scholarly journals Development of revised diagnostic criteria for Fuchs’ uveitis syndrome in a Chinese population

2021 ◽  
pp. bjophthalmol-2021-319343
Author(s):  
Peizeng Yang ◽  
Wanyun Zhang ◽  
Zhijun Chen ◽  
Han Zhang ◽  
Guannan Su ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Symptoms ◽  
Southern China ◽  
High Sensitivity ◽  
Northern China ◽  
Chinese Patients ◽  
Tertiary Referral Centre ◽  
Tree Algorithms ◽  
Vitreous Opacities ◽  
Fuchs Uveitis Syndrome

Background/aimsFuchs’ uveitis syndrome (FUS) is one of the frequently misdiagnosed uveitis entities, which is partly due to the absence of internationally recognised diagnostic criteria. This study was performed to develop and evaluate a set of revised diagnostic criteria for FUS.MethodsThe clinical data of Chinese patients with FUS and patients with non-FUS were collected and analysed from a tertiary referral centre between April 2008 and December 2020. A total of 593 patients with FUS and 625 patients with non-FUS from northern China were enrolled for the development of diagnostic criteria for FUS. Three hundred and seventy-seven patients with FUS and 503 patients with non-FUS from southern China were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients with FUS and patients with non-FUS. Multivariate two-step cluster analysis, logistic regression and decision tree algorithms in combination with the clinical judgement of uveitis experts were used to revise diagnostic criteria for FUS.ResultsThree essential findings including diffuse iris depigmentation, absence of posterior synechiae, mild inflammation in the anterior chamber at presentation and five associated findings including mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms and characteristic iris nodules were used in the development of FUS diagnostic criteria. All essential findings were required for the diagnosis of FUS, and the diagnosis was further strengthened by the presence of associated findings.ConclusionRevised diagnostic criteria for FUS were developed and validated by analysing data from Chinese patients and showed a high sensitivity (96.55%) and specificity (97.42%).

Explicit Diagnostic Criteria for Transient Ischemic Attacks Used in the Emergency Department Are Highly Sensitive and Specific

2020 ◽  
pp. 1-6
Author(s):  
Carl H. Göbel ◽  
Sarah C. Karstedt ◽  
Thomas F. Münte ◽  
Hartmut Göbel ◽  
Sebastian Wolfrum ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Criteria ◽  
Sensitivity And Specificity ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
High Sensitivity ◽  
University Hospital ◽  
Care Hospital ◽  
Transient Ischemic Attacks

<b><i>Background:</i></b> Making a correct diagnosis of a transient ischemic attack (TIA) is prone to errors because numerous TIA mimics exist and there is a shortage of evidence-based diagnostic criteria for TIAs. In this study, we applied for the first time the recently proposed explicit diagnostic criteria for transient ischemic attacks (EDCT) to a group of patients presenting to the emergency department of a large German tertiary care hospital with a suspected TIA. The aim was to determine the sensitivity and specificity of the EDCT in its clinical application. <b><i>Methods:</i></b> A total of 128 patients consecutively presenting to the emergency department of the University Hospital of Lübeck, Germany, under the suspicion of a TIA were prospectively interviewed about their clinical symptoms at the time of presentation. The diagnosis resulting from applying the EDCT was compared to the diagnosis made independently by the senior physicians performing the usual diagnostic work-up (“gold standard”), allowing calculation of sensitivity and specificity of the EDCT. <b><i>Results:</i></b> EDCT achieved a sensitivity of 96% and a specificity of 88%. When adding the additional criterion F (“the symptoms may not be better explained by another medical or mental disorder”), specificity significantly increased to 98%. <b><i>Conclusions:</i></b> The data show that the EDCT in its modified version as proposed by us are a highly useful tool for clinicians. They display a high sensitivity and specificity to accurately diagnose TIAs in patients referred to the emergency department with a suspected TIA.

scholarly journals Genetic Characteristics and Transcriptional Regulation of Sodium Channel Related Genes in Chinese Patients With Brugada Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziguan Zhang ◽  
Hongwei Chen ◽  
Wenbo Chen ◽  
Zhenghao Zhang ◽  
Runjing Li ◽  
...  
Keyword(s):  
Transcriptional Regulation ◽  
Brugada Syndrome ◽  
Southern China ◽  
Gene Mutations ◽  
Northern China ◽  
Chinese Patients ◽  
Α Subunit ◽  
Genetic Characteristics ◽  
C Terminus ◽  
Scn5a Gene

