scholarly journals Thiamine Deficiency and Neurological Symptoms in Patients with Hematological Cancer Receiving Chemotherapy: A Retrospective Analysis

2021 ◽  
Author(s):  
Yohei Iimura ◽  
Shohei Andoh ◽  
Toyotaka Kawamata ◽  
Aki Sato ◽  
Kazuaki Yokoyama ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Thiamine Deficiency ◽  
Medical Records ◽  
Serum Levels ◽  
Neurological Status ◽  
Neurological Symptoms ◽  
Hematological Cancer ◽  
Wilcoxon Rank Sum Test ◽  
Attention Impairment ◽  
The Relationship

Abstract Objectives Patients with hematological cancer receiving chemotherapy have a high risk of thiamine deficiency due to accelerated thiamine usage by tumor cells. Mild or severe thiamine deficiency can lead to varying degrees of neurological symptoms. We evaluated the relationship between thiamine deficiency and neurological symptoms, including mild or nonspecific symptoms, and the influence of chemotherapy on thiamine serum levels in patients with hematological cancer receiving chemotherapy. Materials and Methods We retrospectively identified 42 patients diagnosed with hematological cancer at our hospital, using electronic medical records collected from March 2019 to March 2020. We evaluated the risk factors associated with neurological symptoms (mild-to-severe cognitive impairment, attention impairment, and mood or emotional disorder), the relationship between the presence of neurological symptoms and thiamine serum levels, and changes in thiamine serum levels after chemotherapy. Results Thiamine deficiency was significantly associated with neurological symptoms. The thiamine serum levels in the group with neurological symptoms were significantly lower than those in the group without neurological symptoms. The Wilcoxon rank-sum test showed that thiamine serum levels after chemotherapy were significantly lower than those before administration of chemotherapy. Conclusion Thiamine serum levels in patients with hematological cancer may be used as a reference to maintain neurological status during chemotherapy.

scholarly journals CORRELATION BETWEEN FRACTURES AND ABUSE IN CHILDREN: A RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 29 (1) ◽  
pp. 30-33
Author(s):  
VITOR LUIS PEREIRA ◽  
BERNARDO LOPES CRISOSTOMO ◽  
GIULIA CARVALHO SILVA ◽  
EIFFEL TSUYOSHI DOBASHI
Keyword(s):  
Retrospective Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
National Literature ◽  
Level Of Evidence ◽  
Fracture Patterns ◽  
Associated Lesions ◽  
Reference Hospital ◽  
The Subject ◽  
The Relationship

ABSTRACT Objective: The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject. Methods: Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%). Conclusion: Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Evaluation of Neurological Complications in Hospitalized COVID-19 Patients: A Cross-Sectional Study 2020

2021 ◽  
Author(s):  
Mojtaba Khazaei ◽  
Fatemeh Feizy ◽  
Salman Khazaei
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Neurological Symptoms ◽  
Medical Sciences ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Brain Tissue Damage

Abstract Objective: The coronavirus (COVID-19) has been spreading around the world since December 2019. Neurological symptoms have been reported as a part of the clinical spectrum of the disease. This study aimed to determine the frequency of neurological complications in hospitalized patients with COVID-19.Methods: Electronic medical records in the hospital information system, laboratory findings, and radiological examinations were evaluated for all patients with laboratory-confirmed SARS-CoV-2 infection. The cases were referred to Shahid Beheshti Hospital affiliated to Hamadan University of Medical Sciences from February 20, 2020 to the end of the same year.Results: A total of 477 hospitalized COVID-19 patients were included in the analyses. Based on our results, 105 (22.02%) patients showed neurological manifestations. Ischemic stroke, decreased consciousness, and headache were the most frequent reported neurological symptoms with the rate of 34 (7.13%), 28 (5.88%), and13 (2.72%), respectively. Moreover, 54 (51.43%) cases were male, and the vast majority of the patients (66; 62.86%) had more than 60 years of age. Conclusions: SARS-CoV-2 may involve nervous system and cause brain tissue damage. The findings of this study provide more information on coronavirus disease, contributing to effective interventions for the control of the disease

scholarly journals Effects of Yinzhihuang Granules on Serum Liver Enzymes in Jaundice Patients: A Real-World Study Based on HIS Data

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Cheng Zhang ◽  
Lidan Zhang ◽  
Jian Lyu ◽  
Yanming Xie ◽  
Yuting Xie
Keyword(s):  
Alkaline Phosphatase ◽  
Electronic Medical Records ◽  
Real World ◽  
Medical Records ◽  
Total Bilirubin ◽  
Liver Enzymes ◽  
Serum Levels ◽  
Indirect Bilirubin ◽  
Average Serum ◽  
Glutamyl Transpeptidase

