Impact of demographic factors and tumor characteristics on the lung cancer patients survival in Vojvodina

Širom sveta, karcinom bronha je i dalje vodeći po incidenci i mortalitetu, sa 2,1 milion novih slučajeva i predviđenih 1,8 smrtnih ishoda u 2018. godini. Karcinom bronha predstavlja skoro petinu (18,4%) svih smrtnih ishoda od karcinoma. Istraživanje je sprovedeno kao retrospektivna studija za period 2010-2016 godine. Svi podaci potrebni za sprovođenje ovog istraživanja direktno su prikupljeni iz zdravstvenog informacionog sistema i registra za karcinom bronha Instituta za plućne bolesti Vojvodine (IPBV), koji je referentna ustanova za pacijente sa karcinomom bronha za celu Autonomnu Pokrajinu Vojvodinu. Cilj rada je bio da se utvrdi uticaj demografskih i kliničko-patololoških karakteristika na ukupno vreme preživljavanja kod bolesnika sa karcinomom bronha, kao i da se izradi geoprostorna analiza incidencije i mortaliteta od karcinoma bronha na teritoriji Vojvodine. Podaci o broju novoobolelih i broju umrlih pacijenata potrebni za analizu incidencije i mortaliteta prikupljeni su od lokalnih Instituta za javno zdravlje za svaki od sedam okruga. Za potrebe analize overall survivall, survival rate ukupno je obuhvaćeno 8142 bolesnika lečenih u IPBV, od kojih je nakon provere uključujućih i isključujućih kriterijuma, u konačnu analizu ušlo njih 7540. Za potrebe analize incidencije i mortaliteta prikupljeni su podaci od lokalnih Instituta za javno zdravlje za svaki od sedam okruga i ukupno je uključeno 21915 pacijenata. Od ukupno 7540 bolesnika, bilo je 5456 (72,4%) muškaraca i 2084 (27,6%) žena. Prosečna starost bolesnika iznosila je 63,4±8,85 godina, Najveći broj bolesnika su bili pušači, njih 4911 (65,1%), bivših pušača je bilo 1995 (26,5%), dok je najmanje bilo nepušača, svega 634 (8,4%). Srednja vrednost indeksa paklo-godina (pack-years) iznosila je 50,57±28,80. Posmatrano prema bračnom statusu, najviše bolesnika je bilo oženjeno/udato, njih 5348 (70,9%). Najveći broj bolesnika je ocenio svoj socioekonomski status kao osrednji, njih 4912 (65,1%). Broj bolesnika sa ECOG performans statusom 1 bio je 5679 (75,3%), njih 840 (11,1%) je imalo ECOG performans status 2, dok je ECOG performans status 0 imao 451 (6,0%) bolesnik. Najveći broj bolesnika bio je dijagnostikovan u IV stadijumu bolesti 3108 (41,2%), zatim u IIIB 1886 (25,0%), IIIA 1401 (18,6%), dok je u IA stadijumu dijagnostikovano najmanje bolesnika, njih 234 (3,1%). Najveći broj bolesnika imao je potvrđenu dijagnozu adenokarcinoma, njih 3342 (44,3%), zatim skvamoznog karcinoma 2472 (32,8%), mikrocelularnog karcinoma 1386 (18,4%). Od ukupnog broja bolesnika, tokom perioda praćenja preminulo je njih 6420 (85,1%), dok je 1120 (14,9%) bolesnika bilo živo. Prosečno vreme preživljavanja muškaraca bilo je 17,116 meseci, a žena 23,193 meseca. Muškarci oboleli od karcinoma bronha statistički značajno (p=0,000) kraće su živeli u odnosu na žene. Analiza kumulativnog preživljavanja bolesnika pokazala je da je postojala statistički značajna razlika u preživljavanju u odnosu na pol kod podtipova adenokarcinom (p=0,000), skvamozni karcinom (p=0,000) i mikrocelularni karcinom (p=0,001). Statistički značajna razlika u preživljavanju postojala je i u odnosu na starost, mesto stanovanja, tip tumora, stadijum bolesti, ECOG, pušački status i TNM stadijum bolesti (p=0,000). Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 32,5%, skvamoznog karcinoma 37,3%, adenokarcinoma 33,4% i mikrocelularnog karcinoma 20,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 9,2%, skvamoznog karcinoma 10,8%, adenokarcinoma 10,7% i mikrocelularnog karcinoma 2,0%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 5,0%, kod skvamoznog karcinoma 6,1%, adenokarcinoma 5,4% i mikrocelularnog karcinoma 1,3%. Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 78,1%, u 1B stadijumu 73,2%, 2A stadijumu 70,4%, 2B stadijumu 52,1%, 3A stadijumu 42,3%, 3B stadijumu 28,3%, dok je u 4 stadijumu bolesti ukupno jednogodišnje preživljavanje bilo 17,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 40,8%, u 1B stadijumu 37,5%, 2A stadijumu 31,2%, 2B stadijumu 21,6%, 3A stadijumu 9,7%, 3B stadijumu 5,5%, dok je u 4 stadijumu bolesti ukupno trogodišnje preživljavanje bilo 2,9%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 32,1%, u 1B stadijumu 19,3%, 2A stadijumu 16,2%, 2B stadijumu 13,3%, 3A stadijumu 4,4%, 3B stadijumu 2,6%, dok je u 4 stadijumu bolesti ukupno petogodišnje preživljavanje bilo 1,6%. Kao nezavisni prediktori preživljavanja izdvojeni su muški pol, starost preko 60 godina, ECOG performans status veći od 2, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikrokarcinom kao tip tumora (p=0,000). Incidencija karcinoma bronha za muškarce iznosila je 118,9 na 100000 stanovnika, a za žene 43,3 na 100000 stanovnika. Standardizovana stopa incidencije karcinoma bronha za muškarce iznosila je 65,4 na 100000 stanovnika, a za žene 21,7 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Stopa