câncer de Base Populacional do Recife pelos profissionais que trabalham nas fontes notificadoras do câncer no município. Métodos: abordagem qualitativa por meio de entrevista semiestruturada com os profissionais que trabalham nas fontes notificadoras. A análise de dados utilizou a técnica do Discurso do Sujeito Coletivo. Resultados: A maioria dos entrevistados relatou a importância do trabalho exercido no RCBP para que, a partir do diagnóstico, ações de planejamento sejam realizadas para minimizar esse problema de saúde pública. Conclusão: a aceitabilidade do RCBP do Recife foi avaliada positivamente pelos profissionais que alimentam o sistema. As informações geradas pelos RCBP são essenciais para fortalecer o planejamento de redes integradas que assegurem o acesso oportuno. E oportunidade é a palavra-chave quando as necessidades de saúde são geradas por neoplasia.


Objective: To describe the acceptability of Population Based Cancer Registry in Recife from the perspective of professionals working on cancer reporting source in the city. Methods: Qualitative approach using semi-structured interviews with professionals who work in the notifying sources. The data analysis used the Collective Subject Discourse technique. Results: Most of the interviewees reported the importance of the work performed in the RCBP so that, from the diagnosis, planning actions are taken to minimize this public health problem. Conclusion: The acceptability of the Population Based Cancer Registry in Recife was positively assessed by the professionals who feed the system. The information generatedby themis essential to strengthen the planning of integrated networks that ensure timely access. Opportunity is the keyword when health needs are generated by neoplasia.


Subject(s)
Neoplasms , Medical Records , Health Information Systems
8.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811327

ABSTRACT

PURPOSE: To evaluate clinical outcomes of idiopathic epiretinal membrane removal in patients ≥ 80 years of age.METHODS: A retrospective review of medical records was performed with 56 patients who underwent vitrectomy and removal of idiopathic epiretinal membrane. In the ≥ 80 years of age group (n = 28), the best-corrected visual acuity (BCVA) and central macular thickness (CMT) before surgery were compared with those at the final follow-up. The amount of change in the BCVA after surgery was also compared between the ≥ 80 years of age group and the < 80 years of age group (n = 28).RESULTS: In the ≥ 80 years of age group, the mean follow-up period was 19.1 ± 17.0 months. Before surgery, 11 eyes were pseudophakic and 17 eyes were phakic. Combined cataract surgery was performed with epiretinal membrane removal in all 17 phakic eyes. The mean logarithm of the minimal angle of resolution BCVA was 0.75 ± 0.30 before surgery, which improved to 0.50 ± 0.30 at the final follow-up (p < 0.001). The CMT was 458.0 ± 79.7 µm before surgery, which decreased to 367.2 ± 83.4 µm at the final follow-up (p < 0.001). There was no significant difference in the amount of change in the BCVA after the surgery between the ≥ 80 years of age group and the < 80 years of age group (p = 0.547).CONCLUSIONS: In patients with idiopathic epiretinal membrane who were ≥ 80 years of age, the visual acuity was improved or maintained, and was accompanied with anatomical improvement after epiretinal membrane removal with or without cataract surgery. These results suggest the usefulness of epiretinal membrane removal in older patients.


Subject(s)
Cataract , Epiretinal Membrane , Follow-Up Studies , Humans , Medical Records , Retrospective Studies , Visual Acuity , Vitrectomy
9.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811313

