registry

Registry
  • 文章类型: Journal Article
    目的:报告利用率,有效性,2015年和2016年辅助生殖技术的安全性。
    方法:回顾性,2015年对74个国家的3103个辅助生殖技术诊所和2016年79个国家的3249个诊所进行横断面调查,通过国家和地区登记册提交周期和妊娠结局数据.
    方法:接受辅助生殖技术程序的患者。
    方法:辅助生殖技术。
    方法:关于国家/地区的结果,区域,和全球层面。
    结果:2015年报告:2,358,239个周期,548,652名婴儿出生;2016年:2,807,963个周期,647,188名婴儿出生。估计在2015年,≥2,683,677个周期导致>675,134个婴儿;在2016年,≥3,100,448个周期导致≥723,026个婴儿。报告的周期约占全球利用率的80%。2015年和2016年分别为27.6%和27.8%,分别,接受新鲜自体周期的女性年龄≥40岁.冻融胚胎移植周期分别占47.0%和51.9%,分别,在2015年和2016年的所有胚胎移植中。2015年和2016年,卵母细胞捐赠周期占所有胚胎移植的6.7%和7.1%。2015年和2016年,卵胞浆内单精子注射分别占自体抽吸周期的57.7%和56.4%。新鲜和冻融胚胎移植每个抽吸周期的累积分娩率在2015年和2016年分别为32.4%和33.1%。2015年移植胚胎的平均数量为1.70,2016年为1.69。新鲜自体周期中单个胚胎移植的比例从2015年的42.1%增加到2016年的44.0%。双胞胎分娩率从2015年的16.0%下降到2016年的14.7%,三胞胎分娩率从2015年的0.6%下降到2016年的0.4%。2015年冻融胚胎移植自体周期中单胚胎移植的比例为62.2%,2016年为64.2%,2015年双胎和三胎率分别为10.1%和0.3%,2016年为10.0%和0.2%。
    结论:从2015年到2016年,辅助生殖技术的利用和每个周期的出生增加,而多胎减少。冻融胚胎移植周期的比例增加,胞浆内单精子注射的使用持续广泛变化,据报道,单胚胎移植率增加。
    OBJECTIVE: To report utilization, effectiveness, and safety of assisted reproductive technologies in 2015 and 2016.
    METHODS: Retrospective, cross-sectional survey of 3103 assisted reproductive technology clinics in 74 countries in 2015 and 3249 clinics in 79 countries in 2016 that submitted cycle and pregnancy outcome data through national and regional registries.
    METHODS: Patients undergoing assisted reproductive technology procedures.
    METHODS: Assisted reproductive technology.
    METHODS: Outcomes on country, regional, and global levels.
    RESULTS: Reported for 2015: 2,358,239 cycles with 548,652 babies born; for 2016: 2,807,963 cycles with 647,188 babies born. Estimated in 2015, ≥2,683,677 cycles resulted in >675,134 babies; in 2016, ≥3,100,448 cycles resulted in ≥723,026 babies. Reported cycles represent approximately 80% of global utilization. In 2015 and 2016, 27.6% and 27.8%, respectively, of women undergoing fresh autologous cycles were age ≥40 years. Frozen-thawed embryo transfer cycles accounted for 47.0% and 51.9%, respectively, of all embryo transfers in 2015 and 2016. Oocyte donation cycles accounted for 6.7% and 7.1% of all embryo transfers in 2015 and 2016. Intracytoplasmic sperm injection was performed in 57.7% and 56.4% of autologous aspiration cycles in 2015 and 2016, respectively. The cumulative delivery rate per aspiration cycle for fresh and frozen-thawed embryo transfer was 32.4% in 2015 and 33.1% in 2016, respectively. The average number of transferred embryos was 1.70 in 2015 and 1.69 in 2016. The proportion of single embryo transfers in fresh autologous cycles increased from 42.1% in 2015 to 44.0% in 2016. The twin delivery rate decreased from 16.0% in 2015 to 14.7% in 2016, and the triplet rate decreased from 0.6% in 2015 to 0.4% in 2016. The proportion of single embryo transfers in frozen-thawed embryo transfer autologous cycles was 62.2% in 2015 and 64.2% in 2016, with twin and triplet rates of 10.1% and 0.3% in 2015 and 10.0% and 0.2% in 2016, respectively.
