This article focuses on the potential impact of big data analysis to improve health, prevent and detect disease at an earlier stage, and personalize interventions. The role that big data analytics may have in interrog...This article focuses on the potential impact of big data analysis to improve health, prevent and detect disease at an earlier stage, and personalize interventions. The role that big data analytics may have in interrogating the patient electronic health record toward improved clinical decision support is discussed. Weexamine developments in pharmacogenetics that have increased our appreciation of the reasons why patients respond differently to chemotherapy. We also assess the expansion of online health communications and the way in which this data may be capitalized on in order to detect public health threats and control or contain epidemics. Finally, we describe how a new generation of wearable and implantable body sensors may improve wellbeing, streamline management of chronic diseases, and improve the quality of surgical implants.展开更多
Glomerular filtration rate （GFR） can be measured （mGFR） after intravenous application of indicators that are eliminated by kidneys or estimated （eGFR） using mathematic equations. We have compared eGFR obtained b...Glomerular filtration rate （GFR） can be measured （mGFR） after intravenous application of indicators that are eliminated by kidneys or estimated （eGFR） using mathematic equations. We have compared eGFR obtained by the chronic kidney diseases epidemiology collaboration （CKD-EPI） and the Modification of diet in renal disease （MDRD） Study equations with GFR measured by technetium-99m diethylene triamine penta-acetic acid （99m^Te-DTPA） renal clearance in different stages of renal diseases in order that obtained results may contribute to more adequate choice of methods for the GFR assessment in relation to the type and stage of kidney disease. The study included a total of 189 participants with diabetes mellitus （DM）, glomerulonephritis （GN）, Balkan endemic nephropathy （BEN） and healthy subjects. 99m^Tc-DTPA clearance （ml/min/1.73 m^2） was calculated from the regression equation based on high correlation between distribution volume of radiopharmaceutical and clearance values obtained by multiple blood samples. For blood sample taken at 3 h and 4 h, clearance was calculated according to the equations： y = -0.0128x^2 ＋ 3.077x - 30.3, and y = -0.00628x^2 ＋ 2.066x - 19.3, where y is clearance, and x is distribution volume. MDRD-GFR （ml/min/l.73 m2） was calculated from equation： 186 × Scr^-1154 × age^-0.203 × 0.742 if female. CKD-EPI-GFR was calculated from equation： 141 × min（Scr/K, 1）^ α ×max（Scr/K, 1）^-1 209 × 0.993age × 1.018 if female, where Scr is serum creatinine, n is 0.7 for females and 0.9 for males, c~ is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/K or 1, and max indicates the maximum of Scr/κ or 1. Irrespective of renal disease, both equations underestimated radionuclide clearance at mGFR 〉 90 ml/min/1.73 m^2 （91.7 ± 18.8 and 88.2 ± 22.0 vs. 121± 19.6, p〈0.0001） and at mGFR 60-89 ml/min/1.73 m^2 （67.1 ±19.9 and 65.8 ± 19.9 vs. 75.8 ± 9.2, p 〈 0.05 and p 〈 0.005）. They were also significantly lower than mGFR in DM patients with GFR 〉_ 90 ml/min/1.73 m^2. In patients with GFR 〉 60 ml/min/1.73 m^2, the median bias of CKD-EPI equation was lower and accuracy （percent of eGFR within 30% of mGFR, P30） was higher than that of MDRD equation. Nevertheless, in DM patients with GFR _〉 90 ml/min the accuracy of the former equation is significantly better than that of MDRD formula. Patients GFR 〈 60 ml/min had the similar bias and accuracy both eGFR equations. As CKD-EPI equation has lesser bias and improved accuracy than MDRD equation in patients with GFR 〉 60 ml/min, we suggest its use for prediction of GFR at higher renal function levels. However, underestimation of renal function by CKD-EPI equation seems not to be quite appropriate in diabetic patients with expected GFR above 90 ml/min because it may miss the patients with glomerular hyperfiltration. Thus, priority may be given to 99m^Tc-DTPA clearance method in the earlier stages of kidney diseases in type 1 diabetes mellitus. At last, in patients with expected GFR 〈 60 ml/min, it is better to monitor disease progression by estimating equations than by 99m^Tc-DTPA renal clearance, due to their simpler implementation.展开更多
OBJECTIVE:To analyze the fatigue severity of patients with idiopathic chronic fatigue(ICF) and to compare the severity of this group with that of healthy subjects.METHODS:one hundred and nine ICF patients and 98 healt...OBJECTIVE:To analyze the fatigue severity of patients with idiopathic chronic fatigue(ICF) and to compare the severity of this group with that of healthy subjects.METHODS:one hundred and nine ICF patients and 98 healthy subjects were enrolled in this study.Fatigue severity was measured using the Korean-translated Chalder fatigue severity questionnaire.All subjects scored each item on a 10-point scale as a self-rating numeric scale(NRS),and additionally rated their feeling of general fatigue by visual analogue scale(VAS).RESULTS:The total NRS scores of patients with ICF was 53 ± 15 compared with 25 ± 14 of healthy subjects(2.4 folds for physical symptoms vs.1.7 folds for mental symptoms respectively).The VAS scores of patients with ICF were 2.7 times as high as those of healthy subjects.CONCLUSION:This report is the first to compare the severity of fatigue between ICF patients and healthy subjects.This study contains reference data applicable for the management of this disorder in field of complementary and alternative medicine.展开更多
文摘This article focuses on the potential impact of big data analysis to improve health, prevent and detect disease at an earlier stage, and personalize interventions. The role that big data analytics may have in interrogating the patient electronic health record toward improved clinical decision support is discussed. Weexamine developments in pharmacogenetics that have increased our appreciation of the reasons why patients respond differently to chemotherapy. We also assess the expansion of online health communications and the way in which this data may be capitalized on in order to detect public health threats and control or contain epidemics. Finally, we describe how a new generation of wearable and implantable body sensors may improve wellbeing, streamline management of chronic diseases, and improve the quality of surgical implants.
