ESTG - Artigos em revistas internacionais
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Browsing ESTG - Artigos em revistas internacionais by Field of Science and Technology (FOS) "Ciências Médicas::Medicina Clínica"
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- Development of CART model for prediction of tuberculosis treatment loss to follow up in the state of São Paulo, Brazil: A case–control studyPublication . Yamaguti, Verena Hokino; Alves, Domingos; Rijo, Rui, Rui Pedro Charters Lopes; Miyoshi, Newton Shydeo Brandão; Ruffino-Netto, AntônioBackground: Tuberculosis is the leading cause of infectious disease-related death, surpassing even the immunodeficiency virus. Treatment loss to follow up and irregular medication use contribute to persistent morbidity and mortality. This increases bacillus drug resistance and has a negative impact on disease control. Objective: This study aims to develop a computational model that predicts the loss to follow up treatment in tuberculosis patients, thereby increasing treatment adherence and cure, reducing efforts regarding treatment relapses and decreasing disease spread. Methods: This is a case-controlled study. Included in the data set were 103,846 tuberculosis cases from the state of São Paulo. They were collected using the TBWEB, an information system used as a tuberculosis treatment monitor, containing samples from 2006 to 2016. This set was later resampled into 6 segments with a 1-1 ratio. This ratio was used to avoid any bias during the model construction. Results: The Classification and Regression Trees were used as the prediction model. Training and test sets accounted for 70% in the former and 30% in the latter of the tuberculosis cases. The model displayed an accuracy of 0.76, F-measure of 0.77, sensitivity of 0.80 and specificity of 0.71. The model emphasizes the relationship between several variables that had been identified in previous studies as related to patient cure or loss to follow up treatment in tuberculosis patients. Conclusion: It was possible to construct a predictive model for loss to follow up treatment in tuberculosis patients using Classification and Regression Trees. Although the fact that the ideal predictive ability was not achieved, it seems reasonable to propose the use of Classification and Regression Trees models to predict likelihood of treatment follow up to support healthcare professionals in minimising the loss to follow up.
- Lichen planus and its therapeutic management: a retrospective studyPublication . Rebelo, Mariana Rodrigues; Pereira, Cristina Palmela; Santos, Rui Sousa; Soares-de-Almeida, Luís; Filipe, PauloObjectives: To study the epidemiological distribution of the disease lichen planus and its therapeutic management. Methods: A total of 174 patients with a lichen planus diagnosis between 2008 and 2017 at a Portuguese public hospital were included in this retrospective study. The following data were collected from clinical records: gender, age, topographic distribution of lesions, prescribed therapy (active substance, route, and scheme of administration), mean duration of illness, and episodes of cure and relapse. Statistical analysis was performed using IBM® SPSS® Statistics software, version 25. Results: In this population, lichen planus affected both genders with the same probability (p=0.820), and was more prevalent in the 4th-5th decades of age. The lesions appeared in the skin (75.9% of the patients), mucous membranes (5.2%), or both (19.0%). The most prescribed drugs were corticosteroids, followed by antihistamines and immunosuppressants. Topical corticosteroids were the most common ones, namely clobetasol propionate (37.4%). Within the systemic corticosteroids, prednisolone was the most prescribed drug (12.3%). The average duration of lesions and symptoms was approximately 6.5 months. For the relapsing population (12%), the mean period of symptoms’ remission was 513 days. Conclusions: The epidemiological parameters of lichen planus in these Portuguese patients bear similarities with other described populations. No evidence-based therapeutic has proven to be effective for lichen planus treatment, but topical corticosteroids continue to be the first-line therapy for this pathology.