    CONCLUSIONS: Utilization of assisted reproductive technology and births per cycle increased from 2015 to 2016 while multiple births were reduced . Increasing proportion of frozen-thawed embryo transfer cycles, continuing wide variation in use of intracytoplasmic sperm injection, and increase in single embryo transfer rates are reported.
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  • 文章类型: Journal Article
    自1970年代以来,意大利儿科肿瘤学家通过意大利小儿血液学协会(AIEOP)网络合作,使用通用的儿童癌症登记集中系统,被称为模型1.01(Mod。1.01).在这项研究中,我们报告招聘趋势,1989年至2017年期间,在国家AIEOP网络中登记和治疗的意大利儿童(0-14岁)和青少年(15-19岁)的地区外迁移和随时间变化的结局.在将近30年的时间里,在Mod中登记了43564例诊断为瘤形成的患者。1.01.对国家区域外迁移的分析表明,患者倾向于从南方迁移到北方,在较小程度上,到国家的中心。在学习期间,移民明显减少,尤其是淋巴造血疾病,而它仍然是实质性的实体瘤。我们的数据显示,自1990年代以来,诊断后5年的累积生存率逐渐显着增加,在过去十年中诊断出的所有患者几乎达到84%。Mod的存活率。1.01名患者与主要的国家和国际报告提供的儿童癌症监测估计相似。从流行病学和卫生政策的角度来看,AIEOPMod1.01已被证明是一种宝贵的工具,允许我们,在这项研究中,研究最大的意大利儿科癌症患者队列的生存体验,随访时间很长。
    Since the 1970s, Italian pediatric oncologists have collaborated through the Italian Association for Pediatric Hematology Oncology (AIEOP) network using a common centralized system for the registration of childhood cancer, known as Model 1.01 (Mod. 1.01). In this study, we report on recruitment trends, extra-regional migration and changes in outcome over time in the Italian population of children (0-14 years) and adolescents (15-19 years) registered and treated within the national AIEOP network in the period between 1989 and 2017. In almost 30 years, a cohort of 43,564 patients with a neoplasia diagnosis was registered in Mod. 1.01. The analysis of national extra-regional migration showed that patients tend to migrate from the South to the North and, to a lesser extent, to the Center of the country. During the study period, migration apparently decreased, especially for lymphohematopoietic diseases, whereas it remained substantial for solid tumors. Our data showed a progressive and significant increase in the cumulative survival 5 years after diagnosis since the 1990s, reaching almost 84% for all patients diagnosed in the last decade. Survival rates of Mod. 1.01 patients are similar to those provided by the main national and international reports showing childhood cancer surveillance estimates. The AIEOP Mod 1.01 has proved to be an invaluable tool from both an epidemiological and a health policy point of view, allowing us, in this study, to examine the survival experience of the largest cohort of Italian pediatric cancer patients with a very long follow-up.
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  • 文章类型: Journal Article
    目的:临床注册在适应证的医疗程序质量控制方面具有巨大潜力,治疗过程和结果,包括可能的并发症。当向患有严重听力损失或耳聋的患者提供耳蜗植入物(CI)时尤其如此。这种治疗代表了终身护理过程,需要随着时间的推移进行持续的质量控制。在德国耳鼻喉科学会执行委员会的倡议下(DeutscheGesellschaftfürHals-Nasen-Ohren-Heilkunde,Kopf-undHals-Chirurgiee.V.,DGHNO-KHC),国家GermanCI登记处(Deutsches人工耳蜗植入登记处,DCIR)成立于2022年1月。本文重点介绍DCIR的第一个人口统计学和基线数据。
    方法:DCIR涵盖了从适应症开始的完整治疗过程,手术,CI治疗中的拟合和终身护理。到2022年底,德国已有75家医院同意为DCIR捐款。
    结果:在2022年,63家医院积极为DCIR提供数据。来自2,292CI植入的假名数据(2,176次初次植入,记录了2,108例患者的99例立即重新植入和17例早期植入后重新植入)。1,807名成人(≥18岁)和301名儿童(<18岁)完成了人工耳蜗植入。40例(1.9%)为<1岁的儿童,55例(2.6%)为>85岁的患者。在总共2292次植入中,226例(9.9%)同时进行双侧植入(手术当天在113例患者的双耳中植入CI)和412例植入(2162例植入中的19.1%提供了有关对侧耳听力状态的数据)单侧耳聋(对侧耳听力正常)的患者。此外,还评估了2022年报告的并发症.记录了7例(0.4%)轻度至中度严重面神经功能障碍的报告。无严重或完全面神经功能障碍的报告(House-BrackmannV/VI级),记录与CI治疗相关的脑膜炎或死亡.
