Humans ; Singapore ; Self-Management ; Diabetes Mellitus, Type 2/therapy* ; Health Knowledge, Attitudes, Practice ; Hospitals

coding for the envelope glycoproteins occurred earlier in cells infected with isolate 10/154 than in cells infected with strain 07/435, demonstrating a distinct difference between the strains. Differences in serological response can be attributed to differences in the expression of antigenic proteins or to post-translational modifications that mask neutralizing epitopes. Strain 07/435 induced significantly high titers of neutralizing antibodies in several animal species in addition to bovines. The most relevant serological differences were observed in adult animals. This is the first comprehensive analysis of the expression kinetics of genes coding for BoHV-4 glycoproteins in 2 Argentine strains (genotypes 1 and 2). The results further elucidate the BoHV-4 life cycle and may also help determine the genetic variability of the strains circulating in Argentina.]]>
Adult ; Animals ; Antibodies ; Antibodies, Neutralizing ; Argentina ; Cattle ; Clinical Coding ; Epitopes ; Glycoproteins ; Glycosylation ; Humans ; In Vitro Techniques ; Kinetics ; Life Cycle Stages ; Masks ; Protein Processing, Post-Translational ; Transcriptome ; Virion

BACKGROUND: In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.OBJECTIVE: Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.METHODS: Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the National Institute of Allergy and Infectious Disease and the Food Allergy and Anaphylaxis Network (NIAID/FAAN) were included. Data collected included demographics, signs and symptoms, triggers and management.RESULTS: A total of 105 cases were evaluated. Incidence of anaphylaxis for the 3-year study period was 0.03%. Of the 105 cases, 35 (33%) were diagnosed as “urticaria” or “hypersensitivity reaction” despite fulfilling the NIAID/FAAN anaphylaxis criteria. There was a significant difference in epinephrine administration between those given the diagnosis of anaphylaxis versus misdiagnosed cases (61 [87%] vs. 12 [34%], χ² = 30.77, p < 0.01); and a significant difference in time interval from arrival at the ED to epinephrine administration, with those diagnosed as anaphylaxis (48%) receiving epinephrine within 10 minutes, versus ≥ 60 minutes for most of the misdiagnosed group (χ² = 52.97, p < 0.01).CONCLUSION: Despite current guidelines, anaphylaxis is still misdiagnosed in the ED. Having an ED diagnosis of anaphylaxis significantly increases the likelihood of epinephrine administration, and at a shorter time interval.
Anaphylaxis ; Classification ; Clinical Coding ; Communicable Diseases ; Demography ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Epinephrine ; Food Hypersensitivity ; Hospitals, Urban ; Humans ; Hypersensitivity ; Incidence ; Philippines ; Retrospective Studies ; Tertiary Care Centers

To understand the current situation regarding the knowledge and demand for patients with prediabetes at different self-management levels, and to provide guide for improving their knowledge.
 Methods: A total of 312 prediabetes patients from 3 hospitals in Changsha were enrolled in this survey. The questionnaires covered diabetes self-management behavior scale and prediabetes knowledge status and demand questionnaire. Diabetes knowledge acquisition and demand were analyzed among patients with different levels of self-management.
 Results: The score of self-management behavior for patients with prediabetes was 39.1±13.9. The rate of knowledge acquisition was low and the rate of demand was high. The knowledge acquisition rate was high and the knowledge demand rate was low in patients with high levels of self-management. As for the contents of health education, the dietary collocation and method for glucose detection were highly needed by all self-management levels of patients.
 Conclusion: Prediabetes patients' self-management level are low. Health education to patients with prediabetes should be based on individualized demands.
Diabetes Mellitus ; Health Knowledge, Attitudes, Practice ; Humans ; Prediabetic State ; Self-Management ; Surveys and Questionnaires

