scholarly journals Comparison of the Predictive Value of GlycA and Other Biomarkers of Inflammation for Total Death, Incident Cardiovascular Events, Noncardiovascular and Noncancer Inflammatory-Related Events, and Total Cancer Events

2016 ◽  
Vol 62 (7) ◽  
pp. 1020-1031 ◽  
Author(s):  
Daniel A Duprez ◽  
James Otvos ◽  
Otto A Sanchez ◽  
Rachel H Mackey ◽  
Russell Tracy ◽  
...  
Keyword(s):  
Acute Phase Proteins ◽  
High Sensitivity ◽  
Good Health ◽  
International Classification Of Diseases ◽  
Inflammatory Biomarkers ◽  
Total Death ◽  
Classification Of Diseases ◽  
Total Cancer ◽  
Prediction Coefficient ◽  
D Dimer

Abstract BACKGROUND GlycA is a biomarker that reflects integrated concentrations and glycosylation states of several acute-phase proteins. We studied the association of GlycA and inflammatory biomarkers with future death and disease. METHODS A total of 6523 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of overt cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken. We assayed high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer. A spectral deconvolution algorithm was used to quantify GlycA signal amplitudes from automated nuclear magnetic resonance (NMR) LipoProfile® test spectra. Median follow-up was 12.1 years. Among 4 primary outcomes, CVD events were adjudicated, death was by death certificate, and chronic inflammatory-related severe hospitalization and death (ChrIRD) and total cancer were classified using International Classification of Diseases (ICD) codes. We used Poisson regression to study baseline GlycA, hsCRP, IL-6, and d-dimer in relation to total death, CVD, ChrIRD, and total cancer. RESULTS Relative risk per SD of GlycA, IL-6, and d-dimer for total death (n = 915); for total CVD (n = 922); and for ChrIRD (n = 1324) ranged from 1.05 to 1.20, independently of covariates. In contrast, prediction from hsCRP was statistically explained by adjustment for other inflammatory variables. Only GlycA was predictive for total cancer (n = 663). Women had 7% higher values of all inflammatory biomarkers than men and had a significantly lower GlycA prediction coefficient than men in predicting total cancer. CONCLUSIONS The composite biomarker GlycA derived from NMR is associated with risk for total death, CVD, ChrIRD, and total cancer after adjustment for hsCRP, IL-6, and d-dimer. IL-6 and d-dimer contribute information independently of GlycA.

scholarly journals High-Sensitivity Troponin T Testing: Consequences on Daily Clinical Practice and Effects on Diagnosis of Myocardial Infarction

2020 ◽  
Vol 9 (3) ◽  
pp. 775 ◽  
Author(s):  
Christian Frédéric Zachoval ◽  
Ramona Dolscheid-Pommerich ◽  
Ingo Graeff ◽  
Bernd Goldschmidt ◽  
Andreas Grigull ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Resource Utilization ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
Coronary Intervention ◽  
International Classification Of Diseases ◽  
High Sensitivity Troponin ◽  
Classification Of Diseases ◽  
High Sensitivity Troponin T

It remains unclear how introduction of high-sensitivity troponin T testing, as opposed to conventional troponin testing, has affected the diagnosis of acute myocardial infarction (AMI) and resource utilization in unselected hospitalized patients. In this retrospective analysis, we include all consecutive cases from our center during two corresponding time frames (10/2016–04/2017 and 10/2017–04/2018) for which different troponin tests were performed: conventional troponin I (cTnI) and high-sensitivity troponin T (hs-TnT) assays. Testing was performed in 18,025 cases. The incidence of troponin levels above the 99th percentile was significantly higher in cases tested using hs-TnT. This was not associated with increased utilization of echocardiography, coronary angiography, or percutaneous coronary intervention. Although there were no changes in local standard operating procedures, study site personnel, or national coding guidelines, the number of coded AMI significantly decreased after introduction of hs-TnT. In this single-center retrospective study comprising 18,025 mixed medical and surgical cases with troponin testing, the introduction of hs-TnT was not associated with changes in resource utilization among the general cohort, but instead, led to a decrease in the international classification of diseases (ICD)-10 coded diagnosis of AMI.

