Epidemiology of Visceral Mycoses: Analysis of Data in Annual of the Pathological Autopsy Cases in Japan

1999 ◽  
Vol 37 (6) ◽  
pp. 1732-1738 ◽  
Author(s):  
Toshikazu Yamazaki ◽  
Hikaru Kume ◽  
Setsuko Murase ◽  
Eriko Yamashita ◽  
Mikio Arisawa
Keyword(s):  
Medical Care ◽  
Japanese Society ◽  
Antifungal Drugs ◽  
Pulmonary Aspergillosis ◽  
Hematopoietic System ◽  
Mycotic Infection ◽  
Number Of Patients ◽  
Severe Infections ◽  
Annual Total ◽  
Immunocompromised State

The data on visceral mycoses that had been reported in theAnnual of the Pathological Autopsy Cases in Japan from 1969 to 1994 by the Japanese Society of Pathology were analyzed epidemiologically. The frequency of visceral mycoses among the annual total number of pathological autopsy cases increased noticeably from 1.60% in 1969 to a peak of 4.66% in 1990. Among them, the incidences of candidiasis and aspergillosis increased the most. After 1990, however, the frequency of visceral mycoses decreased gradually. Until 1989, the predominant causative agent was Candida, followed in order by Aspergillus and Cryptococcus. Although the rate of candidiasis decreased by degrees from 1990, the rate of aspergillosis increased up to and then surpassed that of candidiasis in 1991. Leukemia was the major disease underlying the visceral mycoses, followed by solid cancers and other blood and hematopoietic system diseases. Severe mycotic infection has increased over the reported 25-year period, from 6.6% of the total visceral mycosis cases in 1969 to 71% in 1994. The reasons for this decrease of candidiasis combined with an increase of aspergillosis or of severe mycotic infection might be that (i) nonsevere (not disseminated) infections were excluded from the case totals, since they have become controllable by antifungal drugs such as fluconazole, but (ii) the available antifungal drugs were not efficacious against severe infections such as pulmonary aspergillosis, and (iii) the number of patients living longer in an immunocompromised state had increased because of developments in chemotherapy and progress in medical care.

scholarly journals A Multi-Objective Optimization Method for Hospital Admission Problem—A Case Study on Covid-19 Patients

Algorithms ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 38
Author(s):  
Amr Mohamed AbdelAziz ◽  
Louai Alarabi ◽  
Saleh Basalamah ◽  
Abdeltawab Hendawi
Keyword(s):  
Medical Care ◽  
Real Life ◽  
Optimization Method ◽  
Multi Objective Optimization ◽  
Admission Process ◽  
Multi Objective ◽  
Admission Time ◽  
King Faisal Specialist Hospital ◽  
Number Of Patients ◽  
Massive Number

The wide spread of Covid-19 has led to infecting a huge number of patients, simultaneously. This resulted in a massive number of requests for medical care, at the same time. During the first wave of Covid-19, many people were not able to get admitted to appropriate hospitals because of the immense number of patients. Admitting patients to suitable hospitals can decrease the in-bed time of patients, which can lead to saving many lives. Also, optimizing the admission process can minimize the waiting time for medical care, which can save the lives of severe cases. The admission process needs to consider two main criteria: the admission time and the readiness of the hospital that will accept the patients. These two objectives convert the admission problem into a Multi-Objective Problem (MOP). Pareto Optimization (PO) is a common multi-objective optimization method that has been applied to different MOPs and showed its ability to solve them. In this paper, a PO-based algorithm is proposed to deal with admitting Covid-19 patients to hospitals. The method uses PO to vary among hospitals to choose the most suitable hospital for the patient with the least admission time. The method also considers patients with severe cases by admitting them to hospitals with the least admission time regardless of their readiness. The method has been tested over a real-life dataset that consisted of 254 patients obtained from King Faisal specialist hospital in Saudi Arabia. The method was compared with the lexicographic multi-objective optimization method regarding admission time and accuracy. The proposed method showed its superiority over the lexicographic method regarding the two criteria, which makes it a good candidate for real-life admission systems.

scholarly journals Inactivation of Candida auris and Candida albicans by Ultraviolet-C

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s292
Author(s):  
William Rutala ◽  
Hajime Kanamori ◽  
Maria Gergen ◽  
Emily Sickbert-Bennett ◽  
David Jay Weber
Keyword(s):  
Infection Prevention ◽  
Antifungal Drugs ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Environmental Surfaces ◽  
Route Of Transmission ◽  
Indirect Exposure ◽  
Ultraviolet C ◽  
Severe Infections ◽  
Uv C