文摘Glomerular filtration rate （GFR） can be measured （mGFR） after intravenous application of indicators that are eliminated by kidneys or estimated （eGFR） using mathematic equations. We have compared eGFR obtained by the chronic kidney diseases epidemiology collaboration （CKD-EPI） and the Modification of diet in renal disease （MDRD） Study equations with GFR measured by technetium-99m diethylene triamine penta-acetic acid （99m^Te-DTPA） renal clearance in different stages of renal diseases in order that obtained results may contribute to more adequate choice of methods for the GFR assessment in relation to the type and stage of kidney disease. The study included a total of 189 participants with diabetes mellitus （DM）, glomerulonephritis （GN）, Balkan endemic nephropathy （BEN） and healthy subjects. 99m^Tc-DTPA clearance （ml/min/1.73 m^2） was calculated from the regression equation based on high correlation between distribution volume of radiopharmaceutical and clearance values obtained by multiple blood samples. For blood sample taken at 3 h and 4 h, clearance was calculated according to the equations： y = -0.0128x^2 ＋ 3.077x - 30.3, and y = -0.00628x^2 ＋ 2.066x - 19.3, where y is clearance, and x is distribution volume. MDRD-GFR （ml/min/l.73 m2） was calculated from equation： 186 × Scr^-1154 × age^-0.203 × 0.742 if female. CKD-EPI-GFR was calculated from equation： 141 × min（Scr/K, 1）^ α ×max（Scr/K, 1）^-1 209 × 0.993age × 1.018 if female, where Scr is serum creatinine, n is 0.7 for females and 0.9 for males, c~ is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/K or 1, and max indicates the maximum of Scr/κ or 1. Irrespective of renal disease, both equations underestimated radionuclide clearance at mGFR 〉 90 ml/min/1.73 m^2 （91.7 ± 18.8 and 88.2 ± 22.0 vs. 121± 19.6, p〈0.0001） and at mGFR 60-89 ml/min/1.73 m^2 （67.1 ±19.9 and 65.8 ± 19.9 vs. 75.8 ± 9.2, p 〈 0.05 and p 〈 0.005）. They were also significantly lower than mGFR in DM patients with GFR 〉_ 90 ml/min/1.73 m^2. In patients with GFR 〉 60 ml/min/1.73 m^2, the median bias of CKD-EPI equation was lower and accuracy （percent of eGFR within 30% of mGFR, P30） was higher than that of MDRD equation. Nevertheless, in DM patients with GFR _〉 90 ml/min the accuracy of the former equation is significantly better than that of MDRD formula. Patients GFR 〈 60 ml/min had the similar bias and accuracy both eGFR equations. As CKD-EPI equation has lesser bias and improved accuracy than MDRD equation in patients with GFR 〉 60 ml/min, we suggest its use for prediction of GFR at higher renal function levels. However, underestimation of renal function by CKD-EPI equation seems not to be quite appropriate in diabetic patients with expected GFR above 90 ml/min because it may miss the patients with glomerular hyperfiltration. Thus, priority may be given to 99m^Tc-DTPA clearance method in the earlier stages of kidney diseases in type 1 diabetes mellitus. At last, in patients with expected GFR 〈 60 ml/min, it is better to monitor disease progression by estimating equations than by 99m^Tc-DTPA renal clearance, due to their simpler implementation.
基金supported by a grant from the Oriental Medicine R&D Project,Ministry of Health & Welfare(B100045),Republic of Korea
文摘OBJECTIVE:To analyze the fatigue severity of patients with idiopathic chronic fatigue(ICF) and to compare the severity of this group with that of healthy subjects.METHODS:one hundred and nine ICF patients and 98 healthy subjects were enrolled in this study.Fatigue severity was measured using the Korean-translated Chalder fatigue severity questionnaire.All subjects scored each item on a 10-point scale as a self-rating numeric scale(NRS),and additionally rated their feeling of general fatigue by visual analogue scale(VAS).RESULTS:The total NRS scores of patients with ICF was 53 ± 15 compared with 25 ± 14 of healthy subjects(2.4 folds for physical symptoms vs.1.7 folds for mental symptoms respectively).The VAS scores of patients with ICF were 2.7 times as high as those of healthy subjects.CONCLUSION:This report is the first to compare the severity of fatigue between ICF patients and healthy subjects.This study contains reference data applicable for the management of this disorder in field of complementary and alternative medicine.