Objective. Our aim was to analyze the influence of Yinzhihuang granules on serum liver enzymes in jaundice patients and to provide real-world evidence for the efficacy evaluation of Yinzhihuang granules in treating jaundice. Methods. We constructed a data warehouse which integrates real-world electronic medical records from the hospital information system of multiple 3A hospitals in China and used a descriptive statistical method to analyze the changes in the serum liver enzymes of the jaundice patients treated with Yinzhihuang granules and then used Wilcoxon signed-rank to test the changes in the indicators caused by the treatment. Results. After being treated with Yinzhihuang granules, the jaundice patients had a decrease in the average serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, and the differences were statistically significant ( P < 0.05 ) but had no significant changes in the average serum levels of direct bilirubin and alanine aminotransferase ( P > 0.05 ). Conclusion. The data analysis on the real-world electronic medical records demonstrate that Yinzhihuang granules help to reduce jaundice patients’ serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, but there is no evidence that Yinzhihuang granules help to reduce the jaundice patients’ serum levels of direct bilirubin and alanine aminotransferase.

scholarly journals Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

2019 ◽  
Author(s):  
Kwang Yul Jung ◽  
Su Jin Kim ◽  
Ki Hyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Significant Inverse Relationship ◽  
Clinical Scenarios ◽  
The Relationship

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Tantangan Etika dan Hukum Penggunaan Rekam Medis Elektronik dalam Era Personalized Medicine

2019 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Rani Tiyas Budiyanti ◽  
Penggalih Mahardika Herlambang ◽  
Nurhasmadiar Nandini
Keyword(s):  
Personalized Medicine ◽  
Electronic Medical Records ◽  
Data Security ◽  
Medical Records ◽  
Health Sector ◽  
Legal Responsibility ◽  
Ethical Aspects ◽  
Legal Challenges ◽  
Data Ownership ◽  
The Relationship

Background: Personalized medicine is one of the health treatment approaches that has developed in the last ten years. This treatment is specific because it considers the genomics of patients and requires a complete database or medical record covering clinical and genomic data. Nevertheless, there are ethical and legal challenges in the implementation of electronic medical records in personalized medicine.Objective: This study aimed  to determine the ethical and legal challenges in the use of electronic medical records in personalized medicine based on previous literature.Methods: The method used in this study was literature review with sources from journals, books, and articles on electronic medical records, personalized medicine, as well as legal and ethical aspects related both domestically and abroad. Results: Ethical and legal challenges that can occurred in the use of electronic medical records in the personalized medicine era include security and ownership of data, legal responsibility, genomic discrimination, and changes in the relationship between doctors and patients.Conclusion: Indonesia does not yet have specific regulations regarding data security, data ownership, and data sharing in the health sector. Further regulations regarding the use of electronic medical records in the personalized era are needed so that their implementation does not conflict with the ethics and laws that apply in Indonesia

scholarly journals Assessment of the relationship between diabetes treatment intensification and quality measure performance using electronic medical records

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0199011 ◽  
Author(s):  
Renée J. G. Arnold ◽  
Shuo Yang ◽  
Edward J. Gold ◽  
Sepehr Farahbakhshian ◽  
John J. Sheehan
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Quality Measure ◽  
Diabetes Treatment ◽  
Treatment Intensification ◽  
The Relationship

scholarly journals Effects of Yinzhihuang Granules on Serum Liver Enzymes in Jaundice Patients: A Real-World Study Based on HIS Data

2020 ◽  
Author(s):  
Cheng Zhang ◽  
Lidan Zhang ◽  
Jian Lyu ◽  
Yanming Xie ◽  
Yuting Xie
Keyword(s):  
Alkaline Phosphatase ◽  
Electronic Medical Records ◽  
Real World ◽  
Medical Records ◽  
Total Bilirubin ◽  
Liver Enzymes ◽  
Serum Levels ◽  
Indirect Bilirubin ◽  
Average Serum ◽  
Glutamyl Transpeptidase

Abstract Background: Yinzhihuang granule is a proprietary Chinese medicine to treat jaundice. The formula was derived from Yinchenhao decoction in Zhongjing Zhang’s “Treatise on Febrile Diseases,” which has been used to treat jaundice for more than two thousand years. Yinzhihuang granule has been widely used in China to treat neonatal jaundice; its effectiveness has been confirmed by randomized controlled trials, but there have been only few real-world studies. Electronic medical record is an important source of data for the real-world studies. We previously constructed a data warehouse which integrates real-world electronic medical records from the hospital information system of multiple 3A hospitals in China and then performed a series of beneficial real-world exploratory researches. Our aim was to analyze the influence of yinzhihuang granule on serum liver enzymes in jaundice patients and to provide real-world evidence for the efficacy evaluation of yinzhihuang granule in treating jaundice.Methods: We used a descriptive statistical method to analyze the changes in the serum liver enzymes of the jaundice patients treated with yinzhihuang granules and then used Wilcoxon signed-rank to test the changes in the indicators caused by the treatment.Results: After being treated with yinzhihuang granules, the jaundice patients had a decrease in the average serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, alkaline phosphatase, and the differences were statistically significant (P < 0.05), but had no significant changes in the average serum levels of direct bilirubin and alanine aminotransferase (P > 0.05).Conclusion: The data analysis on the real-world electronic medical records demonstrate that yinzhihuang granules help to reduce jaundice patients’ serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, alkaline phosphatase, but there is no evidence that yinzhihuang granules help to reduce the jaundice patients’ serum levels of direct bilirubin and alanine aminotransferase.

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