Clinics and Practice

9 pages, 256 KiB

Open AccessReview

Colorectal Cancer Liver Metastases: Is an R1 Hepatic Resection Accepted?

by Dimitrios Symeonidis, Konstantinos Tepetes, George Tzovaras, Labrini Kissa, Athina A. Samara, Effrosyni Bompou and Dimitrios Zacharoulis

Clin. Pract. 2022, 12(6), 1102-1110; https://doi.org/10.3390/clinpract12060112 - 19 Dec 2022

Cited by 2 | Viewed by 2173

Abstract

Metastatic colorectal cancer is associated with a rather dismal 5-year overall survival. The liver is the most commonly affected organ. Improved 5-year survival rates after successful hepatic resections for metastases confined to the liver have been reported. Certainly, a hepatectomy that results in [...] Read more.

Metastatic colorectal cancer is associated with a rather dismal 5-year overall survival. The liver is the most commonly affected organ. Improved 5-year survival rates after successful hepatic resections for metastases confined to the liver have been reported. Certainly, a hepatectomy that results in an incomplete tumor resection, in terms of leaving macroscopic residual tumor in the future liver remnant, is not associated with survival benefits. However, the prognostic implications of a microscopically positive surgical margin or a clear margin of less than 1 mm (R1) on pathology are debatable. Although it has been a field of extensive research, the relevant literature often reports contradictory results. The purpose of the present study was to define, assess the risk factors for, and, ultimately, analyze the effect that an R1 hepatic resection for colorectal cancer liver metastases might have on local recurrence rates and long-term prognosis by reviewing the relevant literature. Achieving an R0 hepatic resection, optimally with more than 1 mm of clear margin, should always be the goal. However, in the era of the aggressive multimodality treatment of liver metastatic colorectal cancer, an R1 resection might be the cost of increasing the pool of patients finally eligible for resection. The majority of literature reports have highlighted the detrimental effect of R1 resections on local recurrence and overall survival. However, there are indeed studies that degraded the prognostic handicap as a consequence of an R1 resection in selected patients and highlighted the presence of RAS mutations, the response to chemotherapy, and, in general, factors that reflect the biology of the disease as important, if not the determinant, prognostic factors. In these patients, the aggressive disease biology seems to outperform the resection margin status as a prognostic factor, and the recorded differences between R1 and R0 resections are equalized. Properly and accurately defining this patient group is a future challenge in the field of the surgical treatment of colorectal cancer liver metastases. Full article

10 pages, 1048 KiB

Open AccessArticle

Real-Time Muscle Activity and Joint Range of Motion Monitor to Improve Shoulder Pain Rehabilitation in Wheelchair Basketball Players: A Non-Randomized Clinical Study

by Giacomo Farì, Marisa Megna, Pietro Fiore, Maurizio Ranieri, Riccardo Marvulli, Valerio Bonavolontà, Francesco Paolo Bianchi, Filomena Puntillo, Giustino Varrassi and Victor Machado Reis

Clin. Pract. 2022, 12(6), 1092-1101; https://doi.org/10.3390/clinpract12060111 - 16 Dec 2022

Cited by 6 | Viewed by 2408

Abstract

Wheelchair basketball (WB) involves sports gestures that expose the shoulder to high biomechanical stress and frequently lead to shoulder pain (SP). Due to their physical peculiarities and sporting performance, these athletes require specific rehabilitation programs that are as fast, personalized and effective as [...] Read more.

Wheelchair basketball (WB) involves sports gestures that expose the shoulder to high biomechanical stress and frequently lead to shoulder pain (SP). Due to their physical peculiarities and sporting performance, these athletes require specific rehabilitation programs that are as fast, personalized and effective as possible. However, there are few studies specifically dedicated to these purposes. Surface electromyography (sEMG) seems a promising tool for better customization and achieving more targeted rehabilitation results. The aim of this study was to evaluate the usefulness of sEMG to monitor SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled in this non-randomized clinical study and divided into two groups. Both groups underwent a shoulder rehabilitation protocol, but only the experimental group was monitored in real time with sEMG on the shoulders. At enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), the following outcome measures were collected: Wheelchair User’s Shoulder Pain Index (WUSPI), 20 m straight line test, shoulder abduction range of motion (ROM). There was a statistically significant difference for WUSPI and ROM scores in the comparison between groups (p < 0.001), and for all outcomes in the comparison between times and in the interaction between time and group (p < 0.001). Therefore, the experimental group showed a better improvement at all detection times compared to the control group. sEMG seems a useful tool for improving the monitoring of SP rehabilitation outcomes in WB players. This monitoring speeds up and improves the rehabilitative results, limiting the risk of sport abandonment and increasing the possibility for people with disabilities to quickly return to practice physical activity. Full article

(This article belongs to the Special Issue 2022 Feature Papers in Clinics and Practice)

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14 pages, 3738 KiB

Open AccessCommunication

VACS: VAccination disComfort Scale

by Manolis Wallace, Stavros Antonopoulos and Vassilis Poulopoulos

Clin. Pract. 2022, 12(6), 1078-1091; https://doi.org/10.3390/clinpract12060110 - 15 Dec 2022

Cited by 1 | Viewed by 1782

Abstract

The vaccination of children is a crucial tool to protect both individuals and the world in general from various diseases and pathogens. Unfortunately, the vaccination procedure is not a pleasant one for all children, with many experiencing various levels of discomfort, sometimes reaching [...] Read more.

The vaccination of children is a crucial tool to protect both individuals and the world in general from various diseases and pathogens. Unfortunately, the vaccination procedure is not a pleasant one for all children, with many experiencing various levels of discomfort, sometimes reaching intolerable levels. In the first part of this work, we develop VACS, a tool that measures the discomfort children experience during vaccination. VACS takes into consideration the complete timeline of the vaccination experience from the perspective of the child, starting from the moment the child enters the doctor’s office through to their departure, and also the complete range of manifestations of discomfort, ranging from moaning and crying to facial expressions and posture. Their discomfort is quantified as a number from 0 to 25, with zero corresponding to a smooth vaccination and 25 to maximal/unbearable discomfort. In the second part of the work, we apply VACS to 40 vaccinations of children aged 2 to 12. Our findings show that approximately 40% of the children do not face discomfort during vaccination, but for the rest discomfort of varying degrees is observed. We also find that doctors are content with their patients facing considerably higher discomfort levels than what the children themselves are willing to withstand: doctors are content with VACS values up to 19 whilst children start to suffer when the VACS value exceeds 11. Surprisingly, characteristics such as (a) gender, (b) whether the state’s recommended vaccination program has been implemented in full, and even (c) prior negative vaccination experiences are found to be poor predictors of vaccination discomfort. Age on the other hand may be a factor, with younger children experiencing discomfort more often and more intensely; more research is required in order to validate this with higher confidence. The formulation of VACS opens the door for more systematic work towards the mitigation of vaccination discomfort for children. Full article

