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Medical Chart Review (medical + chart_review)
Selected AbstractsAssociates of school absenteeism in adolescents with sickle cell diseasePEDIATRIC BLOOD & CANCER, Issue 1 2009Lisa A. Schwartz PhD Abstract Background Despite high rates of school absenteeism in adolescents with sickle cell disease (SCD), the issue remains understudied. Potential associates of school absenteeism in adolescents with SCD include demographic (age, income), psychosocial (IQ, self-efficacy, competence, internalizing symptoms, negative thinking), and health-related (hemoglobin, health-care utilization, pain, disease knowledge). Procedure Forty participants ages 12,18 completed measures of psychosocial functioning, IQ, and pain. Medical chart reviews identified other health-related variables. A subsample also completed an assessment of goals. Using school records, absenteeism was the percent of school days missed in the previous year. Correlations tested associates of absenteeism and linear regression tested a model of absenteeism. Results Participants missed an average of 12% of the school year and more than 35% missed at least 1 month of school. Health-related and psychosocial variables, but not demographic variables, correlated with absenteeism. Attendance at clinic appointments and parent-reported teen pain frequency were significant associates of absenteeism in the regression model. For those who completed goal assessment, over 40% of goals identified were academically focused. Absenteeism was positively related to current academic goals and health-related hindrance of academic goals, and negatively related to future-oriented academic goals. Conclusions School absenteeism is a significant problem for adolescents with SCD despite the presence of academic goals. Collaboration between schools, parents, patients, and providers to understand and manage the impact of SCD on school attendance is recommended. Pediatr Blood Cancer 2009;52:92,96. © 2008 Wiley-Liss, Inc. [source] Oral manifestations and dental status in paediatric HIV infectionINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2000F.J. Ramos-Gomez Objective. To describe the incidence and prevalence of oral manifestations of HIV infection in a population of perinatally infected children. Design. Retrospective and prospective study of a cohort of perinatally HIV-infected children. Setting. Community hospital and community-based paediatric clinic. Sample and methods. Forty perinatally HIV-infected children with a median age of 12 months were eligible and selected for the study, which included a medical chart review from birth and prospective follow-up. Each child was examined quarterly for oral manifestations, tooth eruption, and for 27 children, caries and periodontal status. Results. The incidence of pseudomembranous candidiasis was 43% (95% CI, 27,58%) within 6 months of birth. Oral candidiasis (defined as pseudomembranous or erythematous) was positively associated with low CD4 counts and the occurrence of plaque. Children with low CD4 counts were also found to have fewer teeth than children with high CD4 counts, after adjusting for age. Conclusions. Oral manifestations are common in paediatric HIV infection and are possible predictors of HIV disease progression. Primary care of HIV-infected children should include periodic oral examinations to monitor their HIV disease progression and to alleviate symptoms associated with oral opportunistic infections. [source] The Relationship Between Glycemic Control and Falls in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2007Joan M. Nelson RN OBJECTIVES: To determine whether glycemic control contributes to fall risk in frail and nonfrail elderly adults with diabetes mellitus. DESIGN: Retrospective, case-controlled design. SETTING: Health maintenance organization in the Denver, Colorado, metropolitan area. PARTICIPANTS: One hundred eleven community-dwelling adults aged 75 and older who receive care through Kaiser Permanente of Colorado. All subjects had been diagnosed with diabetes mellitus, had at least one hemoglobin A1C (HbA1c) measurement in the previous 12 months, and were using oral hypoglycemic medication or insulin to control their diabetes mellitus. MEASUREMENTS: Measurements of risk factors (Vulnerable Elders Survey (VES-13) with a cutpoint of 3 to determine frailty status, self-reported number of falls over the prior 12-month period, HbA1c, fasting low-density lipoprotein cholesterol, average blood pressure, and other factors related to fall risk) were obtained through telephone interview and medical chart review. The outcome measure was falls. RESULTS: Bivariate analyses to assess correlations between falls and risk factors determined that only HbA1c, frailty, and peripheral neuropathy were significantly associated with falls. A stepwise logistic regression determined that fall risk markedly increased when HbA1c was 7 or below, regardless of frailty status. CONCLUSION: In this retrospective study of a convenience sample of frail older adults with diabetes mellitus, tighter glycemic control was associated with greater risk of falling. Prospective studies that further evaluate the risks and benefits of relaxed glucose control in high-risk older adults are needed to confirm this finding. [source] Incidence of myelodysplastic syndromes within a nonprofit healthcare system in western Washington state, 2005,2006,AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2010Anneclaire J. De Roos Myelodysplastic syndromes (MDS) incidence is unclear because of historical lack of population-based registration and possibly because of underdiagnosis. We conducted a study to evaluate completeness of MDS registration in the Seattle-Puget Sound region of the Surveillance, Epidemiology, and End Results (SEER) program,which has reported the highest rates among the SEER registries since mandatory reporting of MDS began in 2001. We identified incident MDS cases of any age that occurred within a