Background:Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it has caused severe infections with frequent mortality in over a dozen countries. C. auris can survive on healthcare environmental surfaces for at least 7 days, and it causes outbreaks in healthcare facilities. C. auris has an environmental route of transmission. Thus, infection prevention strategies, such as surface disinfection and room decontamination technologies (eg, ultraviolet [UV-C] light), will be essential to controlling transmission. Unfortunately, data are limited regarding the activity of UV-C to inactivate this pathogen. In this study, a UV-C device was evaluated for its antimicrobial activity against C. auris and C. albicans. Methods: We tested the antifungal activity of a single UV-C device using the vegetative bacteria cycle, which delivers a reflected dose of 12,000 µW/cm2. This testing was performed using Formica sheets (7.6 × 7.6 cm; 3 × 3 inches). The carriers were inoculated with C. auris or C. albicans and placed horizontal on the surface or vertical (ie, perpendicular) to the vertical UV-C lamp and at a distance from 1. 2 m (~4 ft) to 2.4 m (~8 ft). Results: Direct UV-C, with or without FCS (log10 reduction 4.57 and 4.45, respectively), exhibited a higher log10 reduction than indirect UV-C for C. auris (log10 reduction 2.41 and 1.96, respectively), which was statistically significant (Fig. 1 and Table 1). For C. albicans, although direct UV-C had a higher log10 reduction (log10 reduction with and without FCS, 5.26 and 5.07, respectively) compared to indirect exposure (log10 reduction with and without FCS, 3.96 and 3.56, respectively), this difference was not statistically significant. The vertical UV had statistically higher log10 reductions than horizontal UV against C. auris and C. albicans with FCS and without FCS. For example, for C. auris with FCS the log10 reduction for vertical surfaces was 4.92 (95% CI 3.79, 6.04) and for horizontal surfaces the log10 reduction was 2.87 (95% CI, 2.36–3.38). Conclusions:C. auris can be inactivated on environmental surfaces by UV-C as long as factors that affect inactivation are optimized (eg, exposure time). These data and other published UV-C data should be used in developing cycle parameters that prevent contaminated surfaces from being a source of acquisition by staff or patients of this globally emerging pathogen.Funding: NoneDisclosures: None

scholarly journals Utility of serum galactomannan antigen testing combined with chest computed tomography for early diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment

2018 ◽  
Vol 47 (2) ◽  
pp. 783-790 ◽  
Author(s):  
Xiaoning Wang ◽  
Guili Guo ◽  
Ruibo Cai ◽  
Pengcheng He ◽  
Mei Zhang
Keyword(s):  
Early Diagnosis ◽  
Febrile Neutropenia ◽  
Hematological Malignancies ◽  
Invasive Pulmonary Aspergillosis ◽  
Chest Ct ◽  
Antifungal Drugs ◽  
Control Group ◽  
Pulmonary Aspergillosis ◽  
Galactomannan Antigen ◽  
Observational Group

Objective To investigate the value of serum galactomannan antigen (GM) testing combined with chest computed tomography (CT) as a noninvasive method for early diagnosis of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment. Methods We retrospectively analyzed the data of 376 patients with febrile neutropenia from January 2015 to August 2017. All patients were given broad-spectrum antibiotics and divided into the control group (effective antibiotic treatment, no antifungal drugs given) and the observational group (ineffective antibiotic treatment, antifungal drugs given). The serum GM testing, chest CT, and microbiological examination findings were compared between the two groups. Results The false-positive rates of GM testing for IPA in the control and observational groups were 4.04% and 8.65%, respectively, and the false-negative rates in the two groups were 1.10% and 9.62%, respectively. Sixty-five patients in the observational group and 11 in the control group had typical features of CT imaging. Conclusion Clinical weekly screening of serum GM and chest CT may be an effective combined approach to the early diagnosis of IPA in patients with febrile neutropenia, even if they have undergone antifungal treatment.