ABSTRACT

PURPOSE: We investigated the long-term outcomes of vitrectomy with internal limiting membrane (ILM) peeling as treatment for myopic traction maculopathy (MTM).METHODS: The medical records of patients who underwent vitrectomy to treat MTM were retrospectively evaluated. We excluded patients who exhibited macular holes (MHs) or retinal detachment at the time of primary surgery. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were analyzed preoperatively, at 3, 6, 12, and 24 months after surgery, and at the final visit. Complications including retinal detachment or an MH were noted during follow-up.RESULTS: Twenty-three eyes of 22 patients were enrolled. At the time of primary surgery, the mean patient age was 64.4 ± 11.1 years and the baseline mean logMAR BCVA and CFT, 0.67 ± 0.50 and 431.8 ± 159.5 µm, respectively. The mean follow-up period was 53.7 ± 19.3 months. The mean logMAR BCVAs at 3, 6, 12, and 24 months postoperatively and at the final visit were 0.42 ± 0.39 (p = 0.001), 0.41 ± 0.38 (p = 0.001), 0.39 ± 0.40 (p < 0.001), 0.42 ± 0.43 (p < 0.001), and 0.51 ± 0.47 (p = 0.016), respectively, thus significantly better than the baseline value. The mean CFT at 3, 6, 12, and 24 months postoperatively and at the final visit were 244.6 ± 72.3, 210.5 ± 79.1, 209.6 ± 91.6, 219.8 ± 93.9, and 217.7 ± 81.3 µm, respectively, thus significantly less than baseline (all p < 0.001). MTM resolved in 18 eyes (78.3%) after primary surgery, without any complication, and remained stable to the final visit.CONCLUSIONS: Vitrectomy with ILM peeling afforded favorable long-term efficacy and safety in MTM patients.


Subject(s)
Follow-Up Studies , Humans , Medical Records , Membranes , Myopia, Degenerative , Prognosis , Retinal Detachment , Retinal Perforations , Retinoschisis , Retrospective Studies , Traction , Visual Acuity , Vitrectomy
10.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811228

ABSTRACT

PURPOSE: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.METHODS: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.RESULTS: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change.CONCLUSION: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.


Subject(s)
Hospitals, University , Humans , Medical Records , Motor Activity , Numismatics , Nursing , Physical Fitness , Quality of Life , Renal Dialysis , Self Efficacy , Smartphone
11.
Article in English | WPRIM (Western Pacific) | ID: wprim-782493

ABSTRACT

BACKGROUND: Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.METHODS: Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.RESULTS: Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.CONCLUSION: Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.


Subject(s)
Anaphylaxis , Asia , Beer , Child , Eating , Food Hypersensitivity , Hordeum , Humans , Hypersensitivity , Immunoglobulin E , Immunoglobulins , Korea , Medical Records , Pediatrics , Phenotype , Respiratory System , Retrospective Studies , Sensitivity and Specificity , Triticum , Wheat Hypersensitivity
12.
Article in English | WPRIM (Western Pacific) | ID: wprim-782246

ABSTRACT

BACKGROUND: The quantitative interferon (IFN)-γ response in the IFN-γ release assay (IGRA) has been investigated to predict progression from Mycobacterium tuberculosis infection to active tuberculosis (TB). However, the significance of the quantitative IFN-γ response in active TB is rarely known. We assessed the association between IFN-γ response to nil, mitogen, and TB mycobacterial antigens, and the variations from serial IGRA testing in active TB of various primary infection sites.METHODS: In total, 102 active TB patients with serial QuantiFERON-TB Gold In-Tube (QFT-GIT) (Qiagen, Germany) were enrolled. The medical records of patients were reviewed for demographic information, infection sites, tuberculosis treatment, and the quantitative IFN-γ response to nil, mitogen, and TB antigen.RESULTS: Patients included 20, 68, and 14 cases of pulmonary TB, extrapulmonary TB, and multiple TB infection, respectively. The quantitative IFN-γ responses to TB antigens differed significantly according to the infection sites (P=0.0001). The median IFN-γ response was the highest in lymph node infection (10.0 IU/mL) and the lowest in central nervous system (CNS) infection (0.02 IU/mL). Of the total, 86.3% showed concordant results in serial testing. Both 50% of the patients with persistent negative results and 62.5% of patients with CNS TB had an insufficient IFN-γ response to mitogen.CONCLUSIONS: Different IFN-γ responses to TB antigens may indicate variable host immune responses among infection sites in active TB disease. Because a few active TB patients fail to produce an adequate IFN-γ response, a study of cellular mechanisms is needed in such unresponsive patients.


