Effects of withdrawal of antiparkinson medication on gait and clinical score in the Parkinson patient

SummaryBackground. Despite the availability of several diagnostic methods for the detection of deep-vein thrombosis (DVT), the identification of previous episodes of DVT remains a diagnostic challenge.Study objective. To assess the reliability of a combination of a standardized clinical score with three non-invasive tests: compression ultrasonography (CUS), Doppler ultrasound (DUS), and photoplethysmography (PPG), in determining the presence or the absence of previous proximal DVT.Methods. One hundred consecutive unselected outpatients were identified, who had undergone contrast venography six to nine years previously because of the clinical suspicion of DVT (confirmed in 43). They were blindly reinvestigated by a panel of trained operators unaware of venography results. They underwent a clinical evaluation of the lower limb, by applying a standardized score to five symptoms and six signs (grading each item from 0 to 3); a PPG test to determine the venous refilling time; a DUS test to determine the venous reflux separately in the common femoral and the popliteal vein; and a CUS test to determine vein compressibility in the same regions.Results. An abnormal CUS test and/or the demonstration of venous reflux in the popliteal region and/or a high clinical score (≥ 8) identified twenty-four of the 43 (56%) DVT + patients with a specificity of 89%. The combination of normal CUS with the absence of venous reflux in both the common femoral and popliteal vein and a low clinical score excluded previous thrombosis in 45 (79%) of the 57 DVT- patients (negative predictive value, 78%). Abnormal venous reflux in the isolated common femoral vein did not reliably predict the presence or absence of previous DVT. However, this occurred in only 13 (13%) patients. The PPG determination of venous refilling time did not improve the results obtained with the other tests.Conclusions. The combination of a standardized clinical evaluation with the results of CUS and DUS can reliably diagnose or exclude previous proximal-vein thrombosis in almost 90% of patients with previous episodes of suspected DVT.

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CLINICAL SCORE PREDICTIVE OF THE ABDOMINAL LEAK POINT PRESSURE (ALPP) <60 CM H2O IN WOMEN WITH STRESS URINARY INCONTINENCE.

10.26226/morressier.59b63e42d462b802923897e3 ◽

2017 ◽

Author(s):

Leandro Arribillaga

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Clinical Score ◽

Leak Point Pressure ◽

Point Pressure

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T1 Relaxation Time of Achilles Tendon at 3 Tesla with Special Reference to Relevant Clinical Score: A Preliminary Study

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666181205130816 ◽

2020 ◽

Vol 16 (2) ◽

pp. 164-173

Author(s):

Zeineb Tbini ◽

Mokhtar Mars ◽

Mouna Bouaziz

Keyword(s):

Relaxation Time ◽

Achilles Tendon ◽

Clinical Score ◽

3 Tesla ◽

Acquisition Time ◽

Short Term ◽

T1 Relaxation Time ◽

T1 Relaxation ◽

Spin Echo Sequence ◽

Significant Difference

Purpose: The purpose of this study was to investigate T1 relaxation time of the human Achilles tendon, to test its short-term repeatability as well as the minimal detectable change, and to assess the extent that correlate with clinical symptoms. Methods: Twenty asymptomatic volunteers and eighteen patients with clinically and sonographically confirmed tendinopathy were scanned for ankle using a 3 Tesla (T) MR scanner. T1 maps were calculated from a variable flip angle gradient echo Ultra-short echo time sequence (VFA-GE UTE) and inversion recovery spin echo sequence (IR-SE) using a self-developed matlab algorithm in three regions of interest of Achilles Tendon (AT). Signal to Noise Ratio (SNR) between the two sequences was evaluated. INTRA-class Correlation Coefficient (ICC), Coefficient of Variation (CV) and the Least Significant Change (LSC) were calculated, to test short-term repeatability of T1. Subjects were assessed by the VISA-A clinical score. P values less than 0.005 were considered statistically significant. Results: Mean T1 values were 427.09 ± 53.37 ms and 528.70 ± 103.50 ms using IR-SE sequence and 575.43 ± 110.60 ms and 875.81 ± 425.77 ms with VFA-GE UTE sequence in the whole AT for volunteers and patients, respectively. : T1 values showed a significant difference between volunteers and patients (P=0.001). Regional variation of T1 in healthy and tendinopathic AT were greater for VFA-GE UTE sequence than for IR-SE sequence. VFA-GE UTE sequence showed clearly higher SNR compared to IR-SE sequence. Short-term repeatability of T1 values for volunteers showed an LSC of 22% and 14% for IR-SE sequence and VFA-GE UTE sequence, respectively. For patients, LSC was 14% and 5% for IR-SE sequence and VFA-GE UTE sequence, respectively. There was no correlation between T1 and VISA-A clinical score (p>0.005). Conclusion: VFA-GE UTE sequence used for T1 mapping calculation demonstrated short acquisition time and clearly high SNR. Results revealed that T1 relaxation time can be used as a biomarker to differentiate between healthy and pathologic Achilles tendon. However, T1 showed no correlation with the VISA-A clinical score.

