Development and Usage Patterns of a Home-Grown Drug Information Tool.

Drug information tools help avoid medication errors, a common cause of avoidable harm in health care systems. We sought to describe the design, development process and architecture of an electronic drug information tool, as well as its overall use by health professionals. We developed a tool that can be accessed by all health professionals in a tertiary level university hospital. The functionalities of eDrugs are organized into two main parts: Drug Summary sheet, and Prescription Simulator. Most users accessed eDrugs to use the Drug summary sheet. Clinical information and antimicrobial drugs were the most accessed drug information and drug group. The analysis of log data provides insights into the information priorities of health professionals.

Evaluating the Performance of a Terminology Search Engine Using Historical Data.

Clinical terms are noisy descriptions typed by healthcare professionals in Spanish language in the electronic health record system (EHR). Thus, an evaluation of terminology search engine that extends SNOMED CT and an approach that uses historical data of clinical terms is described. We show how to measure precision and recall using historical search data, and we show how the performance of the search engine can be improved significantly using the technology available in the search engine.

An Information Retrieval Approach to ICD-10 Classification.

ICD-10 (International Classification of Diseases 10th revision) is a classification code for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. This paper describes an automatic information retrieval approach to map free-text disease descriptions to ICD-10 codes. We use the Hospital Italiano de Buenos Aires (HIBA) terminology data mapped to ICD-10 codes as indexed data to find an appropriate ICD-10 code using search engine similarity metrics.

Selection of Semantic Relevant Healthcare Services Subsets.

We describe an approach to select semantically coherent specialty subsets based on the historical use of terminology by different service areas. Our approach uses rule-based and machine learning techniques to obtain a reduced set of 29 specialties.

[Gastrointestinal Epstein Barr virus positive diffuse large B cell lymphoma in elderly: report of five cases and review of literature]. / Linfoma de celulas grandes B difuso gastrointestinal del anciano asociado al virus Epstein Barr: reporte de cinco casos y revision de la literatura.

EBV-positive diffuse large B-cell lymphoma (DLBCL) in elderly is a new entity included provisionally in the most recent WHO Classification of lymphoid neoplasms. It usually affects elderly patients and has a poor survival. The goal of this report was to evaluate clinical, endoscopic characteristics and survival of five patients with this entity and gastrointestinal afectation. From five cases, three cases had gastric infiltration, one ileon and one in cecum.

Linfoma de Celulas Grandes B Difuso Gastrointestinal del Anciano Asociado al Virus Epstein Barr: Reporte de Cinco Casos y Revision de la Literatura / Gastrointestinal Epstein Barr Virus positive diffuse large B cell lymphoma in elderly: report of five cases and review of literatura

El Linfoma de Células Grandes B difuso del anciano asociado al Epstein Barr es una nueva entidad incluida provisionalmente en la más reciente clasificación de neoplasias linfoides de la WHO. Usualmente afecta ancianos y tiene pobre sobrevida. El objetivo de este reporte fue evaluar las característica clínicas, endoscópicas y sobrevida de cinco pacientes portadores de esta entidad y compromiso gastrointestinal. Tres casos tuvieron infiltración gástrica y dos casos tuvieron compromiso del ileón y el ciego.

EBV-positive diffuse large B-cell lymphoma (DLBCL) in elderly is a new entity included provisionally in the most recent WHO Classification of lymphoid neoplasms. It usually affects elderly patients and has a poor survival. The goal of this report was to evaluate clinical, endoscopic characteristics and survival of five patients with this entity and gastrointestinal afectation. From five cases, three cases had gastric infiltration, one ileon and one in cecum.

Expresión de FOXP3 en linfomas de células T: estudio de 47 casos en el Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú / FOXP3 expression in T-cell lymphoma: a 47-case study in Edgardo Rebagliati-Martins Hospital; EsSalud, Lima, Peru

Introducción: Foxp3 es un gen regulatorio clave requerido para el desarrollo y función de las células T regulatorias CD25+ y CD4+, una subpoblación de células T especializadas en el mantener el balance entre la inmunidad y la tolerancia (Treg) Objetivo: determinar la especificidad y el valor pronóstico de la expresión de Foxp3 en el linfoma de células T. Material y método: estudio retrospectivo en 47 pacientes con Linfoma T en el Hospital Nacional Edgardo Rebagliati Martins, EsSalud durante el período 1997- 2004. Resultados: la expresión de Foxp3 en células tumorales fue detectado en 8/33 (24 por ciento) casos de la Leucemia /Linfoma T del Adulto (ATLL) y en 2/8 (28 por ciento) linfomas T periféricos no especificados (LTPNE) . No hubo diferencia estadística en sobrevida global entre el ATLL Foxp3 (+) y el ATLL Foxp3 (-). El Foxp3 está expresado en diferentes Linfomas T y no es un marcador específico para la identificación de ATLL. Conclusión: la expresión de Foxp3 puede darse en ATLL como en LTPNE.

