Initial Experience with Digital Patient Briefing in Computed Tomography

Purpose To assess digital patient briefing as an alternative to conventional paper documentation. Materials and Methods 502 patients with a planned computed tomography (CT) examination were selected for digital patient briefing using the E-ConsentPro software from Thieme Compliance on an iPad by Apple (Cupertino, California, USA). For the analysis, three age groups were formed. The time required for the patient briefing, the number of open questions as well as the time needed for discussion with physicians were determined. Student’s t-test was performed to assess statistical significance. Results There was no significant difference between patient age and briefing time which was about 20 minutes on average. The number of open or unclear questions increased with patient age. While patients younger than 30 years of age had about 2 open questions, patients over 30 and 60 years had about 4 and 5 questions, respectively. The total time needed for discussion with physicians was less than 2 minutes on average. A significant difference in the time required for discussion with physicians could not be observed between the individual age groups. Conclusion Tablet-based digital briefing allows the storage of patient documents with reasonable time and effort. Furthermore, it minimizes the risk of data loss. Key Points Citation Format

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Gene mutational analysis by NGS and its clinical significance in patients with myelodysplastic syndrome and acute myeloid leukemia

Experimental Hematology and Oncology ◽

10.1186/s40164-019-0158-5 ◽

2020 ◽

Vol 9 (1) ◽

Cited By ~ 8

Author(s):

Jifeng Yu ◽

Yingmei Li ◽

Tao Li ◽

Yafei Li ◽

Haizhou Xing ◽

...

Keyword(s):

Gene Mutation ◽

Induction Chemotherapy ◽

Lower Incidence ◽

Mutational Analysis ◽

Statistical Significance ◽

Age Groups ◽

Gene Mutations ◽

Related Gene ◽

Significant Difference ◽

The Individual

Abstract Background In this study, we retrospectively summarized the differences of molecular gene mutations between MDS and AML patients, as well as the young and older age groups of MDS and AML patients. We also analyzed the response of newly diagnosed AML patients to standard DA or IA induction chemotherapy and the relationship between the chemotherapy outcome and the frequency of different gene mutation abnormalities. Methods NGS assay covering 43 genes was studied in 93 de novo MDS and 325 non-M3 AML patients. Bone marrow samples from all patients underwent gene mutational analysis by NGS. Results At least one non-synonymous gene mutation was detected in 279 AML patients (85.8%) and 85 MDS patients (91.4%). Contrary to 59 years and younger AML patients, there was a significantly higher incidence of gene mutation in 60 years and older AML patients (2.37 vs 1.94, p = 0.034). Gene mutation incidence in 60 years and older MDS patients increased, but no statistical significance was present (1.95 vs 1.64, p = 0.216). AML patients had a significantly higher gene mutation incidence compared with MDS-MLD patients (2.02 vs 1.63, p = 0.046). Gene mutation incidence was higher in patients with MDS-EB1/EB2 compared with patients with MDS-MLD but there was no statistical significance present (2.14 vs 1.63, p = 0.081). AML patients had significantly higher incidences of CEBPA, FLT3-ITD, DNMT3A, NPM1 and IDH1/2 gene mutations (p = 0.0043, 0.000, 0.030962, 0.002752, and 0.000628, respectively) and a lower incidence of TET2 and U2AF1 gene mutations (p = 0.000004 and 0.000, respectively) compared with MDS patients. Among the individual genes in different age groups, there were significantly higher incidences of RUNX1, IDH2, TP53 and SF3B1 gene mutations (p = 0.0478, 0.0028, 0.0024 and 0.005, respectively) as well as a trend of higher ASXL gene mutation (p = 0.057) in 60 years and older AML patients compared to 59 years and younger patients. There was no statistically significant difference in MDS patients with the different age groups and among the individual genes. Between AML patients and MDS patients among the different gene functional groups, AML patients had a significantly higher incidence of transcriptional deregulation (27.4% vs 15.1%, p = 0.014963), activated signalling (36.3% vs 10.8%, p = 0.000002) related gene mutations as well as a significantly lower incidence of RNA spliceosome (6.15% vs 60.1%, p = 0.000) related gene mutations. Furthermore, among the patients who received either IA or DA regimen for induction chemotherapy, patients with IA regimen had a significantly better CR rate than those with DA regimen (76.6% vs 57.1%, p = 0.0228). Conclusions Different gene mutations had been found in majority of MDS and AML patients. MDS and AML patients had different gene mutation patterns. AML patients with fewer or no gene mutations had a better chance of achieving CR when treated with IA and DA regimen induction chemotherapy.