Subject(s)
Central Nervous System , Humans , Interferons , Lymph Nodes , Medical Records , Mycobacterium tuberculosis , Tuberculosis
13.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-782245

ABSTRACT

BACKGROUND: The aim of this study was to compare the efficiency of cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA) for the diagnosis of lung cancer and to establish the optimal cut-off values.METHODS: We retrospectively reviewed the medical records of 1,176 subjects with CYFRA 21-2 and CEA data; they were classified into 93 lung cancer cases and 1,083 total controls, including 146 age-matched controls. Multivariate analysis was used to determine the relationship between the concentration of each tumor marker and lung cancer diagnosis. The diagnostic efficiencies of tumor markers were evaluated using receiver operating characteristic curve analysis and areas under the curve (AUCs) were calculated. The optimal cut-offs for CYFRA 21-1 and CEA were also estimated.RESULTS: Age, CYFRA 21-1, and CEA concentrations were independently associated with lung cancer diagnosis. Diagnostic efficiency of each tumor marker and its' combination was different according to the histological types of lung cancer. For non-small cell lung cancer, the AUCs for the two-marker combination were the highest: 0.8661 and 0.7559 for total and age-matched controls, respectively. For squamous cell carcinoma, the AUCs for CYFRA 21-1 were the highest: 0.9245 and 0.8428 for total and age-matched controls, respectively. The sensitivity and specificity of CYFRA 21-1 and CEA for lung cancer diagnosis were improved when the cutoffs determined based on this study were applied.CONCLUSIONS: CYFRA 21-1 and CEA could be useful markers for diagnosing lung cancer and single or combination of markers may be useful according to different histological types of lung cancer.


Subject(s)
Area Under Curve , Biomarkers, Tumor , Carcinoembryonic Antigen , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Diagnosis , Keratin-19 , Lung Neoplasms , Lung , Medical Records , Multivariate Analysis , Retrospective Studies , ROC Curve , Sensitivity and Specificity
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-782234

ABSTRACT

PURPOSE: To investigate prognostic factors related to the surgical outcome of vitrectomy in myopic traction maculopathy (MTM).METHODS: Medical records of patients with MTM who underwent pars plana vitrectomy with internal limiting membrane peeling and follow-up over 12 months were reviewed retrospectively. Best-corrected visual acuity (BCVA), fundoscopic examination and spectral-domain optical coherence tomography findings were evaluated postoperatively. Functional success was defined as visual acuity gain and anatomical success was defined as reduction or resolution of foveoschisis without complications.RESULTS: This study included 40 eyes of 36 patients. BCVA improved from 0.70 ± 0.44 to 0.63 ± 0.57 logarithm of minimum angle of resolution and central macular thickness decreased from 526.6 ± 132.1 to 277.8 ± 92.1 µm at final follow-up. Functional success was achieved in 24 (60.0%) eyes, and 33 (82.5%) eyes reached anatomical success. Presence of foveal detachment (FD) and higher category of myopic maculopathy were associated with both functional (p = 0.014, 0.021, respectively) and anatomical (p = 0.011, 0.022, respectively) failure. Longer preoperative axial length showed an association with functional failure but not with anatomical failure (p = 0.041). In multivariate analysis, FD was the only prognostic factor for both functional and anatomical outcome (p = 0.041, 0.043, respectively). Preoperative BCVA (r² = 0.259, p = 0.001), axial length (r² = 0.172, p = 0.008), and myopic maculopathy category (r² = 0.336, p < 0.001) showed significant correlation with final BCVA.CONCLUSIONS: More severe myopic maculopathy and the presence of FD are associated with poorer functional and anatomical outcomes of pars plana vitrectomy in MTM. Better preoperative BCVA, shorter axial length, and less severe myopic maculopathy are correlated with better final BCVA.