Introduction: Foxp3 is a key regulatory gene required for CD25+ and CD4+ regulatory T-cells development and function (Treg), a cell subpopulation specialized in maintaining a balance between immunity and tolerance. Objective: To determine the specificity and prognostic value of Foxp3 expression in T-cell lymphoma. Material and Methods: A retrospective study carried out in 47 patients with T-cell lymphoma in Edgardo Rebagliati-Martins Hospital, EsSalud (Peruvian Social Security), from 1997 to 2004. Results: The expression of Foxp3 in tumoral cells was detected in 8/33 (24 per cent) ATLL (adult t-cell leukemia/lymphoma) cases and in 2/8 (29 per cent) LTPNE cases. There was no statistically significant difference in overall survival between ATLL Foxp3 (+) and ATLL Foxp3 (-). Foxp3 is expressed in different T-cell lymphoma types, and it is not a specific marker for the dientification of ATLL cases. Conclusion: Foxp3 expression can be seen both in ATLL as in LTPNE.

[Primary colorectal lymphoma of diffuse large B-cells: an experience at a general hospital]. / Linfoma de células grandes B difuso primario colorectal: experiencia en un hospital general.

Primary colorectal lymphoma is a very rare disease. Primary colorectal lymphoma of diffuse large B-cells is a more frequent subtype representing 1% of all colon diseases. In a retrospective study, the clinical characteristics and treatment course of primary colorectal lymphoma of diffuse large B-cells between 1997 and 2003 were reviewed. According to Dawson's criteria, fourteen cases were identified. The average age was 65 and the ratio of men to women was 1:3. The most frequent signs and symptoms were abdominal pain (78%), diarrhea (49%) and abdominal tumor (35%). The most frequently involved regions were the cecum (42%), ascending colon (21%) and rectum (21%). Six were in Stage I, four in Stage II and four in Stage III. The 5-year survival per stage was 26, 11 and 5 months, respectively. Primary colorectal lymphoma of diffuse large B-cells usually affects the right part of the colon in an aggressive manner.

Linfoma de células grandes B difuso primario colorectal: experiencia en un hospital general / Primary colorectal lymphoma of diffuse large B-cells: an experience at a general hospital

El Linfoma primario colorectal es una enfermedad muy infrecuente. El Linfoma difuso de células B grandes primario colorectal es el subtipo más frecuente y se constituye en el 1% de todas las malignidades del colon. En un estudio retrospectivo, se revisó las características clínicas y curso de tratamiento de los linfomas de células grandes B difuso primario colorectal entre 1997-2003. De acuerdo a los criterios de Dawson fueron identificados catorce casos. La edad media fue 65 años y la relación varón /mujer1.1.3. Los signos y síntomas más frecuentes fueron: dolor abdominal (78%), diarrea (49%) y tumor abdominal (35%). Los sitios más frecuentemente involucrados fueron:ciego (42%), colon ascendente (21%) y recto (21%). Seis tuvieron un estadío I , cuatro en estadío II y cuatro en estadio III. La sobrevida a 5 años por estadios fue: 26,11 y 5 meses respectivamente.El Linfoma primario colorectal de Células grandes B difuso usualmente afecta el colon derecho con un comportamiento agresivo.

Primary colorectal lymphoma is a very rare disease. Primary colorectal lymphoma of diffuse large B-cells is a more frequent subtype representing 1% of all colon diseases. In a retrospective study, the clinical characteristics and treatment course of primary colorectal lymphoma of diffuse large B-cells between 1997 and 2003 were reviewed.According to Dawson’s criteria, fourteen cases were identified. The average age was 65 and the ratio of men to women was 1:3. The most frequent signs and symptoms were abdominal pain (78%), diarrhea (49%) and abdominal tumor (35%). The most frequently involved regions were the cecum (42%), ascending colon (21%) and rectum (21%). Six were in Stage I, four in Stage II and four in Stage III. The 5-year survival per stage was 26, 11 and 5 months, respectively. Primary colorectal lymphoma of diffuse large B-cells usually affects the right part of the colon in an aggressive manner.

