Prospective Cohort Study

European Resuscitation Council Guidelines for Resuscitation.

Accumulating evidence implicates metabolites produced by gut microbes as crucial mediators of diet-induced host-microbial cross-talk. Here, we review emerging data suggesting that microbial tryptophan catabolites resulting from proteolysis are influencing host health. These metabolites are suggested to activate the immune system through binding to the aryl hydrocarbon receptor (AHR), enhance the intestinal epithelial barrier, stimulate gastrointestinal motility, as well as secretion of gut hormones, exert anti-inflammatory, anti-oxidative or toxic effects in systemic circulation, and putatively modulate gut microbial composition. Tryptophan catabolites thus affect various physiological processes and may contribute to intestinal and systemic homeostasis in health and disease.

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Microbial tryptophan catabolites in health and disease

Metabolomics uses advanced analytical chemistry techniques to enable the high-throughput characterization of metabolites from cells, organs, tissues, or biofluids. The rapid growth in metabolomics ...

Metabolomics for Investigating Physiological and Pathophysiological Processes

Objective: The objectives of this study were to: (1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor rupture of membranes (PROM); and (2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM.Methods: AF samples obtained from 59 women with preterm PROM were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital mycoplasmas) and with broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). AF concentration of interleukin-6 (IL-6) was determined using ELISA. Results of both tests were correlated with AF IL-6 concentrations and the occurrence of adverse obstetrical/perinatal outcomes.Results: (1) PCR/ESI-MS, AF culture, and the combination of these two tests each identified microorganisms in 36% (21/59), 24% (14/59) and 41% (24/59) of women with preterm PROM, r...

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Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes.

Information mining from textual data becomes a very challenging task when the structure of the text record is very loose without any rules. Doctors often use natural language in medical records. Therefore it contains many ambiguities due to non-standard abbreviations and synonyms. The medical environment itself is also very specific: the natural language used in textual description varies with the personality creating the record (there are many personalized approaches), however it is restricted by terminology (i.e. medical terms, medical standards, etc.). Moreover, the typical patient record is filled with typographical errors, duplicates, ambiguities, syntax errors and many nonstandard abbreviations.

Practical Problems and Solutions in Hospital Information System Data Mining

Background/Aims: Goodpasture syndrome (GS) is an autoimmune disease affecting mainly the kidneys and lungs. This review article focuses on GS occurring during pregnancy, which can seriously threaten the lives of both mother and fetus. We summarize the current clinical diagnosis and management of GS in pregnancy. Methods: A profound literature search was carried out to review all published articles or case studies reporting on GS in pregnancy. We extracted the following data from each case: patient age, parity, gestational age, therapy of GS during pregnancy, pregnancy outcome, neonatal outcome, mode of delivery, and the patient's kidney status. We describe in detail how a recent case of GS diagnosed in pregnancy was successfully treated. Results: A review of the available literature revealed 4 cases of GS in pregnancy. The average patient age was 29.3 ± 2.5 years, and most were primiparous, with an average parity of 1.3 ± 1.5. The average gestational age at the time of diagnosis was 12.5 ± 5.9 weeks. The therapies of GS during pregnancy were remarkably varied. Furthermore, the neonatal outcomes were also quite individual among the observed cases. Conclusion: The occurrence of GS during pregnancy is very rare. This unusual pregnancy complication is associated with significant maternal and fetal morbidity. The management of GS during pregnancy requires intensive care and multidisciplinary cooperation.

Clinical management of pregnancy in women with Goodpasture syndrome.

This paper describes the process of mining information from loosely structured medical textual records with no apriori knowledge. In the paper we depict the process of mining a large dataset of ~50,000–120,000 records × 20 attributes in database tables, originating from the hospital information system (thanks go to the University Hospital in Brno, Czech Republic) recording over 10 years. This paper concerns only textual attributes with free text input, that means 613,000 text fields in 16 attributes. Each attribute item contains ~800–1,500 characters (diagnoses, medications, etc.). The output of this task is a set of ordered/nominal attributes suitable for rule discovery mining and automated processing.

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Obstetric Medical Record Processing and Information Retrieval

Information mining from textual data becomes a very challenging task when the structure of the text record is very loose without any rules. The task becomes even more difficult when natural language is used and no apriori knowledge is available. The medical environment itself is also very specific: the natural language used in textual description varies with the personality creating the record (there are many personalized approaches), however it is restricted by terminology (i.e. medical terms, medical standards, etc.). Moreover, the typical patient record is filled with typographical errors, duplicates, ambiguities, syntax errors and many (nonstandard) abbreviations.

Effective free-text medical record processing and information retrieval.

Objectives: External cephalic version (ECV) is a useful method helping to reduce the incidence of planned caesarean deliveries for fetal malpresentation. There is an effort to look for the best predictors for a successful ECV, the effect of maternal weight is still unclear. The aim of our study is to determine maternal body mass index (BMI) in association with the ECV success rate and the risk of complications. Material and methods: A retrospective observational cohort study in 981 women after the 36th week of gestation with a fetus in a breech presentation who had undergone an ECV attempt. We evaluated the success rate and complications of ECV in association with BMI categories according to the WHO classification of obesity. Results: ECV was successful in 478 cases (48.7%). In the category of overweight patients (BMI > 25; n = 484), ECV was successful in 51% and unsuccessful in 49% (p = 0.28) of cases. In obese patients (BMI > 30; n = 187), ECV was successful in 44.8% and unsuccessful in 55.2% (p = 0.28) of cases. The effect of BMI on the success rate of ECV for the category of overweight and obesity was not proven by statistical analysis. Serious complications occurred in seven cases in similar numbers in all three subgroups according to BMI. Conclusions: BMI in the categories of overweight and obesity is not a factor influencing the success rate and risk of complications of ECV. These results can be helpful when consulting pregnant women the chance of successful ECV.

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Petr Janku

Papers

Practical Problems and Solutions in Hospital Information System Data Mining

Clinical management of pregnancy in women with Goodpasture syndrome.

Obstetric Medical Record Processing and Information Retrieval

Effective free-text medical record processing and information retrieval.

Maternal body mass index and external cephalic version success rate - are they related?