scholarly journals Clinical diagnosis of rigid forms of flatfeet in children

2016 ◽  
Vol 4 (3) ◽  
pp. 59-62
Author(s):  
Andrei V Sapogovskiy
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Feature ◽  
Clinical Test ◽  
Test Evaluation ◽  
Clinical Tests ◽  
Tarsal Coalition ◽  
Tarsal Bones ◽  
Different Types ◽  
Specific Clinical Feature ◽  
Foot Mobility

Introduction. Tarsal coalition is congenital bony, cartilaginous, or fibrous fusion between tarsal bones. The most specific clinical feature of these patients is limitation of tarsal joints mobility. Foot mobility is evaluated using a few clinical tests-tip-toe test, Jack test, and manual evaluation of passive foot inversion/eversion. However, these tests do not have high rates of sensitivity and specificity, and cannot be used to make differential diagnosis among the different types of coalitions.Aims. To improve the clinical diagnosis of calcaneonavicular coalitions.Materials and methods. We present a new clinical test-evaluation of calcaneonavicular segment mobility. To evaluate this test, we studied a group of 100 children (155 feet), which included those with talocalcaneal coalitions (22 patients/30 feet), calcaneonavicular coalitions (28 patients/45 feet), and those without tarsal coalitions (50 patients/80 feet).Results. The sensitivity of the test was 95.6%, and specificity was 93.3%. This test had good reproducibility, as evidenced by the inter-rater reliability coefficient of 0.818.Conclusions. The clinical test presented here can be used to identify patients with calcaneonavicular coalitions, which could not be identified using other clinical tests of foot mobility

The CSF p-tau181/Aβ42 Ratio Offers a Good Accuracy “In Vivo” in the Differential Diagnosis of Alzheimer’s Dementia

2019 ◽  
Vol 16 (7) ◽  
pp. 587-595 ◽  
Author(s):  
Roberto Santangelo ◽  
Alessandro Dell'Edera ◽  
Arianna Sala ◽  
Giordano Cecchetti ◽  
Federico Masserini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Diagnosis ◽  
Fdg Pet ◽  
Amyloid Β ◽  
Cost Effective ◽  
Daily Clinical Practice ◽  
Different Types ◽  
Experimental Trials ◽  
Csf Findings

Background: The incoming disease-modifying therapies against Alzheimer’s disease (AD) require reliable diagnostic markers to correctly enroll patients all over the world. CSF AD biomarkers, namely amyloid-β 42 (Aβ42), total tau (t-tau), and tau phosphorylated at threonine 181 (p-tau181), showed good diagnostic accuracy in detecting AD pathology, but their real usefulness in daily clinical practice is still a matter of debate. Therefore, further validation in complex clinical settings, that is patients with different types of dementia, is needed to uphold their future worldwide adoption. Methods: We measured CSF AD biomarkers’ concentrations in a sample of 526 patients with a clinical diagnosis of dementia (277 with AD and 249 with Other Type of Dementia, OTD). Brain FDG-PET was also considered in a subsample of 54 patients with a mismatch between the clinical diagnosis and the CSF findings. Results: A p-tau181/Aβ42 ratio higher than 0.13 showed the best diagnostic performance in differentiating AD from OTD (86% accuracy index, 74% sensitivity, 81% specificity). In cases with a mismatch between clinical diagnosis and CSF findings, brain FDG-PET partially agreed with the p-tau181/Aβ42 ratio, thus determining an increase in CSF accuracy. Conclusions: The p-tau181/Aβ42 ratio alone might reliably detect AD pathology in heterogeneous samples of patients suffering from different types of dementia. It might constitute a simple, cost-effective and reproducible in vivo proxy of AD suitable to be adopted worldwide not only in daily clinical practice but also in future experimental trials, to avoid the enrolment of misdiagnosed AD patients.

