scholarly journals Comparison between clinical and videofluoroscopic evaluation of swallowing in children with suspected dysphagia

CoDAS ◽  
2015 ◽  
Vol 27 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Lenice de Fatima da Silva-Munhoz ◽  
Karina Elena Bernardis Bühler ◽  
Suelly Cecilia Olivan Limongi
Keyword(s):  
Clinical Sign ◽  
Clinical Evaluation ◽  
Clinical Assessment ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Predictive Values ◽  
Thin Fluid ◽  
Laryngeal Penetration ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

Purpose: To verify the accuracy of clinical evaluation compared with videofluoroscopic swallowing studies in the detection of isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia; to identify clinical signs and symptoms associated with isolated laryngeal penetration and laryngeal aspiration; and to determine the sensitivity and specificity of the clinical signs and symptoms identified. Methods: Retrospective analysis of data from clinical and videofluoroscopic evaluations carried out in 55 children from 1 month to 7 years and 11 months old. For clinical assessment, the Protocol for Clinical Assessment of Pediatric Dysphagia was used. The sensitivity, specificity, and positive and negative predictive values of clinical evaluation were analyzed. For statistical analysis, the Fisher's exact and χ2 tests were used. Results: Clinical evaluation showed, in general, a sensitivity of 86% and a specificity of 32%. For isolated laryngeal penetration, clinical evaluation showed a sensitivity of 88%. For laryngeal aspiration, clinical evaluation showed a sensitivity of 86%. However, the specificity values were low for both alterations. There was no association between clinical evaluation and videofluoroscopic findings. Choking was the only clinical sign associated with isolated laryngeal penetration thin fluid and showed a sensitivity of 53% and a specificity of 77%. Conclusions: Clinical evaluation was sensible to detect isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia. However, it showed a low specificity. Choking was the only clinical sign associated with isolated laryngeal penetration of thin fluid. More prospective studies are needed to confirm these findings in this population.

scholarly journals Validity of selected clinical signs and symptoms in diagnosis of Schistosoma mansoni infection

1991 ◽  
Vol 33 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Maria Fernanda F. de Lima e Costa ◽  
Roberto S. Rocha ◽  
Daniel Colley ◽  
Giovanni Gazzenelli ◽  
Naftale Katz
Keyword(s):  
Schistosoma Mansoni ◽  
Endemic Area ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Predictive Values ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

Sensitivity, specificity and positive predictive values of selected clinical signs and symptoms in the diagnosis of Schistosoma mansoni infection were evaluated in 403 individuals (69% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino). Highest sensitivity (13%) was found for blood in stools. Specificity over 90% was found for blood in stools, palpable liver with normal consistency and palpable hardened liver at middle clavicular (MCL) or middle sternal lines (MSL). Hardened liver at MSL (83%) or MCL (75%), and blood in stools (78%) presented higher positive predictive values for S. mansoni infection, while palpable liver with normal consistency at MCL (45%) or MSL (48%) presented smaller values. Enlarged liver without specification of its consistency has been traditionally used as an indicator of the infection in areas where malaria or Kalazar are not endemic. Our results demonstrate that the probability that a person with blood in stools or hardened palpable liver is infected is higher than among those with palpable liver with normal consistency.

scholarly journals Medical emoji for clinical signs and symptoms: a comprehensive qualitative study

2020 ◽  
Author(s):  
Reza Assadi ◽  
Nasim Lotfinejad ◽  
Amir Hosein Ziae ◽  
Baran Ganjali
Keyword(s):  
Qualitative Study ◽  
Clinical Sign ◽  
General Practitioners ◽  
Facial Expressions ◽  
Delphi Method ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Graphic Designer ◽  
Icd 10 ◽  
Clinical Signs And Symptoms