scholarly journals Collagen Turnover Markers in Relation to Future Cardiovascular and Noncardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

2017 ◽  
Vol 63 (7) ◽  
pp. 1237-1247 ◽  
Author(s):  
Daniel A Duprez ◽  
Myron D Gross ◽  
Otto A Sanchez ◽  
Jorge R Kizer ◽  
Joachim H Ix ◽  
...  
Keyword(s):  
Good Health ◽  
International Classification Of Diseases ◽  
Collagen Type I ◽  
Type I ◽  
Ethnic Study ◽  
Procollagen Type ◽  
Relative Risks ◽  
Total Death ◽  
Turnover Markers ◽  
Remodeling Of Extracellular Matrix

Abstract BACKGROUND Sustained remodeling of extracellular matrix can compromise organs and tissues. Procollagen type III N-terminal propeptide (PIIINP) and collagen type I carboxy-terminal telopeptide (ICTP) reflect collagen synthesis and degradation. We studied their predictive value for future death and disease. METHODS A total of 3068 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken for ICTP and PIIINP. Median follow-up was 13.0 years. Among 4 primary outcomes, CVD events (n = 697) were adjudicated, death (n = 571) was by death certificate, and chronic inflammatory–related severe hospitalization and death (ChrIRD, n = 726) and total cancer (n = 327) were classified using International Classification of Diseases codes. We used Poisson regression to study baseline ICTP and PIIINP relative to these outcomes. RESULTS Mean (SD) PIIINP was 5.47 (1.95) μg/L and ICTP was 3.37 (1.70) μg/L. PIIINP and ICTP were highly correlated with each other and with estimated glomerular filtration rate (eGFR). Adjustment for age and eGFR attenuated relative risks, remaining 20%–30% per SD of both PIIINP and ICTP in prediction for total death and ChrIRD, and of PIIINP for cancer, with little additional attenuation by adjusting for risk factors and inflammatory biomarkers. CVD outcome was generally unrelated to PIIINP but became marginally inversely related to ICTP in the most adjusted model. CONCLUSIONS The collagen biomarkers PIIINP and ICTP, in part through pathophysiologically parallel associations with renal function, predicted ChrIRD and total death. Moreover, PIIINP predicted future cancer. These collagen markers may help differentiate healthy from unhealthy aging.

scholarly journals Long-Term Study about the Incidence of Epilepsy in Male Service Personnel from India: A Retrospective, Cohort Study

2019 ◽  
Vol 10 (04) ◽  
pp. 588-591
Author(s):  
Pawan Dhull ◽  
S. K. Patnaik ◽  
Manoj Somasekharan ◽  
K. V. S Hari Kumar
Keyword(s):  
Incidence Rate ◽  
Good Health ◽  
International Classification Of Diseases ◽  
Service Personnel ◽  
Long Term Study ◽  
Active Service ◽  
Classification Of Diseases ◽  
Alcohol Dependence Syndrome ◽  
Patients With Epilepsy

Abstract Background The data on the epidemiology of epilepsy are limited for developing countries including India. We estimated the incidence of epilepsy in a cohort of service personnel from India followed for over two decades. Materials and Methods The data for this epidemiological study were derived from the electronic medical records (EMRs) of the male service personnel. The participants (age < 18 years) were enrolled into active service between 1990 and 2015 in good health. The data pertaining to the diagnosis of epilepsy were derived from the EMR using the prevalent International Classification of Diseases codes. We calculated the incidence rate as per person-years (py) using appropriate statistical methods. Results Our data included 51,217 participants (median age: 33 years, range: 17–54) with a mean follow-up of 12.5 years, giving a cumulative follow-up duration of 613,925 py. A total of 291 patients developed epilepsy during the study, giving an incidence rate of 0.47 per 1000 py (95% confidence interval: 0.42–0.53). Undifferentiated spondyloarthropathy, central nervous system disorders, and alcohol dependence syndrome were the common comorbid ailments in patients with epilepsy. Conclusion Our cohort had a comparable incidence rate of epilepsy with other studies from India and abroad.

