Notes

[Epidemiology of serious pancreatitis in Chile between 2013 along with 2018].
Sense of preparedness was most strongly and significantly associated with the duration of exposure residents had to long-term care. Conclusion The aging population requires physicians who are interested in care of the elderly and who are adequately prepared through comprehensive training to care for the complex medical and social issues that affect this large segment of society. This study, through its survey of family medicine residents, provides insights about potential curriculum changes and recommendations for updating the approach to care of the elderly.Lung cancer is the second most common cancer and the wide adoption of electronic health records (EHRs) offers a potential of accelerating cohort-related epidemiological studies using informatics approaches. In this study, we developed and evaluated a natural language processing (NLP) system to extract information on stage, histology, grade and therapies (chemotherapy, radiotherapy and surgery) automatically for lung cancer patients from clinical narratives including clinical notes, pathology reports and surgery reports. Evaluation showed promising results with the recalls for stage, histology, grade, and therapies achieving 89%, 98%, 80%, and 100% respectively and the precisions were 71%, 89%, 90%, and 100% respectively. This study demonstrated the feasibility and accuracy of extracting related information from clinical narratives for lung cancer research.In this study, we present a new method for detecting attributes of medical concepts, which uses a sequence labeling approach to recognize attribute entities and classify relations between concepts and attributes simultaneously within one step. A neural architecture combining bidirectional Long Short-Term Memory networks and Conditional Random fields (Bi-LSTMs-CRF) was adopted to detect disorder-modifier pairs in clinical text. PF543 Evaluations on the ShARe corpus show that the proposed method achieved higher accuracy and F1 scores than the traditional two-step approaches, indicating its potential to accelerate practical clinical NLP applications.This case study describes the implementation of the Research Electronic Data Capture (REDCap) software at the United States Department of Veterans Affairs Veterans Health Administration (VA). VA REDCap enables secure and standardized data collection, fosters collaboration with external researchers through use of a widely used data management tool, facilitates multisite studies through use of data forms that can be shared across sites within and outside the VA, is well suited to health services research studies and quality improvement projects, and enables exporting data for analysis in the VA secure computing environment. Using a diffusion of innovation framework approach, authors explore organizational factors that shaped adoption of REDCap technology and constraints on its use within the VA. Lessons learned from the VA experience are discussed.Improvements in the medical management of heart failure have changed the course of the disease. However, mortality rates, hospitalization rates, and treatment costs are not at desired levels. Diuretics have been widely used in the treatment of congestion in heart failure patients. The following case reports represent a special patient group treated and followed by cardiology clinic. Treatment approach of each case report has been tailored on an individual basis depending on the clinical course and hospitalization rates of patients. Authors have highlighted and discussed the common aspects and future perspectives of their cases in which post-discharge intermittent empirical intravenous diuretic administration dramatically improved the clinical status and readmission number due to decompensated congestive heart failure. This is a relatively new and promising approach, which has been thought to cease the recycle of diuretic resistance and silent increase of fluid congestion in patients with congestive heart failure and frequent hospitalization.Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in type 2 diabetes (T2D) patients. Recent cardiovascular outcome trials demonstrated clear cardiovascular benefits of novel classes of glucose-lowering agents. We performed retrospective electronic health record review at two major healthcare systems in the USA to determine the relative frequencies of outpatient encounters (hence prescribing opportunities) that a patient with T2D and CVD had with a cardiologist vs. an endocrinologist over one-year period. Of 109 747 T2D patients, 42.6% had established CVD. The ratio of cardiology-to-endocrinology outpatient encounters was 2.01 for all T2D patients, and 4.11 for those with T2D and CVD. Because each outpatient encounter provides an opportunity to discuss glucose-lowering medications with cardiovascular benefits, the much greater frequency of cardiology encounters highlights the emerging potential for cardiovascular specialists to influence or even implement evidence-based glucose-lowering therapies, thereby improving cardiovascular outcomes in their T2D patients.Brain natriuretic peptide (BNP) is elevated in decompensated systolic and diastolic heart failure. The plasma levels of adipokines, such as adiponectin and leptin, may provide evidence for mechanistic differences in BNP concentrations. African-American-specific associations are limited in the literature. The objective of this study was to evaluate the associations of adiponectin and leptin with BNP among African Americans. Methods Linear and logistic regressions were used to test the associations between adiponectin, leptin, and plasma BNP in 3738 participants of the Jackson Heart Study (JHS), a single-site prospective cohort study of African Americans in Jackson, Mississippi. Results A direct relationship of adiponectin was observed in multiple multivariate-adjusted linear models in men (β = 0.41-0.47), and in women (β = 0.32-0.38). Those in the highest quartile of adiponectin expression were twice as likely to have elevated BNP levels after adjustment [odds ratio 2.66 (95% confidence interval, 1.66-4.34)]. An inverse relationship of leptin with BNP was observed (β = -0.15) but attenuated after adjustment for aldosterone, renin, and adiponectin. Conclusions Different linear associations of adiponectin and leptin with BNP were observed. Odds of elevated adiponectin were observed with elevated BNP in multivariate-adjusted models. This paradoxical relationship of adiponectin and plasma BNP is possibly explained through adiponectin resistance.
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