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Introduction Lung cancer is the most common cause of cancer-related death in the United States (US). Tobacco smoking is a well-recognized cause of lung cancer. About 2% of the United States (US) population lives in Tennessee (TN). Nearly 21 % of TN adults are current smokers as per 2019 data, compared to 14% across the US. The percentage of smokers has historically been high in TN and its surroundings. This can be attributed to the area's socio-economic and cultural characteristics, along with large areas of tobacco farming in the region. This increases the risk of lung cancer in the TN population. Surveillance Epidemiology and End Results Program (SEER) is a collection of cancer registries across the US, covering about 35% of the US population (TN cancer registry is not a part of SEER). Our study compares lung cancer incidence and characteristics in the TN cancer registry with the SEER 18 registry. Materials and Methods Data were collected from the TN cancer registry and SEER separately for lung and bronchial cancer. Data was analyzed for different histological subtypes, age groups, gender, stage at diagnosis, and rural/urban residence. Stata and Microsoft Excel were used in data analysis. A Chi-square test was used to calculate the statistical significance. Results From 2008 to 2017, 58644 cases of lung cancer were reported in the Tennessee cancer registry. During the same period, 519112 cases were reported in the SEER registry. The most frequent histological subtype of lung cancer in TN and SEER was adenocarcinoma (frequency of 17,503 Vs. 182346), followed by squamous cell carcinoma and small cell carcinoma. Most cancers in TN and SEER were diagnosed at stage of distant metastasis (46% vs. 52% ), followed by regional metastasis, localized, and in situ (Image1). The frequency of lung cancer diagnosis was high among those older than 65 in TN and SEER (64% vs. 69%). Males had a higher incidence of lung cancer in both registries. Most lung cancers were reported in the urban area in both registries. Chronic obstructive pulmonary disease was the most commonly reported secondary diagnosis (3,099), followed by pleural effusion in the TN database; the comparable data were not available in SEER. Relative survival at 12 months and five years for lung cancer in TN were 46.6 % and 19.5 % (Vs. 46.4% and 19.9% in SEER) Discussion and Conclusion If both registries were perfect, then lung and bronchial cancer incidence will be 9241 and 6048 per million in ten years in TN and SEER, respectively. But after careful analysis, we conclude that such analysis will be erroneous. The proportion of different histological types, stage at diagnosis, age groups, and gender were in the same order in both groups. Although chi-square test values are significant for all the variables, we infer no conclusion considering the data's inherent bias. Further in-depth analysis of the data is required.

Como reflexo do aumento da incidência de câncer no país, uma alta proporção de pacientes recebem alta hospitalar com diagnóstico de câncer no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Por essa razão, a necessidade de um sistema de informações para a coleta, armazenamento e análise dos dados relativos aos pacientes com câncer atendidos na instituição se tornou bastante crítica para o registro do câncer do HC-FMUSP. Neste projeto de mestrado, realizamos uma avaliação das necessidades do grupo e detectamos a necessidade de criar um instrumento de informática que fosse complementar ao programa já em uso da Função Oncocentro de São Paulo, mas que também pudesse ser usado isoladamente. Isso foi feito tendo em conta uma reavaliação de todos os processos envolvidos com a coleta de dados relativos aos pacientes, desde a identificação deles até o resultado dos tratamentos envolvidos. A construção do instrumento abrangeu o ciclo de vida do sistema, desde o diagnóstico do ambiente, desenvolvimento dos projetos lógico e físico, programação e implantação. Esse sistema ainda está em teste, mas produtos como o boletim do RHC-FMUSP atesta que ele funciona a contento. / Possibly as a reflection of the cancer incidence increase in Brazil, a high proportion of patients are discharged from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo with the diagnosis of cancer. For this reason, the development of a system of information became critical in order to collect and analyse the amount of data stored by Cancer Registry at HCFMUSP. In this study, we first evaluated the needs of the cancer registry personnel and developed an software to support these needs as a complement of the active program in use. This instrument should be used alone if necessary. All processes were re-evaluated and taking into account. This study encloses the cycle of life of a system, since diagnosis of the environment, development of the projects logical and physical, programs e implantation. Although still being tested, the release of some small surveys shows its funcionality.

Severe sepsis and septic shock comprise a significant number of emergency department (ED) admissions annually. With the advent of early goal directed therapies, early identification and intervention have become paramount in this population. Few studies, however, have examined the role of serum lactate as a predictor of mortality or endpoint to resuscitation among this population. We aimed to show that improved lactate clearance is associated with decreased 28-day in-hospital mortality. We retrospectively examined data from the Yale Sepsis Registry for patients with severe sepsis or septic shock who had lactate levels that were measured initially in the ED and subsequently when the patient arrived on the floor. This study received institutional review board approval. Lactate clearance was calculated as a percentage, and comparison between patients who cleared lactate and those who did not were made for mortality data as well as baseline characteristics and interventions required between the two groups. 207 patients (110 male) with mean age and standard deviation (SD) of 63.17 ± 17.9 years were examined. 136 patients (65.7%) were diagnosed with severe sepsis and 71 patients (34.3%) had septic shock. Of those with identified sources of infection, pneumonia was the most common (54 patients, 26.1%). There were 171 patients in the clearance group and 36 patients in the non-clearance group, all of whom had a mean time of 9 hours 8 minutes ± 4 hours 6 minutes between lactate measurements. 28-day mortality rates were 15.2% (26 patients) in the lactate clearance group and 36.1% (13 patients) in the non-clearance group (p<0.01). Vasopressor support within 72 hours of admission was initiated among 61.1% (22 patients) in the non-clearance group compared with 36.8% (63 patients) in the clearance group (p<0.01). Mechanical ventilation was required for 36.3% (62 patients) in the clearance group and 66.7% (24 patients) in the non-clearance group (p=0.001). Rates of severe sepsis, mean number of SIRS and organ dysfunction criteria, and initial creatinine were similar between the two groups; however, only 86.1% (31 patients) in the non-clearance group received intravenous fluids in the ED compared with 98.8% (169 patients) in the clearance group (p=0.002). 33.3% (12 patients) in the non-clearance group had chronic obstructive pulmonary disease (COPD) compared with 15.2% (26 patients) in the clearance group (p<0.05). The mean Mortality in Emergency Department Sepsis (MEDS) scores were 8.78 ± 3.96 for the clearance group and 10.4 ± 4.48 for the non-clearance group (95% CI, -3.1 to -.14, p<0.05). These results show significantly higher mortality rates among patients who do not clear their lactate in the ED. Additionally, these patients require vasopressor support and mechanical ventilation more often. Lactate clearance was significantly associated with receipt of fluids and may also reflect lower MEDS score. Our findings suggest lactate clearance could be used as an endpoint for ED resuscitation and in stratifying mortality risk among patients with severe sepsis or septic shock. Future studies might seek to prospectively validate these findings and incorporate multivariate analysis to determine factors affecting lactate clearance.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 6 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 5 uppsatser.

