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ObjectiveBy analyzing the current situation of drug selection and evaluation in medical institutions in the world,we aim to understand the development of relevant selection methods and tools,provide reference basis for drug selection in traditional Chinese medicine (TCM) medical institutions,and promote the optimization of drug catalogs in TCM medical institutions. MethodBased on the method of scoping review,the eight databases were systematically searched,the included documents were screened,extracted and analyzed,and the research results were graphically displayed. ResultA total of 23 articles were included in this study,including 13 in Chinese and 10 in English,involving 23 methods or tools related to drug selection. Of the 14 methods or tools from Chinese medical institutions,the earliest one was published in 2012,and five were published in 2022. The published methods or tools involved different levels of hospitals,different drug varieties,different evaluation angles,etc.,such as the drug selection methods of one county hospital and one township hospital, methods and tools for different types of drugs such as antibacterial drugs,ibuprofen preparations,proton pump inhibitors and hypoglycemic drugs used in pediatric intensive care units, Chinese patent medicine selection tools, tools for evaluation from the perspective of pharmacoeconomics, and universal tools for selecting domestic medical institutions. The nine drug selection tools of foreign medical institutions were from the European,American,Asian and African countries. It was first published in 1955. The contents included the formulation standards that medical institutions should follow for drug prescription sets,the management formulation and update of hospital prescription sets,and drug evaluation tools. ConclusionOn the whole,the drug selection methods and institutional methods of foreign medical institutions developed earlier than those in China. In recent years,Chinese medical institutions have paid high attention to drug selection and released various types of drug selection tools. However,the standardization should be further improved in the future.
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Objective:To analyze the application effect of standardized exercise program based on motivation and volitional model in home-based cardiac rehabilitation of patients with acute myocardial infarction.Methods:The method of non-simultaneous control trial was used. Using convenient sampling method, 60 patients with acute myocardial infarction treated in the Department of Cardiovascular Medicine of Huaibei People's Hospital Affiliated to Bengbu Medical College from December 2021 to April 2023 were selected as subjects. The patients were divided into two groups according to the order of admission: 30 patients admitted from December 2021 to June 2022 as the control group, and 30 patients from July 2022 to April 2023 as the observation group. The control group received routine nursing methods,on the basis of routine nursing, the observation group was intervened with the standardized exercise program based on the theoretical model of motivation and will. The differences of 6-minute walking distance, Duke Activity Status Index Score, Exercise Self-efficacy Score, compliance level of cardiac rehabilitation exercise prescription between the two groups were compared.Results:There were 23 males and 7 females in the control group with age of (58.27 ± 10.86) years old, and 24 males and 6 females in the observation group with age of (57.07 ± 10.91) years old. After 3 months of intervention, 6-minute walking distance, Duke Activity Status Index Score and Exercise Self-efficacy Score in the observation group were (565.53 ± 66.90) m, (29.80 ± 9.76) and (41.87 ± 11.76) points respectively, significantly higher than those in the control group (488.00 ± 91.94) m, (21.63 ± 7.21) and (29.80 ± 8.48) points, the differences were statistically significant ( t=3.73, 3.69, 4.56, all P<0.01). The rates of good, average, and poor compliance with cardiac rehabilitation exercise in the observation group were 56.7% (17/30), 36.7% (11/30), and 6.7% (2/30), respectively, while in the control group were 23.3% (7/30), 46.7% (14/30), and 30.0% (9/30), respectively. The difference between the two groups was statistically significant ( χ2=8.98, P<0.05). Conclusions:The application of standardized exercise program in home-based cardiac rehabilitation of patients with acute myocardial infarction can improve patients ′ exercise endurance, improve exercise self-efficacy, enhance the effect of home-based cardiac rehabilitation, and further reduce cardiovascular risk factors.