    结论:尽管仍处于启动阶段,这些初始DCIR数据已经为德国CI治疗的人口结构和基线数据提供了有趣的初步见解.DCIR的成功实施代表了CI护理持续质量控制的重要一步。
    OBJECTIVE: Clinical registries have great potential for quality control of medical procedures regarding the indications, therapeutic processes and results, including their possible complications. This is particularly true when providing patients with severe hearing loss or deafness with a cochlear implant (CI). This treatment represents a lifelong care process that requires continuous quality control over time. On the initiative of the Executive Committee of the German Society of Otorhinolaryngology (Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., DGHNO-KHC), a national German CI registry (Deutsches Cochlear Implant Register, DCIR) was established in January 2022. This article focuses on the first demographic and baseline data of the DCIR.
    METHODS: The DCIR covers the complete therapeutic process from indication, surgery, fitting and lifelong aftercare in CI therapy. By the end of 2022, 75 hospitals in Germany had agreed to contribute to the DCIR.
    RESULTS: During the year 2022, 63 hospitals actively contributed data to the DCIR. Pseudonymized data from 2,292 CI implantations (2,176 primary implantations, 99 explantations with immediate re-implantations and 17 re-implantations following an earlier explantation) in 2,108 patients were documented. Cochlear implantation was accomplished in 1,807 adults (≥ 18 years) and 301 children (< 18 years). Fourty patients (1,9%) were children < 1 year of age and 55 (2,6%) were patients > 85 years. From the total of 2,292 implantations, 226 (9.9%) were performed as simultaneous bilateral implantations (CI implantation in both ears of 113 patients on the same day of surgery) and 412 implantations (19.1% of 2,162 implantations with data provided on the contralateral ear\'s hearing status) were in patients with single sided deafness (normal hearing in the contralateral ear). In addition, the reported complications in 2022 were also evaluated. Seven reports (0.4%) of mild to moderate severe facial nerve dysfunctions were documented. No reports of severe or total facial nerve dysfunction (House-Brackmann grade V/VI), meningitis or death related to CI therapy were documented.
    CONCLUSIONS: Although still in the start-up phase, these initial DCIR data already provide an interesting first insight into the demographic structure and baseline data of CI therapy in Germany. The successful implementation of the DCIR represents an important step towards continuous quality control of CI care.
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  • 文章类型: Journal Article
    目的:总结150,000次检查的SCMR注册状态。
    背景:心血管磁共振(CMR)越来越多地用于评估不断扩大的心血管疾病。SCMRRegistry是支持心血管研究的现实世界临床数据的中央存储库。包括与结果有关的那些,质量改进,和机器学习。SCMR注册表建立在符合法规的基础上,基于云的基础设施,可容纳可搜索的内容以及医学数字成像和通信(DICOM)图像。
    方法:数据安全的过程,数据提交,并概述了研究访问。我们询问了书记官处,并提供了其内容摘要。
    结果:数据来自美国20个站点的154,458次CMR扫描,包含299,622,066张总图像(约100TB的存储空间)。人类受试者的平均年龄为58岁(范围为1个月至>90岁),44%是女性,72%白种人,死亡率为8%。最常见的适应症是心肌病(27%),最常用的当前程序术语(CPT)代码为75561(35%).2015年后,基于大环钆的造影剂占造影剂利用率的89%。在99%的扫描中进行了短轴扫描,短轴LGE在66%,和30%的应力灌注序列。死亡率数据显示左心室射血分数(LVEF)<35%的患者死亡率增加,壁运动异常的存在,应力灌注缺陷,和梗塞晚期钆增强(LGE),与没有这些标记的人相比。有456,678个患者年的全因死亡率随访,中位随访时间为3.6年。
    结论:SCMRRegistry的愿景是通过协作努力,通过为中心提供一种网络机制,安全地上传去识别的数据和图像进行研究,促进CMR的循证利用。教育,和质量控制。注册表量化随时间变化的实践,并支持对预后效用的大规模现实世界多中心观察研究。
    结论:SCMRRegistry是一个符合监管标准的基于云的中央存储库,用于多中心心血管研究的真实世界临床数据和DICOM图像。包括基于结果的数据。该注册表包含299,622,066个DICOM图像和456,678个患者年随访。来自美国20个地点的154,458次CMR扫描的数据显示,2015年后,心肌病是最常见的适应症,大环钆造影剂利用率为89%。总死亡率为8%,LVEF<35%的患者发病率较高,异常壁运动,缺血存在,或梗塞部位。登记处旨在通过合作努力促进基于证据的CMR利用,以积极影响心血管结果。
    OBJECTIVE: To summarize the status of the SCMR Registry at 150,000 exams.