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9 pages, 1094 KiB

Open AccessCase Report

Portal Vein Thrombosis after C-Section in a Patient with Polycythemia Vera (PV) Due to Pregnancy and Iron Deficiency Anemia (IDA)

by Thomas Ntounis, Konstantinos A. Zioutos, Antonios Koutras, Ioannis Prokopakis, Zacharias Fasoulakis, Ioakeim Sapantzoglou, Paraskevas Perros, Athina A. Samara, Emmanouil Spanoudakis, Asimina Valsamaki, Sevasti-Effraimia Krouskou, Konstantinos Nikolettos, Vasileios-Chrysovalantis Palios, Paschalis Mousios, Kallirroi Goula, Kyriakos Konis, Athanasios Chionis and Emmanuel N. Kontomanolis

Clin. Pract. 2022, 12(6), 1069-1077; https://doi.org/10.3390/clinpract12060109 - 14 Dec 2022

Viewed by 2371

Abstract

Polycythemia vera (PV) is one of the three main classic disorders of Philadelphia-negative myeloproliferative neoplasms (MPNs), with the other two being essential thrombocythemia (ET) and primary myelofibrosis (PMF). PV may develop (15%) in women of childbearing age (15–45 years), with an anticipated rate [...] Read more.

Polycythemia vera (PV) is one of the three main classic disorders of Philadelphia-negative myeloproliferative neoplasms (MPNs), with the other two being essential thrombocythemia (ET) and primary myelofibrosis (PMF). PV may develop (15%) in women of childbearing age (15–45 years), with an anticipated rate of roughly 0.3 per 100,000 people, although maintaining a male to female ratio predominance of about 2:1 and a peak prevalence in the sixth and seventh decades of life. Without always being presented with its actual clinical manifestations due to pregnancy itself, and most commonly due to iron deficiency, PV can be frequently missed and therefore belatedly diagnosed. We describe the case of a primipara woman in her 40s, without risk factors for thrombosis, who developed a portal vein occlusion 1.5 month postpartum after C-section and who had a delayed diagnosis of PV. Full article

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15 pages, 2288 KiB

Open AccessArticle

Implications of Cellular Immaturity in Necrosis and Microvascularization in Glioblastomas IDH-Wild-Type

by Cristian Ionut Orasanu, Mariana Aschie, Mariana Deacu, Madalina Bosoteanu, Sorin Vamesu, Manuela Enciu, Gabriela Izabela Bălţătescu, Georgeta Camelia Cozaru, Anca Florentina Mitroi and Raluca Ioana Voda

Clin. Pract. 2022, 12(6), 1054-1068; https://doi.org/10.3390/clinpract12060108 - 13 Dec 2022

Cited by 2 | Viewed by 1474

Abstract

Necrosis and increased microvascular density in glioblastoma IDH-wild-type are the consequence of both hypoxia and cellular immaturity. Our study aimed to identify the main clinical-imaging and morphogenetic risk factors associated with tumor necrosis and microvascular in the prognosis of patient survival. We performed [...] Read more.

Necrosis and increased microvascular density in glioblastoma IDH-wild-type are the consequence of both hypoxia and cellular immaturity. Our study aimed to identify the main clinical-imaging and morphogenetic risk factors associated with tumor necrosis and microvascular in the prognosis of patient survival. We performed a retrospective study (10 years) in which we identified 39 cases. We used IDH1, Ki-67 and Nestin immunomarkers, as well as CDKN2A by FISH. The data were analyzed using SPSS Statistics. The clinical characterization identified only age over 50 years as a risk factor (HR = 3.127). The presence of the tumor residue, as well as the absence of any therapeutic element from the trimodal treatment, were predictive factors of mortality (HR = 1.024, respectively HR = 7.460). Cellular immaturity quantified by Nestin was associated with reduced overall survival (p = 0.007). Increased microvascular density was associated with an increased proliferative index (p = 0.009) as well as alterations of the CDKN2A gene (p < 0.001). CDKN2A deletions and cellular immaturity were associated with an increased percentage of necrosis (p < 0.001, respectively, p = 0.017). The main risk factors involved in the unfavorable prognosis are moderate and increased Nestin immunointensity, as well as the association of increased microvascular density with age over 50 years. Necrosis was not a risk factor. Full article

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11 pages, 1337 KiB

Open AccessArticle

Accuracy of Three Types of Apex Locators versus Digital Periapical Radiography for Working Length Determination in Maxillary Premolars: An In Vitro Study

by Masoumeh Ramezani, Marjan Bolbolian, Mohaddeseh Aliakbari, Ahad Alizadeh, Maryam Tofangchiha, Seyed Mohammad Faegh, Romeo Patini and Giuseppe D’Amato

Clin. Pract. 2022, 12(6), 1043-1053; https://doi.org/10.3390/clinpract12060107 - 12 Dec 2022

Cited by 1 | Viewed by 3448

Abstract

This study aimed to compare the accuracy of three types of apex locators versus digital radiography for working length (WL) determination. This experimental study was conducted on 58 extracted maxillary premolars. The teeth were decoronated, the access cavity was prepared, and WL was [...] Read more.

This study aimed to compare the accuracy of three types of apex locators versus digital radiography for working length (WL) determination. This experimental study was conducted on 58 extracted maxillary premolars. The teeth were decoronated, the access cavity was prepared, and WL was determined using a #15 K-file to serve as reference. The WL was then measured by Woodpex V, Woodpex III, and Root ZX apex locators in the presence of 0.9% saline, and also on a photostimulable phosphor plate (PSP) digital radiograph taken by the parallel technique. The values were compared with the actual WL using the paired t-test (alpha = 0.05). Digital radiography, Root ZX, Woodpex V, and Woodpex III determined the WL within ±0.5 mm from the actual value in 84.48%, 100%, 89.66%, and 87.93% of the cases, respectively. Woodpex V (p = 0.039), Woodpex III (p = 0.001), and Root ZX (p = 0.001) significantly over-estimated the WL. The WL measured on digital radiographs was not significantly different from the actual WL (p = 0.213). The position of the apical foramen (central/lateral) had no significant effect on the accuracy of WL determination by different techniques (p >0.05). Within the limitations of this in vitro study, all the tested modalities showed acceptable accuracy for WL determination in maxillary premolars. Full article