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Background and purpose:Follow-up data of 6 737 patients undergoing surgery for gastric cancer were collected based on hospital registration,and the 1-,3-and 5-years observed overall survival(OS)rates and disease-free survival(DFS)rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China.Methods:A total of 6 737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was November 30,2023.Kaplan-Meier method was applied in evaluating the 1-,3-and 5-year OS rate and DFS rate,and survival data were described by different subgroups including age group,gender,treatment period,tumor staging,and pathological characteristics.Results:With a median follow-up time of 50.99 months,the 5-year OS rate of surgically resected gastric cancer patients was 70.37%,and 5-year DFS rate in Ⅰ-Ⅲ stage cases was 69.46%.The 5-year OS rates of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 94.32%,82.56%,51.01%and 23.97%,respectively.The differences in survival among patients with different age,tumor location,gross classification,Borrmann classification and Laurence classification were significant.Conclusion:Staging is an important factor directly affecting the survival of gastric cancer patients.Screening and early diagnosis and treatment in large population,especially high-risk group,should be strengthened to further improve the patients'survival.
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The access evaluation of new medical technology is an important part of the preclinical application of medical technology and plays a vital role in ensuring the quality and safety of medical services.However,in the con-crete practice of access evaluation,there are still some problems such as imperfect access theoretical framework,imperfect evaluation index system.With the strategic support of health policies,laws,and regulations,the theory and method of HB-HTA are used for reference,core elements such as assessment subject,assessment object,and assessment content are comprehensively considered,the index system is designed from the dimensions of tech-nical characteristics,safety,effectiveness,economy and applicability,and the access evaluation framework of im-ported medical new technologies is constructed.To offer a theoretical framework and evidence-based basis for medi-cal facility medical technology access management.
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ObjectiveThis study aims to understand the recognition of practitioners in traditional Chinese medicine (TCM) hospitals on hospital-based health technology assessment (HB-HTA), assessment needs, challenges, and suggestions, so as to provide references for the future work. MethodThe convenient sampling method was adopted to survey the relevant practitioners in TCM hospitals. The questionnaire included 39 questions in 4 dimensions and was distributed through the online platform Weijuanxing. ResultA total of 244 questionnaires were recovered, and the obtained data were analyzed in SPSS. The results showed that 137 practitioners were very familiar with HB-HTA and there was no significant difference in the recognition of practitioners in different occupations (F=0.251; P=0.778). The practitioners in Hong Kong, Macao, and Taiwan had lower recognition than those in other regions. In terms of the assessment needs, 127 practitioners believed that it was very necessary to carry out HB-HTA in TCM hospitals in the future. Chinese patent medicines/Chinese herbal medicine decoction pieces (5.91) and TCM appropriate technology (5.57) had higher assessment priority scores. The assessment needs were high for the effectiveness (235 practitioners) and safety (224 practitioners) of health technology. The lack of specialized organization and standardized evaluation process system and the shortage of talents were considered to be the major challenges for the future development in this field. ConclusionThe stakeholders carrying out the health technology assessment in TCM hospitals had certain awareness of HB-HTA. Most practitioners believed that it was necessary to carry out HB-HTA in TCM hospitals in the future, while the work might face challenges such as the lack of organizations and system and the shortage of talents, which requires policy support.
