The impact of HIV-related neuropsychological dysfunction on driving behavior

2000 ◽  
Vol 6 (7) ◽  
pp. 854-854 ◽  
Author(s):  
THOMAS D. MARCOTTE ◽  
ROBERT K. HEATON ◽  
TANYA WOLFSON ◽  
MICHAEL J. TAYLOR ◽  
OMAR ALHASSOON ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Visual Inspection ◽  
Driving Behavior ◽  
Personality Change ◽  
Impaired Consciousness ◽  
Neuropsychological Dysfunction ◽  
Gcs Score ◽  
The Impact

The following is a correction for an error that occurred in the Journal of the International Neuropsychological Society, Vol. 6, No. 3. The error occurred in the article titled “Personality change disorder in children and adolescents following traumatic brain injury,” pp. 279–289, by Max et al. On page 285, under the subheading “Injury Factors,” beginning with the second sentence in the first paragraph, the statement should read:Visual inspection of the distribution of PC relative to lowest post-resuscitation GCS scores revealed that a cut-off of lowest post-resuscitation GCS score of 4 or less versus more than 4 yielded a sensitivity for a diagnosis of persistent PC of 9/14 (64.3%), specificity of 18/23 (78.3%), and a positive predictive value of 0.64 (9.14).A cut-off of duration of impaired consciousness of 100 hr or less versus more than 100 hr yielded a sensitivity for a diagnosis of persistent PC of 11/14 (78.6%), specificity of 20/23 (87.0%), and a positive predictive value (PPV) of 0.79 (11/14).

scholarly journals Investigating the impact of disease and health record duration on the eMERGE algorithm for rheumatoid arthritis

2020 ◽  
Vol 27 (4) ◽  
pp. 601-605
Author(s):  
Vanessa L Kronzer ◽  
Liwei Wang ◽  
Hongfang Liu ◽  
John M Davis ◽  
Jeffrey A Sparks ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Index Date ◽  
Model Performance ◽  
Area Under The Curve ◽  
Population Based ◽  
Health Record ◽  
The Impact

Abstract Objective The study sought to determine the dependence of the Electronic Medical Records and Genomics (eMERGE) rheumatoid arthritis (RA) algorithm on both RA and electronic health record (EHR) duration. Materials and Methods Using a population-based cohort from the Mayo Clinic Biobank, we identified 497 patients with at least 1 RA diagnosis code. RA case status was manually determined using validated criteria for RA. RA duration was defined as time from first RA code to the index date of biobank enrollment. To simulate EHR duration, various years of EHR lookback were applied, starting at the index date and going backward. Model performance was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC). Results The eMERGE algorithm performed well in this cohort, with overall sensitivity 53%, specificity 99%, positive predictive value 97%, negative predictive value 74%, and AUC 76%. Among patients with RA duration <2 years, sensitivity and AUC were only 9% and 54%, respectively, but increased to 71% and 85% among patients with RA duration >10 years. Longer EHR lookback also improved model performance up to a threshold of 10 years, in which sensitivity reached 52% and AUC 75%. However, optimal EHR lookback varied by RA duration; an EHR lookback of 3 years was best able to identify recently diagnosed RA cases. Conclusions eMERGE algorithm performance improves with longer RA duration as well as EHR duration up to 10 years, though shorter EHR lookback can improve identification of recently diagnosed RA cases.

scholarly journals The relationship between consciousness and the ascending reticular activating system in patients with traumatic brain injury

2020 ◽  
Author(s):  
Sung Ho Jang ◽  
YOUNGHYEON KWON
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Control Group ◽  
Impaired Consciousness ◽  
Patient Subgroup ◽  
Chronic Stage ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Gcs Score ◽  
The Relationship