Numerous health issues can arise from improper domestic waste management. Uncollected wastes provide food and breeding sites for insect, bird and rodent which can expose the community to vector borne disease. Therefore, this study aims to investigate the community awareness towards domestic waste management. This study is a cross-sectional study conducted at Bandar Baru Sungai Buloh, Selangor, Malaysia. The questionnaire consists of five sections with a total of 57 questions. The questionnaire consists of four parts: Socio-demographic, knowledge, attitude and practice. The data were analysed using SPSS version 22.0. T-test, ANOVA test, Chi-squared test were used according to the type of variables and significance level will be taken at 95% or p-value of less than 0.05. A total of 355 respondents participated in this study. The mean age was 40.52 ±14.94. The majority of them were male (52.1%), Malay (71.0%), married (71.3%), with secondary educational (81%) and employed (41.1%). The majority of respondents mentioned that inappropriate waste management can cause dengue fever and leptospirosis (98.0%, 97.2%; respectively). Property type, education, occupation, ethnicity, religions and household income were significant influenced the knowledge of the participants towards domestic waste management. For attitude, gender, education, ethnicity, religion and income significantly influenced the attitude of the participants towards domestic waste management. For practice, ethnicity, religion and occupation were significantly influenced the practice of the participants towards domestic waste management. In conclusion, the community has moderate awareness of domestic waste management. Awareness of waste management should also be taught in school so that the next generation of people will have a better understanding and eventually have better practice in domestic waste management. It is also hoped that a carefully thought-out strategy can be developed to further improve the community awareness towards domestic waste management which will shed a new light on tackling this issue.
Waste Management ; Health ; Knowledge ; Attitude ; Practice ; general population

BACKGROUND: It is not possible to measure how much activity is required to understand and code a medical data. We introduce an assessment method in clinical coding, and applied this method to neurosurgical terms.METHODS: Coding activity consists of two stages. At first, the coders need to understand a presented medical term (informational activity). The second coding stage is about a navigating terminology browser to find a code that matches the concept (code-matching activity). Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) was used for the coding system. A new computer application to record the trajectory of the computer mouse and record the usage time was programmed. Using this application, we measured the time that was spent. A senior neurosurgeon who has studied SNOMED CT has analyzed the accuracy of the input coding. This method was tested by five neurosurgical residents (NSRs) and five medical record administrators (MRAs), and 20 neurosurgical terms were used.RESULTS: The mean accuracy of the NSR group was 89.33%, and the mean accuracy of the MRA group was 80% (p=0.024). The mean duration for total coding of the NSR group was 158.47 seconds, and the mean duration for total coding of the MRA group was 271.75 seconds (p=0.003).CONCLUSION: We proposed a method to analyze the clinical coding process. Through this method, it was possible to accurately calculate the time required for the coding. In neurosurgical terms, NSRs had shorter time to complete the coding and higher accuracy than MRAs.
Animals ; Clinical Coding ; Humans ; Medical Informatics ; Medical Record Administrators ; Methods ; Mice ; Neurosurgeons ; Systematized Nomenclature of Medicine

Child ; Consensus ; Disease Management ; Disorders of Sex Development ; diagnosis ; therapy ; Gonadal Steroid Hormones ; administration & dosage ; therapeutic use ; Humans ; Practice Guidelines as Topic ; Risk Factors

OBJECTIVE: The aim of this study was to examine the experience of volunteer psychiatrists who provided mental health interventions to adolescents and teachers of Danwon High School from April 16, 2014, to November 30, 2014. METHODS: Data for this study were collected from 72 volunteer psychiatrists about their intervention experiences for 212 adolescents and 32 teachers during the eight months following the disaster. Developmental survey themes were identified, and coding was used to analyze the data. In addition, qualitative data analysis was performed using ATLAS.ti (version 8.2, 2018, ATLAS.ti GmbH). RESULTS: A volunteer prepared with appropriate mental health interventions may facilitate the emergency response to a disaster. Intervention services included psychological first aid, psychoeducation, screening, anxiety reduction techniques, and group therapy. CONCLUSION: In the acute aftermath of the Sewol Ferry disaster of April 16, 2014, volunteer psychiatrists were able to provide mental health interventions in a disaster response setting. The outcomes from this study have important policy and mental health system implications for volunteer psychiatrists. The results of this study constitute the basis of a better understanding of the essential mechanisms of crisis interventions after a disaster.
Adolescent ; Anxiety ; Clinical Coding ; Crisis Intervention ; Disasters ; Emergencies ; First Aid ; Humans ; Mass Screening ; Mental Health ; Psychiatry ; Psychotherapy, Group ; Statistics as Topic ; Volunteers