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Abstract The aim of this study is to provide a real picture of the disease burden of Prameha in society. The study was performed in Government Ayurved College and Hospital, Nagpur, Maharashtra during Oct 2015-Mar 2016. Total 60 patients of newly diagnosed type 2 diabetes mellitus attending the Kayachikitsa Opd of GAC Nagpur were included for the study. The subjects details were recorded in case report form. The CRF included many variables such as sociodemographic factors, presenting symptoms, risk factors such as hypertension, obesity and glycaemic status, family history of diabetes and physical activity. Other parameters like BMI, glycosylated haemoglobin, fasting and post prandial blood sugar and fasting lipid profile were documented. Descriptive and bivariate analyses were carried out using the XLSTAT software (2020). Amongst 60 subjects, 65% were male and 93.3% were adults. 78% of subjects were following sedentary lifestyle and 40% had family history of diabetes. The results revealed that, obesity, family history of diabetes, uncontrolled glycemic status, sedentary lifestyles, and hypertension were prevalent among the Prameha subjects. The characterization of this risk profile and early detection of prameha by observing poorvarupa will contribute to designing more effective and specific strategies for screening and controlling Prameha in Maharashtra, India.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Estudo Observacional , Hospitais/classificação , Índia/etnologiaRESUMO
Background: Psoriasis is a chronic autoimmune inflammatory disorder of skin. Though the exact etio-pathogenesis is not well-understood, several studies hypothesised it as a complex interaction between genetics, immunology, and environment. Hence, we aimed toassess the insulin resistance among psoriasis patients and to correlate the insulin resistance with the disease severity, and inflammation.Methods:A tertiary hospital-based observational study was conducted for a year (2016-2017) at dermatology and endocrinology OPD, IPGMER andSSKM Hospital, Kolkata. The eligible participants were selected after applying the inclusion and exclusion criteria. After obtaining the written informed consent, basic demographic details were collected and examined for certain physical and biochemical parameters. Data was entered in Microsoft excel and analysed using SPSS software. Appropriate statistical analysis was carried out.Results: A total of 48 cases and 40 controls participated in the study. The median fasting insulin (p<0.001), HOMA-IR (p<0.001), and hs CRP (p=0.047) in cases were significantly higher than controls. There were significant differences of HOMA-IR within three groups of psoriasis. There was a positive correlation and statistically significant between PASI and HOMA-IR (rho=0.469, p value=0.001) and between PASI and fasting insulin (rho-0.528, p value<0.001).Conclusions: Chronic psoriasis patients were more insulin resistant and significantly correlated with the disease severity index.
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Introduction: Intervertebral disc disorders (IDDs) are being commonly observed nowadays among the young and middle aged population. Objectives: This hospital record based study was done to study the risk factors, clinical presentation, imaging findings and management practices among patients with all types of IDDs. Methods: A validated proforma was used to obtain information of patients confirmed with IDDs over the past three years. Results: Mean age at onset of disc disorders among the 219 patients was 44.7±14.2 years. History of poor exercising habits were present among 72(32.9 percent) patients. The most common site of disc involvement was L4-L5 [151(68.9 percent)]. 