Abstract Background: We investigated the relationship between consciousness and the ascending reticular activating system(ARAS) by using diffusion tensor tractography(DTT) in patients with traumatic brain injury(TBI).Methods: Twenty-six patients with TBI and 13 healthy control subjects were recruited for this study. Glasgow Coma Scale(GCS) scores were used for evaluation of subject consciousness state at the chronic stage of TBI(at DTT scanning), According to the GCS score, the patient group was divided into two subgroups: A(14 patients;impaired consciousness:GCS score<15, and B(12 patients;intact consciousness;GCS score=15). Fractional anisotropy(FA) and tract volume(TV) values were assessed in the lower dorsal and upper ARAS.Results: The FA values of the lower dorsal ARAS and the upper ARAS in patient subgroup A were significantly lower than those in patient subgroup B and the control group(p<0.05). However, the FA and TV values for the lower dorsal ARAS and the upper ARAS were not significantly different between patient subgroup B and the control group(p>0.05). The FA value of the lower dorsal ARAS(r=0.473,p<0.05) and the TV of upper ARAS(r=0.484,p<0.05) had moderate positive correlations with the GCS score. The FA value of the upper ARAS had a strong positive correlation with the GCS score of the patient group(r=0.780,p<0.05).Conclusions: We detected a close relationship between consciousness at the chronic stage of TBI and injuries of the lower dorsal and upper ARAS(especially, the upper ARAS) in patients who showed impaired consciousness at the onset of TBI. We believe that our results can be useful during the development of therapeutic strategies for patients with impaired consciousness following TBI.

scholarly journals Diagnostic Value of VIA Comparing with Conventional Pap Smear in the Detection of Colposcopic Biopsy Proved CIN

1970 ◽  
Vol 6 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Divya Hegde ◽  
Harish Shetty ◽  
Prasanna K Shetty ◽  
Supriya Rai ◽  
Lakshmi Manjeera ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
High Grade ◽  
Low Resource Settings ◽  
Low Resource

Aim: A study to assess the role of visual inspection with acetic acid VIA as an alternative to Pap smear in screening program for cervical cancer in low resource settings. Method: Two hundred and twenty five women in reproductive age group attending the Gynecology department at K.S Hegde Charitable Hospital were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All women then underwent colposcopy using the video colposcope. All patients who tested positive on screening then underwent colposcopy guided biopsy. Pap smear of Low grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was chi square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0. Results: Out of 225 patients, VIA was positive in 27(12%) patients and Pap smear was abnormal in 26(11.7%). There were 15 LSIL, 6 high Grade Squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia and 3 squamous cancers. Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80 % and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9 % and negative predictive value of 96.5%. Conclusion: Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting high grade lesion we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings. Keywords: Cervical cancer in low resource settings, Pap smear- colposcopy, visual inspection with acetic acid   DOI: http://dx.doi.org/10.3126/njog.v6i1.5245 NJOG 2011; 6(1): 7-12

scholarly journals How Partners Experience Personality Change After Traumatic Brain Injury – Its Impact on Their Emotions and their Relationship

2015 ◽  
Vol 16 (3) ◽  
pp. 205-220 ◽  
Author(s):  
Sarah E. M. Bodley-Scott ◽  
Gerard A. Riley
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Personality Change ◽  
Emotional Impact ◽  
Couple Relationship ◽  
Emotional Wellbeing ◽  
Social Emotional ◽  
Spousal Relationship ◽  
Behavioural Changes ◽  
The Impact

Objective: The aim of this qualitative study was to explore how spouses/partners experience social, emotional and behavioural changes in persons following traumatic brain injury (TBI), with a particular focus on their emotional impact and the effect on the couple relationship.Method: Interpretative phenomenological analysis (IPA) of interview data explored five women's experiences of these changes in their partners following TBI.Results: Themes describe the direct emotional impact of living with the changes as well as the emotional impact of attempts to manage and make sense of the changes (identity change, managing the changes and making sense of the changes). The impact on the couple relationship is described under the themes of feeling love and receiving love. Changes led three of the participants to experience their partner as having been replaced by a new person; they actively disliked this new person; they felt unable to love the new person in the same way as the old person; and their love was defined in terms of a caring relationship, rather than a spousal relationship.Conclusions: The study provides insight into why social, emotional and behavioural changes might be so consistently associated with reduced emotional wellbeing and lower levels of relationship quality and satisfaction.

scholarly journals VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

2017 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Anita Paswan ◽  
Anil Kumar ◽  
Kumudini Jha ◽  
Shail Kumari Sinha
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Lugol’S Iodine ◽  
Resource Setting ◽  
Sensitivity Specificity

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

scholarly journals Validation of the Malay Version of the Hospital Anxiety and Depression Scale among Patients with Traumatic Brain Injury

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Leong Abdullah MFI ◽  
Sidi H ◽  
Ng YP
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Positive Predictive Value ◽  
Internal Consistency ◽  
Predictive Value ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Anxiety Subscale

Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.

scholarly journals Diagnostic accuracy of basal cell carcinoma in dermatology setting in Serbia - single center study

2021 ◽  
pp. 12-12
Author(s):  
Milana Ivkov-Simic ◽  
Branislava Gajic ◽  
Dejan Ogorelica ◽  
Zorica Gajinov
Keyword(s):  
Skin Cancer ◽  
Basal Cell Carcinoma ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Cell Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Skin Examination ◽  
Total Body

Background/Aim. Growing incidence of skin tumors require their accurate diagnosis. Dermoscopy, especially in-vivo, enhances diagnosis of basal cell carcinoma (BCC). Total body skin examination (TBSE), a visual inspection of the patient?s total body surface, is considered basic step in dermatological exam, especially in skin cancer screening. However, TBSE is still a matter of debate of its expediency in real clinical setting. Aim of this study is to analyze diagnostic accuracy of BCC detected and treated by referred dermatologists in Skin Cancer Unit of a Dermatology and Venereology Clinic. Methods. Retrospective analysis of the BCC detection during total body skin examination with visual inspection and dermoscopy. We calculated sensitivity and specificity and positive predictive value for BCC using histopathological results as correct diagnosis. Results. Out of 3346 biopsied skin tumors 49.58% were malignant and 50.42% benign. The most common malignant tumor was BCC, accounting for 84.09%. Localization of BCCs was mainly on the trunk 38.92% and on H-zone of the face 37.63%. Other localizations were face (non-H-zone) 6.67%, neck 3.01%, scalp 3.37%, arms 6.88% and limbs 3.51%. Of all BCCs, 0.83% were recurrent BCC. The sensitivity for diagnosis BCC was 97.71%, and positive predictive value 95.08%. Conclusion. In dermatology setting, total body skin examination (TBSE) and visual inspection with in-vivo dermoscopy results with very good diagnostic performance of BCC.

Evaluation of initial shockable rhythm as an indicator of short no-flow time in cardiac arrest: a national registry study

2022 ◽  
pp. emermed-2021-211823
Author(s):  
Keita Shibahashi ◽  
Kazuhiro Sugiyama ◽  
Takuto Ishida ◽  
Yuichi Hamabe
Keyword(s):  
Cardiac Arrest ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Cardiac Rhythm ◽  
Flow Time ◽  
Lower Probability ◽  
Time Duration ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
The Impact

BackgroundThe duration from collapse to initiation of cardiopulmonary resuscitation (no-flow time) is one of the most important determinants of outcomes after out-of-hospital cardiac arrest (OHCA). Initial shockable cardiac rhythm (ventricular fibrillation or ventricular tachycardia) is reported to be a marker of short no-flow time; however, there is conflicting evidence regarding the impact of initial shockable cardiac rhythm on treatment decisions. We investigated the association between initial shockable cardiac rhythm and the no-flow time and evaluated whether initial shockable cardiac rhythm can be a marker of short no-flow time in patients with OHCA.MethodsPatients aged 18 years and older experiencing OHCA between 2010 and 2016 were selected from a nationwide population-based Japanese database. The association between the no-flow time duration and initial shockable cardiac rhythm was evaluated. Diagnostic accuracy was evaluated using the sensitivity, specificity and positive predictive value.ResultsA total of 177 634 patients were eligible for the analysis. The median age was 77 years (58.3%, men). Initial shockable cardiac rhythm was recorded in 11.8% of the patients. No-flow time duration was significantly associated with lower probability of initial shockable cardiac rhythm, with an adjusted OR of 0.97 (95% CI 0.96 to 0.97) per additional minute. The sensitivity, specificity and positive predictive value of initial shockable cardiac rhythm to identify a no-flow time of <5 min were 0.12 (95% CI 0.12 to 0.12), 0.88 (95% CI 0.88 to 0.89) and 0.35 (95% CI 0.34 to 0.35), respectively. The positive predictive values were 0.90, 0.95 and 0.99 with no-flow times of 15, 18 and 28 min, respectively.ConclusionsAlthough there was a significant association between initial shockable cardiac rhythm and no-flow time duration, initial shockable cardiac rhythm was not reliable when solely used as a surrogate of a short no-flow time duration after OHCA.

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