Subject(s)
Follow-Up Studies , Humans , Medical Records , Membranes , Multivariate Analysis , Retrospective Studies , Tomography, Optical Coherence , Traction , Visual Acuity , Vitrectomy
15.
Article in English | WPRIM (Western Pacific) | ID: wprim-782209

ABSTRACT

OBJECTIVE: This study aimed to investigate the potential predictive factors for platinum resistance and poor prognosis in epithelial ovarian, fallopian tube, and primary peritoneal cancer treated with platinum-based chemotherapy.METHODS: Medical records of 306 patients with the above mentioned cancers treated with platinum-based chemotherapy between 2007 and 2017 were retrospective reviewed. Clinical data, preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platinum-free interval, and survival time were recorded. NLR, PLR, and cancer antigen 125 (CA125) levels were calculated for an optimal cutoff point using receiver operating characteristic curves. The clinicopathological variables were compared using univariate and multivariate analyses to identify independent predictive factors for platinum resistance and poor survival outcomes.RESULTS: The optimal cutoff points for NLR, PLR, and CA125 were 3.38, 210, and 365 IU/L, respectively. Univariate analysis indicated that NLR >3.38, PLR >210, CA125 >365, advanced stage, suboptimal disease, serous type, and ascites were significant predictive factors for platinum resistance. However, only NLR >3.38 and advanced stage were independent predictive factors with an adjusted odds ratio of 1.880 and 3.333, respectively. Regarding factors associated with poor survival outcomes, only PLR >210 and advanced stage were independent factors, with a hazard ratio of 1.578 and 3.994, respectively.CONCLUSION: High NLR and advanced stage were potential independent predictive factors for platinum resistance, whereas high PLR and advanced stage were potential independent predictive factors for poor survival outcomes.


Subject(s)
Ascites , Blood Platelets , Drug Therapy , Fallopian Tubes , Female , Humans , Lymphocytes , Medical Records , Multivariate Analysis , Neutrophils , Odds Ratio , Ovarian Neoplasms , Platinum , Prognosis , Retrospective Studies , ROC Curve
16.
Annals of Dermatology ; : 38-46, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782142

ABSTRACT

BACKGROUND: Data on the natural history and prognostic variables of chronic urticaria (CU) are rare and information about spontaneous remission of CU is limited.OBJECTIVE: This study evaluated the natural history of CU and identified predictors for remission.METHODS: Total 329 Korean patients with CU, who had follow-ups more than 6 months after diagnosis during a 7-year period in the department of dermatology in three university hospitals were enrolled. Clinical data and laboratory findings obtained by medical records and telephone interviews were analyzed, retrospectively.RESULTS: The proportion recovered in 1, 3, and 5 years after the onset of CU was 10.8%, 18.8%, and 32.9%, respectively. The mean duration of CU was 6.3 years. There were no significant differences in median recovery time depending on sex, age group, severity of CU, and type of CU. The presence of angioedema was significantly related to CU severity. There were no differences in prognosis with respect to the presence of dermographism or angioedema. Patients with atopic dermatitis (AD) had a significantly worse prognosis than patients without a history of AD; but not in patients with the history of allergic rhinitis or asthma. Patients with abnormal laboratory findings did not differ significantly in prognosis.CONCLUSION: CU remission rate significantly differ according to the presence of AD. This study provides information about the natural course of CU of Korean patients.


Subject(s)
Angioedema , Asthma , Dermatitis, Atopic , Dermatology , Diagnosis , Epidemiology , Follow-Up Studies , Hospitals, University , Humans , Interviews as Topic , Korea , Medical Records , Natural History , Prognosis , Remission, Spontaneous , Retrospective Studies , Rhinitis, Allergic , Urticaria
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-811200