143(65.3 percent) patients had single site disc involvement. The most common clinical symptom was lower back pain [180(82.2 percent)]. Nerve root compression was present among 154(70.3 percent) patients. Disc bulge, protrusion, extrusion and sequestration were present among 116(53 percent), 90(41.1 percent), 52(23.7 percent) and 4(1.8 percent) patients respectively. Age at onset >65 years (p=0.035), age at onset ≤55 years (p=0.004) and history of direct impact to the neck region (p=0.017) were associated with disc prolapse at L2-L3 level, L4-L5 level and C5-C6 level respectively, among patients with single site disc involvement. Risk of multiple level disc involvement was found to increase after 35 years (p<0.001). It was seen more involving cervical vertebrae (p=0.0068). Lumbar (p<0.0001) and lumbosacral vertebrae (p<0.0001) involvement were seenmore among patients with single site disc involvement. NSAIDs [155(70.8 percent)] were the most the commonly used medication. Microdiscectomy was done among 35(76.1 percent) out of the 46 patients who underwent surgical management. Conclusions: Exercising habits need to be encouraged among people for the prevention of IDDs. The various high risk groups identified in this study need to be periodically screened for IDDs(AU)
Introducción: Actualmente, los trastornos de los discos intervertebrales (TDI) son frecuentes en la población joven y de mediana edad. Objetivos: Este estudio hospitalario de las historias clínicas se realizó para examinar los factores de riesgo, la presentación clínica, los hallazgos imagenológicos y las prácticas de tratamiento entre los pacientes con todos los tipos de trastornos de los discos intervertebrales. Métodos: Se utilizó una proforma validada para obtener información de los pacientes confirmados con trastornos de los discos intervertebrales en los últimos tres años. Resultados: La edad media de aparición de los trastornos discales entre los 219 pacientes fue de 44,7 ± 14,2 años. El historial de malos hábitos de ejercicio estuvo presente en 72 (32,9 por ciento) pacientes. El sitio más común de afectación del disco fue L4-L5 [151 (68,9 por ciento)]. 143 (65,3 por ciento) pacientes tenían compromiso de disco en un solo sitio. El síntoma clínico más frecuente fue el dolor lumbar [180(82,2 por ciento)]. La compresión de la raíz nerviosa estuvo presente en 154 (70,3 por ciento) pacientes. Se mostró presencia de protuberancia, protrusión, extrusión y secuestro discal en 116 (53 por ciento), 90 (41,1 por ciento), 52 (23,7 por ciento) y 4 (1,8 por ciento) pacientes, respectivamente. La edad de inicio >65 años (p=0,035), la edad de inicio ≤55 años (p=0,004) y el antecedente de impacto directo en la región del cuello (p=0,017) se asociaron con prolapso discal a nivel L2-L3, L4- Nivel L5 y nivel C5-C6 respectivamente, entre pacientes con compromiso discal en un solo sitio. Se encontró que el riesgo de afectación del disco en múltiples niveles aumenta después de 35 años (p<0,001). Se vio más involucradas las vértebras cervicales (p=0,0068). La afectación de las vértebras lumbares (p<0,0001) y lumbosacras (p<0,0001) se observó más entre los pacientes con afectación del disco en un solo sitio. Los fármacos anti-inflamatorios no esteroideos (AINE) [155 (70,8 por ciento)] fueron los medicamentos más utilizados. La microdiscectomía se realizó en 35 (76,1 por ciento) de los 46 pacientes que se sometieron a manejo quirúrgico. Conclusiones: Es necesario fomentar hábitos de ejercicio entre las personas para la prevención de los TDI. Los diversos grupos de alto riesgo identificados en este estudio deben someterse a pruebas periódicas de IDD(AU)
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Humanos , Masculino , Feminino , Adulto , Idoso , Exame Físico/métodos , Doenças da Coluna Vertebral/terapia , Disco Intervertebral/diagnóstico por imagem , Exercício Físico , Anti-Inflamatórios não Esteroides/administração & dosagemRESUMO
This article briefly discloses what home hospitalization consists of, its different models of care, and the benefits and difficulties associated with it. We also describe the operation of the home hospitalization unit of the Padre Hurtado Hospital in Santiago de Chile and the role it took in the context of the first wave of the COVID-19 Pandemic, specifically between March and August of the year 2020. We aim to share our experience with this emerging form of hospitalization that is already working in Chilean public hospitals. We also hope that this hospitalization modality will continue to grow over the years.