AbstractIntroductionEmojis have surpassed facial expressions and they are now widely used to deliver complex concepts by representing graphical expressions in the digital platform. In this study, we endeavored to develop medical emojis for clinical signs and symptoms to be used as tools for text-based counselling.MethodsThe present study was conducted using the Delphi method with medical studnets and general practitioners, drawing and discussing in several repeated rounds. For this purpose, about 100 clinical signs/symptoms were considered using the ICD-10 website.ResultsIn the present study, from one hundred signs and symptoms we reached to 85 signs/symptoms that after first round of sessions were illustrated. Out of these 85 eligible emojis, 4 cases were removed due to the lack of consensus. The rest of the emojis were finalized and prepared by the graphic designer. These emojis then were published online to collect online votes.ConclusionIn this study, we could design up to 81 medical emojis presenting clinical sign and symptoms with acceptable consensus between the participants. These emojis were reasonably acceptable by our panelists in presenting the established clinical concepts.

scholarly journals The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

scholarly journals The aetiology of pharyngotonsillitis in primary health care: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jon Pallon ◽  
Mattias Rööst ◽  
Martin Sundqvist ◽  
Katarina Hedin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Antigen Detection ◽  
Predictive Values ◽  
Primary Health ◽  
Clinical Signs And Symptoms

Abstract Background Few studies on pharyngotonsillitis have examined the clinical presentation of different aetiologies where pathogens have been detected using molecular methods. We aimed to assess how well clinical signs and symptoms can predict (1) the presence or absence of a broad range of viruses and bacteria, and (2) reconsultations for a sore throat or a complication. Methods In this descriptive observational prospective study in primary health care 220 patients aged 15–45 with suspected pharyngotonsillitis were sampled from nose, throat and blood and screened for 20 bacteria and viruses using polymerase chain reaction (PCR), culture and serology. Odds ratios (OR) and predictive values with 95% confidence intervals (CI) were used to show association between microbiological findings and clinical signs and symptoms. Patients were followed up after 3 months by reviewing electronic medical records. Results Both cough and coryza were more common in patients with only viruses (67%) than in patients with only bacteria (21%) (p < 0.001), whereas tonsillar coating was more common in patients with only bacteria (53%) than in patients with only viruses (29%) (p = 0.006). Tonsillar coating (adjusted OR 6.0; 95% CI 2.5–14) and a lack of cough (adjusted OR 3.5; 95% CI 1.5–8.0) were significantly associated with Streptococcus pyogenes (group A streptococci; GAS) and with any bacterial finding. A Centor score of 3–4 had a positive predictive value of 49% (95% CI 42–57) for GAS and 66% (95% CI 57–74) for any bacterial findings. The use of rapid antigen detection test for GAS increased the positive predictive value for this group to 93%. Conclusions Signs and symptoms, both single and combined, were insufficient to rule in GAS or other pathogens. However, both cough and coryza were useful to rule out GAS. The results support the clinical approach of restricting rapid antigen detection testing to patients with 3–4 Centor criteria. The low carriage rate of bacteria among asymptomatic controls implied that most detections in patients represented a true infection.

scholarly journals Magnetic resonance imaging of temporomandibular joint in juvenile idiopathic arthritis

2020 ◽  
Vol 8 (5) ◽  
pp. 1848
Author(s):  
Namrita Sachdev ◽  
Yashvant Singh ◽  
Parikha Rampal ◽  
Sana .
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Joint Effusion ◽  
Facial Dysmorphism ◽  
Cross Sectional ◽  
Wide Range ◽  
Clinical Signs And Symptoms ◽  
Mri Changes ◽  
Sensitivity Specificity

Background: Juvenile Idiopathic Arthritis (JIA) is the most common autoimmune inflammatory synovial arthritis causing wide range of disability in children. The involvement of temporo-mandibular joint (TMJ) in JIA varies ranging from 17% to 87%. Unlike other synovial joints, the TM joint is particularly vulnerable to inflammatory damage as the mandibular growth plate is superficial. JIA is a clinical diagnosis and is characterized by synovial hyperplasia and inflammation leading to joint effusion. TMJ involvement is clinically difficult to assess and often goes untreated. Children with TMJ arthritis have mastication dysfunction and pain. Delayed detection and treatment leads to abnormalities like micrognathia, jaw deformity, facial dysmorphism and chewing problems. MRI is the most sensitive modality to diagnose synovitis and involvement of TMJ in children of JIA.Methods: A cross-sectional observational study was undertaken in 30 children diagnosed as JIA as per ILAE criteria. They were evaluated clinically followed by contrast enhanced MRI for evidence of TMJ arthritis.Results: Of the 60 joints evaluated, clinical involvement was found in 18 joints (10 patients). 12(66.7%) out of them had MRI changes. 3(7.1%) joints out of 42 asymptomatic joints had MRI changes. 13 joints had synovial hypertrophy, 8 joints showed bone erosions. Bone marrow edema was seen in 2 joints, with no evidence of cartilage involvement in any joint. The sensitivity, specificity, PPV and NPV of clinical examination to diagnose TMJ arthritis as compared to MRI was 80.0%, 86.7%, 66.7% and 92.7% respectively.Conclusions: With paucity of clinical signs and symptoms, early involvement of TMJ arthritis in children of JIA can be detected by MRI to prevent long term disability in patients.