Objective: To investigate the genetic characteristics and transcriptional regulation of the SCN5A gene of Brugada syndrome (BrS) patients in China.Methods: Using PubMed, Medline, China National Knowledge Internet (CNKI), and Wanfang Database, Chinese patients with BrS who underwent SCN5A gene testing were studied.Results: A total of 27 suitable studies involving Chinese BrS patients who underwent the SCN5A gene test were included. A total of 55 SCN5A gene mutations/variations were reported in Chinese BrS patients, including 10 from southern China and 45 from northern China. Mutations/variations of BrS patients from southern China mostly occurred in the regions of the α-subunit of Nav1.5, including DIII (Domain III), DIV, DIII-DIV, C-terminus regions, and the 3'UTR region. Furthermore, we analyzed the post-transcriptional modifications (PTMs) throughout the Nav1.5 protein encoded by SCN5A and found that the PTM changes happened in 72.7% of BrS patients from southern China and 26.7% from northern China.Conclusions: SCN5A mutations/variations of BrS patients in southern China mostly occurred in the DIII-DIV to C-terminus region and the 3'-UTR region of the SCN5A gene, different from northern China. PTM changes were consistent with the mutation/variation distribution of SCN5A, which might be involved in the regulation of the pathogenesis of BrS patients.

Spatial variation of East Asian winter monsoon evolution between northern and southern China since the last glacial maximum

2021 ◽  
pp. 1-14
Author(s):  
Qin Li ◽  
Haibin Wu ◽  
Jun Cheng ◽  
Shuya Zhu ◽  
Chunxia Zhang ◽  
...  
Keyword(s):  
East Asian Winter Monsoon ◽  
Southern China ◽  
Ice Sheets ◽  
Northern China ◽  
Winter Monsoon ◽  
Asian Winter Monsoon ◽  
Spatial Differences ◽  
The Last Glacial Maximum ◽  
The Last Glacial

Abstract The East Asian winter monsoon (EAWM) is one of the most dynamic components of the global climate system. Although poorly understood, knowledge of long-term spatial differences in EAWM variability during the glacial–interglacial cycles is important for understanding the dynamic processes of the EAWM. We reconstructed the spatiotemporal characteristics of the EAWM since the last glacial maximum (LGM) using a comparison of proxy records and long-term transient simulations. A loess grain-size record from northern China (a sensitive EAWM proxy) and the sea surface temperature gradient of an EAWM index in sediments of the southern South China Sea were compared. The data–model comparison indicates pronounced spatial differences in EAWM evolution, with a weakened EAWM since the LGM in northern China but a strengthened EAWM from the LGM to the early Holocene, followed by a weakening trend, in southern China. The model results suggest that variations in the EAWM in northern China were driven mainly by changes in atmospheric carbon dioxide (CO2) concentration and Northern Hemisphere ice sheets, whereas orbital insolation and ice sheets were important drivers in southern China. We propose that the relative importance of insolation, ice sheets, and atmospheric CO2 for EAWM evolution varied spatially within East Asia.

Anorexia Nervosa in a Black Zimbabwean

1984 ◽  
Vol 145 (3) ◽  
pp. 326-330 ◽  
Author(s):  
T. Buchan ◽  
L. D. Gregory
Keyword(s):  
Anorexia Nervosa ◽  
Special Reference ◽  
Diagnostic Criteria ◽  
Traditional Healer ◽  
Clinical Symptoms ◽  
The Social ◽  
Speculative Hypothesis ◽  
African Patients

SummaryIn spite of the comparative rarity of anorexia nervosa in African patients, the case of a young black Zimbabwean woman which fulfils Feighner's diagnostic criteria is presented. Special reference is made to several unusual features which include the social and psychological conflicts engendered by changes of culture, the clinical symptoms, and the role of a traditional healer in her recovery. A speculative hypothesis concerning aetiology is suggested.

scholarly journals Comparison of classical diagnostic criteria and Chinese revised diagnostic criteria for fever of unknown origin in Chinese patients