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Duration of nursing care in patients with hip fractures

Croatian Nursing Journal ◽

10.24141/2/3/1/6 ◽

2019 ◽

Vol 3 (1) ◽

pp. 71-77

Author(s):

Tihana Harapin Savić ◽

Valentina Košćak

Keyword(s):

Nursing Care ◽

Hip Fractures ◽

Statistical Significance ◽

Age Groups ◽

University Hospital ◽

Patient Age ◽

Patient Âgé ◽

The University

The research regarding the duration of nursing care in patients with hip fractures was conducted at the Traumatology and Orthopedic Institute of the University Hospital Dubrava in a period of 4 months. The research was conducted on 59 patients with a diagnosis of a broken hip, that have undergone surgery. The goal of this research was to determine the differences in the duration of nursing care due to age, gender, comorbidities and postoperative day. Statistical significance in all measurements was reduced to p<0.05. The research shows connection between patient age and the duration of nursing care. The presence of comorbidity also prolongs the duration of nursing care. Shorter duration of nursing care was determined in women compared to men in all age groups, but it wasn’t of statistical significance.

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Dispatcher CPR Instructions Across the Age Continuum

Prehospital and Disaster Medicine ◽

10.1017/s1049023x18000377 ◽

2018 ◽

Vol 33 (3) ◽

pp. 342-345 ◽

Cited By ~ 1

Author(s):

Kristi L. Weinmeister ◽

E. Brooke Lerner ◽

Clare E. Guse ◽

Khalid A. Ateyyah ◽

Ronald G. Pirrallo

Keyword(s):

Cardiopulmonary Resuscitation ◽

Survival Rates ◽

Age Groups ◽

Retrospective Chart Review ◽

Age Group ◽

Publication Type ◽

Patient Age ◽

Patient Âgé ◽

Significant Difference ◽

Bystander Cpr

AbstractBackgroundSurvival rates following out-of-hospital cardiac arrest (OHCA) increase two to three times when cardiopulmonary resuscitation (CPR) is started by bystanders, as compared to starting CPR when Emergency Medical Services (EMS) arrives. Municipalities that have implemented dispatcher-assisted bystander CPR programs have seen increased rates of bystander CPR. Cardiopulmonary resuscitation instructions are given for victims of all ages, but it is unknown if offering instructions results in similar rates of EMS-documented bystander CPR across the age continuum in these municipalities.ObjectivesThe aim of this study was to determine if there is a difference in EMS-documented bystander CPR rates based on the age group of the OHCA victim when dispatcher CPR instructions are available in the community.MethodsThis was a three-year, retrospective chart review of OHCA patients in two municipalities within a single county that provided dispatcher-assisted CPR instructions. Bystander CPR and patient age were determined based on EMS documentation. Age was stratified into three groups: child (0-12 years), adult (13-54 years), and geriatric (≥55 years). Chi square was used to compare the rate of bystander CPR in each age group.ResultsDuring the study period, 1,993 patients were identified as being in OHCA at the time of EMS arrival. The overall bystander CPR rate was 10%. The highest rate of bystander CPR was in the child age group (19%). The lowest rate of bystander CPR was in the geriatric age group (9%). There was a statistically significant difference between age groups (P≤.01).ConclusionsThe rate of EMS-documented bystander CPR was low, even though these municipalities provided dispatcher-assisted CPR instructions. The highest rates of bystander CPR were observed in children (0-12 years). Future investigations should determine why this occurs and if there are opportunities to modify dispatcher coaching based on patient age so that bystander CPR rates improve.WeinmeisterKL, LernerEB, GuseCE, AteyyahKA, PirralloRG. Dispatcher CPR instructions across the age continuum. Prehosp Disaster Med. 2018;33(3):342–345.