Linfomas cutáneos primarios: estudio retrospectivo clinicopatológico durante el periodo 1997 - 2004 en el Hospital Edgardo Rebagliati Martins, Essalud, Lima, Perú / Cutaneous lymphoma: A retrospective clinico-pathological study during the 1997-2004 Period in Edgardo Rebagliati-Martins Hospital, Essalud, Lima, Peru

Introducción: las características clínicopatológicas de los linfomas malignos varían de acuerdo a la geografía. La piel es el segundo lugar de compromiso extranodal de linfoma no Hodgkin .El linfoma primario cutáneo tienen un comportamiento clínico y pronóstico diferente de los linfomas sistémicos Objetivo: el objetivo de este estudio fue determinar la frecuencia relativa de los linfomas cutáneos y examinar la relevancia clínica de la nueva clasificación WHO/EORTC y la sobrevida de los casos peruanos de linfoma primario cutáneo. Material y método: se realizó un estudio retrospectivo clínicopatológico de 78 casos de linfomas cutáneos, diagnosticados desde 1997 al 2004 en el Hospital Edgardo Rebagliati Martins, Essalud, Lima,Perú. Las historias clínicas, biopsias y pruebas de inmunohistoquímica de los 78 pacientes enrolados fueron revisadas. Resultados: 67/78 (85,9%) fueron linfomas primarios cutáneos y 11/78 (14,1%) fueron linfomas cutáneos secundarios. El linfoma secundario cutáneo más frecuente fue el linfoma /leucemia T del adulto (ATLL) con 72% de los casos. El linfoma primario cutáneo más frecuente fue la micosis fungoide (MF) 30/67 (44,7%) , seguido del ATLL 13/67 (19,4%) y el linfoma T periférico no especificado 4/67 (6%). La sobrevida a 5 años para la MF, ATLL cutáneo y ATLL sistémico fue de 77%. 18% y 0% respectivamente. Conclusión: MF y ATLL cutáneo fueron los linfomas primarios cutáneos más frecuentes en nuestro hospital. La MF posee un buen pronóstico mientras el ATLL cutáneo posee pobre sobrevida.

Introduction: Clinico-pathological features of malignant lymphomas vary according to geography. The skin is the second site for extranodal Non-Hodgkin Lymphoma. Primary cutaneous lymphoma has a different clinical behavior and prognosis compared with systemic lymphomas. Objective: The aim of this study was to determine the relative rate of cutaneous lymphomas and to examine the clinical relevance of the new WHO/EORTC classification and survival in Peruvian persons with primary cutaneous lymphoma. Methods: We conducted a clinico-pathological retrospective study in 78 cases of cutaneous lymphoma diagnosed between 1997 and 2004 in a National General Hospital. Clinical records, hematoxylin & eosin-stained slides and immunohistochemical studies from 78 patients with malignant lymphoma of the skin were reviewed. Results: 67/78 cases (85,9%) were primary cutaneous lymphomas and 11/78 (14,1%) were secondary cutaneous lymphomas. Most frequent secondary cutaneous lymphoma was systemic adult T-cell lymphoma/Leukemia (ATLL), accounting for 72% of cases. Most frequently found primary cutaneous lymphoma were mycosis fungoides (MF), in 30/67 (44,7%) patients, cutaneous ATLL in 13/67 (19,4%), and non-specific peripheral T-cell lymphoma in 4/67 (6%). 5-year survival rates for MF, cutaneous ATLL and systemic ATLL were 77%, 18%, and 0%, respectively.Conclusions: MF and ATLL are the more frequently found primary cutaneous lymphomas in our hospital. MF has a good prognosis, while cutaneous ATLL has a poor survival rate.

Role of the von Hippel-Lindau tumor suppressor gene in the formation of beta1-integrin fibrillar adhesions.

The von Hippel-Lindau tumor suppressor gene (VHL) is absent or inactivated in the VHLcancer syndrome and in most sporadic renal cancers. VHL is requiredfor the assembly of a proper extracellular fibronectin matrix, although the exact mechanism remains unknown. In this report, we demonstrate that 786-O renal cancer cells are unable to organize an adequate matrix even in the presence of an excess of exogenous fibronectin. Because the formation of integrin fibrillar adhesions plays a pivotal role in the organization of extracellular fibronectin, we next examined the expression and subcellular distribution of integrins in VHL- cells and their wild-type VHL stably transfected counterparts. The levels of beta1 and alphav integrins were increased in VHL- cells when compared with VHL+ transfectants. Early after plating, both VHL+ and VHL- cells were capable of assembling classic "patch-like" alphav focal contacts. As the culture advanced and cells became confluent, alphav integrins partly relocated to the intercellular junctions in VHL+ transfectants, which then developed large beta1 fibrillar-type adhesions and anchored firmly to the substrate. In contrast, confluent VHL- cells were unable to assemble beta1 fibrillar adhesions, and alphav focal contacts remained unchanged at all stages of the culture. Exogenous activation of beta1 integrins with either divalent cations or activating antibodies partly restored the capability of VHL- cells to assemble beta1 fibrillar adhesions and fibronectin fibers. Finally, pulse-chase studies of metabolically labeled 786-O cells revealed that the maturation of the common beta1-integrin chain was delayed in VHL- cells when compared with VHL+ cells. Our results show that VHL is an important regulator of integrins and is essential for the formation of beta1 fibrillar adhesions. These findings help to explain the abnormal extracellular matrix organization and increased motility of VHL- renal cancer cells.