Hospital self-registration system development based on BS
75390329
The application and experience of self registration system in general hospital
Based on the background of application self registration system in Ningbo the 1st Hospital,the experiences of software system development,its functions,staff training and propaganda are introduced. With the analysis of its strength,reasonable suggestions to promote the popularity and smooth operation of self registration system in medical service to improve the quality of hospital management and information construction are discussed.
Ying Liming
73419575
Burden of large vessel occlusion stroke and the service gap of thrombectomy: A population based study using a territory wide public hospital system registry
Background Ischemic stroke due to large vessel occlusion can be effectively treated with thrombectomy but access to this treatment is limited in many parts of the world. Local incidence of large vessel occlusion is critical in determining the development of thrombectomy service, but reliable data from Asian countries are lacking. Aims We performed a population based study to estimate the burden of large vessel occlusion and the service gap for thrombectomy in Hong Kong. Methods All acute ischemic stroke patients admitted in 2016 to the public healthcare system, which provided 90% of the emergency healthcare in the city, was identified from the Hong Kong Hospital Authority's central electronic database. The diagnosis of large vessel occlusion was retrospectively verified by two independent cerebrovascular specialists in a randomly sampled cohort based on clinical and neuroimaging data. The incidence of large vessel occlusion in the population was estimated through weighting the sample results and compared with the thrombectomy data in the same period. Results There were 6859 acute ischemic stroke patients treated in the public health system in 2016. Amongst the 300 patients randomly sampled according to diagnosis coding, 130 suffered from anterior circulation large vessel occlusion. This translated to 918 patients (95% CI 653 1180) and 13.3% of all ischemic stroke patients. The estimated incidence of anterior circulation large vessel occlusion was 12.5 per 100,000 persons per year (95% CI 11.7 13.4) Large vessel occlusion stroke patients were more commonly female than male (67.4% vs. 31.6% p 0.003) and were older than non large vessel occlusion stroke patients (mean of 80.5 years vs. 71.4 years, p 0.001) They also had higher 30 day mortality rate (31.1% vs. 4.6% p 0.001) and longer hospital stay (mean 38.6 vs. 21.1 days, p 0.003) than non large vessel occlusion stroke. In the same period, 83 thrombectomies for large vessel occlusion were performed, representing 9.1% of the estimated large vessel occlusion incidence. Conclusion The estimated incidence of anterior circulation large vessel occlusion in the Hong Kong Chinese population is lower than that in the West. There is however a substantial service gap for endovascular thrombectomy with less than 10% of large vessel occlusion patients receiving thrombectomy.
International journal of stroke official journal of the International Stroke Society
Anderson Chun On Tsang Jia You Lai Fung Li Frederick Chun Pong Tsang Pauline P S Woo Eva L H Tsui Philip S Yu Gilberto Ka Kit Leung
224875324
Acceptance and usability of a web based medication management system among nurses in a telehealth hospital