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Humanos , Pandemias , COVID-19 , Chile/epidemiologia , Hospitalização , Hospitais PúblicosRESUMO
BACKGROUND: Multi-drug resistant tuberculosis has become major public health problem and obstacle to effective control of tuberculosis. Over a period of time, there are several landmark achievements including policy and system preparedness for universal access to TB care including mandatory noti?cation of TB cases, development of standard for TB care in India, comprehensive real time TB information management system-NIKSHAY, use of rapid molecular diagnostics, successful innovations in private sector engagement for TB care-Universal access to TB care. Objective was to ?nd out the challenges in initiation of treatment of Multi Drug Resistant-TB patients get admitted in ITKI Sanatorium Ranchi Jharkhand. METHODS: It was a hospital based cross sectional study carried out from August 2016 to Nov.2018 on Multi drug resistant tuberculosis patients admitted in MDR-TB centre Itki Sanatorium Ranchi after approved from institutional ethics committee. Total study subjects included in study was 64. RESULTS: Most of the study subjects 58 (90.6%) did not know about the MDR-TB. Most of the study subjects 40 (62.5%) had been given reports of CB-NAAT test on same day followed by study subjects 24 (37.5%) on alternate day. No one study subjects 64 (100%) had been given any type of incentive for travelling to pretreatment evaluation centre. In above table, most of the patients 51 (79.7%) had made payment for investigations at district hospital/ SDH level followed by 13 (20.3%) who were free of any expenditure for investigations. Most of the study subjects 60 (93.7%) were not visited by any health staff between ?nal diagnosis of MDR-TB and initiation of treatment for MDR-TB followed by subjects 4 (6.3%) who were being visited by health staff. Most of the study subjects 48 (75%) were unaware about the NIKSHAY POSHAN SCHEME for MDR-TB patients followed by subjects 16 (25%) who knew about the NIKSHAY POSHAN SCHEME for MDR-TB patients by means of various medium.
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OBJECTIVES: To explore the risk factors of essential hypertension with hyperhomocysteinemia (H-type hypertension) and design a nomogram to predict this risk. METHODS: A hospital-based study was conducted on 1,712 individuals, including 282 patients with H-type hypertension, 105 patients with simple hypertension, 645 individuals with hyperhomocysteinemia, and 680 healthy controls. Logistic regression and nomogram models were applied to evaluate the risk factors. RESULTS: Logistic regression showed that advanced age, male sex, high body mass index (BMI), high total cholesterol levels, high glucose levels, and high creatinine levels were risk factors of H-type hypertension in the healthy population and were integrated into the nomogram model. Advanced age, male sex, high BMI, high total cholesterol levels, and high glucose levels were shown to be risk factors of H-type hypertension in the hyperhomocysteinemia population. Male sex and high creatinine levels were shown to be risk factors of H-type hypertension in the hypertension population. Nomogram analysis showed that the total factor score ranged from 106 to 206, and the corresponding risk rate ranged from 0.05 to 0.95. CONCLUSIONS: Men are more likely to have H-type hypertension, and advanced age, high BMI, high total cholesterol levels, and high glucose levels are risk factors of H-type hypertension in healthy and hyperhomocysteinemia populations. Furthermore, high creatinine level is a risk factor of H-type hypertension in healthy and hypertension populations. Nomogram models may be used to intuitively evaluate H-type hypertension risk and provide a basis for personalized interventions.
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Humanos , Masculino , Hiper-Homocisteinemia/complicações , Hiper-Homocisteinemia/epidemiologia , Hipertensão/complicações , Hipertensão/epidemiologia , Fatores de Risco , Nomogramas , Hipertensão Essencial , HospitaisRESUMO
Background: Endocrine therapy for breast cancer is directed at reducing oestrogen synthesis or alternatively blocking oestrogen receptors (ER) in tumour-sensitive tumors. Despite side effects, the use of systemic adjuvant therapy after local management of breast cancer substantially improves survival and reduces the risk of relapse. The study objective was to assess the recurrence of breast cancer and the complications seen in breast cancer patients on tamoxifen therapy at a hospital-based cancer registry, Thrissur, Kerala.Methods: After obtaining institutional ethical clearance, included 75 patients of histologically diagnosed breast carcinoma currently on tamoxifen, diagnosed in the year of 2016. Data was obtained from the patient files and by personal intimation.Results: Of the 75 patients on tamoxifen, four (5.33%) patients had history of recurrence. 22.6% of patients on tamoxifen were noted to have increased endometrial thickness. Other side effects noted were weight gain, TIA, bone pain and vaginal discharge.Conclusions: It was found that the recurrence rate at three years for the study population was 5.33%. More studies from developing countries, with larger sample size and clinical trials will give us more accurate information regarding the efficacy of the drug.