mortaliteta od karcinoma bronha za muškarce iznosila 125,1 na 100000 stanovnika, a za žene 43,8 na 100000 stanovnika. Standardizovana stopa mortaliteta od karcinoma bronha za muškarce iznosila 67,6 na 100000 stanovnika, a za žene 20,9 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Analizom prikupljenih podataka utvrđeno je da postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odnosu na pol (p=0,000), starosnu dob (p=0,000), mesto stanovanja (p=0,014), pušački status (p=0,001), ECOG performans status (p=0,000) i socioekonosmski status (p=0,000). Postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odsnosu na tip tumora (p=0,000), stadijum bolesti (p=0,000), T-deskriptor (p=0,000), N-deskriptor (p=0,000) i M-deskriptor (p=0,000). Utvrđeno je da ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosi 32,5%, trogodišnje preživljavanje obolelih od karcinoma bronha iznosi 9,2%, a petogodišnje preživljavanje iznosi 5,0%. Utvrđeno je da su nezavisni prediktori preživljavanja muški pol, starost preko 60 godina, ECOG performans status 2 i veći, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikroculularni karcinom kao tip tumora. Urađena je analiza incidencije i mortaliteta od karcinoma bronha na teritoriji AP Vojvodine i utvrđeno je da postoje značajne regionalne razlike u incidenciji i mortalitetu od karcinoma bronha na teritoriji AP Vojvodine.Worldwide, lung cancer remains the leading cause of cancer incidencije and mortality, with 2.1 million new lung cancer cases and 1.8 million deaths predicted in 2018. Methodology: For the purpose of this retrospective study we collected data of 21915 patients from seven Public Health Institutes, one for each district. This data was categorized by five-year age groups during 2010–2016. Survival analysis data of 8142 patients was collected from the Institute for Pulmonary Diseases of Vojvodina Hospital Information System and the Lung Cancer Registry. The primary objective was to determine the impact on overall survival by assessing demographic and clinical pathological characteristics in these patients. The secondary objective was to analyze the incidencije and mortality of lung cancer in the region of Vojvodina. Incidencije and mortality rates were directly age-standardized to the World and Europe Standard Population. A total of 7540 patients were eligible for the survival analysis, 5456 (72.4%) males and 2084 (27.6%) females. The average survival time, including all stages and cancer types was 17.1 months for men and 23.2 months for women (p = 0.000). There was statistically significant difference in survival time by gender in subtypes of adenocarcinoma (p = 0.000), squamous cell carcinoma (p= 0.000) and microcellular carcinoma (p = 0.001). Analysis showed significant difference in survival by age (p = 0.000), cancer type (p = 0.000), stage of the disease (p = 0.000), ECOG performance status (p = 0.000), smoking status (p = 0.001), TNM stage of disease (p = 0.000) and among districts (p = 0.014). Male gender (p = 0.000), age over 60 (p = 0.000), ECOG performance status 2 and greater (p = 0.000), smoking habit (p = 0.002), lower socioeconomic status (p = 0.000), stage IV of disease (p = 0.000) and small cell lung cancer as tumor type (p = 0.000) were identified as independent prognostic factors. One-year survival in 1A stage was 78.1%, in 1B stage 73.2%, 2A stage 70.4%, 2B stage 52.1%, 3A stage 42.3%, 3B stage 28.3 %, while in stage 4 was 17.9%. Three-year survival in 1A stage was 40.8%, in 1B stage 37.5%, 2A stage 31.2%, 2B stage 21.6%, 3A stage 9.7%, 3B stage 5.5 %, while in stage 4 was 2.9%. Five-year in 1A stage is 32.1%, in 1B stage 19.3%, 2A stage 16.2%, 2B stage 13.3%, 3A stage 4.4%, 3B stage 2.6 %, while in stage 4 was 1.6%. The incidencije rate was 118.9 per 100000 for males and 43.3 per 100000 for women. The standardized incidencije rate was 65.4 per 100000 for males and 21.7 per 100000 for females. There was a statistically significant difference by districts (p = 0.001). Mortality rate was 125.1 per 100000 for males and 43.8 per 100000 for females. The standardized mortality rate was 67.6 per 100000 for males and 20.9 per 100000 for females. There was also a statistically significant difference by district (p = 0.001). There was a statistically significant difference in overall survival by gender (p = 0.000), age (p = 0.000), place of residence (p = 0.014), smoking status (p = 0.001), ECOG performance status (p = 0.000), and socioeconomic status (p = 0.000). There was also a statistically significant difference in the overall survival by tumor type (p = 0.000), stage of disease (p = 0.000), T-descriptor (p = 0.000), N-descriptor (p = 0.000), and M-descriptor (p = 0.000). One-year survival rate was 32.5%, three-year survival was 9.2%, and five-year survival rate was 5.0%. Incidencije and mortality rates data were analyzed for the territory of Vojvodina, and it was found that there were significant regional differences