    BACKGROUND: Cardiovascular magnetic resonance (CMR) is increasingly utilized to evaluate expanding cardiovascular conditions. The SCMR Registry is a central repository for real-world clinical data to support cardiovascular research, including those relating to outcomes, quality improvement, and machine learning. The SCMR Registry is built on a regulatory-compliant, cloud-based infrastructure that houses searchable content and Digital Imaging and Communications in Medicine (DICOM) images.
    METHODS: The processes for data security, data submission, and research access are outlined. We interrogated the Registry and present a summary of its contents.
    RESULTS: Data were compiled from 154,458 CMR scans across 20 United States sites, containing 299,622,066 total images (~100 terabytes of storage). The human subjects had an average age of 58 years (range 1 month to >90 years old), were 44% female, 72% Caucasian, and had a mortality rate of 8%. The most common indication was cardiomyopathy (27%), and most frequently used current procedural terminology (CPT) code was 75561 (35%). Macrocyclic gadolinium-based contrast agents represented 89% of contrast utilization after 2015. Short-axis cines were performed in 99% of scans, short-axis LGE in 66%, and stress perfusion sequences in 30%. Mortality data demonstrated increased mortality in patients with left ventricular ejection fraction (LVEF) < 35%, the presence of wall motion abnormalities, stress perfusion defects, and infarct late gadolinium enhancement (LGE), compared to those without these markers. There were 456,678 patient-years of all-cause mortality follow-up, with a median follow-up time of 3.6 years.
    CONCLUSIONS: The vision of the SCMR Registry is to promote evidence-based utilization of CMR through a collaborative effort by providing a web mechanism for centers to securely upload de-identified data and images for research, education, and quality control. The Registry quantifies changing practice over time and supports large-scale real-world multicenter observational studies of prognostic utility.
    CONCLUSIONS: The SCMR Registry is a central regulatory-compliant cloud-based repository for real-world clinical data and DICOM images for multicenter cardiovascular research, including outcomes-based data. The Registry contains 299,622,066 DICOM images and 456,678 patient-years follow-up. Data compiled from 154,458 CMR scans across 20 US sites demonstrated cardiomyopathy as the most common indication and 89% macrocyclic gadolinium contrast utilization after 2015. There was an overall mortality rate of 8%, with higher rates in those with LVEF<35%, abnormal wall motion, ischemia presence, or infarct LGE. The Registry aims to promote evidence-based CMR utilization through a collaborative effort to positively impact cardiovascular outcomes.
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  • 文章类型: Journal Article
    背景:法国医疗系统在2020年受到COVID-19大流行的影响,包括癌症护理。
    方法:为了评估这种大流行对癌症发病率的影响,Isere部门癌症登记处比较了2020年黑色素瘤的实际发病率,乳房,结直肠,根据登记处2015年至2019年收集的数据,考虑到封锁和重新开放的时期,前列腺癌和肺癌的预期发病率为2020年。如果可用,记录癌症分期和/或预后评分.
    结果:在初次禁闭期间,54%,观察到乳腺发病率下降了50%和36%,前列腺癌和结直肠癌。尽管它们的年发病率保持稳定,到2020年底,诊断时低分期/分数的数量下降,而更高分期/分数的数量出现恶化趋势.相比之下,观察到黑色素瘤的年发病率显著下降了17.8%,特别是对于Breslow分数<1(-27,4%)。然而,这种趋势在封锁之前很明显,以及女性肺癌发病率降低14%,但不是男人。
    结论:某些癌症的发病率在过去一年中有所上升,但COVID-19大流行似乎与整个2020年诊断时的严重程度变化有关。女性肺癌和黑色素瘤发病率的下降趋势表明了复杂的潜在现象。仍需要进一步分析来评估COVID-19大流行对癌症发病率的全球影响。
    BACKGROUND: The French healthcare system has been affected by the COVID-19 pandemic in 2020, including cancer care.