Summary: This study aims to determine the Acceptance and Usability of a web based medication management system among nurses working in a Pilot Telehealth Hospital in Bulacan. References: Aldosari, B. Al Mansour, S. Aldosari, H. Alanazi, A. (2017) Assessment of factors influencing nurses acceptance of electronic medical record in a Saudi Arabia hospital. Elsevier. https:/doi.org/doi.org/10.1016/j.imu.2017.12.007 Atmowardoyo, H. (2018) Research Methods in TEFL Studies: Descriptive Research, Case Study, Error Analysis, and R D. Journal of Language Teaching and Research, 9, 197 204. https:/doi.org/10.17507/jltr.0901.25 Balestra, M. (2017) Electronic Health Records: Patient Care an Ethical and Legal Implications for Nurse Practitioners. Elsevier, 13(2) https:/doi.org/10.1016/j.nurpra.2016.09.010 Binaymin, S. Smith, S. Rutter, M. J. (2016) The utilization of system usability scale in learning management systems: a case study of jeddah communitycollege. https:/doi.org/10.21125/iceri.2016.2290 Boonen, M. Vosman, F. Niemeijer, A. (2015) Is Technology The Best Medicine? Three practice Theoretical perspectives on Medication Administration Technologies in Nursing. John Wiley and Sons Ltd. DOI:10.1111/nin.12119 Boyd Rabkin, A. Weberg, D. (2015, June 5) Nursing 2.0: Improving Care Through Technology. California Health Care Foundation. Retrieved from www.chcf.org Groube, J. (2017) Postgraduate Study: The Journey for Registered Nurses. Retrieved from https:/ir.canterbury.ac.nz Guetterman, t. fetters, m. creswell, j. (2015) Integrating quantitative and qualitative results in health science mixed methods research through joint displays. Annals of Family Medicine, 13. https:/doi.org/0.1370/afm.1865. First Primary Presenting Author Primary Presenting Author Hanna Monique Arinduque Floresca, PhD, MAN, RN Our Lady of Fatima University School of Nursing Associate Professor 1 Quezon City Philippines Author Summary: The researcher is a graduate of BS Nursing at our Lady of Fatima University and a graduate of Masters of Arts in Nursing major in Nursing Administration and Doctor of Philosophy in Nursing Administration in the same University. She is a college Lecturer and teaches professional nursing subjects and clinical instructor and at the same time a graduate school lecturer in the Philippines. Second Author Michael Joseph Dino, PhD, MAN, RN, LPT Our Lady of Fatima University Research Development and Innovation Center Director Valenzuela City Philippines Author Summary: Prof. Dr. Michael Joseph Dino, Vice President and Program Chair of the Phi Gamma Chapter, is the Director for Research Development and Innovation Center of the Our Lady of Fatima University, Philippines. He is an Apple Distinguished Educator (ADE) an ENFLA scholar of Sigma for Cohort III 2018 2019, and the first Asian recipient of the Nurse in the Limelight Award conferred by the Connecting Nurses Program in partnership with the International Council of Nurses. Third Author Christian Jay S. Orte, PhD, MAN, RN, RM Our Lady of Fatima University Graduate School Professor Pampanga Philippines Author Summary: He is a graduate of Bachelor of Science in Nursing, Master of Arts in Nursing and Doctor of Philosophy in Nursing. He is also a Speaker in Different schools and hospitals in the Philippines Fourth Author Michael Ignacio Aggari, PhD, MSN, RN Our Lady of Fatima University School of Nursing Associate Professor 1 Quezon City Philippines Author Summary: The researcher is a graduate of the following: Associate Health Science Education Bachelor of Science in Nursing Master of Science in Nursing Doctor of Philosophy in Nursing He is currently employed as Nursing Director, Graduate School Coordinator and a Clinical instructor in the Philippines. He engaged also in the Department of Health, Philippines as HIV Counselor. He also invited as a resource Speaker of Infection prevention and Control Program.