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Vertucci's Root Canal Configuration of 11376 Mandibular Anteriors and its Relationship with Distolingual Roots in Mandibular First Molars in A Cantonese Population: A Cone-Beam Computed Tomography Study

10.21203/rs.3.rs-1080802/v1 ◽

2021 ◽

Author(s):

Yeqing Yang ◽

Chong Jiang ◽

Ming Chen ◽

Junkai Zeng ◽

Buling Wu

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Statistical Significance ◽

Age Groups ◽

Cone Beam ◽

Anterior Teeth ◽

Significant Difference ◽

Root Canal Morphology ◽

Canal Morphology

Abstract Background: Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).Methods: A total of 11376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data are presented as the mean ± standard deviation. Student’s t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.Results: In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.Conclusion: There is a correlation between the presence of DLRs in MFMs and complicated root canal morphology in MCIs in the Cantonese population.

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Survival Associations between Patient Age and Treatment Modality in Olfactory Neuroblastoma: A Retrospective Population-Based Study

Journal of Clinical Medicine ◽

10.3390/jcm10122685 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2685

Author(s):

Andre J. Burnham ◽

Phillip A. Burnham ◽

Edwin M. Horwitz

Keyword(s):

Treatment Modality ◽

Age Groups ◽

Olfactory Neuroblastoma ◽

Population Based ◽

Treatment Modalities ◽

Long Term Outcomes ◽

Patient Age ◽

Population Based Study ◽

Patient Âgé

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.

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Use of F-18 FDG PET/CT Through Delayed Diuretic Imaging for Preoperative Evaluation of Upper Urinary Tract-Occupying Lesions

Frontiers in Oncology ◽

10.3389/fonc.2021.699801 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jun Wang ◽

Liang Zhang ◽

Jian Guo Wu ◽

Ruohua Chen ◽

Jia lin Shen

Keyword(s):

Urinary Tract ◽

Fdg Pet ◽

Malignant Tumors ◽

Upper Urinary Tract ◽

Characteristic Analysis ◽

Patient Age ◽

Patient Âgé ◽

Pet Ct ◽

Significant Difference ◽

Fdg Pet Ct

PurposeTo evaluate the value of F-18 FDG PET/CT in the differentiation of malignant and benign upper urinary tract-occupying lesions.Patients and Methods64 patients with upper urinary tract-occupying lesions underwent F-18 FDG PET/CT at RenJi Hospital from January 2015 to February 2019 in this retrospective study. Of the 64 patients, 50 patients received nephroureterectomy or partial ureterectomy; 14 patients received ureteroscopy and biopsy. The comparisons of PET/CT parameters and clinical characteristics between malignant and benign upper urinary tract-occupying lesions were investigated.ResultsOf the 64 patients, 49 were found to have malignant tumors. Receiver operating characteristic analysis determined the lesion SUVmax value of 6.75 as the threshold for predicting malignant tumors. There were significant associations between malignant and benign upper urinary tract-occupying lesions and SUVmax of lesion (P<0.001), lesion size (P<0.001), and patient age (P=0.011). Multivariate analysis showed that SUVmax of lesion (P=0.042) and patient age (P=0.009) as independent predictors for differentiation of malignant from benign upper urinary tract-occupying lesions. There was a significant difference in tumor size between the positive (SUVmax >6.75) and negative (SUVmax ≤6.75) PET groups in 38 of the 49 patients with malignant tumors.ConclusionThe SUVmax of lesion and patient age is associated with the nature of upper urinary tract-occupying lesions. F-18 FDG PET/CT may be useful to distinguish between malignant and benign upper urinary tract-occupying lesions and determine a suitable therapeutic strategy.