scholarly journals Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey

2020 ◽  
Vol 10 (2) ◽  
pp. 27
Author(s):  
Grisell Vargas-Schaffer ◽  
Suzie Paquet ◽  
Andrée Neron ◽  
Jennifer Cogan
Keyword(s):  
Chronic Pain ◽  
Nmda Antagonist ◽  
Treatment Modalities ◽  
Clinical Test ◽  
Physician Practice ◽  
Clinical Tests ◽  
Opioid Rotation ◽  
Number Of Patients ◽  
Opioid Induced Hyperalgesia ◽  
Age Range

Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.

scholarly journals Epidemiological Distribution and Subtype Analysis of Premenstrual Dysphoric Disorder Syndromes and Symptoms Based on TCM Theories

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Mingqi Qiao ◽  
Peng Sun ◽  
Haijun Wang ◽  
Yang Wang ◽  
Xianghong Zhan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Clinical Diagnosis ◽  
Premenstrual Dysphoric Disorder ◽  
Diagnosis And Treatment ◽  
Epidemiological Investigation ◽  
Different Types

We performed an epidemiological investigation of subjects with premenstrual dysphoric disorder (PMDD) to identify the clinical distribution of the major syndromes and symptoms. The pathogenesis of PMDD mainly involves the dysfunction of liver conveyance and dispersion. Excessive liver conveyance and dispersion are associated with liver-qi invasion syndrome, while insufficient liver conveyance and dispersion are expressed as liver-qi depression syndrome. Additionally, a nonconditional logistic regression was performed to analyze the symptomatic features of liver-qi invasion and liver-qi depression. As a result of this analysis, two subtypes of PMDD are proposed, namely, excessive liver conveyance and dispersion (liver-qi invasion syndrome) and insufficient liver conveyance and dispersion (liver-qi depression syndrome). Our findings provide an epidemiological foundation for the clinical diagnosis and treatment of PMDD based on the identification of different types.

scholarly journals Calcaneonavicular coalition resection

2020 ◽  
Vol 14 (3) ◽  
pp. 297-300
Author(s):  
Mercedes Juncay ◽  
Rafael Sposeto ◽  
Alexandre Godoy-Santos ◽  
Túlio Fernandes
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Conservative Treatment ◽  
Treatment Option ◽  
Expert Opinion ◽  
Tarsal Bone ◽  
Tarsal Coalition ◽  
Level Of Evidence ◽  
Calcaneonavicular Coalition ◽  
Tarsal Bones

Tarsal coalition is an abnormal connection between tarsal bones, caused by an embryogenic failure. Its most common forms are calcaneonavicular and talocalcaneal coalition, which are present in 53% and 37% of the cases, respectively. The onset of symptoms is related to tarsal bone ossification, and mean age for this event is estimated at 16 years for calcaneonavicular coalition. Surgical treatment is indicated for patients who did not improve symptoms with conservative treatment. The aim of this study is to present a surgical technique as a treatment option for resection of calcaneonavicular coalition associated with abnormal cuboid-navicular joint. Level of Evidence V; Therapeutic Studies; Expert Opinion.

To the problem of pregnant women's cholestasis

2021 ◽  
Vol 50 (2) ◽  
pp. 90-93
Author(s):  
T. V. Timofeeva ◽  
N. N. Petrishchev ◽  
M. S. Zainulina ◽  
I. N. Mukhina
Keyword(s):  
Liver Disease ◽  
Pregnant Women ◽  
Chronic Liver Disease ◽  
Clinical Diagnosis ◽  
Chronic Liver ◽  
Complex Concept ◽  
Different Types ◽  
Management Method ◽  
Pathological Pregnancy

Liver disease andpregnancy usually aggravates each other. Its rather difficult to differentiate pregnant womens cholestasis from gestosis accompanied with chronic liver disease preceding pregnancy. 60 pregnant women were examined, the first group with cholestatic hepatosis, the second group with gestosis and liver disease. The practical aim o f the study was to choose righttactics o f pregnancy management, method and date o f confinement.Pregnant womens hepatosis turned out to be a complex concept: it may embrace different types o f pathological pregnancy under the single clinical diagnosis.

scholarly journals Surgical treatment of tarsal coalitions in children and adolescents