Hanna Monique Arinduque Floresca Michael Joseph S Dino Christian Jay T Orte Michael I Aggari
212587688
Portable Monitoring Diagnostic System based on the Combining of Real Time WSN with GSM and Internet
The development of the healthcare systems, by combining E health, I health and GSM health together, recently became the focus of attention of researchers. In this research, will develop our research that practically designed in the name of &quot;Real Time Portable Health Care PP, GSR, BG, EMG with Alarm System Based on WSN&quot; to assist in the development of the health situation in the hospitals. The system develops by supporting GSM and Internet together in the wireless sensor network (WSN) under ZigBee protocol and by supporting the printing of medical reports. Where the implemented system measures the biomedical data utilizing a group of biomedical sensors, which are patient position sensor (PPS) galvanic skin response sensor (GSR) blood glucose sensor (BGS) and electromyography sensor (EMG) The System monitors the sleep position and skin conductance (indicator to patient&apos;s calm) of the patients in real time with alarm for each abnormal case in the base station (BS) and lobbies, and sends SMS alarm to doctor&apos;s phone, and it follows up patient&apos;s glucose rate and diagnosis the patient&apos;s electromyography status. Moreover, it sends the glucose data to doctor&apos;s phone and uploads it to the special web site by using the GSM and Internet technologies. In addition, it introduces a printed hard copy medical report. Moreover,
Salvatore Domenic Morgera
211163108
Healthcare Utilization and End of Life Care Outcomes for Patients with Decompensated Cirrhosis Based on Transplant Candidacy (RP500)
I. Importance: Patients with decompensated cirrhosis have high rates of healthcare utilization at end of life (EOL) However, the impact of transplant candidacy on intensity of EOL care is currently unknown. II. Objective(s) To assess the relationship between transplant candidacy and intensity of EOL care in the last year of life in an ambulatory cohort of patients with decompensated cirrhosis. III. Method(s) We performed a retrospective analysis of 230 patients with decompensated cirrhosis who were evaluated for liver transplantation in a large healthcare system between 1/1/2010 and 12/31/2017 and died by 6/20/2018. We compared healthcare utilization in the last year of life and EOL care outcomes between transplantlisted (n=133) and non listed (n=97) patients. We examined predictors of palliative and hospice care utilization using multivariate logistic regression. IV. Results: During the last year of life, patients had a median of 3 [IQR 2 5] hospitalizations and spent a median of 31 days [IQR 16 49] in the hospital. In all, 80% of patients died in the hospital, with 70% dying in the intensive care unit. The majority (70.0% received a life sustaining procedure (mechanical ventilation, renal replacement therapy, or cardiopulmonary resuscitation) during their terminal hospitalization, which did not differ between transplantlisted and non listed patients (74.4% vs. 63.9% p=0.09) Transplant listed patients had lower odds of receiving specialty palliative care (OR 0.43, p=0.005) Patients with hepatocellular carcinoma had higher odds of receiving hospice care (OR 2.03, p=0.049) V. Conclusion(s) Patients with decompensated cirrhosis had intensive healthcare utilization during their last year of life regardless of transplant candidacy. VI. Impact: Further work is needed to optimize EOL care for patients with decompensated cirrhosis, particularly for patients who are ineligible for transplantation. Lack of Exposure to Hospice and Palliative Medicine Training for African American Students: the State of the U.S. Medical Education System (RP501) Presenter: Lindsay Bell, BA, Palliative Research Center, Univ. of Pit, Pittsburgh, PA Jessica Livingston, BS, MPH, Children's National Hospital, Washington, DC Yael Schenker, MD, University of Pittsburgh, Pittsburgh, PA Robert Arnold, MD,FACP,FAAHPM, University of Pittsburgh, Pittsburgh, PA Tessie October, MD, Children's National, Washington, DC Objectives 1.By the end of the presentation, participants will be able to compare HPM training opportunities at HBCUs, nonminority serving institutions with the highest and lowest percentage of AA students, and the top ten ranked medical schools in the U.S. 2.After attending this session, learners will be able to analyze factors in the U.S. medical education system that contribute to underrepresentation of African American doctors in the HPM workforce. Abstract I. Importance: The hospice and palliative medicine (HPM) workforce lacks racial diversity; less than 5% of HPM fellows are African American (AA) Little is known about AA trainees' exposure to HPM during medical school and residency training.I. Importance: The hospice and palliative medicine (HPM) workforce lacks racial diversity; less