Impact of demographic factors and tumor characteristics on the lung cancer patients survival in Vojvodina

Širom sveta, karcinom bronha je i dalje vodeći po incidenci i mortalitetu, sa 2,1 milion novih slučajeva i predviđenih 1,8 smrtnih ishoda u 2018. godini. Karcinom bronha predstavlja skoro petinu (18,4%) svih smrtnih ishoda od karcinoma. Istraživanje je sprovedeno kao retrospektivna studija za period 2010-2016 godine. Svi podaci potrebni za sprovođenje ovog istraživanja direktno su prikupljeni iz zdravstvenog informacionog sistema i registra za karcinom bronha Instituta za plućne bolesti Vojvodine (IPBV), koji je referentna ustanova za pacijente sa karcinomom bronha za celu Autonomnu Pokrajinu Vojvodinu. Cilj rada je bio da se utvrdi uticaj demografskih i kliničko-patololoških karakteristika na ukupno vreme preživljavanja kod bolesnika sa karcinomom bronha, kao i da se izradi geoprostorna analiza incidencije i mortaliteta od karcinoma bronha na teritoriji Vojvodine. Podaci o broju novoobolelih i broju umrlih pacijenata potrebni za analizu incidencije i mortaliteta prikupljeni su od lokalnih Instituta za javno zdravlje za svaki od sedam okruga. Za potrebe analize overall survivall, survival rate ukupno je obuhvaćeno 8142 bolesnika lečenih u IPBV, od kojih je nakon provere uključujućih i isključujućih kriterijuma, u konačnu analizu ušlo njih 7540. Za potrebe analize incidencije i mortaliteta prikupljeni su podaci od lokalnih Instituta za javno zdravlje za svaki od sedam okruga i ukupno je uključeno 21915 pacijenata. Od ukupno 7540 bolesnika, bilo je 5456 (72,4%) muškaraca i 2084 (27,6%) žena. Prosečna starost bolesnika iznosila je 63,4±8,85 godina, Najveći broj bolesnika su bili pušači, njih 4911 (65,1%), bivših pušača je bilo 1995 (26,5%), dok je najmanje bilo nepušača, svega 634 (8,4%). Srednja vrednost indeksa paklo-godina (pack-years) iznosila je 50,57±28,80. Posmatrano prema bračnom statusu, najviše bolesnika je bilo oženjeno/udato, njih 5348 (70,9%). Najveći broj bolesnika je ocenio svoj socioekonomski status kao osrednji, njih 4912 (65,1%). Broj bolesnika sa ECOG performans statusom 1 bio je 5679 (75,3%), njih 840 (11,1%) je imalo ECOG performans status 2, dok je ECOG performans status 0 imao 451 (6,0%) bolesnik. Najveći broj bolesnika bio je dijagnostikovan u IV stadijumu bolesti 3108 (41,2%), zatim u IIIB 1886 (25,0%), IIIA 1401 (18,6%), dok je u IA stadijumu dijagnostikovano najmanje bolesnika, njih 234 (3,1%). Najveći broj bolesnika imao je potvrđenu dijagnozu adenokarcinoma, njih 3342 (44,3%), zatim skvamoznog karcinoma 2472 (32,8%), mikrocelularnog karcinoma 1386 (18,4%). Od ukupnog broja bolesnika, tokom perioda praćenja preminulo je njih 6420 (85,1%), dok je 1120 (14,9%) bolesnika bilo živo. Prosečno vreme preživljavanja muškaraca bilo je 17,116 meseci, a žena 23,193 meseca. Muškarci oboleli od karcinoma bronha statistički značajno (p=0,000) kraće su živeli u odnosu na žene. Analiza kumulativnog preživljavanja bolesnika pokazala je da je postojala statistički značajna razlika u preživljavanju u odnosu na pol kod podtipova adenokarcinom (p=0,000), skvamozni karcinom (p=0,000) i mikrocelularni karcinom (p=0,001). Statistički značajna razlika u preživljavanju postojala je i u odnosu na starost, mesto stanovanja, tip tumora, stadijum bolesti, ECOG, pušački status i TNM stadijum bolesti (p=0,000). Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 32,5%, skvamoznog karcinoma 37,3%, adenokarcinoma 33,4% i mikrocelularnog karcinoma 20,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 9,2%, skvamoznog karcinoma 10,8%, adenokarcinoma 10,7% i mikrocelularnog karcinoma 2,0%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 5,0%, kod skvamoznog karcinoma 6,1%, adenokarcinoma 5,4% i mikrocelularnog karcinoma 1,3%. Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 78,1%, u 1B stadijumu 73,2%, 2A stadijumu 70,4%, 2B stadijumu 52,1%, 3A stadijumu 42,3%, 3B stadijumu 28,3%, dok je u 4 stadijumu bolesti ukupno jednogodišnje preživljavanje bilo 17,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 40,8%, u 1B stadijumu 37,5%, 2A stadijumu 31,2%, 2B stadijumu 21,6%, 3A stadijumu 9,7%, 3B stadijumu 5,5%, dok je u 4 stadijumu bolesti ukupno trogodišnje preživljavanje bilo 2,9%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 32,1%, u 1B stadijumu 19,3%, 2A stadijumu 16,2%, 2B stadijumu 13,3%, 3A stadijumu 4,4%, 3B stadijumu 2,6%, dok je u 4 stadijumu bolesti ukupno petogodišnje preživljavanje bilo 1,6%. Kao nezavisni prediktori preživljavanja izdvojeni su muški pol, starost preko 60 godina, ECOG performans status veći od 2, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikrokarcinom kao tip tumora (p=0,000). Incidencija karcinoma bronha za muškarce iznosila je 118,9 na 100000 stanovnika, a za žene 43,3 na 100000 stanovnika. Standardizovana stopa incidencije karcinoma bronha za muškarce iznosila je 65,4 na 100000 stanovnika, a za žene 21,7 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Stopa mortaliteta od karcinoma bronha za muškarce iznosila 125,1 na 100000 stanovnika, a za žene 43,8 na 100000 stanovnika. Standardizovana stopa mortaliteta od karcinoma bronha za muškarce iznosila 67,6 na 100000 stanovnika, a za žene 20,9 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Analizom prikupljenih podataka utvrđeno je da postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odnosu na pol (p=0,000), starosnu dob (p=0,000), mesto stanovanja (p=0,014), pušački status (p=0,001), ECOG performans status (p=0,000) i socioekonosmski status (p=0,000). Postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odsnosu na tip tumora (p=0,000), stadijum bolesti (p=0,000), T-deskriptor (p=0,000), N-deskriptor (p=0,000) i M-deskriptor (p=0,000). Utvrđeno je da ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosi 32,5%, trogodišnje preživljavanje obolelih od karcinoma bronha iznosi 9,2%, a petogodišnje preživljavanje iznosi 5,0%. Utvrđeno je da su nezavisni prediktori preživljavanja muški pol, starost preko 60 godina, ECOG performans status 2 i veći, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikroculularni karcinom kao tip tumora. Urađena je analiza incidencije i mortaliteta od karcinoma bronha na teritoriji AP Vojvodine i utvrđeno je da postoje značajne regionalne razlike u incidenciji i mortalitetu od karcinoma bronha na teritoriji AP Vojvodine.Worldwide, lung cancer remains the leading cause of cancer incidencije and mortality, with 2.1 million new lung cancer cases and 1.8 million deaths predicted in 2018. Methodology: For the purpose of this retrospective study we collected data of 21915 patients from