scholarly journals SCREENING IN CARDIOLOGY

2018 ◽  
Vol 7 (4) ◽  
pp. 92-100 ◽  
Author(s):  
I. V. Samorodskaya
Keyword(s):  
Risk Factors ◽  
The United States ◽  
Diagnostic Methods ◽  
Screening Programs ◽  
Advantages And Disadvantages ◽  
Target Populations ◽  
Screening Strategies ◽  
National Programs ◽  
Expensive Process ◽  
Current Guidelines

The organization of screening is a complex and expensive process. Many countries have implemented and continue to implement various health screening programs in the population groups. However, there is a process of refusing to screen certain diseases. In cardiology, some screening strategies are integrated in the national programs aimed at identifying risk factors and preventing chronic non-communicable diseases. None of the countries have established the screening of the entire population for all known cardiovascular diseases (CVD) using all known diagnostic methods. The decision to screen individuals for CVDs / risk factors within the opportunistic screening in the target populations in different countries varies, since it depends on many factors. The article discusses the advantages and disadvantages of screening for CVD, presents current guidelines from professional communities and national services of the United States of America, Great Britain, and Canada.

scholarly journals Subacute ruminal acidosis in dairy cows - physiological background, risk factors and diagnostic methods

2020 ◽  
Vol 51 (1) ◽  
pp. 5-17
Author(s):  
Levente Kovács ◽  
Otto Szenci ◽  
Walter Baumgartner ◽  
Mátyás Hejel ◽  
László Rózsa
Keyword(s):  
Risk Factors ◽  
Dairy Cows ◽  
Continuous Measurement ◽  
Clinical Signs ◽  
The United States ◽  
Diagnostic Methods ◽  
Subacute Ruminal Acidosis ◽  
Field Techniques ◽  
Ruminal Ph ◽  
Ruminal Acidosis

According to the latest studies, the prevalence of subacute ruminal acidosis (SARA) is around 20% in early and mid- lactation dairy cows, generating annual losses in the United States of approximately USD 500 million to 1 billion. The diagnosis of SARA is still difficult due to lack of pathognomonic clues and the delayed appearance of certain clinical signs. Therefore, SARA remains neglected or even unrecognized in many dairy herds. SARA is characterized by daily episodes of low ruminal pH, when the pH remains in the range of 5.2 to 6 for a prolonged period due to the accumulation of short-chain fatty acids and insufficient rumen buffering. The causes of SARA are related to high-grain diets, such as feeding excessive amounts of non-structural carbohydrates and highly fermentable forages, and insufficient dietary coarse fibre. SARA is associated with the inflammation of several organs and tissues in dairy cows, and its main long-term health and economic consequences are the fluctuation of feed intake, reduced fibre digestion, depression of milk yield and milk fat content, gastrointestinal damage, diarrhoea, laminitis, liver abscesses, and lameness. The aim of this review is to summarize the information available on the physiological aspects, risk factors, prevalence and possible indicators of SARA in dairy cattle. Basedon the existing literature, rumenocentesis and the use of an oral stomach tube are reliable field techniques to detect SARA. Nowadays, improved field techniques allowing the continuous measurement of reticuloruminal pH are also available for better diagnosis of SARA. Wireless indwelling pH probes may become important tools for the continuous measurement of ruminal pH in the coming years.

scholarly journals Venous Thromboembolism Prophylaxis in Elective Spine Surgery

2020 ◽  
pp. 219256822096243
Author(s):  
Samantha Solaru ◽  
Ram K. Alluri ◽  
Jeffrey C. Wang ◽  
Raymond J. Hah
Keyword(s):  
Risk Factors ◽  
Spine Surgery ◽  
The United States ◽  
Diagnostic Methods ◽  
Orthopedic Procedures ◽  
Bleeding Events ◽  
Thromboembolism Prophylaxis ◽  
Vte Prophylaxis ◽  
Incidence Data ◽  
Increased Risk