Health Care Services in Shopping Centers: A Routine Mass-Gathering Event

2020 ◽  
Vol 35 (6) ◽  
pp. 669-675
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Shopping Centers ◽  
Medical Conditions ◽  
Care Providers ◽  
Care Services ◽  
Number Of Patients ◽  
Number Of Customers

AbstractBackground:Shopping centers (SCs) are social areas with a group of commercial establishments which attract customers of numerous people every day. However, analysis of urgent health conditions and provided health care in SCs has not been performed so far.Objective:The aim of the study was to perform a comparative analysis of clients visiting SCs and demographics, complaints, and health care of patients admitted to Emergency Medical Intervention Units (EMIU) located in grand SCs in Ankara, Turkey.Methods:Customer and health care records of nine grand SCs in Ankara from January 1, 2018 through December 31, 2018 were evaluated retrospectively. Health care services in EMIUs of SCs were provided by employed medical staff. Data including demographic characteristics, complaints, treatment protocols, discharge, and referral to hospital of the patients were retrospectively analyzed from medical registration forms.Results:Medical records of nine grand SCs were analyzed. Number of customers could not be obtained in three SCs due to privacy issues and were not included in patient presentation rate (PPR) and transport-to-hospital rate (TTHR) calculation. Total number of customers in the remaining six SCs were 53,277,239. The total number of patients seeking medical care was 6,749. The number of patients seeking health care in six SCs with known number of customers was 4,498 and PPR ranged from 0.018 to 0.381 patients per 1,000 attendants. The median age of the recorded 4,065 patients (60.2%) was 28 (interquartile range [IQR]: 38-21), and 3,611 (53.5%) of the patients admitted to EMIUs were female. The number of patients treated in the SC was 4,634 (68.6%) and 189 patients (2.8%) were transferred-to-hospital by ambulance for further evaluation and treatment. Transportation to hospital was required in 125 patients who sought medical care in six SCs which provided total number of customers, and TTHR ranged from 0.000 to 0.005 patients per 1,000 attendants. No sudden cardiac death was seen. Medical conditions were the primary reasons for seeking health care. The most frequent causes of presentation were laceration and abrasions (639 patients, 9.4%).Conclusion:The PPR and TTHR in SCs are low. The most common causes of presentation are minor conditions and injuries. Majority of urgent medical conditions in SCs can be managed by health care providers in EMIUs.

scholarly journals COVID-19-Associated Candidiasis (CAC): An Underestimated Complication in the Absence of Immunological Predispositions?

2020 ◽  
Vol 6 (4) ◽  
pp. 211 ◽  
Author(s):  
Amir Arastehfar ◽  
Agostinho Carvalho ◽  
M. Hong Nguyen ◽  
Mohammad Taghi Hedayati ◽  
Mihai G. Netea ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Molecular Techniques ◽  
Antifungal Drugs ◽  
Diagnostic Tools ◽  
Candida Spp ◽  
Comparative Performance ◽  
Number Of Patients ◽  
Clinical Awareness

The recent global pandemic of COVID-19 has predisposed a relatively high number of patients to acute respiratory distress syndrome (ARDS), which carries a risk of developing super-infections. Candida species are major constituents of the human mycobiome and the main cause of invasive fungal infections, with a high mortality rate. Invasive yeast infections (IYIs) are increasingly recognized as s complication of severe COVID-19. Despite the marked immune dysregulation in COVID-19, no prominent defects have been reported in immune cells that are critically required for immunity to Candida. This suggests that relevant clinical factors, including prolonged ICU stays, central venous catheters, and broad-spectrum antibiotic use, may be key factors causing COVID-19 patients to develop IYIs. Although data on the comparative performance of diagnostic tools are often lacking in COVID-19 patients, a combination of serological and molecular techniques may present a promising option for the identification of IYIs. Clinical awareness and screening are needed, as IYIs are difficult to diagnose, particularly in the setting of severe COVID-19. Echinocandins and azoles are the primary antifungal used to treat IYIs, yet the therapeutic failures exerted by multidrug-resistant Candida spp. such as C. auris and C. glabrata call for the development of new antifungal drugs with novel mechanisms of action.

The Significance of Palifermin (Kepivance) in Reduction of Oral Mucositis (OM) Incidence and Acute Graft Versus Host Disease (aGvHD) in Patients with Hematological Diseases Undergoing HSCT.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2965-2965
Author(s):  
B. Nasilowska-Adamska ◽  
P. Rzepecki ◽  
J. Manko ◽  
A. Czyz ◽  
M. Markiewicz ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Median Duration ◽  
Opioid Analgesics ◽  
High Dose Chemotherapy ◽  
Control Group ◽  
High Dose ◽  
Hematological Diseases ◽  
Number Of Patients ◽  
Severe Infections ◽  
And Control