    METHODS: In order to evaluate the impact of this pandemic on cancer incidence, the Isere Departmental Cancer Registry compared the actual 2020 incidence of melanoma, breast, colorectal, prostate and lung cancers with the expected 2020 incidence based on data collected by the Registry between 2015 and 2019, taking into account periods of lockdown and reopening. When available, cancer stages and/or prognostic scores were recorded.
    RESULTS: During the period of initial confinement, a 54%, 50% and 36,8% drop in incidence was observed for breast, prostate and colorectal cancer respectively. Although their annual incidence remained stable, a worsening trend emerged as a decline in the number of low stages/scores at diagnosis in favour of higher stages/scores towards the end of 2020. In contrast, a significant 17,8% drop was observed in annual incidence of melanoma, particularly for Breslow scores < 1 (-27,4%). However, this trend was noticeable before the lockdown, as well as the 14% reduction in the incidence of lung cancer in women, but not in men.
    CONCLUSIONS: The incidence of certain cancers was caught up over the year but the COVID-19 pandemic seems to be associated with a change in their severity at diagnosis throughout 2020. The downward trends in female lung cancer and melanoma incidence point to complex underlying phenomena. Further analysis is still needed to assess the global impact of the COVID-19 pandemic on cancer incidence.
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  • 文章类型: Journal Article
    截至2019年,这是菲律宾皮肤病中第二常见的残疾原因。没有大规模的全国性研究描述该国sc疮的流行病学特征。
    本研究旨在描述人口统计,季节性,以及菲律宾的sc疮的地理特征。
    我们比较了两个当地患者登记处的次要数据(菲律宾皮肤病学会,PDS,2010年至2021年;菲律宾儿科学会,PPS,2009年至2021年)菲律宾报告的sc疮病例。我们根据年龄报告了频率和百分比分布,性别,月,Year,和诊断类型,和区域。
    PDS(从2010年开始)的sc疮病例(主要是门诊)的年中位数为4087(范围([QR],342-6422[3271.5]),当它是183(范围[IQR],64-234[96.5])(所有住院患者)用于PPS(从2009年起)。在大流行期间(2020-2021年),大流行前的数字减少了三分之一(PDS)和四分之一(PPS)。sc疮病例的高峰月份是较凉爽的月份:1月(中位数,年度病例的12.1%;范围[IQR],2.6%-31.4%[3.6%])至2月(中位数,10.0%的年度病例;范围[IQR],1.5%-27.8%[2.5%])基于PDS数据,和11月(中位数,10.0%的年度病例;范围[IQR],0.0%-24.3%[7.0%])至1月(中位数,9.0%的年度病例;范围[IQR],0.0%-24.3%[6.6%])用于PPS数据。总的来说,对于PDS,1-4岁是受影响最大的年龄组(中位数,PDS,17.5%的年度病例;范围[IQR],11.9%-25.4%[8.1%]),虽然是不到1岁的儿童(年病例中位数,48.9%;范围[IQR],29.1%-67.3%[13.20%])在0至18岁的PPS儿科人群中。男性(中位数,53.9%的年度病例;范围[IQR],在PPS中,45.0%-67.2%[8.8%])的受影响大于女性。而对于PDS在早些年(2015年之前),男性(中位数,2010年至2014年的年度病例占51.6%;范围[IQR],47.4%-52.9%[0.2%])的受影响程度高于女性。然而,男性比女性受影响小,从2015年起,占年度病例的44.7%(范围[IQR],43.4%-46.5%[1.2%])。NCR是PPS病例发生频率最高的地区(中位数,52.6%的年度病例;范围[IQR],22.7%-75.0%[20.4%])。受影响第二大的地区是中东部米沙yas(34.2%,2009-2013;范围[IQR],17.9%-54.1%[5.3%]),比科尔地区(12%;2014年至2018年;范围[IQR],17.9%-54.1%[7.4%]),吕宋岛中部(18%;2019年),中部/东部米沙群岛(29%,2020),和棉兰老岛北部/中部(17%,2021)。
    镰刀常见于年轻年龄组,PDS中的女性略多,虽然PPS中的男性稍多,在一年中凉爽的月份,在城市化的NCR中。
    UNASSIGNED: Scabies is the second most common cause of disability among skin diseases in the Philippines as of 2019. There is no large nationwide study describing the epidemiologic profile of scabies in the country.