nonprofit healthcare system in western Washington State in 2005 or 2006 through the local SEER registry or by relevant diagnostic code followed by medical chart review to classify these patients as unlikely, possible, or definite/probable MDS. We calculated age-standardized incidence rates for all identified MDS cases and for case groups based on identification method, and we summarized medical histories of the MDS patients. MDS incidence in our study population was estimated as 7.0 per 100,000 person-years in 2005,2006 when combining MDS cases identified by SEER and definite/probable cases identified by chart review, which was similar to the rate of 6.9 reported by our local SEER registry. The addition of possible MDS cases identified from chart review increased the rate to 10.2 per 100,000. MDS patients frequently had previous cancer diagnoses (25%) and comorbidities such as high blood pressure and diabetes. Our investigation suggests that although reporting of confirmed MDS diagnoses in our region appears complete, MDS incidence is likely underestimated because of omission of cases who are symptomatic but do not receive definitive diagnoses. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source] A validation study: how effective is the Hospital Morbidity Data as a surveillance tool for heart failure in Western Australia?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2008Tiew-Hwa Katherine Teng Abstract Objective: To determine the accuracy of the hospital discharge coding of heart failure (HF) in the Western Australian (WA) Hospital Morbidity Data (HMD). Methods: A retrospective medical chart review of a sample of 1,006 patients with a principal diagnosis code indicating HF in the WA HMD was undertaken. Validation was reported against a written diagnosis of HF in the medical chart and using Boston criteria score as a gold standard. Results: The positive predictive value (PPV) of the HMD coding of HF as the principal diagnosis was 99.5% when compared to the medical chart diagnosis and 92.4% when compared to the Boston score criteria for ,definite' HF and 98.8% for a combined ,possible' and ,definite' HF Boston score. Conclusions: With the high predictive accuracy, the WA HMD can be used with confidence to monitor trends in the epidemiology of in-hospital HF patients. [source] Women's experiences with genomic testing for breast cancer recurrence riskCANCER, Issue 8 2010Janice P. Tzeng MPH Abstract BACKGROUND: Few studies have examined how patients understand and use genomic test results when deciding about treatment. This study examined how women receive and incorporate results of Oncotype DX, a genomic test that offers recurrence risk estimates, into decisions about adjuvant treatment for early stage breast cancer. METHODS: Participants in the cross-sectional study were 77 women with early stage, estrogen receptor-positive breast cancer with 0 to 3 positive lymph nodes who received Oncotype DX between 2004 and 2009. Mailed surveys, supplemented by medical chart review, assessed how women received and understood recurrence risk information based on the test. RESULTS: The most common test results were low (50%, 34 of 68) or intermediate (37%, 25 of 68) breast cancer recurrence risk. Most women accurately recalled their recurrence risk based on the test (71%) and felt they understood much of what they were told about it (67%). Approximately 25% of women recalled experiencing test-related distress. Women's perceived recurrence risk was associated with their actual genomic-based recurrence risks, having had a previous cancer diagnosis, and worry about recurrence. Women with high recurrence risk typically had chemotherapy (78%, 7 of 9), whereas only 2 with a low recurrence risk did (7%, 2 of 30). CONCLUSIONS: This is among the first studies to describe patients' experiences with genomic testing for recurrence risk. Although many women understood discussions about their genomic test results, a third reported not fully understanding these discussions, suggesting a need to aid and improve risk communication and treatment decision making. Cancer 2010. © 2010 American Cancer Society. [source] Retrospective evaluation of pain assessment and treatment for acute vasoocclusive episodes in children with sickle cell diseasePEDIATRIC BLOOD & CANCER, Issue 2 2008William T. Zempsky MD Abstract Background This study was conducted to assess the care of pediatric patients hospitalized for sickle cell disease-related vasoocclusive episodes (VOE). The aim of this research was to illustrate the course of pain scores and methods of therapeutic intervention during hospitalization. Procedure Retrospective medical chart reviews were conducted to collect pain assessment and management data about children hospitalized during a 2-year period at an urban children's hospital. T tests and Chi-square analyses were used to identify differences in demographic variables, pain scores and opiate utilization. Results There were 59 children with 134 hospitalizations for VOE in a 2-year period. 50.8% of the patients were male; the mean age was 11.5,±,4.9 years. The average length of hospitalization was 4.6,±,2.7 days (range 1,19 days). Older patients stayed in the hospital significantly longer than younger patients (P,=,0.002). Pain scores remained in the moderate to severe range (,5 out of 10) for many days in the majority of patients. Results failed to reveal significant differences in pain scores and opiate utilization between patients who had short versus extended hospitalizations, and for those patients with frequent versus infrequent hospitalizations for pain. Conclusions Despite opiate dosing within recommended guidelines, mean pain scores remain in the moderate to severe range for several days following hospitalization for VOE. Future research should explore the factors which influence pain scores, as well as improved pain assessment and management techniques. Pediatr Blood Cancer 2008;51:265,268. © 2008 Wiley-Liss, Inc. [source] | ||||||||||