Abstract AIMS: OM is a frequent complication of the myeloablative therapy and HSCT. In this Polish multi-center study we assessed the ability of palifermin (rHu-KGF1) to reduce the incidence, duration and severity of OM induced by high-dose chemotherapy followed by HSCT in patients with hematological diseases. We also evaluated the requirement for analgesics and total parenteral nutrition (TPN) caused by OM, incidence of febrile neutropenia and severe infections, the influence of palifermin on the engraftment, aGvHD and hospitalization. METHODS AND RESULTS: 106 patients with hematological diseases were enrolled to the study. 53 of them (50%) received palifermin (60 μg/kg/day) for 3 consecutive days before and after conditioning therapy and they were transplanted between June 2005 and March 2006. Each reporting center submitted equal number of patients to palifermin and control group. Both groups were similar in terms of sex, age, diagnosis, type of transplant and conditioning regimens. The patients in control group were transplanted between December 2000 and 2005. The median age of palifermin and control group was 37,0 years (range, 19 to 58) and 36,1 years (range, 18 to 64), respectively. 29 (54,7 %) autologous and 24 (45,3 %) allogeneic HSCT were performed in both groups. OM was assessed daily after HSCT according to the WHO scale. The incidence of OM of grade 1–4 was 58 % vs 94 % and grade 3–4, 13 % vs 43 % in palifermin group vs. control group, respectively (p<0,001). The median duration of OM grade 1–4 was 4,0 days (range, 0 to 16) in palifermin group and 9,0 days (range, 0 to 28) in control group (p<0,001). As compared with control, palifermin group was also associated with significant reductions in the use of analgesics (32 vs. 75,5 %; p<0,001), opioid analgesics (24 vs. 64 %; p<0,001) and TPN (11 vs. 45 %; p<0,001). Moreover, we observed reduction of the incidence of aGvHD in palifermin group (25 vs.50 %; p=0,03), especially gastrointestinal form (8,3 vs. 29,2 %; p=0,03). No statistically significant differences in the incidence of febrile neutropenia, severe infections and the median duration of hospitalization were observed between groups. Also palifermin did not appear to impair engraftment. The drug was generally well tolerated. Adverse events, mainly rash, pruritus, erythema, generalized edema, mouth/tongue thickness and discoloration and taste alteration were mild to moderate in severity and were transient. CONCLUSIONS: Administration of palifermin significantly reduced the incidence, severity and duration of OM and did not have negative effect on engraftment in the patients with hematological diseases after HSCT. It seems that it could also reduce the incidence of aGvHD, especially gastrointestinal form. It was generally well tolerated and safe.

Cost-Effectiveness Analysis for Integral Treatment of Chronic Myeloid Leukemia in Chronic Phase at the Instituto Mexicano del Seguro Social (IMSS) Mexico.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4789-4789
Author(s):  
Luisa Tenorio ◽  
Juan Vargas E ◽  
Enrique Baez ◽  
Carolina Afanador ◽  
Leon Zapata ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Chronic Myeloid Leukemia ◽  
Medical Care ◽  
Imatinib Mesylate ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Number Of Patients ◽  
Health Institutions ◽  
Clinical Records ◽  
The Cost

Abstract The economic analysis has become a priority for health institutions as a result of the increase in medical care costs. Therefore, an analysis model was developed integrating clinical and economic outcomes for the Medical care of chronic myeloid leukemia (CML) in chronic pahse. Objective: To perform a cost-effectiveness assessment of the therapeutic alternatives for CML at UMAE No.25 IMSS. Methodology: Economic evaluation of the use of imatinib mesylate (IM) vs. interferon + citarabine (INF/AraC), using as an effectiveness indicator, the number needed for treatment (NNT), to achieve a complete cytogenetic response (CCR) at 24 and 30 months was used. The integral care was obtained from the revision of clinical records in the UMAE 25, and from disease related-costs published by the IMSS. Results: The NNT reveals the amount of patients that need to be treated with one or the other of the therapies to obtain the desired result (CCR), which means that for every 1.15 patients IC 95% (1.06–1.25) treated with IM for 24 months, one will reach the CCR, with a cost of $867,729 mexican pesos (mx), in comparison to the care cost for 7.14 patients IC 95 % (5.75–8.88) patients that are required to be treated with IFN/AraC for 24 months to obtain the same result, with a cost of mx $4,454,565. This difference is higher when results are assessed at 30 months: A cost of NNT care of 1.27 patients IC 95% (1.07–1.50) of mx $1,178,848 for IM vs. mx $10,182,116 for NNT care of the 13.5 patients, CI 95% (9.40–19.43) required to achieve a CCR with IFN/AraC. Discussion: Comparing these results with the cost of the main treatment used during the same time, the expense effectiveness is evident. In other words, for each peso spent on IM at 24 months, mx $0.63 are effective, whilst for each peso spent on IFN/AraC, only mx $0.02 are beneficial for the patient. When this same reasoning is applied to the success cost at 30 months, we see that for each peso spent on IM, $0.58 are effective vs mx $0.01 per peso effectiveness spent on IFN/AraC. Conclusions: The superiority of IM is evident compared to INF/AraC in regards to the effectiveness of achieving CCR at 24 and 30 months. This positive difference in favor of imatinib mesylate is reflected on the cost that Health Institutions have to spend, in order to obtain a successful CCR, due to the decreased number of patients necessary to treat with IM, in order to achieve this success.

