Clinical Disease Classification Research Articles

What interventions do firefighter nurses carry out?

With the rarefaction of home medical visits, prehospital emergencies are ensured by the Mobile Emergency and Resuscitation Structures (SMUR) and the Firemen accompanied by Firefighters Nurses (FfNs). The main objective of this work is to describe the pathologies managed by the FfNs of the Loire district according to their International Classification of Primary Care version 2 and the Clinical Classification of Diseases of the initial SMUR during all interventions performed in 2019. The secondary objective will be to determine the associated Emergency Care Nursing Protocols (PISU). Among the 2969 interventions and 5036 PISU performed, trauma and polytrauma are the most common pathologies treated. Outside of trauma, the most frequent conditions are chest pain, carbon monoxide poisoning, and cardiopulmonary arrest (CPA). Analgesic protocols are the most used PISU and in second place comes the absence of PISU application, chest pain protocols, adult CPA and glucose administration. FfNs occupy an increasingly important place in the French rescue chain. Thanks to a wide range of interventions and a great autonomy of action, they make it possible to greatly limit the number of SMUR medical teams leaving the hospital, especially in situations that do not require a doctor immediately.

ON THE ISSUE OF CLINICAL CLASSIFICATION OF PRECANCEROUS CHANGES IN THE ORAL MUCOSA AND THE LIPS

Diseases of the oral mucosa are an important and complex problem of dentistry. Due to the fact that diseases and pathological conditions of the oral cavity mucosa are diverse in etiology, pathogenesis, clinical manifestations, possible atypical course, have similarity of morphological elements, overall they characterized diseases of various organs and different body systems. In this regard, different methodological approaches are used for creating an optimal classification. P.T. Maksimenko (2012) indicated that each subsequent classification is statistical and intends to take into account diseases and pathological conditions.
 The existing classifications of the oral mucosa diseases have different principles of design. Diseases and lesions of the oral mucosa according to pathogenesis are divided into primary (own), secondary (symptomatic) and syndromes. In all classifications, one of the subset is precancerous changes.
 Nowadays in the world science literature sources there is a term "potentially malignant disorders of the oral cavity" (OPMDs). By this definition, it is recommended to replace the usual terms of precancer, epithelial precursor lesions, premalignant, precancerous, intraepithelial lesions. The definition of potentially malignant oral disorders is included in the WHO classification of Head and Neck Tumors (2017). In March 2020, this classification was supplemented at the WHO International Seminar on the Nomenclature and classification for Oral Cancer and included oral lichenoid lesions, chronic hyperplastic candidiasis and exophytic verrucous oral hyperplasia.
 In 2008, Maksimenko P.T. and co-authors created a working nomenclature and clinical classification of diseases, changes of the oral mucosa, lips and tongue. Symptoms and complexes symptom of the oral mucosa and lips, which are determined by visualization, in a separate section is mentioned the precancerous changes.
 Analysis of the 10-year work of the center for the diagnosis and treatment of diseases of the oral mucosa and the lips, organized at the Department of Dentists Postgraduate Education, made it possible to create some additions to this classification, taking into account atypically occurring precancerous changes and their malignancy. At the same time, regardless of changes in obligate and optional changes in clinical supervision, clinical signs of malignancy should be taken into account:
 
 static course of disease,
 progression of the lesion,
 increasing in the area of the lesion,
 increasing keratinization processes,
 disappearance of boundaries clarity,
 density of the lesion’s base,
 the occurrence of pain.
 
 As well as cytological and histological examination is crucial.
 Conclusion. According to the methodological principles of classifications, data’s of scientific research, information about previously unknown diseases and their manifestation in the oral cavity, it is possible to make additions to existing classifications, as well as to use international ones.
 Future perspectives. Clinical classification of precancerous changes in the oral mucosa and lips, and additions made to it made are very useful for clinicists in making a diagnosis, management of cancer, treatment of patients.

Lung Aeration in COVID-19 Pneumonia by Ultrasonography and Computed Tomography.