2016 ◽  
Vol Volume 12 ◽  
pp. 1545-1551 ◽  
Author(s):  
Jia-Jun Li ◽  
Wen-Xiang Huang ◽  
Zheng-Yu Shi ◽  
Qiu Sun ◽  
Xiao-Juan Xin ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Chinese Patients

scholarly journals AB0411 CHALLENGES IN THE MANAGEMENT OF MIXED CONNECTIVE TISSUE DISEASE: A RETROSPECTIVE ANALYSIS OF THE MCTD COHORT IN A TERTIARY REFERRAL CENTRE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1233.3-1234
Author(s):  
A. Wanzenried ◽  
A. Garaiman ◽  
S. Jordan ◽  
O. Distler ◽  
B. Maurer
Keyword(s):  
Connective Tissue ◽  
International Symposium ◽  
Diagnostic Criteria ◽  
Connective Tissue Disease ◽  
Lupus Erythematosus ◽  
Mixed Connective Tissue Disease ◽  
Activity Index ◽  
Referral Centre ◽  
Tertiary Referral Centre

Background:As a rare, complex, and heterogeneous disease, mixed connective tissue disease (MCTD) represents a challenge for clinical practice.Objectives:We aimed to unravel potential pitfalls including correct referral diagnosis, fulfilment of diagnostic criteria, distinction from other CTDs, disease course and activity, and treatment modalities.Methods:We analysed the prospectively collected MCTD cohort at our tertiary referral centre. The patients’ medical histories were investigated for fulfilment of Sharp’s (1), Kasukawa’s (2), and Alarcón-Segovia’s (3) diagnostic MCTD criteria. We defined overlap syndromes as simultaneous fulfilment of clinical as well as immunological criteria of two defined rheumatic diseases. Disease conversion was defined as emergence of new symptoms and autoantibodies consistent with another rheumatic disease. Remission was defined by simultaneous systemic lupus erythematosus disease activity index 2000 (SLEDAI-2 K) of 0 and European League Against Rheumatism scleroderma trial and research (EUSTAR) activity index <2.5. Disease phenotype and disease activity were monitored over time and all patients were evaluated for fulfilment of classification criteria of various connective tissue diseases.Results:Out of 85 patients initially referred as MCTD, only one third fulfilled the diagnostic MCTD criteria. Most of the remaining patients had undifferentiated CTD (29%) or overlap syndromes (20%). In our final cohort of 33 MCTD patients, 6 (48%) also met the classification criteria of systemic sclerosis, 13 (39%) those of systemic lupus erythematosus (SLE), 6 (18%) those of rheumatoid arthritis, and 3 (9%) those of primary myositis. Over the median observation period of 4.6 (1.6, 9.9) years, only two patients (6%) underwent disease conversion from MCTD to SLE and no patient converted towards other diseases. The number of patients in remission increased from 6 (18%) to 15 (45%) due to introduction of immune modulatory treatment. Combination therapy was favoured in most cases (17 patients, 52%), whereas monotherapy was less frequent (12 patients, 36%), and only 4 (12%) patients remained without immune modulators until the end of the follow-up period. Hydroxychloroquine, prednisone, and methotrexate were the most frequently used medications in our cohort.Conclusion:Our study showed a high risk for misdiagnosis for patients with MCTD. Phenotype conversion was a very rare event. As a multi-organ disease, MCTD required prolonged (combined) immunosuppressive therapy to achieve remission. The establishment of an international registry with longitudinal data from observational multi-centre cohorts might represent a first step to address the many unmet needs of MCTD.References:[1]Sharp GC. Diagnostic criteria for classification of MCTD. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 23-30.[2]Kasukawa R, Tojo T, Miyawaki S, Yoshida H, Tanimoto K, Nobunaga M, et al. Preliminary diagnostic criteria for classification of mixed connective tissue disease. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 41-7.[3]Alarcón-Segovia D, Villarreal M. Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 33-40.Disclosure of Interests:Adrian Wanzenried: None declared, Alexandru Garaiman: None declared, Suzana Jordan: None declared, Oliver Distler Consultant of: O.D. had consultancy relationship and/or has received research funding from Abbvie, Actelion, Acceleron Pharma, Amgen, AnaMar, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, Catenion, Competitive Drug Development International Ltd, CSL Behring, ChemomAb, Curzion Pharmaceuticals, Ergonex, Ga-lapagos NV, Glenmark Pharmaceuticals, GSK, Inventiva, Italfarmaco, iQone, iQvia, Lilly, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Target Bio Science and UCB in the area of potential treatments of scleroderma and its complications., Britta Maurer Consultant of: Boehringer-Ingelheim, Grant/research support from: AbbVie, Protagen, and Novartis Biomedical Research as well as congress support from Pfizer, Roche, Actelion, mepha, and MSD.