scholarly journals Dementia and Major Neurocognitive Disorders: Some Lessons Learned One Century after the first Alois Alzheimer’s Clinical Notes

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
Donatella Rita Petretto ◽  
Gian Pietro Carrogu ◽  
Luca Gaviano ◽  
Lorenzo Pili ◽  
Roberto Pili
Keyword(s):  
Young Woman ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Neurocognitive Disorders ◽  
Lessons Learned ◽  
Alzheimer Dementia ◽  
Clinical Notes ◽  
Alois Alzheimer ◽  
Clinical Signs And Symptoms

Over 100 years ago, Alois Alzheimer presented the clinical signs and symptoms of what has been later called “Alzheimer Dementia” in a young woman whose name was Augustine Deter [...]

scholarly journals Correction to: Levoketoconazole improves clinical signs and symptoms and patient-reported outcomes in patients with Cushing’s syndrome

Pituitary ◽  
2020 ◽  
Author(s):  
Eliza B. Geer ◽  
Roberto Salvatori ◽  
Atanaska Elenkova ◽  
Maria Fleseriu ◽  
Rosario Pivonello ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Patient Reported Outcomes ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cushing's Syndrome ◽  
Original Version ◽  
Patient Reported ◽  
Author Group ◽  
Clinical Signs And Symptoms

The original version of the article unfortunately contained an error in the first name and the surname of one of the authors in the author group. The last author name was incorrectly published as ‘F. Pecori Giraldi’ and the corrected name is ‘Francesca Pecori Giraldi’ (First name: Francesca; Surname: Pecori Giraldi).

scholarly journals A 38-year demographic study of central and peripheral giant cell granulomas of the jaws

2016 ◽  
Vol 15 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Shadi Saghafi ◽  
Reza Zare-Mahmoodabadi ◽  
Narges Ghazi ◽  
Mohammad Zargari
Keyword(s):  
Giant Cell ◽  
Medical Science ◽  
Age Distribution ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Posterior Maxilla ◽  
Frequent Site ◽  
Male Patients ◽  
Clinical Signs And Symptoms ◽  
Anterior Mandible

Objective: The purpose of this study was to retrospectively analyze the demographic characteristics of patients with central giant cell granulomas (CGCGs) and peripheral giant cell granulomas (PGCGs) in Iranian population.Methods: The data were obtained from records of 1019 patients with CGCG and PGCG of the jaws referred to our department between 1972 and 2010. This 38-year retrospective study was based on existing data. Information regarding age distribution, gender, location of the lesion and clinical signs and symptoms was documented. Results: A total of 1019 patients were affected GCGLs including 435 CGCGs and 584 PGCGs during the study. The mean age was 28.91 ± 18.16. PGCGs and CGCGs had a peak of occurrence in the first and second decade of life respectively. A female predominance was shown in CGCG cases (57.70%), whereas PGCGs were more frequent in males (50.85%). Five hundred and ninety-eight cases of all giant cell lesions (58.7 %) occurred in the mandible. Posterior mandible was the most frequent site for both CGCG and PGCG cases. The second most common site for PGCG was posterior maxilla (21%), whereas anterior mandible was involved in CGCG (19.45%). The majority of patients were asymptomatic. Conclusions: In contrast to most of previous studies PGCGs occur more common in the first decade and also more frequently in male patients. Although the CGCGs share some histopathologic similarities with PGCGs, differences in demographic features may be observed in different populations which may help in the diagnosis and management of these lesions.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.220-223

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