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Background: The aim of this study was to found association between Type 1 Diabetes Mellitus and Carotid Arterial Intimal Thickness (CIMT).Methods: Study design: It was a prospective case control hospital-based study. One hundred type 1 diabetes patient between the age group 3-36 years were taken. The association between type 1 diabetes with CIMT was studied. All the measurements were standardized. 50 age and sex matched controls were taken for comparison.Results: There is positive correlation between type 1 diabetes and CIMT (p<0.0001). The correlation further extends between duration of diabetes, glycemic control, age of onset, frequency and severity of diabetic related complication with CIMT.Conclusions: Carotid atherosclerosis as measured by CIMT has definite association with type 1 diabetes.
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Background: Cancer related anemia (CRA) is a major healthcare issue among patients suffering with cancer. In the Indian context, these figures are likely to be higher due to the prevailing malnutrition and low socio-economic status in the general population. This observational hospital-based study has been conducted among cancer patients with following objectives to assess the socio demographic profile of different cancer patients admitted at hospital. To measure hemoglobin level among different cancer patients admitted at hospital on the basis of socio demographic profile and type of cancer.Methods: The registers maintained in the department of Radiotherapy were checked and those belonging to the year 2011-12 were used to process and analyse the cancer patient抯 data in respect to age, type of cancer, hemoglobin level admitted in health care facility.Results: By far distribution of Hb level is concerned among all cancer patients, 87.56% patients were having Hb level more than 9 gm% and around 12.43 % patients were having Hb level less than 9 gm%. Majority of patients whose Hb level was less than 9gm% were belonging to age group more than 45 years.Conclusions: It is very much evident that anemia among cancer patients is a major healthcare problem and surely adds into morbidity and mortality of cancer patients. It may further aggravate the health condition of cancer patients if not corrected timely. Therefore, anemia among cancer patients should be taken and treated very seriously.
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OBJECTIVE:To provide reference for establi shing evidence-based pharmaceutical management and assessment system in China. METHODS :Through literature study and new medical policy interpretation ,the development course of hospital-based health technology assessment (HB-HTA)and its application in pharmaceutical management at home and abroad were traced;the development prospect of HB-HTA in China ’s hospital drug management was discussed. RESULTS & CONCLUSIONS: The HB-HTA makes scientific evaluation on the process of access and use of medical technology ,so as to optimize the allocation of hospital resources and ensure the quality of medical treatment. Foreign countries have used HB-HTA to assist the decision-making of hospitals. China ’s HB-HTA is still in its initial stage and lags behind the international leading level. As effective means for cost control and quality improvement ,HB-HTA should be applied in drug management and assessment system as soon as possible;it is necessary to explore suitable drug assessment mode (i.g. ambassaclor mode ,Mini-HTA mode ,internal committee mode,HB-HTA unit mode ),strengthen HTA personnel training ,establish HTA methodology (such as Mini-HTA mode assessment tool included outline ,general information ,general methods ,multi-structure evaluation results ,discussion,conclusions and recommendations),pay more attention to it and promote the transformation of achievements.
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PURPOSE: This study aimed to investigate the effect of hospital-based intensive rehabilitation program after ankle ligament operation.METHODS: A total of 35 patients were included in this randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Home-based exercise was conducted in the control group. Outcomes were evaluated at baseline, 12 weeks, and 16 weeks. The primary outcome was measured using the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included the American Orthopedic Foot and Ankle Society (AOFAS) score, ankle strength measured using an isokinetic device, fall index measured using a Tetrax posturography device, and the Berg Balance Scale.RESULTS: Significant improvements in FAOS, AOFAS, ankle strength, and fall index were found in the intervention group after performing the hospital-based rehabilitation (all p<0.05) and these improvements were sustained at T2 (all p<0.05). Between-group comparisons demonstrated significantly greater improvements in FAOS, AOFAS, ankle strength, and fall index in the intervention group than those in the control group at both T1 (all p<0.05), and T2 (all p<0.05).CONCLUSION: The rehabilitation program in this study improved postoperative pain, sports function, quality of life, and strength and balance of the ankle significantly better than home-based self-care. Therefore, we recommend hospital-based systematic rehabilitation programs after surgical treatment for chronic ankle instability.