scholarly journals Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis

2014 ◽  
Vol 44 (10) ◽  
pp. 2163-2176 ◽  
Author(s):  
V. A. Morgan ◽  
J. J. McGrath ◽  
A. Jablensky ◽  
J. C. Badcock ◽  
A. Waterreus ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Good Health ◽  
International Classification Of Diseases ◽  
Two Phase ◽  
Population Mean ◽  
The Metabolic Syndrome ◽  
Co Morbidity ◽  
Premorbid Intelligence ◽  
Morbidity Data ◽  
Classification Of Diseases

BackgroundThere are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities.MethodThe 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18–64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants.ResultsThe 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18–64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence.ConclusionsOur findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.

354 Pre-operative Risk Score Predicts 30-day Mortality Following Subdural Hematoma Evacuation

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 281-281
Author(s):  
Samuel Tomlinson ◽  
Joseph Van Galen ◽  
Alexis E Zavez ◽  
Keaton Piper ◽  
Kristopher T Kimmell ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Subdural Hematoma ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
International Classification Of Diseases ◽  
Improvement Program ◽  
Emergency Case ◽  
Classification Of Diseases ◽  
Wbc Count

Abstract INTRODUCTION Subdural hematoma (SDH) evacuation is a common neurosurgical procedure with high risk for morbidity and mortality. The purpose of this study was to develop a risk score for 30-day mortality following SDH evacuation on the basis of readily available pre-operative information. METHODS Data recorded in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database between 2006 and 2014 were selected on the basis of ICD-9 (International Classification of Diseases, Ninth ed.) and CPT (Current Procedural Terminology) coding. Sequential univariate and multivariate analyses were used to identify significant independent predictors of 30-day mortality among 32 pre- operative factors. Multivariate regression coefficients were used to develop a weighted risk score capable of separating outcome groups with high sensitivity and specificity. RESULTS >Following list-wise exclusion of patients with incomplete datasets, 1271 patients (35.6% F; median age 73.0 years, IQR 44.1-89.0 years) were examined. Sequential univariate and multivariate analysis identified seven independent predictors of 30-day mortality (OR = adjusted odds ratio): emergency case (OR 2.27), age >= 65 years (OR 2.42), ventilator dependent status (OR 4.95), dialysis (OR 5.16), bleeding disorder (OR 2.37), WBC count >= 10,000 mu;L-1 (OR 1.79), and platelets <150,000 μL-1 (OR 2.18). Receiver operating characteristic (ROC) analysis demonstrated impressive outcome discrimination (area under the curve = 0.82, CI 5–95% = 0.78 0.86). Optimal score threshold was used to identify high-risk (mortality 35.0%) and low-risk (mortality 6.33%) patient groups. CONCLUSION We demonstrate a novel risk score capable of classifying patients based on 30-day postsurgical mortality. Application will provide an improved means of predicting outcomes for patients undergoing craniotomy or craniectomy for SDH evacuation.

scholarly journals Validation of the Use of Electronic Health Records for Classification of ADHD Status

2016 ◽  
Vol 23 (13) ◽  
pp. 1647-1655 ◽  
Author(s):  
Siobhan M. Gruschow ◽  
Benjamin E. Yerys ◽  
Thomas J. Power ◽  
Dennis R. Durbin ◽  
Allison E. Curry
Keyword(s):  
Large Scale ◽  
Pediatric Patients ◽  
High Sensitivity ◽  
International Classification Of Diseases ◽  
Diagnostic Codes ◽  
Applied Study ◽  
Classification Of Diseases ◽  
Primary Care Patients ◽  
Electronic Health

