Frequency of hand movements as a possible diagnostic tool for parkinsonian bradykinesia. Proposal of a simple bedside test

BACKGROUNDThere is no technique in general use that reliably predicts the outcome of manual aspiration of spontaneous pneumothorax. We have hypothesised that the absence of a pleural leak at the time of aspiration will identify a group of patients in whom immediate discharge is unlikely to be complicated by early lung re-collapse and have tested this hypothesis by using a simple bedside tracer gas technique.METHODSEighty four episodes of primary spontaneous pneumothorax and 35 episodes of secondary spontaneous pneumothorax were studied prospectively. Patients breathed air containing a tracer (propellant gas from a pressurised metered dose inhaler) while the pneumothorax was aspirated percutaneously. Tracer gas in the aspirate was detected at the bedside using a portable flame ioniser and episodes were categorised as tracer gas positive (>1 part per million of tracer gas) or negative. The presence of tracer gas was taken to imply a persistent pleural leak. Failure of manual aspiration and the need for a further intervention was based on chest radiographic appearances showing either failure of the lung to re-expand or re-collapse following initial re-expansion.RESULTSA negative tracer gas test alone implied that manual aspiration would be successful in the treatment of 93% of episodes of primary spontaneous pneumothorax (p<0.001) and in 86% of episodes of secondary spontaneous pneumothorax (p=0.01). A positive test implied that manual aspiration would either fail to re-expand the lung or that early re-collapse would occur despite initial re-expansion in 66% of episodes of primary spontaneous pneumothorax and 71% of episodes of secondary spontaneous pneumothorax. Lung re-inflation on the chest radiograph taken immediately after aspiration was a poor predictor of successful aspiration, with lung re-collapse occurring in 34% of episodes by the following day such that a further intervention was required.CONCLUSIONSNational guidelines currently recommend immediate discharge of patients with primary spontaneous pneumothorax based primarily on the outcome of the post-aspiration chest radiograph which we have shown to be a poor predictor of early lung re-collapse. Using a simple bedside test in combination with the post-aspiration chest radiograph, we can predict with high accuracy the success of aspiration in achieving sustained lung re-inflation, thereby identifying patients with primary spontaneous pneumothorax who can be safely and immediately discharged home and those who should be observed overnight because of a significant risk of re-collapse, with an estimated re-admission rate of 1%.

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Squash cytology: A simple, bedside test for quick diagnosis of atypical presentations of Molluscum Contagiosum

Diagnostic Cytopathology ◽

10.1002/dc.24819 ◽

2021 ◽

Author(s):

Ishan Agrawal ◽

Arunima Ray ◽

Bhabani S. T. P. Singh ◽

Surabhi Singh ◽

Bikash Ranjan Kar

Keyword(s):

Molluscum Contagiosum ◽

Bedside Test ◽

Atypical Presentations ◽

Simple Bedside

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Leukocyte esterase: A simple bedside test for the detection of bacterial colonization of amniotic fluid

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(88)90504-2 ◽

1988 ◽

Vol 159 (1) ◽

pp. 120-122 ◽

Cited By ~ 21

Author(s):

Charles C. Egley ◽

Vern L. Katz ◽

William N.P. Herbert

Keyword(s):

Amniotic Fluid ◽

Bacterial Colonization ◽

Bedside Test ◽

Simple Bedside

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A simple bedside test to assess the swallowing dysfunction in Parkinson′s disease

Annals of Indian Academy of Neurology ◽

10.4103/0972-2327.128556 ◽

2014 ◽

Vol 17 (1) ◽

pp. 62 ◽

Cited By ~ 8

Author(s):

K Bhanu ◽

SVinoth Kanna

Keyword(s):

Bedside Test ◽

Swallowing Dysfunction ◽

Simple Bedside

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0716 Differentiation of semantic dementia and Alzheimer's disease using a simple bedside test

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(05)81080-9 ◽

2005 ◽

Vol 238 ◽

pp. S282

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Semantic Dementia ◽

Bedside Test ◽

Simple Bedside

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Single-Breath Counting Test Predicts Non-Invasive Respiratory Support Requirements in Patients with COVID-19 Pneumonia

Journal of Clinical Medicine ◽

10.3390/jcm11010179 ◽

2021 ◽

Vol 11 (1) ◽

pp. 179

Author(s):

Yaroslava Longhitano ◽

Christian Zanza ◽

Tatsiana Romenskaya ◽

Angela Saviano ◽

Tonia Persiano ◽

...

Keyword(s):

Respiratory Function ◽

Respiratory Symptoms ◽

Oxygen Therapy ◽

Prospective Observational Study ◽

Roc Curves ◽

Non Invasive ◽

Single Breath ◽

Bedside Test ◽

Study Population ◽

Simple Bedside

The use of non-invasive respiratory strategies (NIRS) is crucial to improve oxygenation in COVID-19 patients with hypoxemia refractory to conventional oxygen therapy. However, the absence of respiratory symptoms may delay the start of NIRS. The aim of this study was to determine whether a simple bedside test such as single-breath counting test (SBCT) can predict the need for NIRS in the 24 h following the access to Emergency Department (ED). We performed a prospective observational study on 120 patients with COVID-19 pneumonia. ROC curves were used to analyze factors which might predict NIRS requirement. We found that 36% of patients had normal respiratory rate and did not experience dyspnea at rest. 65% of study population required NIRS in the 24 h following the access to ED. NIRS-requiring group presented lower PaO2/FiO2 (235.09 vs. 299.02), SpO2/FiO2 ratio (357.83 vs. 431.07), PaCO2 (35.12 vs. 40.08), and SBCT (24.46 vs. 30.36) and showed higher incidence of dyspnea at rest (57.7% vs. 28.6%). Furthermore, SBCT predicted NIRS requirement even in the subgroup of patients without respiratory symptoms (AUC = 0.882, cut-off = 30). SBCT might be a valuable tool for bedside assessment of respiratory function in patients with COVID-19 pneumonia and might be considered as an early clinical sign of impending respiratory deterioration.

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