    UNASSIGNED: This study aimed to describe the demographic, seasonal, and geographic profile of scabies in the Philippines.
    UNASSIGNED: We compared secondary data of two local patient registries (Philippine Dermatological Society, PDS, 2010 to 2021; and Philippine Pediatric Society, PPS, 2009 to 2021) for reported cases of scabies in the Philippines. We reported the frequency and percentage distribution according to age, sex, month, year, and type of diagnosis, and region.
    UNASSIGNED: The median annual frequency of scabies cases (mostly outpatient) for PDS (from year 2010) was 4087 (range ([QR], 342-6422 [3271.5]), while it was 183 (range [IQR], 64-234 [96.5]) (all inpatient) for PPS (from year 2009). There was a reduction to one-third (PDS) and one-fourth (PPS) of pre-pandemic numbers during the pandemic years (2020-2021). The peak months for scabies cases were the cooler months: January (median, 12.1% of annual cases; range [IQR], 2.6%-31.4% [3.6%]) to February (median, 10.0% of annual cases; range [IQR], 1.5%-27.8% [2.5%]) based on PDS data, and November (median, 10.0% of annual cases; range [IQR], 0.0%-24.3% [7.0%]) to January (median, 9.0% of annual cases; range [IQR], 0.0%-24.3% [6.6%]) for PPS data. Overall, for PDS, age 1-4 years is the most affected age group (median, PDS, 17.5% of annual cases; range [IQR], 11.9%-25.4% [8.1%]), while it was the less than 1-year-olds (median annual cases, 48.9%; range [IQR], 29.1%-67.3% [13.20%]) among PPS pediatric population aged 0 to 18 years. Males (median, 53.9% of annual cases; range [IQR], 45.0%-67.2% [8.8%]) were more affected than females in PPS. While for PDS during earlier years (prior to 2015), males (median, 51.6% of annual cases from 2010 to 2014; range [IQR], 47.4%-52.9% [0.2%]) were more affected than females. However, males became less affected than females with median, 44.7% of annual cases from 2015 onwards (range [IQR], 43.4%-46.5% [1.2%]). NCR was the region with the highest frequency of cases in PPS (median, 52.6% of annual cases; range [IQR], 22.7%-75.0% [20.4%]). The 2nd most affected regions were Central/Eastern Visayas (34.2%, 2009-2013; range [IQR], 17.9%-54.1% [5.3%]), Bicol region (12%; 2014 to 2018; range [IQR], 17.9%-54.1% [7.4%]), Central Luzon (18%; 2019), Central/Eastern Visayas (29%, 2020), and Northern/Central Mindanao (17%, 2021).
    UNASSIGNED: Scabies was commonly seen in the younger age group, slightly more in females in the PDS, while slightly more among males in the PPS, in the cooler months of the year, and in the urbanized NCR.
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  • 文章类型: Journal Article
    GeRi评分对120天死亡率的验证,老年儿科医生术前就诊的影响,并根据结果进行手术时机。该评分对120天死亡率具有预测价值。在24小时内手术或术前老年就诊均未发现优势。
    目标:许多工具可以预测髋部骨折患者的死亡率,但是它们包括许多变量,需要耗时的评估,而且很难计算。GeRi评分提供了一种快速的术前评估方法。这项研究的目的是验证120天随访中的分数,并确定老年病学家术前就诊和手术时机对患者预后的影响。
    方法:对2017年至2021年的AltersTraumaRegisterDGU®进行了回顾性分析,包括所有股骨近端骨折.患者被分为低,moderate-,和基于GeRi评分的高危人群。死亡率采用logistic回归分析。为了确定手术时间和术前访视的影响,使用精确的GeRi-Score进行匹配,术前步行能力,骨折类型,还有手术时间.
    结果:该研究包括38,570名患者,分为12,673个低风险,18,338中等风险,和7559名高风险患者。中等风险组的死亡风险是低风险组的三倍(OR3.19(95%CI2.68-3.79;p<0.001)),而高危组的死亡风险几乎是低危组的8倍(OR7.82(95%CI6.51-9.93;p<0.001)).在所有组的前24小时内,手术均未发现优势。术前老年就诊和死亡率之间存在相关性,表明中度和高危人群的内部死亡率增加。
    结论:GeRi评分对120天死亡率具有预测价值。在24小时内没有发现手术的优势。分析没有证明术前老年就诊的益处,但是需要更多的数据。
    A validation of the GeRi-Score on 120-day mortality, the impact of a pre-operative visit by a geriatrician, and timing of surgery on the outcome was conducted. The score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h or a preoperative geriatric visit.