ABSTRACT

PURPOSE: Phosphorylated ribosomal S6 kinase 1 (pS6K1) is a major downstream regulator of the mammalian target of rapamycin (mTOR) pathway. Recent studies have addressed the role of S6K1 in adipogenesis. pS6K1 may affect the outcome of estrogen depletion therapy in patients with hormone-sensitive breast cancer due to its association with adipogenesis and increased local estrogen levels. This study aimed to investigate the potential of pS6K1 as a predictive marker of adjuvant aromatase inhibitor (AI) therapy outcome in postmenopausal or ovarian function-suppressed patients with hormone-sensitive breast cancer.METHODS: Medical records were retrospectively reviewed in postmenopausal or ovarian function-suppressed patients with estrogen receptor-positive and node-positive primary breast cancer. pS6K1 expression status was scored on a scale from 0 (negative) to 3+ (positive) based on immunohistochemical analysis.RESULTS: A total of 428 patients were eligible. The median follow-up duration was 44 months (range, 1–90). In patients with positive pS6K1 expression, AIs significantly improved disease-free survival (DFS) compared to selective estrogen receptor modulators (SERMs) (5 year-DFS: 83.5% vs. 50.7%, p = 0.016). However, there was no benefit of AIs on DFS in the pS6K1 negative group (5 year-DFS 87.6% vs. 91.4%, p = 0.630). On multivariate analysis, AI therapy remained a significant predictor for DFS in the pS6K1 positive group (hazard ratio, 0.39; 95% confidence interval, 0.16–0.96; p = 0.041). pS6K1 was more effective in predicting the benefit of AI therapy in patients with ages < 50 (p = 0.021) compared to those with ages ≥ 50 (p = 0.188).CONCLUSION: pS6K1 expression may predict AI therapy outcomes and serve as a potential predictive marker for adjuvant endocrine therapy in postmenopausal and ovarian function-suppressed patients with hormone-sensitive breast cancer. AIs may be more effective in patients with pS6K1 positive tumors, while SERM could be considered an alternative option for patients with pS6K1 negative tumors.


Subject(s)
Adipogenesis , Aromatase Inhibitors , Aromatase , Biomarkers, Tumor , Breast Neoplasms , Breast , Disease-Free Survival , Estrogens , Follow-Up Studies , Humans , Medical Records , Multivariate Analysis , Retrospective Studies , Ribosomal Protein S6 Kinases , Selective Estrogen Receptor Modulators , Sirolimus , Tamoxifen
18.
Annals of Dermatology ; : 109-114, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-811088

ABSTRACT

BACKGROUND: Tinea capitis is a cutaneous infection of dermatophytes and predominant in children. Although tinea capitis in Korea is controlled by oral antifungal medications and concerted public health initiatives, it's still a health issue.OBJECTIVE: To investigate changes in the epidemiological and mycological characteristics of adult patients with tinea capitis in southeastern Korea.METHODS: Using medical records from Kyungpook National University Hospital and Catholic Skin Clinic from 1989 to 2018, we retrospectively investigated the epidemiological and mycological characteristics of 266 adult patients (aged over 20) with tinea capitis.RESULTS: Among total 266 patients, 239 were KOH-positive. The annual incidence of tinea capitis ranged from 3 to 18 between 1989 and 2018. Of the total, 54 (20.30%) were male and 212 (79.70%) were female. Eighty patients (30.08%) were in their seventies, the most commonly affected age group. Of the remaining, 58 (21.80%) were in their sixties, and 41 (15.41%) in eighties. Among all, 77 (28.95%) visited the hospital in summer, 72 (27.07%) in spring, 64 (24.06%) in winter, and 53 (19.92%) in fall. Dermatophytes were cultured from 171 patients. Microsporum canis was the most common dermatophyte (42.48%), while Trichophyton rubrum was the second (15.79%). Of the 266 patients, 186 (69.92%) lived in urban areas and 80 (30.08%) in rural areas.CONCLUSION: The epidemiological and mycological characteristics of adult patients with tinea capitis were different from those of children in terms of annual incidence, sex distribution, and isolated dermatophytes. These results provide useful information for the treatment and prevention of tinea capitis.


