Clinical “case series”: a concept analysis

Objectives

To analyze the concept of “case series” in the medical literature compared with case reports.

Methods

A PubMed search for articles published during 2009 which had “case series” in their title was performed. A total number of 621 articles were retrieved. 586 papers were included in the analysis and 35 were excluded (18 were commentary letters, 5 were not in English, and twelve could not be retrieved by our Library). The number of patients and category of these articles were analyzed.

Results

The median (range) of the number of cases of articles having “case series” in their title was 7 (1–6432) cases. 186/ 586 articles had less than 5 cases (31.7%, 95% CI (28.3–35.1%)). The median (range) of the number of cases of articles having “case report” as their publication type was 4 (1–178) cases. Out of the 219 articles categorized as case reports 114 (52.1%, 95% CI (45.6–58.6%)) had less than five cases.

Conclusions

The concept of “case series” is not well defined in the literature and does not reflect a specific research design. We suggest that a case series should have more than four patients while four paitents or less should be reported individually as case reports.     

HPLC和络合-UV法测定特非那丁颗粒剂的含量

目的：用ＨＰＬＣ和电荷转移络合ＵＶ法分别测定特非那丁粒剂的含量,并对测定结果进行比较,方法：ＨＰＬＣ法,色谱柱：ＳｐｈｅｒｉｓｏｒｂＣ８（１５０＊４．６ｍｍ,５μｍ）;流动相：甲醇－０．１ｍｏｌ／Ｌ三乙胺磷酸缓冲液（８０：２０）,检测波长２３５ｎｍ。电荷转移络合ＵＶ法,利用碘与ＴＦＮ在氯仿中形成电荷转移络合物的原理,在紫外２９４ｎｍ的波长处测定ＴＦＮ的含量。结果：两法测定的线性范围和平均回收率分别     

A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial

International Urology and Nephrology - Nocturnal enuresis is an infrequent uncontrolled voiding during sleep in a child aged 5 years or more without any congenital or acquired disorders of...     

Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

BACKGROUND:

Multiple myeloma (MM) remains an incurable cancer. Treatment often is initiated at the time patients experience a progressive increase in tumor burden. The authors of this report investigated magnetic resonance imaging of the bone marrow (BM‐MRI) as a novel approach to quantify disease burden and validated a staging system by correlating BM‐MRI with common clinical and laboratory parameters.

METHODS:

The extent of bone marrow involvement was evaluated by BM‐MRI. Clinical and laboratory parameters were assessed in patients with active MM, and correlations between variables were assessed statistically. Bone marrow involvement by BM‐MRI was defined as stage A (0%), stage B (<10%), stage C (10%‐50%), and stage D (>50%).

RESULTS:

In total, 170 consecutive patients were evaluated (77 women and 93 men), including 144 patients who had active MM. The median age was 61 years (age range, 35‐83 years). Advance stage disease (stage >I) based on Durie‐Salmon (DS) staging or International Staging System (ISS) criteria was observed in 122 patients (84%) and 77 patients (53%), respectively. Lytic bone disease was noted in 120 patients (83%). There was a significant association between BM‐MRI involvement and DS stage (P = .0006), ISS stage (P = .0001), the presence of lytic bone disease (P < .0001) and mean β‐2 microglobulin levels (P < .0001). Among the patients with previously untreated MM, there was a significant association between BM‐MRI stage and overall survival (OS) (univariate P = .013; multivariate P = .045). Plasmacytosis on bone marrow biopsy at diagnosis was not predictive of OS (P = .91).

CONCLUSIONS:

BM‐MRI is a novel approach for quantifying disease burden in patients with MM. The current investigation in a large cohort of nontransplantion MM patients demonstrated that the extent of bone marrow involvement determined by BM‐MRI correlates accurately with other conventional parameters of disease burden and can independently predict survival in patients with MM at the time of initial diagnosis. Cancer 2010. © 2010 American Cancer Society.     

Low dose four-dimensional computerized tomography with volume rendering reconstruction for primary hyperparathyroidism: How I do it?

Modification of 4-dimensional computed tomography (4D-CT) technique with volume rendering reconstructions and significant dose reduction is a safe and accurate method of pre-operative localization for primary hyperparathyroidism. Modified low dose 4D-CT with volume rendering reconstructions provides precise preoperative localization and is associated with a significant reduction in radiation exposure compared to classic preoperative localizing techniques. It should be considered the preoperative localization study of choice for primary hyperparathyroidism.     

Mycosis fungoides and Sézary syndrome: Current challenges in assessment,management and prognostic markers

Mycosis fungoides and Sézary syndrome are the most common variants of the cutaneous T‐cell lymphomas. Assessment of a patient with a suspected diagnosis requires thorough history taking and physical examination, in combination with skin biopsy. In some cases flow cytometry, molecular studies and imaging are also required in order to diagnose and stage the disease. Staging is derived from the tumour‐node‐metastasis‐blood classification and is currently our best attempt to stratify prognosis and hence guide management in this complex disease. Many other clinical, biological and pathological factors may help to distinguish groups at risk and predict prognosis more accurately. Management remains heavily guided by staging, such that patients with early‐stage disease generally begin treatment with skin‐directed or local therapies and those with advanced‐stage disease have many treatment options, including chemotherapy, the use of biological agents, local and total body radiotherapy, as well as haematopoietic stem cell transplantation. Besides staging, many other patient‐related factors influence the treatment strategy, particularly where symptom relief is paramount. There are many challenges remaining in the study of Mycosis fungoides and Sézary syndrome and, given the rarity of the disease, concerted worldwide efforts are required to conduct efficient and effective research.