Depression leads the higher personal and socio-economical burden within psychiatric disorders. Despite the fact that over 40 antidepressants (ADs) are available, suboptimal response still poses a major challenge and is thought to be partially a result of genetic variation. Pharmacogenetics studies the effects of genetic variants on treatment outcomes with the aim of providing tailored treatments, thereby maximizing efficacy and tolerability. After two decades of pharmacogenetic research, variants in genes coding for the cytochromes involved in ADs metabolism (CYP2D6 and CYP2C19) are now considered biomarkers with sufficient scientific support for clinical application, despite the lack of conclusive cost/effectiveness evidence. The effect of variants in genes modulating ADs mechanisms of action (pharmacodynamics) is still controversial, because of the much higher complexity of ADs pharmacodynamics compared to ADs metabolism. Considerable progress has been made since the era of candidate gene studies: the genomic revolution has made possible to assess genetic variance on an unprecedented scale, throughout the whole genome, and to analyze the cumulative effect of different variants. The results have revealed key information on the biological mechanisms mediating ADs effect and identified hypothetical new pharmacological targets. They also paved the way for future availability of polygenic pharmacogenetic panels to predict treatment outcome, which are expected to explain much higher variance in ADs response compared to CYP2D6 and CYP2C19 only. As the demand and availability of AD pharmacogenetic testing is projected to increase, it is important for clinicians to keep abreast of this evolving area to facilitate informed discussions with their patients.
Antidepressive Agents ; Biomarkers ; Clinical Coding ; Cytochrome P-450 CYP2C19 ; Cytochrome P-450 CYP2D6 ; Cytochromes ; Depression ; Genetic Variation ; Genome ; Humans ; Metabolism ; Negotiating ; Pharmacogenetics ; Precision Medicine ; Treatment Outcome

OBJECTIVE: Myeloproliferative neoplasm (MPN) is considered as one of the risk factors of ischemic stroke. Some MPN patients manifest stroke as their first symptom. Our purpose was to assess diagnostic rate of MPN in newly diagnosed acute ischemic stroke patients. METHODS: This study was performed using National Health Insurance Service Ilsan Hospital dataset. Data retrieving was performed by defining by defining the patient with coding of acute ischemic stroke from January 2013 to June 2017. We selected only the patients who had checked brain magnetic resonance imaging and complete blood cell count (CBC) in emergency room or on admission. Among the results of CBC finding, hemoglobin and platelet count were analyzed. Erythrocytosis was defined >16.5 g/dL (male), >16 g/dL (female) according to revised World Health Organization (WHO) classification of polycythemia vera (PV) criteria. Thrombocytosis was >450,000/µL according to revised WHO classification of essential thrombocythemia (ET). RESULTS: Total number of newly diagnosed acute ischemic stroke was 1,613 patients. Seven patients (0.43%) were diagnosed MPN (ET=2, PV=5) after ischemic stroke. Patients who had thrombocytosis and erythrocytosis were 18 and 105, respectively. Three patients who had thrombocytosis were diagnosed MPN (ET=2, PV=1). Two patients with erythrocytosis were diagnosed MPN (PV=2). Two patients had both thrombocytosis and erythrocytosis, and two of them were diagnosed PV. Seventy-one patients who had erythrocytosis were normalized in follow-up period. Six patients who had thrombocytosis and 30 patients who had erythrocytosis did not further evaluate. CONCLUSION: CBC has to be carefully read and MPN can be suspected. Diagnosis must be confirmed by hematologist to initiate appropriate treatment. It is important to recognized suspected MPN patients to prevent stroke.
Blood Cell Count ; Brain ; Classification ; Clinical Coding ; Dataset ; Diagnosis ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; National Health Programs ; Platelet Count ; Polycythemia ; Polycythemia Vera ; Risk Factors ; Stroke ; Thrombocythemia, Essential ; Thrombocytosis ; World Health Organization