than 5% of HPM fellows are African American (AA) Little is known about AA trainees' exposure to HPM during medical school and residency training. II. Objective(s) To describe HPM training opportunities for AA students during medical school and residency training. III. Method(s) Data were collected through publicly accessible websites and communication with institutional representatives from 34 medical schools in 4 pre determined categories: historically black colleges and universities (HBCUs) (N 4) non minority serving institutions with the highest (N 10) and lowest (N 10) percentage of AA medical students, and the top ten ranked medical schools nationally (N 10) Questions focused on medical school curricula; internal, family, emergency, and pediatric residency training program curricula; and fellowship programs. IV. Results: No HBCUs offer an HPM course, clerkship, fellowship program, or rotation during residency. Only 75% of HBCUs are affiliated with a hospital that has an HPM program or service. Institutions with a higher percentage of AA students are less likely to offer an HPM fellowship program than institutions with a lower percentage of AA students and top ranked medical schools (50% vs. 80% p 0.026) Similarly, institutions with a higher percentage of AA students are less likely to offer HPM elective rotations during internal (62% vs. 100% p 0.027) and family medicine (43% vs. 100% p 0.003) residency training than institutions with a lower percentage of AA students. V. Conclusion(s) Medical students and residents at schools with the highest percentage of AA medical students are less likely to have access to an HPM fellowship program and HPM elective rotation during their training. VI. Impact: Lack of exposure to HPM training for African American medical students and residents may contribute to underrepresentation in the HPM workforce. Keystones in Behavioral Intervention Research in Hospice and Palliative Care (RP502) Presenter: George Demiris, PHD, University of Pennsylvania, PA Debra Parker Oliver, MS,MSW, University of Missouri, Columbia, MO Karla Washington, PhD, University of Missouri, MO Objectives 1. Incorporate keystone considerations into the behavioral intervention research lifecycle 2. Integrate ethical and cultural considerations in the design and evaluation of behavioral research Abstract I. Importance: The design of behavioral interventions in hospice and palliative care needs to acknowledge the unique challenges of these settings. Strategies to integrate ethical and cultural considerations, and to improve likelihood for translation into practice are needed.I. Importance: The design of behavioral interventions in hospice and palliative care needs to acknowledge the unique challenges of these settings. Strategies to integrate ethical and cultural considerations, and to improve likelihood for translation into practice are needed. II. Objective(s) This presentation demonstrates how ethical considerations, cultural congruence, interdisciplinary collaboration and engagement of stakeholders can serve as keystones, namely foundational threads that inform the design, implementation and evaluation of a behavioral intervention in hospice and palliative care. III. Method(s) A model for behavioral intervention research was developed by our research team specifically for the hospice and palliative care settings. This model includes iterative steps that cover the spectrum of behavioral intervention research, starting from the definition and analysis of a problem, moving into the design of an intervention, pilot testing, refining and formally evaluating the intervention as well as disseminate findings and translating the intervention. IV. Results: Based on three federally funded clinical trials in various settings (including two clinical trials in home hospice and one in outpatient palliative care) we demonstrate how stakeholders can be engaged in all phases of the intervention development and testing. Similarly, strategies to address cultural congruence and methods to incorporate interdisciplinary perspectives are presented. Ethical considerations and challenges associated with the testing of behavioral interventions in these settings are discussed. V. Conclusion(s) In order to ensure that behavioral interventions can be tailored and effective and easily translatable into practice, extensive planning is required. A structured approach that integrates ethical and cultural considerations as well as interdisciplinary perspectives in all phases of the intervention design and testing, rather than an afterthought, can maximize the chances of a successful implementation and translation into practice. VI. Impact: The defined keystone considerations can inform and strengthen the design of behavioral interventions targeting patients, families, clinicians or other stakeholders in hospice and palliative care settings. National Variation in Palliative Care and Associated Outcomes Among Decedents with Heart Failure in Veterans Affairs Medical Centers (RP503) Presenter: Shelli Feder, PHD,APRN,ACHPN, Yale University, New Haven, CT Mary Ersek, RN,FPCN, Dept of Veterans Affairs, Philadelphia, PA Ann Kutney Lee, PHD, RN, FAAN, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA Nancy Redeker, PhD, Yale University, West Haven, CT Lori Bastian, MD, Yale University and VA Connecticut, New Haven, CT Kathleen Akgun, MD, MS, VA Connecticut Healthcare System, West Haven, CT Objectives 1. Understand system level approaches to characterizing palliative care reach in a large, single payer healthcare system. 