The KMDB/MutationView: a mutation database for human disease genes.
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The KMDB/MutationView is a graphical database of mutations in human disease-causing genes and its current version consists of nine category-based sub-databases including diseases of eye, heart, ear, brain, cancer, syndrome, autoimmunity, muscle and blood. The KMDB/MutationView stores mutation data of 97 genes involved in 87 different disease and is accessible through http://mutview.dmb.med. keio.ac.jp. (+info)
Classifications in routine use: lessons from ICD-9 and ICPM in surgical practice.
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OBJECTIVE: Classifications of diagnoses and procedures are very important for the economical as well as the quality assessment of surgical departments. They should reflect the morbidity of the patients treated and the work done. The authors investigated the fulfillment of these requirements by ICD-9 (International Classification of Diseases: 9th Revision) and OPS-301, a German adaptation of the ICPM (International Classification of Procedures in Medicine), in clinical practice. DESIGN: A retrospective study was conducted using the data warehouse of the Surgical Center II at the Medical Faculty in Essen, Germany. The sample included 28,293 operations from the departments of general surgery, neurosurgery, and trauma surgery. Distribution of cases per ICD-9 and OPS-301 codes, aggregation through the digits of the codes, and concordance between the classifications were used as measurements. Median and range were calculated as distribution parameters. The concentration of cases per code was graphed using Lorenz curves. The most frequent codes of diagnoses were compared with the most frequent codes of surgical procedures concerning their medical information. RESULTS: The total number of codes used from ICD-9 and OPS-301 went up to 14 percent, depending on the surgical field. The median number of cases per code was between 2 and 4. The concentration of codes was enormous: 10 percent of the codes were used for about 70 percent of the surgical procedures. The distribution after an aggregation by digit was better with OPS-301 than with ICD-9. The views with OPS-301 and ICD-9 were quite different. CONCLUSION: Statistics based on ICD-9 or OPS-301 will not properly reflect the morbidity in different surgical departments. Neither classification adequately represents the work done by surgical staff. This is because of an uneven granularity in the classifications. The results demand a replacement of the ICD-9 by an improved terminological system in surgery. The OPS-301 should be maintained and can be used at least in the medium term. (+info)
Epidemiology of paediatric surgical admissions to a government referral hospital in the Gambia.
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INTRODUCTION: There is a paucity of published data on the type of conditions that require surgery among children in sub-Saharan Africa. Such information is necessary for assessing the impact of such conditions on child health and for setting priorities to improve paediatric surgical care. METHODS: Described in the article is a 29-month prospective study of all children aged < 15 years who were admitted to a government referral hospital in the Gambia from January 1996 to May 1998. RESULTS: A total of 1726 children were admitted with surgical problems. Surgical patients accounted for 11.3% of paediatric admissions and 34,625 total inpatient days. The most common admission diagnoses were injuries (46.9%), congenital anomalies (24.3%), and infections requiring surgery (14.5%). The diagnoses that accounted for the greatest number of inpatient days were burns (18.8%), osteomyelitis (15.4%), fractures (12.7%), soft tissue injuries (3.9%), and head injuries (3.4%). Gambian children were rarely admitted for appendicitis and never admitted for hypertrophic pyloric stenosis. The leading causes of surgical deaths were burns, congenital anomalies, and injuries other than burns. DISCUSSION: Prevention of childhood injuries and better trauma management, especially at the primary and secondary health care levels, should be the priorities for improving paediatric surgical care in sub-Saharan Africa. Surgical care of children should be considered an essential component of child health programmes in developing countries. (+info)
The soluble interleukin 6 receptor: mechanisms of production and implications in disease.
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Interleukin 6 (IL-6) performs a prominent role during disease and has been described as both a pro- and anti-inflammatory cytokine. A key feature in the regulation of IL-6 responses has been the identification of a soluble interleukin 6 receptor (sIL-6R), which forms a ligand-receptor complex with IL-6 that is capable of stimulating a variety of cellular responses including proliferation, differentiation and activation of inflammatory processes. Elevated sIL-6R levels have been documented in numerous clinical conditions indicating that its production is coordinated as part of a disease response. Thus, sIL-6R has the potential to regulate both local and systemic IL-6-mediated events. This review will outline the central role of sIL-6R in the coordination of IL-6 responses. Details relating to the mechanisms of sIL-6R production will be provided, while the potential significance of sIL-6R during the development of clinical conditions will be emphasized. We want to convey, therefore, that when thinking about the inflammatory capability of IL-6, it is essential to consider not only the action of IL-6 itself, but also the effect sIL-6R may have on cellular processes. (+info)
Who is at risk for influenza? Using criteria other than age.