    OBJECTIVE: Numerous tools predict mortality among patients with hip fractures, but they include many variables, require time-consuming assessment, and are difficult to calculate. The GeRi-Score provides a quick method of pre-operative assessment. The aim of this study is to validate the score in the 120-day follow-up and determine the impact of a pre-operative visit by a geriatrician and timing of surgery on the patient outcome.
    METHODS: A retrospective analysis of the AltersTraumaRegister DGU® from 2017 to 2021 was conducted, including all proximal femur fractures. The patients were divided into low-, moderate-, and high-risk groups based on the GeRi-Score. Mortality was analyzed using logistic regression. To determine the influence of the time to surgery and the preoperative visit by a geriatrician, matching was performed using the exact GeRi-Score, preoperative walking ability, type of fracture, and the time to surgery.
    RESULTS: The study included 38,570 patients, divided into 12,673 low-risk, 18,338 moderate-risk, and 7,559 high-risk patients. The moderate-risk group had three times the mortality risk of the low-risk group (OR 3.19 (95% CI 2.68-3.79; p<0.001)), while the high-risk group had almost eight times the mortality risk than the low-risk group (OR 7.82 (95% CI 6.51-9.93; p<0.001)). No advantage was found for surgery within the first 24 h across all groups. There was a correlation of a preoperative geriatric visit and mortality showing an increase in the moderate and high-risk group on in-house mortality.
    CONCLUSIONS: The GeRi-Score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h. The analysis did not demonstrate a benefit of the preoperative geriatric visit, but more data are needed.
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  • 文章类型: Journal Article
    目的:虽然微创子宫切除术具有优势,腹式子宫切除术仍然是主要的手术方法。创建标准化数据集和建立子宫切除术登记系统为减少体积和选择良性子宫切除术方法的早期干预提供了机会。本研究旨在开发一个用于设计良性子宫切除术配准系统的数据集。
    方法:在2020年4月至9月之间,进行了一项定性研究,以创建一个数据集,用于招募子宫切除术的候选患者。在这个阶段,研究小组进行了信息需求评估,相关数据元素标识,注册表软件开发,和现场测试;随后,设计了一个基于Web的应用程序。2023年6月,使用从大不里士Al-Zahra医院收治的患者的医疗记录中提取的数据对注册软件进行了评估,伊朗。
    结果:在两个月内,40例良性子宫切除术患者均成功登记。子宫切除术患者登记的最终数据集包括11个主要组,27个子类,总共91个数据元素。定义了强制性数据和基本报告。此外,基于Web的注册系统,根据数据集和各种场景进行设计和评估。
    结论:创建子宫切除术登记系统是识别和登记子宫切除术候选患者的第一步。此系统捕获有关程序技术的信息,和相关的并发症。在伊朗,该注册可以作为评估所提供护理质量和临床措施分布的宝贵资源.
    OBJECTIVE: Although minimally invasive hysterectomy offers advantages, abdominal hysterectomy remains the predominant surgical method. Creating a standardized dataset and establishing a hysterectomy registry system present opportunities for early interventions in reducing volume and selecting benign hysterectomy methods. This research aims to develop a dataset for designing benign hysterectomy registration system.
    METHODS: Between April and September 2020, a qualitative study was carried out to create a data set for enrolling patients who were candidate for hysterectomy. At this stage, the research team conducted an information needs assessment, relevant data element identification, registry software development, and field testing; Subsequently, a web-based application was designed. In June 2023the registry software was evaluated using data extracted from medical records of patients admitted at Al-Zahra Hospital in Tabriz, Iran.
    RESULTS: During two months, 40 patients with benign hysterectomy were successfully registered. The final dataset for the hysterectomy patient registry comprise 11 main groups, 27 subclasses, and a total of 91 Data elements. Mandatory data and essential reports were defined. Furthermore, a web-based registry system designed and evaluated based on data set and various scenarios.
    CONCLUSIONS: Creating a hysterectomy registration system is the initial stride toward identifying and registering hysterectomy candidate patients. this system capture information about the procedure techniques, and associated complications. In Iran, this registry can serve as a valuable resource for assessing the quality of care delivered and the distribution of clinical measures.