seven Public Health Institutes, one for each district. This data was categorized by five-year age groups during 2010–2016. Survival analysis data of 8142 patients was collected from the Institute for Pulmonary Diseases of Vojvodina Hospital Information System and the Lung Cancer Registry. The primary objective was to determine the impact on overall survival by assessing demographic and clinical pathological characteristics in these patients. The secondary objective was to analyze the incidencije and mortality of lung cancer in the region of Vojvodina. Incidencije and mortality rates were directly age-standardized to the World and Europe Standard Population. A total of 7540 patients were eligible for the survival analysis, 5456 (72.4%) males and 2084 (27.6%) females. The average survival time, including all stages and cancer types was 17.1 months for men and 23.2 months for women (p = 0.000). There was statistically significant difference in survival time by gender in subtypes of adenocarcinoma (p = 0.000), squamous cell carcinoma (p= 0.000) and microcellular carcinoma (p = 0.001). Analysis showed significant difference in survival by age (p = 0.000), cancer type (p = 0.000), stage of the disease (p = 0.000), ECOG performance status (p = 0.000), smoking status (p = 0.001), TNM stage of disease (p = 0.000) and among districts (p = 0.014). Male gender (p = 0.000), age over 60 (p = 0.000), ECOG performance status 2 and greater (p = 0.000), smoking habit (p = 0.002), lower socioeconomic status (p = 0.000), stage IV of disease (p = 0.000) and small cell lung cancer as tumor type (p = 0.000) were identified as independent prognostic factors. One-year survival in 1A stage was 78.1%, in 1B stage 73.2%, 2A stage 70.4%, 2B stage 52.1%, 3A stage 42.3%, 3B stage 28.3 %, while in stage 4 was 17.9%. Three-year survival in 1A stage was 40.8%, in 1B stage 37.5%, 2A stage 31.2%, 2B stage 21.6%, 3A stage 9.7%, 3B stage 5.5 %, while in stage 4 was 2.9%. Five-year in 1A stage is 32.1%, in 1B stage 19.3%, 2A stage 16.2%, 2B stage 13.3%, 3A stage 4.4%, 3B stage 2.6 %, while in stage 4 was 1.6%. The incidencije rate was 118.9 per 100000 for males and 43.3 per 100000 for women. The standardized incidencije rate was 65.4 per 100000 for males and 21.7 per 100000 for females. There was a statistically significant difference by districts (p = 0.001). Mortality rate was 125.1 per 100000 for males and 43.8 per 100000 for females. The standardized mortality rate was 67.6 per 100000 for males and 20.9 per 100000 for females. There was also a statistically significant difference by district (p = 0.001). There was a statistically significant difference in overall survival by gender (p = 0.000), age (p = 0.000), place of residence (p = 0.014), smoking status (p = 0.001), ECOG performance status (p = 0.000), and socioeconomic status (p = 0.000). There was also a statistically significant difference in the overall survival by tumor type (p = 0.000), stage of disease (p = 0.000), T-descriptor (p = 0.000), N-descriptor (p = 0.000), and M-descriptor (p = 0.000). One-year survival rate was 32.5%, three-year survival was 9.2%, and five-year survival rate was 5.0%. Incidencije and mortality rates data were analyzed for the territory of Vojvodina, and it was found that there were significant regional differences