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Humanos , Tornozelo , Pé , Ligamentos , Ortopedia , Dor Pós-Operatória , Qualidade de Vida , Recuperação de Função Fisiológica , Reabilitação , Autocuidado , EsportesRESUMO
Background: The adoption of the Medical Termination of Pregnancy (MTP) Act has allowed for abortion on the grounds of medical and social reasons since 1972.The aim of the present study is to establish the demographic of women seeking abortion care services and to determine the role of different factors in the timing of seeking an abortion.Methods: A retrospective hospital record-based study was carried out among pregnant women seeking an MTP in a tertiary care hospital in Mumbai. The records of women seeking MTP over a 5-year period from January 2012 to December 2016 were accessed and data pertaining to their demographic and obstetric history was recorded. Statistical tests of significance and analysis were done.Results: A total of 803 women underwent an MTP from January 2012 to December 2016. The number of deliveries during the same time period was 13735. The most common age group was 25-30 years. Stratification in terms of the educational backgrounds showed that 45.7% had received only secondary school education while 12.7% had no schooling. Majority of the women (74.8%) availed an MTP in the first trimester, out of which, most of them (36.9%) had 2 previous pregnancies. Most women coming in the second trimester (43.6%) hadn’t conceived before.Conclusions: Education didn’t seem to be a significant factor in determining the timing of seeking an MTP. School education did not necessarily include exposure to sexual education. Experience in terms of parity was more relevant in identifying signs of pregnancy and seeking appropriate services in a timely manner.
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Resumen Objetivo: Proporcionar características demográficas y clínicas, así como estimaciones de supervivencia global a tres años de pacientes con cáncer epitelial de ovario (CEO) tratadas entre 2005 y 2014 en el Instituto Nacional de Cancerología de Colombia (INC). Métodos: Se incluyeron 783 pacientes diagnosticadas y tratadas por primera vez en el INC por CEO en los periodos 2005-2008, 2009-2011 y 2012-2014 sin un diagnóstico previo de otro cáncer. Se cruzaron datos del registro hospitalario de cáncer con bases de datos gubernamentales para obtener información de seguimiento. Utilizando el método Kaplan-Meier se estimó la probabilidad de sobrevivir a 36 meses a partir de la fecha de ingreso, evaluando diferencias en supervivencia entre grupos con la prueba de rango logarítmico. Se utilizaron modelos multivariados de riesgos proporcionales de Cox para evaluar: el efecto relativo de edad, el estadio clínico, el subtipo histológico y el tipo de tratamiento inicial en la supervivencia. Resultados: La probabilidad de supervivencia global a 36 meses fue de 56,5% (IC 95%: 53,0; 60,0), que se mantuvo estable en los tres periodos. La edad avanzada, el estadio clínico y el subtipo histológico afectaron significativamente la supervivencia global a tres años: 49,5% (IC 95%: 43; 55,6) para mujeres >59 años; 21,9% (IC 95%: 14,7; 29,2) para la enfermedad en estadio IV y 56,3% (IC 95%: 37,5; 54,3) para los tumores serosos. Las estimaciones de hazard fueron significativamente más altas en pacientes de 59 años o más (HR 1,54 (IC del 95%: 1,04 a 2,27)) y en cánceres con estadio avanzado (HR 13,47 (IC 95%: 7,92-22,92)); la cirugía más quimioterapia tuvo una reducción en el riesgo en comparación con otros tratamientos (HR 0,84 (IC 95% 0,52-1,36). Conclusiones: La supervivencia del cáncer epitelial de ovario se mantuvo estable con el tiempo. La variación se presentó en factores como: la edad, el estadio clínico y el primer tratamiento.