2. Discuss study methodology for assessing variation in palliative care reach among multiple healthcare facilities. 3. Recognize the role of facility level variation in palliative care reach and patient outcomes. Abstract I. Importance: National policies require that all Veterans with serious life limiting illness have access to palliative care at all Veterans Affairs Medical Centers (VAMCs).I. Importance: National policies require that all Veterans with serious life limiting illness have access to palliative care at all Veterans Affairs Medical Centers (VAMCs) II. Objective(s) To describe VAMC variation in rates of palliative care consultation (PCC) and associated outcomes among decedents with heart failure (HF) III. Method(s) Retrospective analysis of Veterans Affairs (VA) medical records and Bereaved Family Survey data. Veterans with HF who received a PCC within 90 days of death were identified. Outcomes included 1) the Bereaved Family Survey Performance Measure (BFS PM) defined as an overall rating of "excellent" for care received during the last month of life, 2) death in inpatient hospice, 3) documented famil
Nneka N Ufere Jennifer L Halford Joshua Caldwell Minyoung Jang Sunil Mahesh Bhatt John Donlan Vicki Ann Jackson Raymond T Chung Areej R El-Jawahri
63782218
Application of a calling and queuing system in blood sampling centers based on pure software technology
Objective:To solve the problem of the standing long queuing in outpatients for blood sampling to improve confusion,crowded environment at the Blood Sampling Center.Methods:With Delphi development including self help registration,software call,large screen display,statistics module of Calling and Queuing System in Blood Sampling Center,we realized the realtime access to patient information from the hospital information system by using speech synthesis and live recording the method which combines the voice call.Results:We had improved the blood collection process,shortened the waiting time of patients with blood sampling,promoted service quality and reduced the work pressure.Realization of blood collection management of scientific,modernization and digitalization had been achieved.Conclusion:The method is simple and of less investment and high practicability for the hospital to provide a modern scientific management means.
Xun Yan-mei
2928139
Portable Monitoring Diagnostic System based on the Combining of Real Time WSN with GSM and Internet
The development of the healthcare systems, by combining Ehealth, I health and GSM health together, recently became the focus of attention of researchers. In this research, will develop our research that practically designed in the name of "Real Time Portable Health Care PP, GSR, BG, EMG with Alarm System Based on WSN" to assist in the development of the health situation in the hospitals. The system develops by supporting GSM and Internet together in the wireless sensor network (WSN) under ZigBee protocol and by supporting the printing of medical reports. Where the implemented system measures the biomedical data utilizing a group of biomedical sensors, which are patient position sensor (PPS) galvanic skin response sensor (GSR) blood glucose sensor (BGS) and electromyography sensor (EMG) The System monitors the sleep position and skin conductance (indicator to patient's calm) of the patients in real time with alarm for each abnormal case in the base station (BS) and lobbies, and sends SMS alarm to doctor's phone, and it follows up patient's glucose rate and diagnosis the patient's electromyography status. Moreover, it sends the glucose data to doctor's phone and uploads it to the special web site by using the GSM and Internet technologies. In addition, it introduces a printed hard copy medical report. Moreover, the system stores the patient information and his health data in order to use it for any archiving process or statistical study. In the achievement system, three nodes are considered according to the facilities available but it stays monitor diagnosis for an open node number. The system is implemented practically and applied for some persons under supervision of the specialist physicians, and the results obtained are very satisfied and present a great service to human care. All obtained results are presented in this paper.
