Clinical Epidemiology of Cholangiocarcinoma

Coronavirus disease 2019 (COVID-19) is a new infectious respiratory disease that has caused the ongoing global pandemic. The primary purpose of this article is to describe evolving clinical epidemiology of COVID-19, including 1) infection and testing, 2) clinical spectrum including classification of clinical type, asymptomatic cases, severe cases and comorbidity, and clinical and immunological response, 3) regional variation in clinical presentation, 4) population distribution by age, sex, and occupation, and finally, 5) case-fatality. This content may provide important information on detailed clinical type and presentation of the disease, in which appropriate clinical outcomes can be derived for developing prevention strategies and clinical studies or trials that aim to test potential therapeutics or products for different patient populations.

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Design and Rationale of the National Tunisian Registry of Percutaneous coronary Intervention: Protocol for a Prospective, Multicenter Trial (Preprint)

10.2196/preprints.24595 ◽

2020 ◽

Author(s):

Rania Hammami ◽

Slim Boudiche ◽

Rami Tlili ◽

Nejeh Ben Hlima ◽

Ahmed Jamel ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Clinical Epidemiology ◽

Artery Bypass ◽

Coronary Intervention ◽

Long Term Results ◽

Adverse Cardiovascular Event ◽

Chronic Occlusion ◽

Percutaneous Coronary ◽

Intervention Protocol

BACKGROUND Coronary diseases remain the first cause of death in the world; the management of this condition has improved, thanks to new technical tools and multicentric registries. Recently in Tunisia, the number of intervention procedures has markedly increased, giving the explosion of cardiovascular risk factors among Tunisian people. OBJECTIVE The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in Tunisia. METHODS We will conduct a prospective, multicentric, observational study including patients > 18 year-old who underwent a PCI between 31January and 30 June 2020. The primary end point are the occurrence of a major adverse cardiovascular event , defined as cardiovascular death, myocardial infarction, cerebrovascular accident, and target vessel revascularization with either repeat PCI or coronary artery bypass surgery (CABG). Secondary end-points consist in procedural success rate, stent thrombosis, and the rate of redo-PCI/CABG for in-stent restenosis. RESULTS Results will be available at the end of the study as well as the demographic profile and general risk profile of Tunisian patients undergoing PCI. The complexity level of procedures, as left main, bifurcation, chronic occlusion PCI will be analyzed and immediate as well as long term results will be determined. NATURE-PCI will be the first national multicentric registry of angioplasty in Africa. CONCLUSIONS This study would add data and provide a valuable opportunity for real-world clinical epidemiology and practice in the field of interventional cardiology in Tunisia with insights into the uptake of contemporary coronary artery disease in this developing region. CLINICALTRIAL clinicaltrials.gov

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Key concepts in clinical epidemiology: Responsiveness, the longitudinal aspect of validity

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2021.06.002 ◽

2021 ◽

Author(s):

L.B. Mokkink ◽

C.B. Terwee ◽

H.C.W. de Vet

Keyword(s):

Clinical Epidemiology ◽

Key Concepts

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Clinical Epidemiology and Outcomes of Pediatric Musculoskeletal Infections

The Journal of Pediatrics ◽

10.1016/j.jpeds.2021.03.028 ◽

2021 ◽

Author(s):

Jumi Yi ◽

James B. Wood ◽

C. Buddy Creech ◽

Derek Williams ◽

Natalia Jimenez-Truque ◽

...

Keyword(s):

Clinical Epidemiology

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Clinical Epidemiology of Systolic and Diastolic Orthostatic Hypotension in Patients on Peritoneal Dialysis

Journal of Clinical Medicine ◽

10.3390/jcm10143075 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3075

Author(s):

Claudia Torino ◽

Rocco Tripepi ◽

Maria Carmela Versace ◽

Antonio Vilasi ◽

Giovanni Tripepi ◽

...

Keyword(s):

Blood Pressure ◽

Peritoneal Dialysis ◽

Orthostatic Hypotension ◽

Clinical Epidemiology ◽

Hemodialysis Patients ◽

Excess Death ◽

Death Risk ◽

Standardized Protocol ◽

Pressure Changes ◽

The Impact

Blood pressure changes upon standing reflect a hemodynamic response, which depends on the baroreflex system and euvolemia. Dysautonomia and fluctuations in blood volume are hallmarks in kidney failure requiring replacement therapy. Orthostatic hypotension has been associated with mortality in hemodialysis patients, but neither this relationship nor the impact of changes in blood pressure has been tested in patients on peritoneal dialysis. We investigated both these relationships in a cohort of 137 PD patients. The response to orthostasis was assessed according to a standardized protocol. Twenty-five patients (18%) had systolic orthostatic hypotension, and 17 patients (12%) had diastolic hypotension. The magnitude of systolic and diastolic BP changes was inversely related to the value of the corresponding supine BP component (r = −0.16, p = 0.056 (systolic) and r = −0.25, p = 0.003 (diastolic), respectively). Orthostatic changes in diastolic, but not in systolic, BP were linearly related to the death risk (HR (1 mmHg reduction): 1.04, 95% CI 1.01–1.07, p = 0.006), and this was also true for CV death (HR: 1.08, 95% CI 1.03–1.12, p = 0.001). The strength of this association was not affected by further data adjustment (p ≤ 0.05). These findings suggest that independent of the formal diagnosis of orthostatic hypotension, even minor orthostatic reductions in diastolic BP bear an excess death risk in this population.

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