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Clinical and Electrooculographical Finding in Patient with Essential Tremor

Austin Journal of Clinical Neurology ◽

10.26420/austinjclinneurol.2021.1150 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Cenikli U ◽

◽

Bir LS ◽

Degirmenci E ◽

Ardıç FN ◽

...

Keyword(s):

Essential Tremor ◽

Rating Scale ◽

Test Results ◽

Patient Age ◽

Disease Characteristics ◽

Correlation Analyses ◽

Patient Âgé ◽

Significant Difference ◽

Ocular Movement ◽

And Control

Background: Essential Tremor (ET) is the most common movement disorder, yet the location of the primary disease substrate continues to be a matter of debate. In this study, we aimed to evaluate ocular movement abnormalities with Electrooculography (EOG) in patients with ET to find a possible location of disease pathology. Methods: Electrooculographic evaluation including saccade, tracking, optokinetic, gaze and positional tests were performed to 36 ET patients and 36 healthy subjects. Patient age on the onset of the tremor, duration of the disease, characteristics and the location of the tremor were also investigated. Fahn- Tolosa-Marin tremor rating scale was used to determine the tremor severity. Differences of abnormal test results between patient and control groups were analysed with Pearson’s and Fisher’s Exact and correlation analyses of EOG tests and clinical data were performed with Spearman’s and Pearson’s correlation tests. Results: There was not any significant difference in EOG tests between the ET patients and controls. Significant correlation was only found between EOG abnormality and patient age in correlation analyses. Conclusions: Our results showed that ET patients may not have specific EOG test abnormalities. These tests would be used especially in the different diagnosis of other movement disorders.

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Population-based survey of HIV sero-status and vertical transmission among naive pregnant women in Sokoto, Nigeria

Asian Journal of Medical Sciences ◽

10.3126/ajms.v6i3.11530 ◽

2014 ◽

Vol 6 (3) ◽

pp. 49-57 ◽

Cited By ~ 2

Author(s):

Fiekumo Igbida Buseri ◽

Charity Ngozi Okonkwo

Keyword(s):

Antiretroviral Therapy ◽

Pregnant Women ◽

Vertical Transmission ◽

Statistical Significance ◽

Demographic Data ◽

Age Groups ◽

P Value ◽

Full Time ◽

Cross Sectional ◽

Significant Difference

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57

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UTILIZATION OF COMPUTED TOMOGRAPHY FOR PEDIATRIC HEAD TRAUMA FROM 2007–2014 IN THE UNITED STATES: BEFORE AND AFTER PECARN CLINICAL DECISION RULES

Paediatrics & Child Health ◽

10.1093/pch/pxy054.020 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e8-e8

Author(s):

Brett Burstein ◽

Julia Upton ◽

Heloisa Fuzaro Terra ◽

Mark I Neuman

Keyword(s):