scholarly journals The Attitude of Patients from a Romanian Tertiary Cardiology Center Regarding Participation in Biomarker-Based Clinical Trials

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1180
Author(s):  
Iulia Rusu ◽  
Nicoleta-Monica Popa-Fotea ◽  
Mihaela Octavia Stanculescu ◽  
Diana Rusu ◽  
Alexandra Dumitru ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medical Care ◽  
Participation Rate ◽  
Chronically Ill ◽  
Critical Determinant ◽  
Number Of Patients ◽  
Tailored Approach ◽  
Quality Of Medical Care ◽  
Patient Enrollment

Background and Objectives: biomarker-based studies are the cornerstone of precision medicine, providing key data for tailored medical care. Enrollment of the planned number of patients is a critical determinant of a successful clinical trial. Moreover, for inclusive medical care, patients from different socio-demographic backgrounds must be recruited. Still, a significant number of trials fail to reach these prerequisites. Designing the informed consent forms based on the patients’ feedback could optimize accrual. We aimed to explore the attitudes of patients from a Romanian tertiary cardiology center towards participation in biomarker-based clinical trials. Materials and Methods: three hundred forty inpatients were interviewed based on a semi-structured questionnaire which included four sections: demographics, personal medical history, attitudes and trust. Results: Roughly, 62.5% of the respondents were interested in enrolling, while altruistic reasons were the most frequently expressed. Clear exposure of the possible risks was most valued (37.78%), followed by the possibility of directly communicating with the research team (23.78%). The most frequently chosen answer by acutely ill patients was improvement of their health, whereas chronically ill individuals indicated the possibility of withdrawal without affecting the quality of medical care. Importantly, the participation rate could be improved if the invitation to enrollment were made by both the current physician and the study coordinator (p = 0.0001). The level of trust in researchers was high in more than 50% of the respondents, and was correlated with therapeutic compliance and with the desire to join a biomarker study. Conclusions: the information gained will facilitate a tailored approach to patient enrollment in future biomarker-based studies in our clinic.

scholarly journals Primary hyperparathyroidism in Russia according to the registry

2019 ◽  
Vol 65 (5) ◽  
pp. 300-310 ◽  
Author(s):  
Natalya G. Mokrysheva ◽  
Svetlana S. Mirnaya ◽  
Ekaterina A. Dobreva ◽  
Irina S. Maganeva ◽  
Elena V. Kovaleva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Medical Care ◽  
Russian Federation ◽  
Parathyroid Carcinoma ◽  
Large Scale ◽  
Active Phase ◽  
Symptomatic Disease ◽  
Number Of Patients ◽  
The Russian Federation

