scholarly journals Interdisciplinary assessment and diagnostic algorithm: the role of the cardiologist

2021 ◽  
pp. 108851
Author(s):  
Giuseppe M.C. Rosano ◽  
Cristiana Vitale ◽  
Giuseppe Maltese
Keyword(s):  
Diagnostic Algorithm ◽  
Interdisciplinary Assessment

P862Hypoxemia during sleep in patients with vasospastic angina

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Nakagawa ◽  
M Sairyo ◽  
S Nozaki
Keyword(s):  
Drug Therapy ◽  
Sleep Disordered Breathing ◽  
Diagnostic Algorithm ◽  
Early Morning ◽  
Interquartile Range ◽  
Vasospastic Angina ◽  
Apnea Hypopnea Index ◽  
Nocturnal Hypoxemia ◽  
High Prevalence

Abstract Background Previous studies have shown the associations between sleep-disordered breathing (SDB) and vasospastic angina (VSA). However the characteristics of SDB related to VSA have been unknown. Purpose We investigate the characteristics of SDB in VSA patients, with focus on the role of nocturnal hypoxemia, which may trigger nocturnal ischemic attacks, typical attacks occurred during sleep in early morning. Methods We studied 33 patients who were diagnosed with VSA, based on diagnostic algorithm in the Japanese Circulation Society guidelines 2013 for VSA. All patients underwent polysomnography. Twenty one patients with moderate-severe SDB [apnea-hypopnea index (AHI) of at least 15/hour] diagnosed with polysomnography, but without cardiovascular diseases, were served as controls. Results Only 3 patients with VSA were free of SDB (AHI less than 5/hour). Moderate to severe SDB was found in 25 of 33 patients with VSA. These 25 patients were further studied. Daytime sleepiness assessed by the Epworth sleepiness scale, was lower in SDB patients with VSA than those without it (4.8±4.2 vs. 8.9±4.0; p=0.02). There were no differences in AHI between SDB patients with and without VSA (41.2±17.2/hour vs. 39.9±14.4/hour), but hypoxemic burden (time with oxygen saturation <90%) was higher in those with VSA than those without it [(median 20.7minitutes, interquartile range 6.4–48.0minitues) vs. median 5.9minitutes, interquartile range 3.9–11.0minitues); p=0.01]. In VSA patients, 39% of hypoxemia was observed in rapid eye movement (REM) periods of sleep, which accounts for only 18% of total sleep. Conclusions A high prevalence of moderate-severe SDB was found in VSA patient, although the symptoms were mild. Hypoxemia is a characteristic of SDB associated with VSA, which may be a target for therapeutic intervention in addition to drug therapy.

scholarly journals Acute Bronchiolitis: Is There a Role for Lung Ultrasound?

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 172 ◽  
Author(s):  
Di Mauro ◽  
Ammirabile ◽  
Quercia ◽  
Panza ◽  
Capozza ◽  
...  
Keyword(s):  
Clinical Management ◽  
Lung Ultrasound ◽  
Ultrasound Examination ◽  
Diagnostic Algorithm ◽  
Current Evidence ◽  
Radiographic Examination ◽  
First Year ◽  
Pubmed Database ◽  
First Year Of Life

Introduction: Viral bronchiolitis is a common cause of lower respiratory tract infection in the first year of life, considered a health burden because of its morbidity and costs. Its diagnosis is based on history and physical examination and the role of radiographic examination is limited to atypical cases. Thus far, Lung Ultrasound (LUS) is not considered in the diagnostic algorithm for bronchiolitis. Methods: PubMed database was searched for trials reporting on lung ultrasound examination and involving infants with a diagnosis of bronchiolitis. Results: Eight studies were suitable. Conclusions: This review analyzed the current evidence about the potential usefulness of LUS in the clinical management of bronchiolitis. Literature supports a peculiar role of LUS in the evaluation of the affected children, considering it as a reliable imaging test that could benefit the clinical management of bronchiolitis.

Role of qualitative choriogonadotropin assays in diagnosis of ectopic pregnancy.

1987 ◽  
Vol 33 (10) ◽  
pp. 1908-1910 ◽  
Author(s):  
A LeMaistre ◽  
A Bracey ◽  
A Katz ◽  
A H Wu
Keyword(s):  
Cost Effectiveness ◽  
Ectopic Pregnancy ◽  
Screening Method ◽  
Diagnostic Algorithm ◽  
Turnaround Time ◽  
Quantitative Assay ◽  
Clinical Sensitivity ◽  
Qualitative And Quantitative ◽  
Qualitative Assay

Abstract We compared the clinical sensitivity and cost-effectiveness of a qualitative assay for choriogonadotropin in human urine ("Icon" hCG) with a quantitative assay of serum from 142 women with pathologically-diagnosed ectopic pregnancy. Results show that although the qualitative assay had a clinical sensitivity for pregnancy of 98.6%, as compared to 100% for the quantitative assay, it was more economical to use, and had a significantly shorter turnaround time. We conclude that qualitative hCG assay of either urine or serum is a good screening method for detecting pregnancy, and can replace the stat quantitative assay in women with suspected ectopic pregnancy. We present a diagnostic algorithm to illustrate the role of qualitative and quantitative hCG assays in conjunction with ultrasonography, culdocentesis, and laparoscopy for diagnosis of ectopic pregnancy.