We conducted a prospective single-center observational study to determine lung ultrasound reliability in assessing global lung aeration in 38 hospitalized patients with non-critical COVID-19. On admission, fixed chest CT scans using visual (CTv) and software-based (CTs) analyses along with lung ultrasound imaging protocols and scoring systems were applied. The primary endpoint was the correlation between global chest CTs score and global lung ultrasound score. The secondary endpoint was the association between radiographic features and clinical disease classification or laboratory indices of inflammation. Bland–Altman analysis between chest CT scores obtained visually (CTv) or using software (CTs) indicated that only 1 of the 38 paired measures was outside the 95% limits of agreement (−4 to +4 score). Global lung ultrasound score was highly and positively correlated with global software-based CTs score (r = 0.74, CI = 0.55–0.86; p < 0.0001). Significantly higher median CTs score (p = 0.01) and lung ultrasound score (p = 0.02) were found in severe compared to moderate COVID-19. Furthermore, we identified significantly lower (p < 0.05) lung ultrasound and CTs scores in those patients with a more severe clinical condition manifested by SpO2 < 92% and C-reactive protein > 58 mg/L. We concluded that lung ultrasound is a reliable bedside clinical tool to assess global lung aeration in hospitalized non-critical care patients with COVID-19 pneumonia.

Correlation-driven framework based on graph convolutional network for clinical disease classification

With the increasing popularity of computer-aided technology applied in medicine, great achievements have been made in certain diseases. However, due to the similarity of clinical and histological features, the problem of disease classification has not been well resolved, especially the Crohn’s disease (CD) and intestinal tuberculosis (ITB). In this paper, a novel sample connection driven framework named RFG-GCN is presented to overcome this. Firstly, the RFG-GCN employs a random forest based graph generation algorithm (RFG) to convert structured data into graph data, which considers the correlation between samples. Under the training of two layer-wise graph convolution neural network, an efficient model is established. Our findings show that the classification performance has been significantly improved compared withother methods. Furthermore, to show the extensibility and consistency, we apply our framework to other four public medical datasets. The results indicate that the RFG-GCN framework can achieve competitive and better classification performance.

Double adaptive weights for stabilization of moth flame optimizer: Balance analysis, engineering cases, and medical diagnosis

Moth flame optimization (MFO) is a swarm-based algorithm with mediocre performance and marginal originality proposed in recent years. It tried to simulate the fantasy navigation mode of moth lateral positioning. The basic MFO has no specific, deep strategies in different periods of the algorithm and a fragile evolutionary basis, which may lead to the problem of falling into local optimum and slow convergence trend. Therefore, this paper introduces a double adaptive weight mechanism into the MFO algorithm, termed as WEMFO, to boost the search capability of the basic MFO and provide a more efficient tool for optimization purposes. The proposed WEMFO adjusts the search strategy adaptively in different periods of the algorithm, making it more flexible between global search (diversification) and local search (intensification). The WEMFO algorithm is compared with some illustrious metaheuristic solvers and advanced metaheuristic methods developed in recent years on thirty benchmark functions. The experimental results expose that the developed WEMFO has apparent compensations in terms of convergence speed and solution accuracy. Moreover, this paper analyzes the diversity and balance of WEMFO and applies the algorithm to several engineering problems. The experimental results show that the WEMFO algorithm has good performance in engineering problems. Additionally, the proposed WEMFO was also applied to train Kernel Extreme Learning Machine (KELM), the resultant optimized WEMFO-KELM model was applied to six clinical disease classification problems. By comparing with MFO-KELM and other five classification models, the experimental results showed that the proposed algorithm had shown better performance in practical problems. An online guide for the algorithm in this research WEMFO and proposed classifier WEMFO-KELM will be publicly available at https://aliasgharheidari.com.