Subject(s)
Adult , Arthrodermataceae , Child , Epidemiology , Female , Humans , Incidence , Korea , Male , Medical Records , Microsporum , Public Health , Retrospective Studies , Sex Distribution , Skin , Tinea Capitis , Tinea , Trichophyton
19.
Annals of Dermatology ; : 115-121, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-811087

ABSTRACT

BACKGROUND: Recently, the number of nationwide medical researches on psoriasis using the National Health Insurance Service database has been on the rise. However, identification of psoriasis using diagnostic codes alone can lead to misclassification. Accuracy of the diagnostic codes and their concordance with medical records should be validated first to identify psoriasis patients correctly.OBJECTIVE: To validate the diagnostic codes of psoriasis (International Classification of Diseases, 10th Revision L40) and to find the algorithm for the identification of psoriasis.METHODS: We collected medical records of patients who received their first diagnostic codes of psoriasis during 5 years from five hospitals. Fifteen percent of psoriasis patients were randomly selected from each hospital. We performed a validation by reviewing medical records and compared 5 algorithms to identify the best algorithm.RESULTS: Total of 538 cases were reviewed and classified as psoriasis (n=368), not psoriasis (n=159), and questionable (n=11). The most accurate algorithm was including patients with ≥1 visits with psoriasis as primary diagnostic codes and prescription of vitamin D derivatives. Its positive predictive value was 96.5% (95% confidence interval [CI], 93.9%~98.1%), which was significantly higher than those of the algorithm, including patients with ≥1 visits with psoriasis as primary diagnostic codes or including ≥1 visits with diagnostic codes of psoriasis (primary or additional) (91.0% and 69.8%). Sensitivity was 90.8% (95% CI, 87.2%~93.4%) and specificity was 92.5% (95% CI, 86.9%~95.9%).CONCLUSION: Our study demonstrates a validated algorithm to identify psoriasis, which will be useful for the nationwide population-based study of psoriasis in Korea.


Subject(s)
Classification , Electronic Health Records , Humans , International Classification of Diseases , Korea , Medical Records , National Health Programs , Prescriptions , Psoriasis , Sensitivity and Specificity , Vitamin D
20.
Article in English | WPRIM (Western Pacific) | ID: wprim-811068

ABSTRACT

PURPOSE: The incidence of drug-induced liver injury (DILI) has been increasing; however, few algorithms are available to identify DILI in electronic health records (EHRs). We aimed to identify and evaluate DILI with an appropriate screening algorithm.METHODS: We collected data from 3 university hospitals between June 2015 and May 2016 using our newly developed algorithm for identifying DILI. Among patients with alanine transferase (ALT) ≤ 120 IU/L and total bilirubin (TB) ≤ 2.4 mg/dL in blood test results within 48 hours of admission, those who either had 1) ALT > 120 IU/L and TB > 2.4 mg/dL or 2) ALT > 200 IU/L at least once during hospitalization were identified. After excluding patients with liver disease-related diagnosis at discharge, medical records were retrospectively reviewed to evaluate epidemiological characteristics of DILI.RESULTS: The total number of inpatients was 256,598, of whom 1,100 (0.43%) were selected by the algorithm as suspected DILI. Subsequently, 365 cases (0.14% of total inpatients, 95% confidence interval, 0.13–0.16) were identified as DILI, yielding a positive predictive value of 33.1%. Antibiotics (n = 214, 47.2%) were the major class of causative drug followed by chemotherapeutic agents (n = 87, 19.2%). The most common causative drug was piperacillin-tazobactam (n = 38, 8.4%); the incidence of DILI by individual agent was highest for methotrexate (19.4 cases/1,000 patients administered the drug). Common reasons for excluding suspected DILI cases were ischemic hepatitis and postoperative liver dysfunction.CONCLUSIONS: Using our EHR-based algorithm, we identified that approximately 0.14% of patients developed DILI during hospitalization. Further studies are needed to modify criteria for more accurate identification of DILI.


Subject(s)
Alanine , Anti-Bacterial Agents , Bilirubin , Diagnosis , Chemical and Drug Induced Liver Injury , Drug-Related Side Effects and Adverse Reactions , Electronic Health Records , Hematologic Tests , Hepatitis , Hospitalization , Hospitals, University , Humans , Incidence , Inpatients , Liver , Liver Diseases , Mass Screening , Medical Records , Methotrexate , Pharmacoepidemiology , Retrospective Studies , Transferases
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