Current Approaches on Forming the Assessment Tools Stock for Basic University Curricula

2016 ◽  
Vol 4 (1) ◽  
pp. 8-18 ◽  
Author(s):  
�������� ◽  
O. Naumenko ◽  
������ ◽  
M. Chandra
Keyword(s):  
Assessment Tools ◽  
Course Assessment ◽  
Assessment Program ◽  
University Curriculum ◽  
State Pedagogical ◽  
Potential Problems ◽  
Interdisciplinary Assessment ◽  
University Curricula ◽  
End Of Course Assessment

The paper presents the experience of the Volgograd State Pedagogical University in elaborating the assessment tools stock for the basic university educational programs for the current, midterm and end-of-course assessment. The role of disciplinary and interdisciplinary assessment toolkits in the structure of the basic university curriculum is defi ned. Also suggested is the author�s vision on how the assessment toolkits should be structured and also the techniques for developing such toolkits. Based on the specifi c examples, the authors show some possible approaches to assessing the level of students� competences formedness in the course of the current, midterm and end-of course certifying in the higher school institutions. The features, indicating various levels of competencies formedness are described. The technology for development of the End-of-Course Assessment Program is presented. The paper is focused mainly on the new approaches to selecting appropriate assessment tools for the state exam. Potential problems, arising while developing the assessment tools for the end-of-term exam on the �Education and Pedagogy� training program are identifi ed. Also presented are the examples of practice-oriented assignments, allowing, on the authors� opinion, to identify the level of formedness of the professionally signifi cant competences.

The role of transbronchial cryobiopsy and surgical lung biopsy in the diagnostic algorithm of interstitial lung disease

2015 ◽  
Vol 10 (5) ◽  
pp. 589-595 ◽  
Author(s):  
Lars Hagmeyer ◽  
Dirk Theegarten ◽  
Jeremias Wohlschläger ◽  
Marcel Treml ◽  
Sandhya Matthes ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Diagnostic Algorithm ◽  
Surgical Lung Biopsy

Angiogenic growth factors in the diagnosis and prediction of pre-eclampsia

2011 ◽  
Vol 122 (2) ◽  
pp. 43-52 ◽  
Author(s):  
Stefan Verlohren ◽  
Holger Stepan ◽  
Ralf Dechend
Keyword(s):  
Blood Pressure Measurement ◽  
Perinatal Outcomes ◽  
Diagnostic Algorithm ◽  
Basic Research ◽  
Recent Decade ◽  
Angiogenic Growth Factors ◽  
The Status ◽  
Low Sensitivity ◽  
Plgf Ratio

The pathogenesis of pre-eclampsia is still not completely known; however, in the recent decade, there have been tremendous research efforts leading to impressive results highlighting the role of a disturbed angiogenic balance as one of the key features of the disease. Numerous studies have shown the key role of the placenta in the pathogenesis of pre-eclampsia. A shift in the sFlt-1 (soluble Fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio is associated with the disease. Although pre-eclampsia seems to be a clearly defined disease, clinical presentation, and particularly the dynamics of the clinical course, can vary enormously. The only available tools to diagnose pre-eclampsia are blood pressure measurement and urine protein sampling. However, these tools have a low sensitivity and specificity regarding the prediction of the course of the disease or maternal and perinatal outcomes. The only cure for the disease is delivery, although a timely diagnosis helps in decreasing maternal and fetal morbidity and mortality. The sFlt1/PlGF ratio is able to give additional valuable information on the status and progression of the disease and is apt to be implemented in the diagnostic algorithm of pre-eclampsia. In the present review, we aim to provide an overview of the vast literature on angiogenesis and anti-angiogenesis factors in pre-eclampsia that have been published over the last decade. We introduce work from basic research groups who have focused on the pathophysiological basis of the disease. Furthermore, we review studies with a clinical focus in which the sFlt-1/PlGF ratio has been analysed along with other candidates for routine clinical assessment of pre-eclampsia.

scholarly journals En innføring i depresjonsvurdering med PHQ-9

2020 ◽  
Author(s):  
Tomas Formo Langkaas ◽  
Even Rognan ◽  
Sverre Urnes Johnson
Keyword(s):  
Clinical Practice ◽  
Diagnostic Algorithm ◽  
Test Results ◽  
Measurement Instruments ◽  
National Guidelines ◽  
General Introduction ◽  
Icd 10 ◽  
Dsm Iv ◽  
Cutoff Scores

Assessment of depression is a routine task in clinical practice in Norway. National guidelines (Helsedirektoratet, 2009) recommend the use of measurement instruments in assessment of depression. PHQ-9 is widely used in research and practice. The official PHQ-9 manual provides practical guidance on interpreting test results with the use of clinical cutoff scores and a diagnostic algorithm for DSM-IV. With background from clinical practice and research, we summarize and provide guidance on the practical use of PHQ-9 beyond what the official PHQ-9 manual offers, applied to a Norwegian context. We provide a general introduction to diagnostic assessment of depression and the limited role of measurement instruments in such assessments. We describe how the original diagnostic algorithm can be adapted to ICD-10 criteria, we describe how to apply clinical significance to use PHQ-9 as a feedback instrument to monitor treatment progress, and we describe how to interpret results with missing answers. Finally, we discuss the shortcomings of relying on measurement instruments in assessment of depression and conclude that PHQ-9 is better suited in ordinary practice than other instruments recommended in the national guidelines.

scholarly journals Role of inflammation in non-allergic rhinitis

2014 ◽  
Vol 52 (2) ◽  
pp. 142-149
Author(s):  
E. de Corso ◽  
M. Battista ◽  
M. Pandolfini ◽  
L. Liberati ◽  
S. Baroni ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Inflammatory Cell Infiltrate ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

Objective: To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. Methodology: Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b). All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. Results: The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: “NAR without inflammation”(NAR-) and “NAR with inflammation”(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR–, NAR+ and between different NAR+ subtypes. Conclusion: Our data suggest that NAR- and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.

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