Clinical Classification of Diseases and Conditions of Mammary Glands in Children and Adolescents

The article describes the proposed current clinical classification of breast diseases and pathology in childhood and adolescence. The classification is based on the analysis of data obtained from the examination and follow-up monitoring of 6,126 children for up to 8 years. The clinical classification is recommended for widespread use in the work of primary care physicians who conduct follow-up monitoring. The use of this classification creates groups for referral to specialists for further examination and further treatment and follow-up monitoring. The classification is based on the separation of physiological (normal conditions) and pathological processes, as well as on temporary deviations from normal development (temporary conditions not leading to pathological processes) and anomalies in development of mammary glands and nipple-areolar complex. If any abnormalities are suspected, a patient shall be sent to a mammologist for further examination and US scanning. Control of growth and development of mammary glands in childhood and adolescence ensures early detection of abnormalities and allows necessary remedial measures to protect reproductive health.

Treatment of pulmonal hypertension

While the clinical classification of diseases with pulmonary hypertension (PH) has remained fairly stable in recent years, the treatment options have improved significantly. In addition to the General measures (vaccinations, physical training) new recommendations for supportive therapy (administration of diuretics, iron supplementation and oral anticoagulant) exist currently. Some new substances (mostly in the indication pulmonary arterial hypertension) have been admitted to the targeted drug treatment in recent years. For the first time, exist a approved drug therapy for the non-operable and residual chronic thromboembolic pulmonary hypertension.

Nihil certum: historical development of the term prurigo

The term prurigo is still used to designate primary dermatoses and secondary reaction patterns. A clear definition of the term is not available nor a clear clinical classification of diseases categorized under the term. Furthermore, there is no certainty about the entity it was primarily used to refer to, and whether it should always be considered in relation to pruritus. The concept appears already in very early medical treatises. From the very beginning, it was used in dermatology in a non-uniform way, and was alternately accorded and denied the status of an independent disease entity. Moreover, prurigo was subdivided into many different forms, but their descriptions are partly very similar, so that, for instance, it is quite difficult today to draw any conclusions about the clinical entities the frequently used terms prurigo mitis and prurigo formicans referred to. In contrast, the term prurigo nodularis is still commonly used. This article traces exemplarily the use of the term prurigo in the standard medical textbooks up to the definition of prurigo nodularis.

Using gene set signature to guide hypothesis-driven experiments

Complex diseases, such as cancer, are inherently multi-genetic mutations. Since it may be caused by a combinatorial effect of many mutations, the individual effect of each mutation may be too small to discover. In addition, the progresses of tumorigenesis not only include the mutations that facilitate tumorigenesis (called tumor drivers), but also include those accumulated during the growth of the tumor (known as tumor passengers) (1). Therefore, high degree of morphologic and clinical diversities exists among various types of cancers; intrinsic heterogeneity of cancer is very common among patients due to different genetic and environmental perturbations. However, traditional approaches of clinical disease classification are mainly based on pathological analysis of patients and existing knowledge of diseases. The current pathologic classification and ability to predict postsurgical prognosis are quite inadequate. Hence, although the existence of marked heterogeneity is well appreciated, virtually all cancers currently are treated similarly.

Clinical Application of Proteomics in Ovarian Cancer Prevention and Treatment

As recent scientific findings using whole-genome mutational scanning technologies have concluded, cancer is a protein pathway disease, which is often diagnosed too late, when the success of therapeutic modalities is very limited. Proteomics has been proposed as the field that can help overcome this limitation and usher in a new era of molecular investigation for early diagnosis and classification of tumors. Proteomics applications in cancer research encompass two general aspects: (i) the study and characterization of protein production; and (ii) the definition of protein function. The first aims to identify qualitative or quantitative differences in the proteome that can help differentiate between healthy and diseased states or achieve a better clinical classification of diseases. The second studies the complexity of protein interactions and their activation states, mapping the network of signaling pathways within and outside the cells. The challenges in translating the findings of proteomics research into clinical practice are numerous. Lack of reproducibility, variable availability of samples and the bias associated with their selection and handling, the need for large, prospective validation trials, and finally the strict requirement for a very high level of clinical sensitivity and specificity are some of the hurdles that need to be overcome to achieve early detection and treatment. Nevertheless, proteomics is a field in rapid progression that has already developed beyond initial criticism and is making its way toward important applications and discoveries. Specifically, there has been an increasing number of reports on the potential clinical application of proteomics for early detection as well as risk assessment and management of ovarian cancer. This disease is the leading cause of death from gynecologic malignancies in the US, with poor prognosis resulting from the lack of reliable, sensitive screening tests and the limited understanding of the mechanisms of chemoresistance and relapse. In the future, serum proteomics applications in the gynecologic oncology field could identify blood-based biomarkers that are predictors of disease presence or progression, and tissue proteomics could help define the optimal targeted agent and effective dose for each patient's disease. These advances will allow improved monitoring of therapy response and disease relapse, and aid in the engineering of new drugs and strategies to circumvent resistance mechanisms while avoiding the adverse effects of traditional chemotherapy.