Abstract Aims: To provide demographical and clinical characteristics and estimations of 3-year overall survival of epithelial ovarian cancer (EOC) patients treated at the Colombian National Cancer Institute (INC) between 2005 and 2014. Methods: All 783 patients first treated at INC for EOC in the three periods: (2005-2008, 2009-2011, 2012-2014), without a prior cancer diagnosis, were included in this study. Follow-up was realized by cross-linkage with governmental databases using person identification numbers. Probability of surviving 36 months since the date of entry at INC was estimated using Kaplan-Meier methods, using the log-rank test to evaluate differences between groups. We used multivariate Cox proportional hazard models to evaluate the relative effect of age, clinical stage, histological subtype and treatment first on survival. Results: The overall survival probability at 36 months was 56.5% (95% CI: 53.0, 60.0), which was stable over time. Advanced age and clinical stage significantly affected 3-year overall survival, being 49.5°% (95°% CI: 43.4, 55.6) for age > 59, 21.9°% (95°% CI: 14.7, 29.2) for stage IV disease and 56.3% (95% CI: 37.5, 54.3) for serous tumors. Hazard ratios were significantly higher for patients aged 59 and over (HR 1.54 (95%CI 1.04-2.27)) and advanced stage cancers (HR 13.47 (95%CI 7.92-22.92)), whereas patients with surgery plus chemotherapy had a strongly reduced risks compared to other treatments (HR 0.84 (95%CI 0.52-1.36)). Conclusions: Survival of epithelial ovarian cancer was stable over time, with a variation according to age, clinical stage and first treatment.
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Humanos , Registros Hospitalares , Carcinoma Epitelial do Ovário , Sistema de RegistrosRESUMO
Background: The purpose of this study was to explore the stroke types and the risk factors of the first-time stroke in the holy city of Madinah Munawarah. Methods: A prospective hospital-based research study was carried out over the year of 2014. The patients with the diagnosis of the cerebrovascular accident were enrolled in the study. The details of patients’ history, demographic data, stroke type, and risk factors were collected. Results: First-time stroke were determined in 164 patients (91 male and 73 female) during the entire periods of this study with a mean age of 67.52 ± 2.31 years. The prevalence of types of stroke was ischaemic strokes in 133 patients (% 81.1), intercerebral hemorrhage in 24 patients (14.63%), and subarachnoid hemorrhage in one patient (0.6%). The most common risk factors recorded were hypertension (86.6%), diabetes mellitus (63.4%), and ischaemic heart disease (41.5%). There was no significant relationship between the frequency of ischaemic stroke and intercerebral hemorrhage stroke ( p> 0.05). Conclusion: The study indicates that hypertension, diabetes, and ischaemic heart disease are critical risk factors for developing stroke and fairly commensurate with the global reported risk factors. Further research is needed to investigate stroke patterns and other possible risk factors concurrently with Saudi national prevention programs.
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Thyroid disorders constitute the commonest endocrine abnormality. 42 million people in India are suffering from thyroid disorders. Methods: The present hospital-based study was conducted upon 136 patients reporting to OPD of VIMS, Pawapuri to evaluate their thyroid function status. Detailed history was taken along with blood sample collection after overnight fast for estimation of thyroid hormones. Results: Majority of the patients belonged to the age group of 20-40 years (47.8%). Male: female ratio was 3.69. 71.3% of the patients were euthyroid. 19.8% patients were hypothyroid of which 13.2% were clinically euthyroid, 3.7% suffered from subclinical hypothyroidism and 2.9% had primary hypothyroidism. 9.4% were hyperthyroid of which 5.1% had central hyperthyroidism, 2.9% suffered from primary hyperthyroidism, and 0.7% each had subclinical hyperthyroidism and T3 thyrotoxicosis. Conclusion: Hypothyroidism is alarmingly high in this region with higher prevalence in women.