Computed Tomography ◽

Head Trauma ◽

The United States ◽

Research Network ◽

Discharge Diagnosis ◽

Patient Age ◽

Head Ct ◽

Patient Âgé ◽

Before And After ◽

Neuro Imaging

Abstract BACKGROUND The Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules identify children at low risk of clinically important traumatic brain injury in whom computed tomography (CT) neuro-imaging can safely be avoided. Since publication in 2009, these rules have been externally validated and are widely used in the Emergency Department (ED) assessment of children with acute head trauma. OBJECTIVES This study sought to determine if the proportion of children receiving CT-imaging in US EDs following head trauma has decreased following the development of PECARN rules. DESIGN/METHODS This study was a cross-sectional study using the National Hospital Ambulatory Care Survey (NHAMCS) database from 2007–2014. NHAMCS collects data on approximately 30,000 nationally representative visits annually to 300 randomly selected U.S EDs. We included all children <18 years old presenting with a chief complaint or discharge diagnosis of head injury. We collected data on patient demographics, reason for ED visit, discharge diagnosis, patient disposition, and use of head CT. Multivariable logistic regression was used to identify characteristics of CT use, with appropriate weighting to account for the survey methodology. The primary outcome was proportion of children receiving a head CT before and after 2009. RESULTS There were 55,253 paediatric visits during the 8-year study period. Among these, 2,783 (5.3% 95%CI 5.0%-5.6%) met inclusion criteria, representing 12,417,725 paediatric head trauma visits. Median patient age was 6 years (IQR 2–13 years), 62% were male, and a majority were evaluated in non-teaching and non-paediatric hospitals (88% and 90%, respectively). Overall, 32% (95%CI 29%-35%) underwent CT neuroimaging. There was no significant difference in CT use after 2009 (31% after vs. 33% before, p=0.41). Multivariate analysis similarly demonstrated no difference after adjustment for patient age, gender, race, insurance provider, paediatric or teaching hospital, admission status and triage acuity (AOR 1.02 after vs. before, 95%CI 0.79–1.32, p=0.85). Factors associated with increased CT use were age ≥2 years (AOR 1.4, 95%CI 1.1–1.9, p=0.02), admission (AOR 5.3, 95%CI 2.2–12.4, p<0.001), highest triage acuity (AOR 7.3, 95%CI 3.5–15.3, p<0.001) and presentation to a non-teaching (AOR 1.5, 95%CI 1.1–2.2, p=0.02) or non-paediatric (AOR 1.5, 95%CI 1.3–2.8, p<0.01) hospital. CONCLUSION The use of CT neuro-imaging did not decrease in the 5-year period following derivation of PECARN rules. Findings suggest an important need for quality improvement initiatives to ensure appropriate CT utilization among head injured children.

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Prognosticating Traumatic Brain Injury (TBI): Analysis of CRASH, IMPACT Models and Patient Age in a Cohort of TBI Patients

Neurosurgery ◽

10.1093/neuros/nyz001.nt3 ◽

2019 ◽

Vol 84 (5) ◽

pp. E271-E272 ◽

Cited By ~ 1

Author(s):

Conor Gillespie ◽

Catherine McMahon

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Survival Rates ◽

Predictive Performance ◽

Good Survival ◽

Post Injury ◽

Patient Age ◽

Patient Âgé ◽

Significant Difference ◽

Impact Models

Abstract INTRODUCTION Both CRASH and IMPACT models have been developed in recent years to predict the outcome of Traumatic Brain Injury (TBI). However, there is no clear evidence as to how these models perform in a modern cohort of UK-patients. There is also predictive uncertainty with regards to survival rates and functional outcome in elderly (>65 yr) patients. METHODS Patients referred to a tertiary neuroscience center from December 2014 to January 2016 with a suspected TBI were retrospectively examined. For each model, the predicted survival and overall outcome were compared to the actual outcome on admission and at 6 mo post injury, stratified by patient age (>65 yr vs ≤65 yr). RESULTS A total of 161 patients met the initial criteria; mean age 65 yr (SD = 21) and 110 male. Both CRASH and IMPACT correctly predicted 6-mo mortality rates and functional outcomes in most patients (range 61.7%-82.4%), with better predictive performance for patients not accepted to the center (range 84%-98%). There was no significant difference in the initial survival of elderly patients if accepted (78% [95% CI 50.6-104.0] vs 81% [95% CI 67.8-94.8] but were lower for those not accepted (24% [95% CI 4.2-43.7] vs 76% [95% CI 63.5-88.5], P = .027). CONCLUSION Patients >65 yr admitted to tertiary neuroscience center had good survival rates on admission and at 6 mo. The lesser ability of CRASH and IMPACT models to predict poorer outcomes when accepted suggests that acceptance to specialist centers may be able to improve outcome and suggests more optimistic treatment and acceptance of appropriate over 65 yr should be considered.

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