(This article belongs to the Special Issue New Developments in Endodontic Treatments)

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9 pages, 216 KiB

Open AccessArticle

The Missing Quality of Tuberculosis Care and Treatment Delivered in Public-Health Facilities, Northeast Ethiopia: A Cross-Sectional Study

by Asrat Agalu Abejew, Hussen Abdu, Yimer Seid and Agumas Shibabaw

Clin. Pract. 2022, 12(6), 1034-1042; https://doi.org/10.3390/clinpract12060106 - 12 Dec 2022

Cited by 1 | Viewed by 1584

Abstract

Tuberculosis (TB) remains a major global public-health problem. TB prevention and control measures are compromised by poor quality of care delivered to TB patients in health facilities during diagnosis, treatment, and follow-up; thus, this study was intended to determine the quality of TB [...] Read more.

Tuberculosis (TB) remains a major global public-health problem. TB prevention and control measures are compromised by poor quality of care delivered to TB patients in health facilities during diagnosis, treatment, and follow-up; thus, this study was intended to determine the quality of TB care and treatment delivered in public-health facilities in Northeast Ethiopia. A cross-sectional study was conducted in health facilities in South Wollo zone from January to April 2018. Data were collected from each study participant through face-to-face interviews. A TB registration logbook was reviewed for every registered TB patient and compiled using a structured questionnaire and standard checklists. The quality of care for each health facility was graded as very good, good, marginal, poor, and very poor if health facilities achieved [90–100%], [80–90%), [70–80%), [60–70%), and <60% of performance indicators, respectively, using the Donabedian structure, process, and outcome model of healthcare quality. All the health facilities had at least one functional microscope, and all the facilities had sufficient TB drugs almost all the time. All the facilities had reported to have sufficient laboratory reagents and slides for sputum smear microscopy. Of 1579 patients registered, 18.5% and 66.1% were cured and successfully completed the course of treatment, respectively. The overall quality of TB care and treatment was good (72.5%), and ranged from 70.9% to 74.8% among health facilities. Outcome (83.4%) and process (80%) qualities of care were very good but the structural quality of care was very poor. In conclusion, the overall quality of TB care and treatment analysed in this study was found to be good. There should be an integrated approach to improve the quality of TB care and treatment in health facilities in Ethiopia. Based on the findings, continuous supply of anti-TB drugs, laboratory equipment and reagents, availing current guidelines, providing up to-date training for healthcare workers, and proper documentation are important to improve the quality of care delivered to TB patients. Full article

14 pages, 12474 KiB

Open AccessEditor’s ChoiceCase Report

Disappearance of Plaque Following Treatment with Antioxidants in Peyronie’s Disease Patients—A Report of 3 Cases

by Gianni Paulis and Giovanni De Giorgio

Clin. Pract. 2022, 12(6), 1020-1033; https://doi.org/10.3390/clinpract12060105 - 09 Dec 2022

Cited by 1 | Viewed by 7578

Abstract

Peyronie’s disease (PD) is a fibrotic disorder of the penile tunica albuginea. To date, only a few cases of recovery from PD following medical treatment have been reported in the literature. In this article, we describe three new cases of PD where patients [...] Read more.

Peyronie’s disease (PD) is a fibrotic disorder of the penile tunica albuginea. To date, only a few cases of recovery from PD following medical treatment have been reported in the literature. In this article, we describe three new cases of PD where patients achieved complete resorption of plaque following multimodal antioxidant treatment. In all three cases, treatment included the following antioxidants: bilberry, propolis, ginkgo biloba, silymarin, and vitamin E. Only in case nos. 1 and 2 did we also use the following antioxidant substances: L-carnitine, coenzyme Q10, and Boswellia. In all three cases, we also used a local therapy with diclofenac gel. Only in case no. 2 did we also use periodic perilesional injections with pentoxifylline. Although the sample of cases presented here was small, these patients incontrovertibly experienced complete plaque disappearance and recovery (in one case, only after a short course of treatment). Therefore, it is our conviction that urologists may find our experiences of considerable interest in their clinical practices. Full article

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11 pages, 663 KiB

Open AccessArticle

The Antimicrobial and Anti-Biofilm Effects of Hypericum perforatum Oil on Common Pathogens of Periodontitis: An In Vitro Study

by Reza Bagheri, Sepideh Bohlouli, Solmaz Maleki Dizaj, Shahriar Shahi, Mohammad Yousef Memar and Sara Salatin

Clin. Pract. 2022, 12(6), 1009-1019; https://doi.org/10.3390/clinpract12060104 - 06 Dec 2022

Cited by 6 | Viewed by 1704

Abstract

The antibacterial and anti-biofilm effects of Hypericum perforatum oil against the common pathogens of periodontitis (Escherichia coli, Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, Porphyromonas gingivalis) was investigated. Disk diffusion (DD), minimum inhibitory concentration (MIC), and minimum bactericidal [...] Read more.

The antibacterial and anti-biofilm effects of Hypericum perforatum oil against the common pathogens of periodontitis (Escherichia coli, Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, Porphyromonas gingivalis) was investigated. Disk diffusion (DD), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) approaches were applied to test the antimicrobial effects. In order to determine the anti-biofilm effects, the amount of bacterial biofilm formation was assessed using the microtiter plate technique. The anti-biofilm effects were then confirmed by determining the minimum biofilm inhibitor concentration (MBIC). The MIC, MBC, MBIC, and DD values were 64, 256, 512 μg/mL, and 14 mm for Staphylococcus aureus; 128, 256, 512 μg/mL, and 16 mm for Streptococcus mutans; 256, 512, 256 μg/mL, and 20 mm for Escherichia coli; 32, 128, 512 µg/mL, and 16 mm for Enterococcus faecalis; and 64, 128, 256 µg/mL, and 15 mm for Porphyromonas gingivalis, respectively. According to our results, Hypericum perforatum oil has antibacterial and anti-biofilm properties against the common bacteria associated with periodontitis. Full article

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8 pages, 767 KiB

Open AccessArticle

Estimation of Serum Calcium on the Severity and Mortality in COVID-19 Infections in Sulaymaniyah City, Kurdistan Region of Iraq: A Cross-Sectional Study

by Jihad M. Hadi, Shkar M. J. Hassan, Mudhafar M. M. Saeed, Bilal K. Hussein, Banwan M. Ali, Lava E. Muhamad, Ardalan J. Abdullah, Nzar N. Ali, Hawre A. Rahman, Hassan Q. Sofihussein and Jeza M. Abdul Aziz

Clin. Pract. 2022, 12(6), 1001-1008; https://doi.org/10.3390/clinpract12060103 - 29 Nov 2022

Cited by 3 | Viewed by 1903

Abstract

Background: Coronaviruses (COV) are a large family of viruses that cause infections ranging from the common cold to more serious diseases. Mild to severe respiratory illnesses have been linked to coronavirus disease 2019 (COVID-19), which has been classified as a pandemic disease by [...] Read more.

