Data verification of nationwide clinical quality registries.

Background: Clinical auditing is an emerging instrument for quality assessment and improvement. Moreover, clinical registries facilitate medical research as they provide 'real world' data. It is important that entered data are robust and reliable. The aim of this study was to describe the evolving procedure and results of data verification within the Dutch Institute for Clinical Auditing (DICA). Methods: Data verification performed on several (disease-specific) clinical registries between 2013 and 2015 was evaluated. Sign-up, sample size and process of verification were described. For each procedure, hospitals were visited by external data managers to verify registered data. Outcomes of data verification were completeness and accuracy. An assessment of the quality of data was given per registry, for each participating hospital. Using descriptive statistics, analyses were performed for different sections within the individual registries. Results: Seven of the 21 registries were verified, involving 174 visits to hospital departments. A step-by-step description of the data verification process was provided. Completeness of data in the registries varied from 97·2 to 99·4 per cent. Accuracy of data ranged from 88·2 to 100 per cent. Most discrepancies were observed for postoperative complications (0·7-7·5 per cent) and ASA classification (8·5-11·4 per cent). Data quality was assessed as 'sufficient' for 145 of the 174 hospital departments (83·3 per cent). Conclusion: Data verification revealed that the data entered in the observed DICA registries were complete and accurate.

Antecedentes: La auditoría clínica es un instrumento emergente para la evaluación y mejora de la calidad. Además, los registros clínicos facilitan la investigación médica ya que proporcionan datos de la "vida real". Es importante que los datos introducidos sean completos y fiables. El objetivo de este estudio fue describir la evolución y los resultados del procedimiento de verificación de datos en el seno del Instituto Holandés de Auditorias Clínicas (Dutch Institute for Clinical Auditing, DICA). Métodos: Se evaluó la verificación de datos realizada en varios registros clínicos (específicos de enfermedad) entre 2013­2015. Se describió el sistema de registro, tamaño de la muestra y el proceso de verificación. Para cada procedimiento, los hospitales fueron visitados por administradores de datos externos para verificar los datos registrados. Los resultados de la verificación de datos fueron la integridad y la exactitud. Se proporcionó una evaluación de la calidad de los datos para cada registro en cada uno de los hospitales que participaron. Mediante la utilización de estadística descriptiva, se realizaron análisis de diferentes secciones para cada uno de los registros. Resultados: Siete de los 21 registros fueron verificados, lo que implicó un total 174 visitas a los departamentos de los hospitales. Se proporcionó una descripción paso a paso del proceso de verificación de los datos. La integridad de los datos en los registros varió entre 97,3­99,4%. La exactitud de los datos varió entre 86,6­97,0%. La mayoría de las discrepancias se observaron en las complicaciones postoperatorias (0,7­7,5%) y clasificación ASA (7,5­11%). La calidad de los datos se consideró "suficiente" en 145 de 174 (83%) departamentos hospitalarios. Conclusión: La verificación de los datos reveló que la introducción de datos en los registros DICA analizados era bastante completa y exacta.

Circulating concentrations of soluble granzyme A and B increase during natural and experimental Plasmodium falciparum infections.

Release of soluble Granzymes (sGranzymes) is considered to reflect activation of cytotoxic T lymphocytes and NK cells. sGranzymes and a number of pro-inflammatory cytokines were measured in plasma of malaria patients with natural or experimentally induced Plasmodium falciparum infections. Concentrations of sGranzyme A and B, IL-10, IL-12p70 and CRP were significantly increased in African children presenting with clinical malaria; IL-10 and CRP concentrations were significantly correlated with disease severity. In nonimmune Dutch volunteers which were experimentally infected by P. falciparum-infected mosquitoes, sGranzyme A increment started 1-2 days prior to clinical symptoms and microscopically detectable parasitaemia. This coincided with increases in IFNgamma, IL-12p40 and IL-8, while sGranzyme B and IL-10 levels increased 24-48 h later. The elevation of sGranzyme A and IFNgamma in nonimmune volunteers suggests that NK cells are activated upon release of parasites by infected liver cells and subsequently during blood stage infection; thus, NK cells are likely involved innate immune human host resistance in the early phase of a malaria infection.

Prevalence of Campylobacter enteritis in children from Yaounde (Cameroon).

A cross sectional study on the prevalence of Campylobacter jejuni/coli and its possible aetiologic role in childhood diarrhoea in Yaounde was undertaken in 272 children presenting with diarrhoea and 157 age matched controls from April 1989 to October 1990. Stool cultures were performed according to standard techniques for Campylobacter jejuni/coli shigella and salmonella species. Rotavirus was detected using a latex agglutination test. Campylobacter jejuni/coli was isolated from 21 (7,7 pc) of 272 patients with diarrhoea and five of 157 (3,2 pc) controls (p > 0.05), all aged zero to four years old. Shigella and salmonella species were cultured from 2,2 pc and 1,1 pc of 272 patients respectively while rotavirus antigen was detected in 19,6 pc of 204 patients. Twenty eight pc of children with Campylobacter enteritis were exposed to chickens while 23,8 regularly drank water from streams which probably were contaminated. Our results indicate a high prevalence of campylobacter enteritis in children living in Yaounde and also suggest that a high rate of carriage of Campylobacter jejuni/coli could exist in children zero to four years without diarrhoeal illness. to four years without diarrhoeal illness.

The effects of early Le Fort I osteotomies on craniofacial growth of juvenile Macaca nemestrina monkeys.

Le Fort I osteotomies were performed on three juvenile Macaca nemestrina monkeys with midface deficiencies from prior extraoral traction. The maxillas of these monkeys were moved anteriorly an amount necessary to achieve about 8 mm. of horizontal overjet. Interosseous wires were used to stabilize the segments; the animals were not placed in intermaxillary fixation. Craniofacial growth in the three experimental monkeys and in three control monkeys was monitored for 2 years with serial cephalometric radiographs. Compared to the controls, the maxillas of the experimental animals demonstrated less anterior growth, and this was manifested clinically in anterior dental cross-bite relationships. Histologic examination of the circummaxillary sutural complex revealed normal morphology. It is concluded, therefore, that early Le Fort I osteotomies significantly affect subsequent maxillary growth in monkeys and that this effect probably is due to formation of scar tissue.