Classification of science

In the constellation of global oscillations of the development of science, classification of science and research is set up scientific research problem: knowledge of scientists, researchers, intellectuals on the classification of science as a scientific paradigms of modern methodology and technology of scientific research under the scientific and the existential minimum. From the analysis of the definition of science can be concluded that the views of some scientists about the concept of science are not identical, but that there are no substantial differences, and that they all have in common is that it includes a system of cognitive facts, events, principles, data, information, theories, principles and the laws of the objective reality of nature and society. Science has the main task of discovering the truth, or determining the legality of natural and social phenomena

Clinical research and sampling in the scientific: Research work

The survey is used to verify existing knowledge, to extend or discover a previously unknown knowledge, with the aim to come to the knowledge in the most efficient manner. Scientific research is systematic, planned testing of a problem to certain methodological rules. The aim of this study is that nurses and health workers informed on the methodology of scientific research. According to the purpose of the study vary basic and applied study by. Basic research increases our knowledge of a particular field without a goal that the results are directly applied in medical practice. On the other hand, applied research with direct practical valuable asset and usability. Results of clinical research should be directly applied in the prevention, detection and treatment of disease

Information systems in nephrology

The level of application of information technology in modern health systems is continuously growing throughout the world. Utilising new technology facilitates and speeds up the process of health care. The World Health Organisation has defined telemedicine 1997,, as the provision of health services in which distance represents a critical factor by health care professionals who use information and communication technologies for diagnosis, suggesting treatment and prevention of diseases, as well as the permanent training of health professionals in research and evaluation of health activities, in order to improve the health of people and the communities in which they live and work. Given,, tip of the iceberg ' which is now seen in terms of nephrology diseases in the future we can expect an increasing number of new information systems and technologies that will be applied in nephrology

A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

Publisher Copyright: © Copyright 2017 S. Karger AG, Basel. All rights reserved.Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings.publishersversionpublishe

Current Practice of Airway Stenting in the Adult Population in Europe: A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings. (C) 2017 S. Karger AG, Base

FAIR4Health: Findable, Accessible, Interoperable and Reusable data to foster Health Research

Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reusable (FAIR). To confirm the feasibility of the FAIR4Health solution, we performed two pathfinder case studies to carry out federated machine learning algorithms on FAIRified datasets from five health research organizations. The case studies demonstrated the potential impact of the developed FAIR4Health solution on health outcomes and social care research. Finally, we promoted the FAIRified data to share and reuse in the European Union Health Research community, defining an effective EU-wide strategy for the use of FAIR principles in health research and preparing the ground for a roadmap for health research institutions. This scientific report presents a general overview of the FAIR4Health solution: from the FAIRification workflow design to translate raw data/metadata to FAIR data/metadata in the health research domain to the FAIR4Health demonstrators' performance.This research was financially supported by the European Union’s Horizon 2020 research and innovation programme under the grant agreement No 824666 (project FAIR4Health). Also, this research has been co-supported by the Carlos III National Institute of Health, through the IMPaCT Data project (code IMP/00019), and through the Platform for Dynamization and Innovation of the Spanish National Health System industrial capacities and their effective transfer to the productive sector (code PT20/00088), both co-funded by European Regional Development Fund (FEDER) ‘A way of making Europe’.Peer reviewe

The efficacy outcomes in non-small cell lung cancer patients treated with PD axis inhibitor agents - a population-based study of the Vojvodina region