Background: Coronaviruses (COV) are a large family of viruses that cause infections ranging from the common cold to more serious diseases. Mild to severe respiratory illnesses have been linked to coronavirus disease 2019 (COVID-19), which has been classified as a pandemic disease by the World Health Organization. It has been demonstrated that the severity of COVID-19 is highly positively linked with hypocalcemia. Furthermore, calcium imbalances among other electrolytes are linked to the prognosis of COVID-19. Objectives: This study demonstrates a connection between serum calcium levels and COVID-19 as biomedical indicators of COVID-19 infections in Sulaymaniyah city, Iraq. Methods: A cross-sectional study was conducted at Baxshin Hospital for about two months from February 2022 to April 2022. The work was conducted with a total of 40 patients including 22 males and 18 females. The patients’ ages ranged from 22 to 80 years old. By analyzing a sample from a nasopharyngeal swab and performing real-time reverse transcription-polymerase chain reaction (RT-PCR), all of the patients tested positive as having COVID-19 infection. Serum calcium was determined from the blood samples of the patients in order to evaluate their serum calcium levels. The statistical package for social science (SPSS) was utilized to examine the obtained data. Results: The study revealed a level of calcium between 6.10 and 9.86 mg/dL in male and female patients. The majority of the female patients (61%) displayed low levels of serum calcium, and 33% of the males had a low level of calcium. It can be seen that the highest rate of male patients (66.6%) exhibited a normal level of serum calcium, while 33.3% showed decreased serum calcium. Based on gender and age groups, a statistically significant difference in calcium levels was observed. Conclusions: This study discovered that infection with COVID-19 has some significant laboratory abnormalities, including hypocalcemia, showing that serum calcium might be employed as a prognostic marker in the clinic. Full article

(This article belongs to the Special Issue 2022 Feature Papers in Clinics and Practice)

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15 pages, 5844 KiB

Open AccessArticle

Clinical Decision-Making in Practice with New Critical Care Ultrasound Methods for Assessing Respiratory Function and Haemodynamics in Critically Ill Patients

by Stefan Schmidt, Jana-Katharina Dieks, Michael Quintel and Onnen Moerer

Clin. Pract. 2022, 12(6), 986-1000; https://doi.org/10.3390/clinpract12060102 - 25 Nov 2022

Cited by 1 | Viewed by 1906

Abstract

Situations often arise in intensive care units (ICUs) for which only sparse primary evidence or guidelines are applicable or to which existing evidence cannot be applied owing to interactions of multiple disease states. To improve and guide intensive care management in complex scenarios, [...] Read more.

Situations often arise in intensive care units (ICUs) for which only sparse primary evidence or guidelines are applicable or to which existing evidence cannot be applied owing to interactions of multiple disease states. To improve and guide intensive care management in complex scenarios, ultrasonography and echocardiography are invaluable. In five clinical scenarios involving acute deterioration, serial ultrasound examinations of the respiratory system, general critical care ultrasound (GCCUS), and non-invasive haemodynamic critical care echocardiography (CCE) were used routinely. Ultrasonographic results were used to guide further management and initiate experimental therapy or transition from curative to supportive care. The process of initiation of ultrasound examinations to clinical decision-making in these complex scenarios is outlined. These case vignettes highlight the utility of ultrasound and echocardiography. When clinical management is not clear, or evidence is not available, the use of ultrasound for the evaluation of the respiratory system, GCCUS, and non-invasive haemodynamic CCE can help to guide management, reveal newly developed pathologies, lead to clinical management changes, and support the decision for employing experimental therapy approaches in a dynamic way of which few other imaging modalities or monitoring tools are currently capable. Full article

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31 pages, 3941 KiB

Open AccessReview

The State of Cancer Care in the United Arab Emirates in 2022

by Humaid O. Al-Shamsi

Clin. Pract. 2022, 12(6), 955-985; https://doi.org/10.3390/clinpract12060101 - 23 Nov 2022

Cited by 5 | Viewed by 14718

Abstract

Cancer is the third-leading cause of death in the United Arab Emirates (UAE); cancer care in the UAE has evolved dramatically over the last 40 years, from a single center in Al Ain in 1981 to more than 30 cancer centers and clinics [...] Read more.

Cancer is the third-leading cause of death in the United Arab Emirates (UAE); cancer care in the UAE has evolved dramatically over the last 40 years, from a single center in Al Ain in 1981 to more than 30 cancer centers and clinics across the UAE, with at least four comprehensive cancer centers in the UAE nowadays. Despite the significant progress in medical care, cancer quality control across the UAE is still lacking, with significant variations in cancer care across the cancer centers. Access to clinical trials is still hampered by a lack of expertise and research infrastructure and a small population, which renders patient accrual for trials a major challenge. Education and training are other areas for improvement that require immediate attention, and, in this review, we try to address these critical aspects for stakeholders to consider better cancer care in the UAE. Early cancer detection and screening are still evolving in the UAE, and a national screening program is lacking. There is also a need to address barriers to screening and to consider less invasive screening methods such as approved blood-based screening, which is likely to be more acceptable to the UAE population. In this review, we also address new topics that have not been addressed previously, including oncology medical tourism, psycho-oncology, onco-fertility, precision oncology, survivorship, oncology nursing, cancer support programs, and the oncology sector’s response to the COVID-19 pandemic, all in the context of the UAE cancer landscape. Finally, we provide recommendations for policymakers, regulators, payers, patient advocacy groups, and the UAE oncology community regarding the delivery and future planning of high-quality cancer care. These recommendations are aligned with the UAE government’s vision to reduce cancer mortality and provide high-quality healthcare for its citizens and residents. Full article

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5 pages, 471 KiB

Open AccessBrief Report

Assessment of Nutritional Risk at ICU Admission and Mortality in Patients with Suspected COVID-19

by Gustavo D. Pimentel, Claude Pichard, Paula M. Martins and Emanoelly P. Franco

Clin. Pract. 2022, 12(6), 950-954; https://doi.org/10.3390/clinpract12060100 - 23 Nov 2022

Cited by 1 | Viewed by 1536

Abstract

Background/Objectives: The association between the nutritional risk and mortality in Brazilians with COVID-19 is poorly documented. Therefore, this study, for the first time, aimed at investigating the length of stay in the ICU and the chance of dying in patients with suspected COVID-19, [...] Read more.