Samir Jasim Mohammed Mahmoud Shaker Nasr Ali Jasim Ramadhan
231933549
Recent and forecast post COVID trends in hospital activity in England amongst 0 to 24 year olds: analyses using routine hospital administrative data
BackgroundIncreasing hospital use in the past decade has placed considerable strain on children and young peoples (CYP) health services in England. Greater integration of healthcare may reduce these increases. We projected CYP healthcare activity out to 2040 and examined the potential impact of integrated care systems on projected activity. MethodsWe used routine administrative data (Hospital Episode Statistics (HES) on emergency department (ED) attendances, emergency admissions and outpatient (OP) attendances for England by age group for 0 24 year olds from 2007 to 2017. Bayesian projections of future activity used projected population and ethnicity and future child poverty rates. Cause data were used to identify ambulatory care sensitive conditions (ACSC) FindingsED attendances, emergency admissions and OP attendances increased in all age groups from 2007 to 2017. ED and OP attendances increased 60 80% amongst children under 10 years. ACSC and neonatal causes drove the majority of increases in emergency admissions. Activity was projected to increase by 2040 by 50 145% for ED attendances, 20 125% for OP attendances and 4 58% for total admissions. Scenarios of increasing or decreasing child poverty resulted in small changes to forecast activity. Scenarios in which 50% of ACSC were seen outside hospital in integrated care reduced estimated activity in 2040 by 21.2 25.9% for admissions and 23.5 30.1% for ED attendances across poverty scenarios amongst infants. InterpretationThe rapid increases in CYP healthcare activity seen in the past decade may continue for the next decade given projected changes in population and child poverty, unless some of the drivers of increased activity are addressed. Contrary to these pessimistic scenarios, our findings suggest that development of integrated care for CYP at scale in England has the potential to dramatically reduce or even reverse these forecast increases FundingNil funding obtained. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSThere has been marked increases in hospital use (inpatient, outpatient and emergency department (ED) by children and young people (CYP) Search of the PubMed database using the search terms: "child"[MeSH Major Topic] OR "adolescent"[MeSH Major Topic] OR "infant"[MeSH Major Topic] AND (healthcare use[Text Word] OR (emergency admission[Text Word] AND (united kingdom[Text Word] Drivers of increased activity include population growth and sociodemographic factors, help seeking behaviour, growth in medical knowledge and capability, and by factors within the health system. Additional factors in child health include increased survival of premature neonates and those with congenital conditions and rising parental expectations of modern medicine. Previous studies have shown that ambulatory care sensitive conditions (ACSC) are responsible for much of the increase in CYP emergency activity in England and Scotland. Added value of this studyThis is the first study to use existing data to project possible future scenarios for CYP healthcare activity out to 2030 and 2040 in any country. Our future scenarios are based upon authoritative projections for population, ethnic diversity and child poverty in England and allow us to estimate the potential impact of integrated care scenarios in which ACSC are treated outside hospital. We show that future projected CYP activity is very high if mitigations such as integrated care are not instituted in England. Implications of all the available evidenceHealthcare activity has grown dramatically over the last decade in CYP, largely due to ACSC and the consequences of premature delivery. Projections to 2040 suggest that similar increases are likely over the next 2 decades without action to reduce child poverty and implementation of integrated care at scale in the NHS.