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Antibiotic Susceptibility Evaluation of Bacterial Agents Causing Infection in Children with Acute Tonsillopharyngitis

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666201116102441 ◽

2020 ◽

Vol 20 ◽

Author(s):

Hamidreza Sherkatolabbasieh ◽

Majid Firouzi ◽

Shiva Shafizadeh ◽

Iman Amiri

Keyword(s):

Sore Throat ◽

Predictive Value ◽

Positive Culture ◽

Clinical Score ◽

Streptococcal Pharyngitis ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Clinical Sensitivity ◽

Group A

Background: The aim of this study is to evaluate the prevalence of group A beta-hemolytic pharyngitis by assessing the outcome of the culture and the resistance and sensitivity of group A beta hemolytic streptococcus to antibiotics. Methods: This cross-sectional study was conducted on 170 patients, aged 3-15 years, referred to the clinic with complaints of sore throat. Patients’ history was collected and physical examination was performed and were score based on clinical findings. Patients with other underlying pathologies and those taking antibiotics prior to the study were excluded from our study. Antimicrobial susceptibility test was performed by disk diffusion method against cephalexin, cefazolin, erythromycin and amoxicillin. Results: A total of 170 patients were reported with sore throat. Patients with positive culture results were 60% male and 40% female. Amoxicillin resistance was the greatest (5%) in the culture. All isolated bacteria were sensitive to amoxicillin, cephalexin, cefazolin and erythromycin. Patients with McIssac score ≥ 6 showed clinical sensitivity 75% specificity 61% negative predictive value 94.8% and positive predictive value 20.3% for Group A beta-hemolytic streptococcal pharyngitis. Conclusion: The results showed the higher the clinical score, the greater the chance of positive throat culture.

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Verification of Finger Joint Stiffness Estimation Method With Soft Robotic Actuator

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2020.592637 ◽

2020 ◽

Vol 8 ◽

Author(s):

Xiang Qian Shi ◽

Ho Lam Heung ◽

Zhi Qiang Tang ◽

Kai Yu Tong ◽

Zheng Li

Keyword(s):

Estimation Method ◽

Joint Stiffness ◽

Ground Truth ◽

Clinical Score ◽

Metacarpophalangeal Joint ◽

Finger Joint ◽

Joint Torque ◽

Hand Rehabilitation ◽

Stiffness Characteristic ◽

Modified Ashworth Scale

Stroke has been the leading cause of disability due to the induced spasticity in the upper extremity. The constant flexion of spastic fingers following stroke has not been well described. Accurate measurements for joint stiffness help clinicians have a better access to the level of impairment after stroke. Previously, we conducted a method for quantifying the passive finger joint stiffness based on the pressure-angle relationship between the spastic fingers and the soft-elastic composite actuator (SECA). However, it lacks a ground-truth to demonstrate the compatibility between the SECA-facilitated stiffness estimation and standard joint stiffness quantification procedure. In this study, we compare the passive metacarpophalangeal (MCP) joint stiffness measured using the SECA with the results from our designed standalone mechatronics device, which measures the passive metacarpophalangeal joint torque and angle during passive finger rotation. Results obtained from the fitting model that concludes the stiffness characteristic are further compared with the results obtained from SECA-Finger model, as well as the clinical score of Modified Ashworth Scale (MAS) for grading spasticity. These findings suggest the possibility of passive MCP joint stiffness quantification using the soft robotic actuator during the performance of different tasks in hand rehabilitation.

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Etiological Work-Up for Adults with Bronchiectasis: A Predictive Diagnostic Score for Primary Ciliary Dyskinesia and Cystic Fibrosis

Journal of Clinical Medicine ◽

10.3390/jcm10163478 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3478

Author(s):

Frederic Schlemmer ◽

Agnes Hamzaoui ◽

Sonia Zebachi ◽

Aurelie Le Thuaut ◽

Gilles Mangiapan ◽

...

Keyword(s):

Cystic Fibrosis ◽

Primary Ciliary Dyskinesia ◽

Clinical Score ◽

Adult Patients ◽

Operating Characteristics ◽

Diagnostic Score ◽

Receiver Operating Characteristics Curve ◽

Diagnostic Work ◽

Work Up ◽

Ciliary Dyskinesia

Background: etiological investigations are not done for all adult patients with bronchiectasis because of the availability and interpretation of tests. The aim of the study was to elaborate a score to identify patients at high risk of having cystic fibrosis or primary ciliary dyskinesia (CF/PCD), which require appropriate management. Methods: diagnostic work-ups were carried out on a French monocenter cohort, and results were subjected to logistic-regression analyses to identify the independent factors associated with CF/PCD diagnosis and, thereby, elaborate a score to validate in a second cohort. Results: among 188 patients, 158 had no obvious diagnosis and were enrolled in the algorithm-construction group. In multivariate analyses, age at symptom onset (8.69 (2.10–35.99); p = 0.003), chronic ENT symptoms or diagnosed sinusitis (10.53 (1.26–87.57); p = 0.03), digestive symptoms or situs inversus (5.10 (1.23–21.14); p = 0.025), and Pseudomonas. aeruginosa and/or Staphylococcus aureus isolated from sputum (11.13 (1.34–92.21); p = 0.02) are associated with CF or PCD. Receiver operating characteristics curve analysis, using a validation group of 167 patients with bronchiectasis, confirmed the score’s performance with AUC 0.92 (95% CI: 0.84–0.98). Conclusions: a clinical score may help identify adult patients with bronchiectasis at higher risk of having CF or PCD.

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