Background/Objectives: The association between the nutritional risk and mortality in Brazilians with COVID-19 is poorly documented. Therefore, this study, for the first time, aimed at investigating the length of stay in the ICU and the chance of dying in patients with suspected COVID-19, without and with nutritional risk. Subjects/Methods: This retrospective monocentric study enrolled adult, COVID-19-positive patients that were admitted to the ICU at a university hospital. Biochemical analysis and clinical data were collected from medical records and the nutritional risk was assessed according to the Modified-Nutrition Risk in the Critically Ill (mNUTRIC) score. The Cox model was used to assess the chance of mortality in the patients with and without nutritional risk. Results: Out of 71 patients, 63.3% were male and 52% were older (≥60 years). Although no differences were found between groups for the length of stay in ICU, C-reactive protein, alanine aminotransferase and aspartate aminotransferase concentrations, the mNUTRIC ≥ 5 group had higher D-dimer than the mNUTRIC < 5 group. Regarding ICU mortality, most patients (69.5%) in the mNUTRI ≥ 5 group died while in the mNUTRIC < 5 group 33.3% died (p = 0.0001). In addition, patients with mNUTRIC ≥ 5 had (HR: 2.04 [95% CI: 1.02–4.09], p = 0.04) a more likely chance of dying than patients in the mNUTRIC < 5 group, even that adjusted by BMI and D-dimer concentrations (HR: 2.18 [95% CI: 1.04–4.56], p = 0.03). Conclusion: In patients with COVID-19, an mNUTRIC ≥ 5 score at admission leads to a more likely chance of death even after controlling for confounding variables. Full article

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8 pages, 650 KiB

Open AccessArticle

Assessment of Tissue Adequacy by EBUS in Conjunction with PET Scan and Operator’s Experience

by Nagla Abdel Karim, Asad Ullah, Steven Pulliam, Ahmed Mostafa, Alejandro Aragaki, Audrey Eubanks, Amit Mahajan, Mahmoud Shehata and Sadia Benzaquen

Clin. Pract. 2022, 12(6), 942-949; https://doi.org/10.3390/clinpract12060099 - 20 Nov 2022

Cited by 2 | Viewed by 1389

Abstract

Mediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is quick, accurate, [...] Read more.

Mediastinal lymph node assessment is a crucial step in non-small cell lung cancer staging. Positron emission tomography (PET) has been the gold standard for the assessment of mediastinal lymphadenopathy, though it has limited specificity. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is quick, accurate, and a less invasive method for obtaining a diagnostic sample in contrast to mediastinoscopy. We performed a retrospective chart analysis of 171 patients to assess the adequacy of tissue obtained by EBUS for diagnosis and molecular profiling as well as the assessment of staging and lymph node (LN) stations diagnostic yield, in correlation to PET scan and the operator’s level of experience. A significantly increased tissue adequacy was observed based on the operators’ experience, with the highest adequacy noted in trained Interventional Pulmonologist (IP) (100%), followed by >5 years of experience (93.33%), and 88.89% adequacy with <5 years of experience (p = 0.0019). PET-CT scan ¹⁸F-fluorodeoxyglucose (FDG) uptake in levels 1, 2, and 3 LN had a tissue adequacy of 76.67%, 54.64%, and 35.56%, respectively (p = 0.0009). EBUS bronchoscopy method could be used to achieve an accurate diagnosis, with IP-trained operators yielding the best results. There is no correlation with PET scan positivity, indicating that both PET and EBUS are complementary methods needed for staging. Full article

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3 pages, 390 KiB

Open AccessEditorial

Clinics and Practice: A Rapidly Developing Journal

by Giustino Varrassi

Clin. Pract. 2022, 12(6), 939-941; https://doi.org/10.3390/clinpract12060098 - 18 Nov 2022

Cited by 1 | Viewed by 1689

Abstract

Recently, MDPI has acquired a new journal, Clinics and Practice, and started its development [...] Full article

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13 pages, 1314 KiB

Open AccessArticle

Dextrose Prolotherapy for Symptomatic Grade IV Knee Osteoarthritis: A Pilot Study of Early and Longer-Term Analgesia and Pain-Specific Cytokine Concentrations

by Gastón Andrés Topol, Ines Guerrero Pestalardo, Kenneth Dean Reeves, Fernando Elias, Neven J. Steinmetz, An-Lin Cheng and David Rabago

Clin. Pract. 2022, 12(6), 926-938; https://doi.org/10.3390/clinpract12060097 - 14 Nov 2022

Cited by 3 | Viewed by 2660

Abstract

Background: Neurocytokines may upregulate or downregulate neuropathic pain. We hypothesized that dextrose (D-glucose) injections for therapeutic purposes (dextrose prolotherapy: DPT) in painful knee osteoarthritis (KOA) would favorably affect synovial-fluid neurocytokine concentrations. Methods: Twenty participants with grade IV symptomatic KOA received synovial-fluid aspiration followed [...] Read more.

Background: Neurocytokines may upregulate or downregulate neuropathic pain. We hypothesized that dextrose (D-glucose) injections for therapeutic purposes (dextrose prolotherapy: DPT) in painful knee osteoarthritis (KOA) would favorably affect synovial-fluid neurocytokine concentrations. Methods: Twenty participants with grade IV symptomatic KOA received synovial-fluid aspiration followed by dextrose or simulated dextrose injections, followed by the reverse after one week. All participants then received open-label dextrose injections monthly for 6 months, with serial assessments of walking pain at 20 min for 9 months, as well as synovial-neurocytokine-concentration measurements (calcitonin gene-related peptide, substance P (SP), and neuropeptide Y (NPY)) at one week and three months. Results: Clinically important analgesia was observed at 20 min and for 9 months post dextrose injection. One -week synovial-fluid SP concentration rose by 111% (p = 0.028 within groups and p = 0.07 between groups) in the dextrose-injected knees compared to synovial-fluid aspiration only. Three-month synovial-fluid NPY concentration dropped substantially (65%; p < 0.001) after open-label dextrose injection in all knees. Conclusions: Prompt and medium-term analgesia after intra-articular dextrose injection in KOA was accompanied by potentially favorable changes in synovial-fluid neurocytokines SP and NPY, respectively, although these changes were isolated. Including neurocytokines in future assessments of DPT to elucidate mechanisms of action is recommended. Full article