Alternatives to HIV-RNA and CD4 count to monitor HIV disease progression: A prospective cohort study in Romania

Little evidence exists on how to efficiently and effectively monitor HIV-disease progression in developing countries. Better understanding regarding cost-effective tests may help to resolve questions regarding treatment. A prospective cohort study was conducted with a 1-year follow-up period. Immune complex-dissociated (ICD) p24 antigen (ICD p24Ag), alone or in combination with HIV p24 antibody (p24Ab), was compared to HIV-RNA and CD4+ count in a cohort of 160 HIV-infected adolescents in Romania. The main outcome measure was disease progression, defined as >50,000 copies/ml of HIV-RNA or death. Among the 160 adolescents, a higher mean ICD p24Ag was significantly associated with clinical disease classification (CDC), plasma HIV-RNA concentration, and p24Ab. Multivariate logistic regression showed detectable ICD p24Ag had an odds ratio of 3.7 (95% CI 1.4-9.7) for disease progression in comparison to undetectable ICD p24Ag. ICD p24Ag is of value in determining the prognosis of disease in HIV-1-infected adolescents in developing countries. Additional studies for validation of this assay for HIV clades primarily affecting developing countries, are now needed.

The economic burden of skin disease in the United States

Background: Skin diseases and their complications are a significant burden on the nation, both in terms of acute and chronic morbidities and their related expenditures for care. Because accurately calculating the cost of skin disease has proven difficult in the past, we present here multiple comparative techniques allowing a more expanded approach to estimating the overall economic burden. Objectives: Our aims were to (1) determine the economic burden of primary diseases falling within the realm of skin disease, as defined by modern clinical disease classification schemes and (2) identify the specific contribution of each component of costs to the overall expense. Methods: Costs were taken as the sum of several factors, divided into direct and indirect health care costs. The direct costs included inpatient hospital costs, ambulatory visit costs (further divided into physician's office visits, outpatient department visits, and emergency department visits), prescription drug costs, and self-care/over-the-counter drug costs. Indirect costs were calculated as the outlay of days of work lost because of skin diseases. Results: The economic burden of skin disease in the United States is large, estimated at approximately $35.9 billion for 1997, including $19.8 billion (54%) in ambulatory care costs; $7.2 billion (20.2%) in hospital inpatient charges; $3.0 billion (8.2%) in prescription drug costs; $4.3 billion (11.7%) in over-the-counter preparations; and $1.6 billion (6.0%) in indirect costs attributable to lost workdays. Conclusions: Our determination of the economic burden of skin care in the United States surpasses past estimates several-fold, and the model presented for calculating cost of illness allows for tracking changes in national expenses for skin care in future studies. The amount of estimated resources devoted to skin disease management is far more than required to treat conditions such as urinary incontinence ($16 billion) and hypertension ($23 billion), but far less than required to treat musculoskeletal conditions ($193 billion). (J Am Acad Dermatol 2003;48:592-9.)

Clinical classification of vertebral neurological syndromes

At present, when classifying vertebrogenic diseases of the nervous system (VZNS), methodological recommendations "Clinical classification of diseases of the peripheral nervous system", approved by M3 of the USSR (1987), are used as the basis. The applied classification does not fully reflect modern concepts of patho- and sanogenesis and complicates the use of many methods (manual therapy and reflexotherapy) necessary for the treatment and rehabilitation of patients with VNS.

Clinical Classification of Diseases

Clinical Classification of Diseases