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  • 文章类型: Journal Article
    CARMEN-France注册是一个潜在的,法国的多中心登记包括新诊断为免疫性血小板减少症或自身免疫性溶血性贫血的成年患者(2023年12月31日纳入2402例患者).临床记录,生物和治疗数据允许详细的流行病学和药物流行病学真实世界的研究。这篇综述总结了CARMEN-France注册协议,列举了在登记处进行的研究的例子,并指出未来的方向,如纳入患者报告的结果,与法国国家健康保险数据库的联系以及与欧洲其他注册管理机构的联系。
    The CARMEN-France registry is a prospective, multicenter registry in France including adult patients with a new diagnosis of immune thrombocytopenia or of autoimmune immune hemolytic anemia (2402 patients included in December 31, 2023). The recording of clinical, biological and treatment data allows detailed epidemiological and pharmacoepidemiological real-world studies. This review summarizes the CARMEN-France registry protocol, gives examples of studies conducted in the registry, and indicates future directions such as inclusion of patient reported outcomes, linkage with the French national health insurance database and linkage with other registries in Europe.
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  • 文章类型: Journal Article
    背景:在斯洛伐克,一项强制性的全国通用儿科总胆固醇(TC)筛查计划已经到位,以确定家族性高胆固醇血症(FH)的病例.然而,该计划的有效性尚未得到系统评估。
    目的:本研究旨在评估筛查中发现TC水平升高的儿童父母中FH的患病率。
    方法:这种前瞻性,非干预性,观察性研究纳入了在2017年至2018年期间在23个选定的儿科门诊诊所接受TC筛查的11岁儿童的父母.使用荷兰脂质诊所网络(DLCN)标准和靶向下一代测序来诊断FH。主要目的是估计TC水平>188mg/dL(>4.85mmol/L)的儿童的父母被确诊为FH的比例。
    结果:共纳入112名TC水平升高的儿童的父母。五个孩子(8.9%)的父母中的FH经过基因确认。没有基因分析,根据DLCN标准,所有五名父母都将被诊断为“可能的FH”。父母,83.9%(n=94/112)的LDL-C水平>116mg/dL(>3mmol/L),但只有5.3%(n=5/94)接受了降脂治疗。在基因证实FH的五位父母中,所有人的LDL-C水平均>116mg/dL(>3mmol/L),平均值(±SD)为191(±24)mg/dL(4.94[±0.61]mmol/L)。这些父母中只有两个人接受了降脂治疗。
    结论:本研究表明强制性儿童TC筛查在确定FH患者家庭和其他需要降脂治疗的高危家庭中的重要性。
    BACKGROUND: In Slovakia, a mandatory national universal pediatric total cholesterol (TC) screening program is in place to identify cases of familial hypercholesterolemia (FH). However, the program\'s effectiveness has not been systematically assessed.
    OBJECTIVE: This study aimed to estimate the prevalence of FH among parents of children that had elevated TC levels identified during screening.
    METHODS: This prospective, non-interventional, observational study enrolled parents of 11-year-old children who underwent TC screening in 23 selected pediatric outpatient clinics between 2017 and 2018. FH was diagnosed using the Dutch Lipid Clinic Network (DLCN) criteria and targeted next-generation sequencing. The primary objective was to estimate the proportion of children with a TC level of >188 mg/dL (>4.85 mmol/L) who had a parent with a confirmed diagnosis of FH.
    RESULTS: A total of 112 parents of 56 children with an elevated TC level were enrolled. Five children (8.9%) had a parent in whom FH was genetically confirmed. Without genetic analysis, all five parents would only be diagnosed with \"possible FH\" by DLCN criteria. Of parents, 83.9% (n = 94/112) had an LDL-C level of >116 mg/dL (>3 mmol/L), but only 5.3% (n = 5/94) received lipid-lowering therapy. Among the five parents with genetically confirmed FH, all had an LDL-C level >116 mg/dL (>3 mmol/L), with a mean (±SD) of 191 (±24) mg/dL (4.94 [±0.61] mmol/L). Only two of these parents received lipid-lowering therapy.
    CONCLUSIONS: The present study demonstrates the significance of mandatory universal pediatric TC screening in identifying families with FH and other at-risk families in need of lipid-lowering therapy.
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