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8 pages, 242 KiB

Open AccessReview

Current Understanding of “Mixed Corticomedullary Adrenal Tumor” and an Insight into Genomic Profiling

by Asad Ullah, Farah Ayman Elsaid Mohamed, Jaffar Khan, Katharine Tracy, Muhabat Khan, Samiha Mohsen, Abdul Qahar Khan Yasinzai, Kaleemullah Badini, Philip T. Sobash, Saleh Heneidi and Nagla Abdel Karim

Clin. Pract. 2022, 12(6), 918-925; https://doi.org/10.3390/clinpract12060096 - 11 Nov 2022

Viewed by 2142

Abstract

Background: Malignant mixed corticomedullary adrenal tumors (MCMTs) are extremely rare, with limited cases reported in the literature. The pathophysiology of malignant MCMTs is not well understood; the most prevailing theories are that it is a composite tumor of embryologically derived mesodermal (adrenal cortex) [...] Read more.

Background: Malignant mixed corticomedullary adrenal tumors (MCMTs) are extremely rare, with limited cases reported in the literature. The pathophysiology of malignant MCMTs is not well understood; the most prevailing theories are that it is a composite tumor of embryologically derived mesodermal (adrenal cortex) and neural crest (medulla) origin, perpetuating as two distinct cell lines forming a singular mass. Clinical features and laboratory diagnosis are associated with hypersecretions of the adrenal cortex and medulla. Surgical resection is curative in an isolated tumor. We reviewed and compared cases in the literature highlighting the pathogenesis and genetics of benign and malignant MCMT. Methods: Comprehensive literature analysis was conducted on PubMed and all the cases of mixed corticomedullary adrenal tumor published in English were included. Results: Most patients were female (73.1%) with a median age of 49 in women and 50 in men. Surgery was performed in all patients, and in four patients with malignant disease, chemotherapy was used as well. Clinically, most patients presented with hypertension (69%) followed by Cushing syndrome (42%) and diabetes (19%). Tumors often produced cortisol (74%), catecholamines (50%), and adrenocorticotrophic hormone (ACTH) (38%), with lower incidence of aldosterone- (7%) or dopamine (4%)-producing tumors. Immunohistochemical staining of 96% of cases showed Chromogranin-A (73%) and Synaptophysin (62%), followed by Inhibin-α (50%), Melan-A (31%), and S-100 (23%). Of the reported four cases with malignant disease, three showed a Ki-67 index of 40–50% with one showing less than 5%. Conclusion: Mixed corticomedullary adrenal tumors rarely present as a malignant disease requiring chemotherapy. Most MCMTs confer a good prognosis and respond well to surgical resection, though their pathogenesis is largely up to speculation because of limited data. Current theories regarding MCMT pathogenesis should be investigated further with genetic testing. Future research on MCMT may provide ways to guide physician diagnosis and subsequent treatment for refractory cases. Full article

10 pages, 245 KiB

Open AccessArticle

The Effects of Isotretinoin on The Menstrual Cycle: A Cross-Sectional Study

by Ghadah Alhetheli, Sadin Alhazmi, Shumukh Almutairi, Samar Alharbi, Norah Alharbi, Maha Alsweed, Mohammed Saleh Al-Dhubaibi, Jolan Alsaud and Lina Asiri

Clin. Pract. 2022, 12(6), 908-917; https://doi.org/10.3390/clinpract12060095 - 10 Nov 2022

Viewed by 9369

Abstract

Menstrual irregularities during isotretinoin therapy, including amenorrhea, can cause a great deal of health-status uncertainty such as the possibility of pregnancy. This study aimed to evaluate the effects of isotretinoin treatment on the menstrual cycle. This cross-sectional study was conducted among females aged [...] Read more.

Menstrual irregularities during isotretinoin therapy, including amenorrhea, can cause a great deal of health-status uncertainty such as the possibility of pregnancy. This study aimed to evaluate the effects of isotretinoin treatment on the menstrual cycle. This cross-sectional study was conducted among females aged between 15–45 years taking isotretinoin for acne. Descriptive statistics were used in the form of frequencies and percentages to represent categorical variables. Pearson’s chi-squared test was performed to assess the relationship between some of the variables with menstrual irregularities. A logistic regression model was performed to assess the risk factors for developing menstrual irregularities during isotretinoin therapy. Of participants with a known regular menstrual cycle, 10.4% were found to have irregularity in their cycle after starting the drug (p < 0.001). Amenorrhea was the most commonly reported menstrual irregularity in isotretinoin-treated females. Our results showed that single females, those who took isotretinoin for 10–12 months and who were concurrently taking hormonal contraceptives all have a statistically significant higher risk of developing menstrual irregularities than others. In conclusion, we found that a statistically significant number of participants with a regular menstrual cycle pre-isotretinoin intake developed irregularity in their cycle after starting the drug. The mechanism of how isotretinoin influences female hormonal imbalances, thereby affecting menstrual irregularities is still poorly understood and needs to be clarified in further clinical studies. Full article

(This article belongs to the Special Issue 2022 Feature Papers in Clinics and Practice)

11 pages, 4349 KiB

Open AccessArticle

Five-Year Retrospective Study of Uterine STUMP and Leiomyosarcoma

by Madalina Bosoteanu, Mariana Deacu, Raluca Ioana Voda, Cristian Ionut Orasanu, Mariana Aschie, Sabina Elena Vlad, Roxana Cleopatra Penciu and Sergiu Ioachim Chirila

Clin. Pract. 2022, 12(6), 897-907; https://doi.org/10.3390/clinpract12060094 - 10 Nov 2022

Cited by 1 | Viewed by 2057

Abstract

Taking into account the unpredictable evolution of uterine STUMP and leiomyosarcomas, there are no clearly established therapeutic protocols to date, the only certified treatment being total hysterectomy. We performed a 5-year retrospective study including cases of malignant tumors and those with uncertain malignant [...] Read more.