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PURPOSE: Colorado Access is a safety-net managed care organization that serves the medical and behavioral needs of the medically underserved. Because 75 percent of our population is children, we have had difficulty defining criteria to determine who is at risk for influenza and thus should receive an annual influenza vaccination. Our objective was to create a comprehensive list of diagnostic codes to be used to identify these high-risk individuals, using criteria other than age. METHODOLOGY: A task force of medical experts familiar with diseases and chronic conditions associated with influenza and pneumonia convened to determine criteria other than age that can be used to identify populations recommended to receive an annual influenza vaccination. The task force used previously published criteria, compared them to the Advisory Committee on Immunization Practices (ACIP) recommendations, and developed a single, comprehensive diagnostic-criteria list that correlates with the ACIP recommendations, defined by ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification, Fifth Edition) codes, to identify populations recommended to receive an annual influenza vaccination. PRINCIPAL FINDINGS: A comprehensive list of ICD-9 codes that indicate diagnostic criteria to be used to define populations at risk for influenza according to the ACIP recommendation was developed. CONCLUSION: Colorado Access found that having criteria to target groups recommended to receive an annual influenza vaccine facilitates the planning of preventive health programs. These criteria may be beneficial to other health plans and agencies that promote flu vaccination. (+info)
Identifying proper names in parallel medical terminologies.
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We propose several criteria to identify proper names in biomedical terminologies. Traditional, pattern-based methods that rely on the immediate context of a proper name are not applicable. However, the availability of translations of some terminologies supports methods based on invariant words instead. A combination of five criteria achieved 86% precision and 88% recall on the 16,401 word forms of the International Classification of Diseases. (+info)
Comparison of the inpatients admitted during the recent 5 years (January 1994-December 1998) with those admitted during the previous 5 years (January 1989-December 1993): a clinico-statistical study.
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As society ages, the composition of the diseases that occur within it changes accordingly. With that in mind, we examined the characteristics and trends in the recent inpatients and compared these recent inpatients with those of a previous report to identify the changes that accompany the aging of society. Subjects were 1,534 cases (men 56.9%, female 43.1%, average age 47.1 years) who were hospitalized at Kurume University Hospital for treatment during the 5-year period from January 1st, 1994 through December 31st, 1998. The ratio of inpatients over 65 years old was about 1.8 times higher than in the previous study, showing a clear trend toward an increased overall age of inpatients. As for the types of disease observed, the most common malignancies were epithelial tumor, followed by other benign tumors, as well as 76 cases which included diseases resembling tumor (epulis and exostosis etc.). A majority of the patients (55.6%) were directed to the Hospital by their dentist, a finding similar to that of the previous report. As for geographical distribution, 93.3% of the inpatients lived within 40 km of the center of Kurume City where our oral surgery is located, an increase of about 10% from the last report. In other words, our results showed a reduction in the sphere of treatment distribution. (+info)
Predictive power of a risk-assessment questionnaire across different disease states: results in an elderly managed care enrolled population.
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OBJECTIVE: To examine the predictive power of self-reported assessment questionnaire data to explain changes in healthcare service utilization and expenditures of a population of Medicare health maintenance organization enrollees during a 2-year period. STUDY DESIGN: A prospective cohort study with a 2-year postenrollment follow-up period. Multiple robust regression analyses were conducted to examine associations among self-reported health status variables obtained from responses to the questionnaire. SAMPLE AND METHODS: Participants were administered a voluntary comprehensive questionnaire at enrollment that collected self-reported information on morbidity, health status, perceptions of health, and healthcare service utilization during the preenrollment year. Questionnaire responses were combined with actual 2-year postenrollment claims data. For the complete follow-up period, 4128 patients were available. RESULTS: Participants with such chronic conditions as depression and diabetes were likelier than the average enrollee to have higher healthcare service utilization. Self-reported health status predictors examined in this study explained a larger percentage of the variance (as much as 20%) in such chronic conditions as cancer and depression. Despite evidence of underreporting of preenrollment healthcare service utilization, these variables were highly predictive of actual postenrollment utilization patterns. CONCLUSIONS: Self-reported health status information collected at baseline is as predictive of postenrollment risk as are currently used traditional approaches that require archival healthcare service utilization data. In addition, this approach is sensitive to changes in healthcare service utilization across differing morbidity states in older adults. (+info)