Study Design: Review. Objective: Venothromboembolic (VTE) complications, composed of deep vein thrombosis and pulmonary embolism are commonly observed in the perioperative setting. There are approximately 500 000 postoperative VTE cases annually in the United States and orthopedic procedures contribute significantly to this incidence. Data on the use of VTE prophylaxis in elective spinal surgery is sparse. This review aims to provide an updated consensus within the literature defining the risk factors, diagnosis, and the safety profile of routine use of pharmacological prophylaxis for VTE in elective spine surgery patients. Methods: A comprehensive review of the literature and compilation of findings relating to current identified risk factors for VTE, diagnostic methods, and prophylactic intervention and safety in elective spine surgery. Results: VTE prophylaxis use is still widely contested in elective spine surgery patients. The outlined benefits of mechanical prophylaxis compared with chemical prophylaxis varies among practitioners. Conclusion: The benefits of any form of VTE prophylaxis continues to remain a controversial topic in the elective spine surgery setting. A specific set of guidelines for implementing prophylaxis is yet to be determined. As more risk factors for thromboembolic events are identified, the complexity surrounding intervention selection increases. The benefits of prophylaxis must also continue to be balanced against the increased risk of bleeding events and neurologic injury.

Trends in Diagnosis for Active Tuberculosis Using Nanomaterials

2019 ◽  
Vol 26 (11) ◽  
pp. 1946-1959 ◽  
Author(s):  
Le Minh Tu Phan ◽  
Lemma Teshome Tufa ◽  
Hwa-Jung Kim ◽  
Jaebeom Lee ◽  
Tae Jung Park
Keyword(s):  
Sensitivity And Specificity ◽  
High Efficiency ◽  
Point Of Care ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Advantages And Disadvantages ◽  
Treatment And Prevention ◽  
Clinical Tools ◽  
Diagnostic Applications

Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.

scholarly journals The ‘wave sign’ in hip arthroscopy: a systematic review of epidemiological factors, current diagnostic methods and treatment options

2020 ◽  
Author(s):  
Jason Derry Onggo ◽  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Andrew Duong ◽  
Olufemi R Ayeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Protective Factor ◽  
Treatment Options ◽  
Arthroscopic Surgery ◽  
Classification Systems ◽  
Diagnostic Methods ◽  
Suture Repair ◽  
Significant Heterogeneity ◽  
Epidemiological Factors

ABSTRACT This study aims to present a systematic review and synthesized evidence on the epidemiological factors, diagnostic methods and treatment options available for this phenomenon. A multi-database search (OVID Medline, EMBASE and PubMed) was performed according to PRISMA guidelines on 18 June 2019. All studies of any study design discussing on the epidemiological factors, diagnostic methods, classification systems and treatment options of the wave sign were included. The Newcastle–Ottawa quality assessment tool was used to appraise articles. No quantitative analysis could be performed due to heterogeneous data reported; 11 studies with a total of 501 patients with the wave sign were included. Three studies examined risk factors for wave sign and concluded that cam lesions were most common. Other risk factors include alpha angle >65° (OR=4.00, 95% CI: 1.26–12.71, P=0.02), male gender (OR 2.24, 95% CI: 1.09–4.62, P=0.03) and older age (OR=1.04, 95% CI: 1.01–1.07, P=0.03). Increased acetabular coverage in setting of concurrent cam lesions may be a protective factor. Wave signs most commonly occur at the anterior, superior and anterosuperior acetabulum. In terms of staging accuracy, the Haddad classification had the highest coefficients in intraclass correlation (k=0.81, 95% CI: 0.23–0.95, P=0.011), inter-observer reliability (k=0.88, 95% CI: 0.72–0.97, P<0.001) and internal validity (k=0.89). One study investigated the utility of quantitative magnetic imaging for wave sign, concluding that significant heterogeneity in T1ρ and T2 values (P<0.05) of acetabular cartilage is indicative of acetabular debonding. Four studies reported treatment techniques, including bridging suture repair, reverse microfracture with bubble decompression and microfracture with fibrin adhesive glue, with the latter reporting statistically significant improvements in modified Harris hip scores at 6-months (MD=19.2, P<0.05), 12-months (MD=22.0, P<0.05) and 28-months (MD=17.5, P<0.001). No clinical studies were available for other treatment options. There is a scarcity of literature on the wave sign. Identifying at risk symptomatic patients is important to provide prompt diagnosis and treatment. Diagnostic techniques and operative options are still in early developmental stages. More research is needed to understand the natural history of wave sign lesions after arthroscopic surgery and whether intervention can improve long-term outcomes. Level IV, Systematic review of non-homogeneous studies.

scholarly journals Age-Related Chronic Diseases and Alzheimer’s Disease in Texas: A Hispanic Focused Study