Taking into account the unpredictable evolution of uterine STUMP and leiomyosarcomas, there are no clearly established therapeutic protocols to date, the only certified treatment being total hysterectomy. We performed a 5-year retrospective study including cases of malignant tumors and those with uncertain malignant potential originating in the smooth muscle tissue of the uterine body. The clinical data, pathological aspects, and the immunohistochemical results were statistically analyzed using SPSS Statistics Version 26. The main associations of the p53 gene were identified with age, atypia, and the occurrence of metastases. The average number of CD8+ T cells correlated with the hormonal status of the patients, the presence of diabetes, and alteration of thyroid function, but also with the severity of the atypia. The therapeutic method was represented by total hysterectomy, and 30% of the patients with leiomyosarcoma also benefited from adjuvant chemotherapy. The average period until death was 25.66 months. The present study showed that the mutant expression of p53 could have a role in assessing the clinical evolution of patients, given the association with exitus and metastasis. In addition, the average number of CD8+ T cells corresponded to severe atypia, indicating the possibility of applying targeted immunotherapies in these cases. Full article

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12 pages, 738 KiB

Open AccessReview

Barriers and Facilitators to Conducting Oncology Clinical Trials in the UAE

by Humaid O. Al-Shamsi

Clin. Pract. 2022, 12(6), 885-896; https://doi.org/10.3390/clinpract12060093 - 07 Nov 2022

Cited by 1 | Viewed by 2699

Abstract

Cancer research and clinical trials are essential to improve cancer patients’ outcomes and advance the oncology field. The United Arab Emirates (UAE) has been lagging in cancer research with many barriers, including healthcare, institutional, regulatory, patient and community, the global oncology community, and [...] Read more.

Cancer research and clinical trials are essential to improve cancer patients’ outcomes and advance the oncology field. The United Arab Emirates (UAE) has been lagging in cancer research with many barriers, including healthcare, institutional, regulatory, patient and community, the global oncology community, and the pharmaceutical industry. In this report, we try to address these challenges from our perspective. Making clinical trials accessible for cancer patients in the UAE requires a collaborative approach from all stakeholders and serious consideration for the greater cause to improve the patient’s outcome and contribute to the advancement of the cancer field worldwide. There has been significant support from the UAE government and the regulators in the UAE to facilitate and encourage research in general and cancer research in particular with recent initiatives and international collaborations. Private and public institutions must overcome their competitive moods and work together to strengthen the research network across the UAE and improve accrual for potential clinical trials. Public awareness and education must overcome long-standing perceptions about research and clinical trials in the UAE. The pharmaceutical industry must work closely with institutions across the UAE and support them in establishing accredited research programs and clinical trial units. The Emirates Oncology Society is establishing the Oncology Research Working Group to advocate and advance cancer research in the UAE. All stakeholders must be engaged to successfully implement impactful clinical trials in the UAE and the region. Full article

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9 pages, 544 KiB

Open AccessArticle

Does the Saudi Population Have Sufficient Awareness of Vitiligo in Southwest Saudi Arabia? A Cross-Sectional Survey, 2022

by Fatmah Ahmed Keraryi, Alhanouf Adel Hadi Hakami, Nouf Adel Hadi Hakami, Mohamed Salih Mahfouz and Hadi Adel Hadi Hakami

Clin. Pract. 2022, 12(6), 876-884; https://doi.org/10.3390/clinpract12060092 - 04 Nov 2022

Cited by 1 | Viewed by 1889

Abstract

Background: Vitiligo is a common acquired hypopigmentation skin condition defined by an idiopathic, gradual, and restricted loss of melanin pigment from otherwise healthy-looking skin. The present study aims to evaluate the knowledge and perceptions of and attitudes toward vitiligo among the general population [...] Read more.

Background: Vitiligo is a common acquired hypopigmentation skin condition defined by an idiopathic, gradual, and restricted loss of melanin pigment from otherwise healthy-looking skin. The present study aims to evaluate the knowledge and perceptions of and attitudes toward vitiligo among the general population of Jazan Province, Saudi Arabia. Methods: An observational cross-sectional survey targeting adults of the Jazan region was conducted in 2022. The data were collected using an electronic questionnaire distributed through social media in the region. Statistical analysis was performed using the SPSS computer program. Knowledge and attitude scores were computed. Results: Most of the respondents (83.7%) had an adequate knowledge level of vitiligo, and almost half of the respondents (46.8%) had a positive attitude toward the disease. The majority of the respondents (84.5%) knew that vitiligo is not contagious. However, the majority of the participants (78.6%) did not know that vitiligo is an autoimmune disease. Most of the respondents (93.1%) do not avoid shaking hands with a vitiligo patient to prevent infection, accept food prepared by a vitiligo patient (69.4%), accept sharing a plate with a vitiligo patient (73.6%), and accept to be helped by a vitiligo patient (86.7%). However, about half of the participants (50.4%) refused to marry a person diagnosed with vitiligo. The knowledge of vitiligo in the study population was not correlated with any of the demographic characters, such as age, gender, education, or occupation (p > 0.05). The most important factors associated with good attitudes were male gender (COR = 1.92; 95% CI: 1.92–2.84; p = 0.001) and being aged over 50 years (COR = 3.06; 95% CI: 1.53–6.13; p = 0.002). Conclusions: The population in Jazan had a good level of knowledge of vitiligo and a positive attitude toward patients with vitiligo. Social media is the source of information for vitiligo for the majority of the study population. The good attitude toward patients with vitiligo was more prevalent in males and older people. More efforts are needed to improve the knowledge of and attitudes toward vitiligo. Full article

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9 pages, 3000 KiB

Open AccessArticle

Global Prevalence and Associated Clinical Markers of Thrombocytopenia in People Living with HIV: Evidence from Meta-Analysis

by Faisal K. Alkholifi, Sayed Aliul Hasan Abdi and Marwa Qadri

Clin. Pract. 2022, 12(6), 867-875; https://doi.org/10.3390/clinpract12060091 - 31 Oct 2022

Viewed by 1964

Abstract

Thrombocytopenia is one of the complications in human immunodeficiency virus (HIV) patients. To improve the health outcomes of patients living with HIV, it is important to understand the prevalence and pattern of associated key clinical markers globally. This meta-analysis, therefore, aimed to estimate [...] Read more.