medRxiv
Dougal S Hargreaves Alison Firth Steven Turner Russell M Viner
74286825
Enhancement of hospital libraries and information services through an e support system for lifelong learning quality methodologies and tools
Quality is indeed a multifaceted concept entailing multiple consequences for the overall management of healthcare services. Quality methods and tools are designed to be simple and effective in identifying, organizing, quantitative and qualitative operational healthcare data. Healthcare professionals are empowered through the use of such tools and methods. Furthermore, quality methods and tools are essential; hence they must "communicate" efficiently to the healthcare professionals. This work is providing a Library and Information Services (LIS) framework for the development of a professional centered e support system for learning quality methods and tools. The approach is based on taxonomy for studying the contributions of hospital LIS as well as British Standards and in particular the BS 8423 2003 "a code of practice for e support in e learning systems" Moreover, novel methods for teaching quantitative statistical methods as well as qualitative approaches for quality in healthcare are considered. Therefore, the role and the contributions of a modern hospital library are exhibited for providing the information services required for the most excellent learning experience
Petros A Kostagiolas Stelios Zimeras
214696282
The geographic and clinical clusters of Behcet's syndrome
Behcet's syndrome (BS) is a complex disorder characterised by oral aphtous ulcerations often associated with genital aphtae and skin lesions. Vascular, ocular, central nervous system and gastrointestinal lesions occur less frequently, but are associated with increased morbidity and mortality [1, 2] The aetiology of BS remains unclear and several pathogenic pathways are likely to be involved [3 6] BS can affect males and females in equal proportions, but it seems to present with a more severe course in males [1, 7] Since no laboratory or imaging findings are specific for BS, the diagnosis is usually based on clinical features only. However, the situation is far more complicated, since there is a strong variability among different geographical locations both in the prevalence and expression of the disease. Classically, BS has been referred to the Silk Route, because the Middle East and the Far East Asia are considered endemic for this condition [8] Lately, severe epidemiologic studies have outlined that the increasing awareness of the condition is changing the view. Indeed, BS was considered rare among black individuals, but a study from Dakar, Senegal has proposed a yearly incidence of 3.84 per 100,000 people [9] Moreover, also human migration is playing a role as outlined by a survey based study done in Paris among immigrants: the incidence rate of BS was not different than that in the countries of origin [10] The studies are different and sometimes difficult to compare, but we can assume that gastrointestinal manifestations are more frequent in the Far East Asia, whereas vascular lesions, such as arterial aneurysms or inflammatory thromboses are more frequent in the Middle East Asia [11] Moreover, a milder course of the disease has been reported in non endemic areas [7] These geographical differences in clinical features account for the difficulties in the classification of BS. The International Study Group (ISG) for Behcet's Disease criteria [12] and the International Classification for Behcet's Disease (ICBD) criteria [13] do not consider enough geographic variability, leading to some difficulties in differentiating some clinical features of BS from other autoimmune or inflammatory conditions (e.g. the gastrointestinal involvement in BS and Crohn's disease) [7] Sota et al. in this issue of Internal and Emergency Medicine analyse the current situation of BS in Italy [14] They report on a retrospective hospital based analysis of 396 cases referred to three referral centers in Central and Southern Italy. This is the largest Italian cohort ever described. Patients were admitted between January 2015 and January 2017, and their medical charts were retrospectively reviewed. The diagnosis of BS was made according to ISG or ICBD. All patients were Caucasian, predominantly of Italian ancestry. The majority of patients were female (female/male ratio of 1.22/1) and 81% were younger than 40 years at the disease onset. The authors recorded as most frequent manifestations at onset oral and genital ulcers (91% and 21.5% respectively) skin manifestations (in particular psudofollicolitis, pustular lesions and erythema nodosum) and the ocular involvement presenting mostly as a bilateral panuveitis. With regard to clinical features, hospital based studies have the tendency to collect mostly complicated cases presenting with more severe involvements, whereas population based studies include milder forms of the disease. This could explain the high prevalence of severe ocular involvement. Another interesting issue is the tendency of different clinical features to cluster together, forming different clinical subsets, such as the acne arthritis enthesitis subset or the vascular subset [15 18] This tendency could suggest that multiple pathogenic pathways contribute to the development of BS [6] In this regard, the authors have also performed a factor analysis, to detect some clinical associations. They described two independent factors: the association of bipolar aphtosis with erythema nodosum and pseudofollicolitis, and uveitis as a distinct feature. The authors did not confirm other clusters Chiara Marvisi chiara.marvisi@gmail.com
Internal and Emergency Medicine
Chiara Marvisi