Objective: To validate an electronic health record (EHR)–based algorithm to classify ADHD status of pediatric patients. Method: As part of an applied study, we identified all primary care patients of The Children’s Hospital of Philadelphia [CHOP] health care network who were born 1987-1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of “314.x” at a clinical visit or on a list of known conditions. We manually reviewed EHRs for ADHD patients ( n = 2,030) and a random weighted sample of non-ADHD patients ( n = 807 of 13,579) to confirm the presence or absence of ADHD. Results: Depending on assumptions for inconclusive cases, sensitivity ranged from 0.96 to 0.97 (95% confidence interval [CI] = [0.95, 0.97]), specificity from 0.98 to 0.99 [0.97, 0.99], and positive predictive value from 0.83 to 0.98 [0.81, 0.99]. Conclusion: EHR-based diagnostic codes can accurately classify ADHD status among pediatric patients and can be used by large-scale epidemiologic and clinical studies with high sensitivity and specificity.

Comparison of Alcohol Use Disorders in DSM and ICD

2020 ◽  
Vol 66 (3) ◽  
pp. 143-153
Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss
Keyword(s):  
Alcohol Use Disorders ◽  
International Classification Of Diseases ◽  
Clinical Use ◽  
Diagnostic Systems ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Historical Developments

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Störungen durch Substanzgebrauch und abhängige Verhaltensweisen in der ICD-11

2020 ◽  
pp. 1-8
Author(s):  
Nicolas Arnaud ◽  
Rainer Thomasius
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases

Zusammenfassung. Der Beitrag informiert über die Eingliederung der Suchtstörungen in die 11. Auflage der International Classification of Diseases (ICD-11) der Weltgesundheitsorganisation (WHO). Die Revision der ICD soll einem gewandelten Verständnis der Suchtstörungen und deren Diagnostik Rechnung tragen und die klinische Anwendbarkeit vereinfachen. Im Bereich der substanzbezogenen und nicht substanzbezogenen Störungen sind gegenüber der Vorgängerversion erhebliche Neuerungen eingeführt worden. Die wichtigsten Änderungen betreffen ein erweitertes Angebot an Stoffklassen, deutliche (vereinfachende) Anpassungen in den konzeptuellen und diagnostischen Leitlinien der substanzbezogenen Störungsbilder und insbesondere der „Abhängigkeit“, sowie die Einführung der Kategorie der „abhängigen Verhaltensweisen“ und damit verbunden die Zuordnung der „Glücksspielstörung“ zu den Suchtstörungen sowie die Aufnahme der neuen (bildschirmbezogenen) „Spielstörung“. Zudem findet eine Erweiterung der diagnostischen Optionen für frühe, präklinische Phänotypen der Suchtstörungen („Episodisch Schädlicher Gebrauch“) erstmals Eingang in den ICD-Katalog. Im vorliegenden Beitrag werden die Änderungen Episodisch schädlicher Gebrauch für den Bereich der Suchtstörungen aus kinder- und jugendpsychiatrischer Sicht zusammenfassend dargestellt und diskutiert.

Zusatzklassifikation zur Kennzeichnung von Personen ohne akute Beschwerden oder Krankheiten)

1968 ◽  
Vol 07 (03) ◽  
pp. 141-151 ◽  
Author(s):  
H. Fassl
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases

In Krankenprotokollen finden sieb, nicht selten Angaben über den Patienten, die nicht mehr als Diagnosen anzusprechen sind. Dennoch sollten diese Feststellungen nicht verworfen werden, da sie wichtige Informationen darstellen. In der vorliegenden Arbeit wird (dem Vorschlag der Weltgesundheitsorganisation folgend) eine sog. Y-Klassifikation vorgestellt, mittels derer Feststellungen bei Personen ohne akute Klagen oder. Erkrankungen verschlüsselt werden können (z. B. Zustand nach einer Krankheit oder Verletzung, Verdacht auf eine Krankheit, Nachsorgemaßnahmen, prophylaktische Maßnahmen usw.). Der Entwurf folgt der Systematik der ICD (International Classification of Diseases) und kann dazu benutzt werden, gewisse Lücken darin zu überbrücken.

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