Thrombocytopenia is one of the complications in human immunodeficiency virus (HIV) patients. To improve the health outcomes of patients living with HIV, it is important to understand the prevalence and pattern of associated key clinical markers globally. This meta-analysis, therefore, aimed to estimate the pooled prevalence of and associated clinical marker of thrombocytopenia globally. Methodology: The meta-analysis was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All statistical analyses were conducted using Stata. Twelve full-text papers out of 454 were eligible for meta-analysis. Results: Among 6686 participants, overall pooled prevalence of thrombocytopenia was 10.90% (95% CI: 7.91, 13.88) I² = 93.62%. In addition, thrombocytopenia was more prevalent by 25.11% (95% CI: 13.33, 36.88) in patients with CD + T < 200 cells/μL, and less prevalent in patients with CD + T < 200 cells/μL 10.10% (95% CI: 7.37, 12.83), respectively. Conclusions and recommendations: This meta-analysis established the prevalence of thrombocytopenia among patients living with HIV, and that it may be more prevalent in patients with CD + T < 200 cells/μL indicating the necessity of routine screening for various haematological markers and a careful treatment plan for HIV patients. Full article

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15 pages, 700 KiB

Open AccessArticle

The Use of Artificial Intelligence in Medical Imaging: A Nationwide Pilot Survey of Trainees in Saudi Arabia

by Ahmad A. Mirza, Omar M. Wazgar, Ammar A. Almaghrabi, Roaa M. Ghandour, Sarah A. Alenizi, Abdulrahim A. Mirza, Khalid S. Alraddadi, Fayzah H. Al-Adwani, Mohammed A. Alsakkaf and Sattam M. Aljuaid

Clin. Pract. 2022, 12(6), 852-866; https://doi.org/10.3390/clinpract12060090 - 28 Oct 2022

Cited by 5 | Viewed by 2704

Abstract

Artificial intelligence is dramatically transforming medical imaging. In Saudi Arabia, there are a lack of studies assessing the level of artificial intelligence use and reliably determining the perceived impact of artificial intelligence on the radiology workflow and the profession. We assessed the levels [...] Read more.

Artificial intelligence is dramatically transforming medical imaging. In Saudi Arabia, there are a lack of studies assessing the level of artificial intelligence use and reliably determining the perceived impact of artificial intelligence on the radiology workflow and the profession. We assessed the levels of artificial intelligence use among radiology trainees and correlated the perceived impact of artificial intelligence on the workflow and profession with the behavioral intention to use artificial intelligence. This cross-sectional study enrolled radiology trainees from Saudi Arabia, and a 5-part-structured questionnaire was disseminated. The items concerning the perceived impact of artificial intelligence on the radiology workflow conformed to the six-step standard workflow in radiology, which includes ordering and scheduling, protocoling and acquisition, image interpretation, reporting, communication, and billing. We included 98 participants. Few used artificial intelligence in routine practice (7%). The perceived impact of artificial intelligence on the radiology workflow was at a considerable level in all radiology workflow steps (range, 3.64–3.97 out of 5). Behavioral intention to use artificial intelligence was linearly correlated with the perceptions of its impact on the radiology workflow and on the profession (p < 0.001). Artificial intelligence is used at a low level in radiology. The perceived impact of artificial intelligence on radiology workflow and the profession is correlated to an increase in behavioral intention to use artificial intelligence. Thus, increasing awareness about the positive impact of artificial intelligence can improve its adoption. Full article

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7 pages, 533 KiB

Open AccessCase Report

A Case of Severe Hypoxia Caused by Phenazopyridine-Induced Methemoglobinemia: A near Fatal Event from Over-the-Counter Medication Use

by Ojbindra KC, Ananta Subedi, Rakshya Sharma, Punya Hari Dahal and Manisha Koirala

Clin. Pract. 2022, 12(6), 845-851; https://doi.org/10.3390/clinpract12060089 - 27 Oct 2022

Cited by 5 | Viewed by 2003

Abstract

Methemoglobinemia is a rare blood disorder characterized by the oxidation of heme iron from ferrous (Fe²⁺) to ferric (Fe³⁺) state, which increases oxygen affinity and impairs oxygen release to the tissue causing hypoxia. It can be congenital or acquired; [...] Read more.

Methemoglobinemia is a rare blood disorder characterized by the oxidation of heme iron from ferrous (Fe²⁺) to ferric (Fe³⁺) state, which increases oxygen affinity and impairs oxygen release to the tissue causing hypoxia. It can be congenital or acquired; however, most cases are acquired and caused by exogenous substances such as medications, chemicals, and environmental substances. Phenazopyridine is an over-the-counter urinary analgesic medication commonly used for symptomatic relief of dysuria and has been reported to cause methemoglobinemia. However, only a handful of cases of phenazopyridine-induced methemoglobinemia have been reported. We present a case of an 89-year-old female who presented with severe hypoxia, shortness of breath, headache, nausea, and dizziness caused by phenazopyridine-induced methemoglobinemia. She was found to have a methemoglobin level of 21.5% and was treated with methylene blue, leading to a rapid improvement of her symptoms. She was taking one over-the-counter phenazopyridine 200 mg tablet three times daily for two weeks for her chronic dysuria. This case highlights the need to have a high index of suspicion of phenazopyridine-induced methemoglobinemia in a patient presenting with unexplained shortness of breath with a history of phenazopyridine use as it could lead to severe methemoglobinemia with hypoxia that could potentially be fatal if not promptly diagnosed. Full article

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13 pages, 835 KiB

Open AccessArticle

Data Collection Theory in Healthcare Research: The Minimum Dataset in Quantitative Studies

by Chun Shing Kwok, Elena-Andra Muntean, Christian D. Mallen and Josip Andelo Borovac

Clin. Pract. 2022, 12(6), 832-844; https://doi.org/10.3390/clinpract12060088 - 26 Oct 2022

Cited by 1 | Viewed by 2811

Abstract

There is considerable interest in data analytics because of its value in informing decisions in healthcare. Data variables can be derived from routinely collected records or from primary studies. The level of detail for individual variables in quantitative studies is often disregarded. In [...] Read more.

There is considerable interest in data analytics because of its value in informing decisions in healthcare. Data variables can be derived from routinely collected records or from primary studies. The level of detail for individual variables in quantitative studies is often disregarded. In this work, we aim to present the concept of a minimum dataset for any variable. The most basic level of data collection is the value of a variable. In addition, there may be an indicator of severity and a measure of duration or how long the value has been present. The time course defines how the values for a variable fluctuated over time. The validity or accuracy of the values for a variable is also important to avoid spurious findings. Finally, there may be additional modifiers which drastically change the impact of a variable. In conclusion, the minimum dataset is a framework which can be used for the purposes of study design and appraisal of studies. Not all data requires full consideration of the minimum dataset framework for each variable, but the framework may be important if more detailed results are desired. Full article

(This article belongs to the Special Issue 2022 Feature Papers in Clinics and Practice)

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Clin. Pract., Volume 12, Issue 6 (December 2022) – 25 articles

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