High-sensitivity troponin assays: analytical and clinical aspects

2016 ◽  
Vol 51 (4) ◽  
pp. 315-320
Author(s):  
Magdalena Krintus
Keyword(s):  
Myocardial Infarction ◽  
Clinical Symptoms ◽  
High Sensitivity ◽  
Reference Population ◽  
Clinical Aspects ◽  
Analytical Sensitivity ◽  
Reference Limit ◽  
Highly Sensitive ◽  
Time Required ◽  
Highly Sensitive Troponin

Cardiac troponins are considered the most sensitive and specific biomarkers for the diagnosis of acute coronary syndromes (ACS). According to the Third Universal Definition of Acute Myocardial Infarction, the diagnosis requires a rise / or fall of troponin concentration with at least one value exceeding the 99th percentile upper reference limit (URL) in a reference population with the coexistence of clinical symptoms of ischemia. The introduction of highly sensitive assays has resulted in lower detection limits for the concentration of troponin, allowing for early diagnosis of, as well as the detection of quantifiable concentrations of this biomarker in healthy subjects. According to current guidelines, the use of high-sensitivity tests can shorten the time required to make clinical decisions from the current 3-6 hours to 1-2 hours. The use of highly sensitive troponin assays also carries other potential benefits associated with their predictive value, as well as challenges that include reduced specificity for myocardial infarction, lack of standardization or the presence of biological variability. Given the increasing availability of new, highly sensitive troponin assays we should be aware that their increased analytical sensitivity and precision is accompanied by accurate clinical assessment of the patient, and takes into account other non-cardiac causes of their increased concentrations.

Comparative Analysis of Nutritional Quality of Dendrobium Officinale Kimura Et Migo After Transplantation of Artificially Cultivated Plants From South to North China During Different Growing Years

2021 ◽  
Author(s):  
Xiaohui Guo ◽  
Shijing Zhang ◽  
Ting Yan ◽  
Guoqiang Yuan ◽  
Yafeng Dai ◽  
...  
Keyword(s):  
Nutritional Quality ◽  
Southern China ◽  
Northern China ◽  
Habitat Destruction ◽  
Dendrobium Officinale ◽  
Cultivated Plants ◽  
Total Phenolic ◽  
The Third ◽  
Nutritional Compounds ◽  
Nutrient Profiles

Abstract Background: Dendrobium officinale Kimura et Migo is a traditional functional food and medicinal plant in China. Due to low natural regeneration rates, habitat destruction, excessive collection and commercial trade, D. officinale is severely threatened, and commercial artificial-sheltered cultivation has been massively used to meet the needs of the market. Aim: To comprehensively compare the accumulation of nutritional compounds during 3-5 years of introduced, artificial-sheltered cultivation from southern to northern China.Methods: D. officinale of the same species were artificially cultivated in the southern traditional cultivation area, Anhui and the new northern cultivation area, Beijing. First, samples were collected in the third, fourth, and fifth years of growth, and nutritional quality indexes, including polysaccharides, alkaloids, flavonoids and total phenolic content, were determined. Second, an untargeted metabolomics method was used to investigate metabolic variations in D. officinale stems between Anhui and Beijing cultures in the fifth year.Results: After comparing the nutrient accumulation in different growing years, the idea harvest time was found in the third growing year in both cultivation areas. Of them, the contents of polysaccharides, flavonoids and total polyphenol were higher in cultivation in Anhui than Beijing, but the accumulation of alkaloid content was much lower in Anhui. The highest amount of polysaccharides of Dendrobium officinale was found in the three-year cultivation in Anhui, which reached 515.75 mg/g. When metabolites were analysed, a total of 272 metabolites were detected in the current study, including 27 up-regulated and 73 down-regulated metabolites in D. officinale cultivated in Beijing compared with samples from Anhui. Conclusion: D. officinale artificially and transplanted cultivated from southern to northern China showed some significant differences in the accumulation of nutrient compounds. Planting in northern China has some specific advantages, but the overall nutritional value is not as good as planting in southern China. Our study contributes to a better understanding of the nutrient profiles of D. officinale through artificial cultivation in different areas.

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