BACKGROUND: There are no large-scale epidemiological studies on primary hyperparathyroidism (PHPT) in Russia. The high prevalence of the disease, the high risk of disability and death in this cohort of patients requires the study of the epidemiological and clinical structure of PHPT to determine the extent of medical care. AIM: Evaluate the frequency of PHPT detection and characterize its clinical forms in Russia using an online registry. METHODS: The object of the study is the database of the State Register of Patients with PHPT 1914 patients from 71 regions of the Russian Federation. New cases of the disease, as well as dynamic indicators are recorded when patients visit outpatient clinics or medical institutions. The analysis of data made at the end of December 2017 was carried out. The following parameters were evaluated: demographic and clinical indicators; indicators of phosphorus-calcium metabolism, the main forms of PHPT and its course, the primary characteristic of PHPT in hereditary syndromes and parathyroid carcinoma. Results are presented as mean and standard deviations, or medians and quartiles; descriptive statistics of qualitative attributes absolute and relative frequencies. RESULTS: the total number of patients with PHPT in the registry on 31 of December 2017 was 1914 cases (0.001% of the population of the Russian Federation). Identification of PHPT was 1.3 cases per 100 thousand of the population in Russia, 7.6 cases in Moscow, 6.1 cases per 100 thousand in the Moscow region. The average age of patients at the time of diagnosis was 55.6 10 years. The active phase of the disease was registered in 84.6% of patients (1620/1914), most of whom had a symptomatic PHPT 67.1% (1087/1620), and 32.9% a asymptomatic disease (533/1620). Symptomatic disease with visceral complications was detected in 15.8% cases (172/1087), with bone complications in 48.4% (526/1087). The mixed form of the disease was detected in 35.8% of patients with manifest form (389/1087). Normocalcemic variant PHPT (nPHPT) was registered in 14.5% cases (234/1620). Sporadic PHPT occurs in 83% of cases (1592/1914). 326 patients (17%) had a suspicion for hereditary form of the disease: average age was 31.2 12.3 years. A genetic analysis was conducted in 61 patients (3.2%): showed the mutation in the MEN1 gene in 2.9% of cases (55/1914) and the mutation in the CDC73 gene in 0.3% of cases (6/1914) (HPT-JT syndrome). Parathyroid carcinoma was confirmed in 1.8% of all patients (35/1914). Surgical treatment was performed in 64.5% of patients (1234/1914). Remission was achieved in 94% of cases (1160/1234), in 6% of cases relapse after surgical treatment or persistence of PHPT was recorded. CONCLUSION: detection of PHPT in the Russian Federation raised in comparison to 2016, which is associated with an active start of registration of patients in the regions. At this stage, it is necessary to modify the principles of registration and control, to make a platform for gathering information and calculating the necessary volumes of medical care for PHPT patients.

scholarly journals CANCER OF TRACHEA, BRONCHI AND LUNG IN THE FAR EASTERN FEDERAL DISTRICT

2019 ◽  
Vol 1 (71) ◽  
pp. 71-79
Author(s):  
Виктор Гордиенко ◽  
Viktor Gordienko ◽  
А. Вахненко ◽  
A. Vahnenko ◽  
Д. Екония ◽  
...  
Keyword(s):  
Medical Care ◽  
Cancer Patients ◽  
Federal District ◽  
Morbidity And Mortality ◽  
Malignant Neoplasms ◽  
Oncology Patients ◽  
Female Population ◽  
Annual Increase ◽  
Number Of Patients ◽  
Far Eastern

The first two decades of the XXI century in the Far Eastern Federal District continue to be characterized by a constantly decreasing level of the population living on its territory with an annual increase in the number of patients with cancer pathology, which makes a negative contribution to the already negative demographic situation in the region. The purpose of this study was to make a scientific assessment of the main morbidity and mortality rates of the population from malignant tumors of the trachea, bronchi and lung in the Far Eastern Federal District over the past ten years (2008-2017). In the course of the work, morbidity and mortality indicators, reporting forms of statistical records of cancer patients and regulatory documents of higher organizations, information on ten-year observations of the dynamics of changes in the numerical values of indicators of the studied pathology were used. The main indicators of medical care for oncology patients in the Far Eastern Federal District are shown, and it was found out that 3180 new cases of tracheal, bronchial and lung malignant neoplasms were registered in 2017, which is 30.9% more than ten years ago (in 2008 there were 2429 cases). The maximum number of cases was in the age group of 50-69 years. The number of patients with stages I-II (29.4%) of the cancer process increased slightly whereas the number of patients with advanced forms of the disease increased significantly (41.5%). The percentage of patients identified during routine check-ups was 28.0% (in 2008 it was 15.8%). Mortality in the first year from the time of diagnosis was reduced to 49.2% (in 2008 – 55.0%) remaining, at the same time, at very high numbers, which makes it impossible to characterize medical care for oncology patients as adequate for the time required. In the structure of total mortality, trachea, bronchus and lung tumors (20.7%) take the first place significantly exceeding the Russian level (17.3%). There was designated the quality of the service’s activity according to the confidence index of accounting for this category of patients, which in 2017 did not fall below 0.6 in any of the territories forming the Far Eastern Federal District. A great deal of work of primary health care institutions responsible for identifying malignant neoplasms in the initial stages of the process, unfortunately, has not led to the desired reduction in morbidity and mortality in the Far Eastern Federal District in the last decade. On the contrary, the level of intensive indicators of medical care for cancer patients in the region remains high, with an annual increase in mortality and the number of cases, especially among the female population

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