Background: By 2021, the FDA approved the use of the drugs pembrolizumab and atezolizumab in the first-line treatment of patients with high positivity of programmed death ligand-1 (PD-L1) in locally advanced and metastatic non-small-cell-lung cancer (NSCLC). This approval was the result of statistically significant evidence from international, multicentric clinical studies that all reported increasing progression-free survival (PFS) and overall survival (OS) in these patients.Methods: In our study, we reported the demographic and clinical characteristics of 79 patients diagnosed with NSCLC with expression of PD-L1 ≥50% from January 2019 to December 2022 at the Institute for Pulmonary Diseases of Vojvodina, who received pembrolizumab therapy as the first-line treatment. Patients were divided according to the histological type of lung cancer as adenocarcinoma (ADC) or squamous cell carcinoma (SCC) of the lung. In 52 of the 79 patients, PFS and in 32 of them overall survival (censored OS) was shown according to the histological type of tumor, the tumor proportion score (TPS) of PDL-1 expression, and the metastatic status within the Tumor Nodes Metastasis (TNM) disease classification. Independent factors of death outcome were shown by multivariable proportional hazard regression analysis.Results: The study included 79 patients diagnosed with NSCLC with an expression of PD-L1 ≥50%, 50 (63.3%) patients with ADC, and 29 (36.7%) patients with SCC, whose 55 (69.6%) PDL-1 expression was obtained from broncho biopsy (BB). The majority of patients, 49 (62%), had a TPS PD-L1 score of 51%–79%. Median, PFS for adenocarcinoma was 22 months and censored OS was 27 months, while for squamous cell carcinoma, median PFS was 12 months, and censored OS was 21 months. M1b disease stage, which was the most common in patients, had a PFS of 16 months and a censored OS of 18 months.Conclusion: Pembrolizumab monotherapy in patients with NSCLC in the fourth stage of the disease and with the positivity of the immune checkpoint protein TPS PD-L1 above 50% represents a safe therapy that allows a satisfactory period without disease progression and overall survival with acceptable treatment complications

Mortality of COVID-19 pneumonia during anticancer treatment in lung cancer patients

Background/Aim. The coronavirus disease 2019 (COVID-19) pandemic has multiple impacts on the management of cancer patients. Treatment of malignancies, including chemotherapy, targeted therapy, immunotherapy, and radiotherapy, can suppress the immune system and lead to the development of severe complications of COVID-19. The aim of this study was to determine the mortality of lung cancer (LC) patients in whom the COVID-19 was confirmed during active antitumor treatment. Methods. This retrospective study was conducted at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. All patients included in the study underwent active anticancer treatment at the time of diagnosis of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was determined by a polymerase chain reaction (PCR) test. Patient data were collected using the institutional database and the observed period was from November 20, 2020, to June 5, 2021. Statistical analysis of the derived patient data used multivariate and univariate testing. Results. Out of 828 observed COVID-19 hospitalized patients, 81 were LC patients on active antitumor treatment. Patients were predominantly male (67.9%), smokers (55.6%), and with an average age of 66.5 years (range 43–83). The majority of patients (50.6%) had the Eastern Cooperative Oncology Group Performance Status (ECOG PS) 1, and 83.9% had at least one comorbidity. The most common comorbidities were arterial hypertension (66.7%), chronic obstructive pulmonary disease (COPD) (28.4%), and diabetes mellitus (21%). Obesity, congestive heart failure, and other cardiovascular diseases were present in 11%, 6.2%, and 7.4% of patients, respectively. The most common was adenocarcinoma (33.3%), followed by squamous (30.9%) and small-cell LC (24.7%). Predominantly, 63% of the patients were in stage III of the disease, and 33.3% were in stage IV. Metastases were most commonly present in the contralateral lung/pleura (14.8%), brain (6.2%), bone (3.7%), and liver (3.7%). Systemic anticancer therapy was applied in 37 out of 81 patients (45.6%), chest radiotherapy in 35 (43.2%), concurrent chemo-radiotherapy in 1 (1.2%), and other types of radiotherapy in 8 (9.87%) patients. The most common forms of systemic therapy were chemotherapy (35.8%), immunotherapy (7.4%), and targeted therapy (2.4%). The most common chemotherapy was a cisplatin-based regiment applied in 34.6% of patients. The mortality from COVID-19 was 19.8%. The statistical significance in relation to the type of treatment was not observed. Statistical significance was observed between mortality and the ECOG PS (p = 0.011). Conclusion. LC patients are dependent on antitumor treatment and, at the same time, highly susceptible to potential infection. In this study, we did not find statistically significant differences in mortality related to the type of antitumor treatment in COVID-19 positive LC patients. Further detailed research on a larger scale is needed in order to explore the effects of SARS-CoV-2 on cancer patients. All possible methods of protection against SARS-CoV-2 virus should be performed in order to minimize the risk of infection in all but especially in immunocompromised cancer patients