Como reflexo do aumento da incidência de câncer no país, uma alta proporção de pacientes recebem alta hospitalar com diagnóstico de câncer no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Por essa razão, a necessidade de um sistema de informações para a coleta, armazenamento e análise dos dados relativos aos pacientes com câncer atendidos na instituição se tornou bastante crítica para o registro do câncer do HC-FMUSP. Neste projeto de mestrado, realizamos uma avaliação das necessidades do grupo e detectamos a necessidade de criar um instrumento de informática que fosse complementar ao programa já em uso da Função Oncocentro de São Paulo, mas que também pudesse ser usado isoladamente. Isso foi feito tendo em conta uma reavaliação de todos os processos envolvidos com a coleta de dados relativos aos pacientes, desde a identificação deles até o resultado dos tratamentos envolvidos. A construção do instrumento abrangeu o ciclo de vida do sistema, desde o diagnóstico do ambiente, desenvolvimento dos projetos lógico e físico, programação e implantação. Esse sistema ainda está em teste, mas produtos como o boletim do RHC-FMUSP atesta que ele funciona a contento. / Possibly as a reflection of the cancer incidence increase in Brazil, a high proportion of patients are discharged from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo with the diagnosis of cancer. For this reason, the development of a system of information became critical in order to collect and analyse the amount of data stored by Cancer Registry at HCFMUSP. In this study, we first evaluated the needs of the cancer registry personnel and developed an software to support these needs as a complement of the active program in use. This instrument should be used alone if necessary. All processes were re-evaluated and taking into account. This study encloses the cycle of life of a system, since diagnosis of the environment, development of the projects logical and physical, programs e implantation. Although still being tested, the release of some small surveys shows its funcionality.

This master thesis was done at Uppsala Clinical Research Center (UCR). UCR have recently developed the technical platform QReg 5 for managing quality registries. UCR have been in contact with several international organizations interested in collaborating with UCR because of their expertise within quality registries as well as their technical competence. UCR have a complicated owner structure as well as organizational structure, as they are owned by Uppsala University and Uppsala County Council. The purpose of this master thesis was to present how QReg 5 could be commercialized under UCR's preconditions. In order for the internationalization plans to be successful, it was shown that the shared ownership of UCR needs to become clearer. By taking advantage of the possibilities with the new development section at UCR, the management of the contacts will be more efficient. Potential competitors for UCR are registry centers that have created their own technical solutions, large software companies, Life Science related organizations (e.g. hospitals), the organizations that UCR license QReg 5 to, as well as software companies creating electronic medical records. The most interesting customer segment for UCR are organizations with technical competences, which are placed in countries were quality registries are not yet in use.

The aim of this work was the evaluation of some statistic indicators from the data obtained from the Health Informatic System Clinicom. The data used in this informatic system are administrated by the database system Caché. The data from the database which is administrated by Departement of Biomedical Engineering in Brno, have been also used. Data mentioned in this work were mined from the database by SQL queries. The statistic indicators obtained this way were needed to be presented on internet. The user interface for this presentation was designed and realized in programming language CSP. The resulting statistic indicators were split up into 3 basic groups: Hospitalization, Mandatory reporting and Medicament requirement. Besides the statistic indicators some pacients‘ data and the graphs of results are shown in the user interface. The part which has also been used in this work is the concept of the online form for reporting of cancers.

<p dir="ltr">Software Package Registries are an integral part of the Software Supply Chain, acting as collaborative platforms that unite contributors, users, and packages, and streamline package management processes. Much of the engineering work around reusing packages from these platforms deals with the issue of synthesis, combining multiple packages into a new package or downstream project. Recently, researchers have examined registries that specialize in providing Pre-Trained Models (PTMs), to explore the nuances of the PTM Supply Chain. These works suggest that the main engineering challenge of PTM reuse is not synthesis but selection. However, these findings have been primarily qualitative and lacking quantitative evidence of the observed differences. I therefore evaluate the following hypothesis:</p><p dir="ltr"><i>The prioritization of selection over synthesis in Pre-Trained Model reuse means that the evolution and reuse of Pre-Trained Models differs compared to traditional software. </i><i>The evolution of models will be more linear, and the reuse of models will be more centralized.</i></p>