2021 ◽  
Vol 5 (1) ◽  
pp. 121-133
Author(s):  
Shyam Sheladia ◽  
P. Hemachandra Reddy
Keyword(s):  
United States ◽  
Risk Factors ◽  
Chronic Diseases ◽  
Hispanic Americans ◽  
The United States ◽  
Modifiable Risk Factors ◽  
American Population ◽  
Hispanic American ◽  
West Texas ◽  
Age Related

The emergence of age-related chronic diseases within the United States has led to the direct increase of Alzheimer’s disease (AD) as well as other neurological diseases which ultimately contribute to the development of dementia within the general population. To be specific, age-related chronic diseases such as cardiovascular disease, high cholesterol, diabetes, and kidney disease contribute greatly to the advancement and rapid progression of dementia. Furthermore, unmodifiable risk factors such as advancing age and genetics as well as modifiable risk factors such as socioeconomic status, educational attainment, exercise, and diet further contribute to the development of dementia. Current statistics and research show that minority populations such as Hispanic Americans in the United States face the greatest burden of dementia due to the increase in the prevalence of overall population age, predisposing genetics, age-related chronic diseases, low socioeconomic status, as well as poor lifestyle choices and habits. Additionally, Hispanic Americans living within Texas and the rural areas of West Texas face the added challenge of finding appropriate healthcare services. This article will focus upon the research associated with AD as well as the prevalence of AD within the Hispanic American population of Texas and rural West Texas. Furthermore, this article will also discuss the prevalence of age-related chronic diseases, unmodifiable risk factors, and modifiable risk factors which lead to the progression and development of AD within the Hispanic American population of the United States, Texas, and rural West Texas.

scholarly journals THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Confidence Intervals ◽  
Burden Of Illness ◽  
Average Length ◽  
Private Insurance ◽  
Significant Risk ◽  
Case Fatality ◽  
The United States ◽  
The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

scholarly journals 1665. Using Electronic Health Records to Describe TB in Community Health Settings: a Cohort Analysis in a Large Safety-Net Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S819-S820
Author(s):  
Jonathan Todd ◽  
Jon Puro ◽  
Matthew Jones ◽  
Jee Oakley ◽  
Laura A Vonnahme ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Electronic Health Records ◽  
Safety Net ◽  
The United States ◽  
Research Network ◽  
Health Records ◽  
Treatment Regimens ◽  
Data Source ◽  
Electronic Health

Abstract Background Over 80% of tuberculosis (TB) cases in the United States are attributed to reactivation of latent TB infection (LTBI). Eliminating TB in the United States requires expanding identification and treatment of LTBI. Centralized electronic health records (EHRs) are an unexplored data source to identify persons with LTBI. We explored EHR data to evaluate TB and LTBI screening and diagnoses within OCHIN, Inc., a U.S. practice-based research network with a high proportion of Federally Qualified Health Centers. Methods From the EHRs of patients who had an encounter at an OCHIN member clinic between January 1, 2012 and December 31, 2016, we extracted demographic variables, TB risk factors, TB screening tests, International Classification of Diseases (ICD) 9 and 10 codes, and treatment regimens. Based on test results, ICD codes, and treatment regimens, we developed a novel algorithm to classify patient records into LTBI categories: definite, probable or possible. We used multivariable logistic regression, with a referent group of all cohort patients not classified as having LTBI or TB, to identify associations between TB risk factors and LTBI. Results Among 2,190,686 patients, 6.9% (n=151,195) had a TB screening test; among those, 8% tested positive. Non-U.S. –born or non-English–speaking persons comprised 24% of our cohort; 11% were tested for TB infection, and 14% had a positive test. Risk factors in the multivariable model significantly associated with being classified as having LTBI included preferring non-English language (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 4.09–4.32); non-Hispanic Asian (aOR 5.17, 95% CI 4.94–5.40), non-Hispanic black (aOR 3.02, 95% CI 2.91–3.13), or Native Hawaiian/other Pacific Islander (aOR 3.35, 95% CI 2.92–3.84) race; and HIV infection (aOR 3.09, 95% CI 2.84–3.35). Conclusion This study demonstrates the utility of EHR data for understanding TB screening practices and as an important data source that can be used to enhance public health surveillance of LTBI prevalence. Increasing screening among high-risk populations remains an important step toward eliminating TB in the United States. These results underscore the importance of offering TB screening in non-U.S.–born populations. Disclosures All Authors: No reported disclosures

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