2020 ◽  
Vol 5 (2) ◽  
pp. 80-89
Author(s):  
Alpesh Kothari ◽  
Javier Masquijo
Keyword(s):  
Surgical Intervention ◽  
Operative Management ◽  
Foot And Ankle ◽  
Ankle Pain ◽  
Tarsal Coalition ◽  
Algorithmic Approach ◽  
Tarsal Bones ◽  
Non Operative Management ◽  
Impaired Quality

A tarsal coalition is an abnormal connection between two or more tarsal bones caused by failure of mesenchymal segmentation. The two most common tarsal coalitions are calcaneonavicular coalition (CNC) and talocalcaneal coalition (TCC). Both CNC and TCC can be associated with significant foot and ankle pain and impaired quality of life; there may also be concomitant foot and ankle deformity. Initial, non-operative management for symptomatic tarsal coalition commonly fails, leaving surgical intervention as the only recourse. The focus of this article is to critically describe the variety of methods used to surgically manage CNC and TCC. In review of the pertinent literature we highlight the ongoing treatment controversies in this field and discuss new innovations. The evidence-based algorithmic approach used by the authors in the management of tarsal coalitions is illustrated alongside some clinical pearls that should help surgeons treating this common, and at times complex, condition. Cite this article: EFORT Open Rev 2020;5:80-89. DOI: 10.1302/2058-5241.5.180106

scholarly journals Plasma D-Dimer Level in Different Types of Acute Ischaemic Stroke Patients: Experience at a Tertiary Hospital in Dhaka City

2019 ◽  
Vol 5 (1) ◽  
pp. 13-17
Author(s):  
Paritosh Kumar Sarkar ◽  
Anwar Israil ◽  
Mohammad Sayeed Hassan ◽  
Abu Nayeem ◽  
Md Azharul Hoque ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Ischemic Stroke ◽  
Ischaemic Stroke ◽  
Clinical Diagnosis ◽  
Acute Ischaemic Stroke ◽  
Stroke Patients ◽  
College Hospital ◽  
Medical College ◽  
Different Types ◽  
D Dimer

Background: Plasma D-Dimer is a biomarker of thrombo-embolism. Objective: The purpose of the present study was to see the plasma D-dimer level in different types of acute ischaemic stroke patients. Methodology: This cross-sectional study was conducted in the Department of Neurology & Department of Internal Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2010 to June 2012 for a period of two (02) years. Patients with ischemic stroke with history within 7 days attending in the stroke clinic of Department of Neurology or admitted in the Department of Neurology and Internal Medicine through the outpatient and emergency Department of Dhaka Medical College Hospital (DMCH) were selected as study population for this study. Analysis of plasma D-Dimer was done in the Department of Hematology of DMCH.b Result: A total of 50 cases were recruited for this study. There were 24.0% lacunar infarcts, 40.0% atherothrombotic and 36.0% embolic infarcts in the study group. Highest level of plasma D-Dimer was observed in embolic (1700±964 ηg/ml) followed by atherothrombotic group (536±234 ηg/ml). The plasma D-Dimer was lowest (100±0 ηg/ml) in lacunar group. Concentration of Plasma D-Dimer showed significant correlation with clinical diagnosis in different subtypes of ischemic stroke (r=0.902; p=0.001) and also with risk factors, example, diabetes (r=0.319; p=0.012) and valvular heart disease (r=0.281; p=0.024), but no significant correlation with age, hypertension, hyperlipidaemia and smoking. Conclusion: In conclusion plasma D-Dimer is an important bio-marker in the clinical diagnosis and subtypes of ischemic stroke patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 13-17

Clinical Diagnosis of Triquetrolunate Ligament Injuries

1999 ◽  
Vol 24 (5) ◽  
pp. 598-600 ◽  
Author(s):  
L. CHRISTODOULOU ◽  
L. C. BAINBRIDGE
Keyword(s):  
Positive Predictive Value ◽  
Clinical Diagnosis ◽  
Predictive Value ◽  
Diagnostic Technique ◽  
Definitive Diagnosis ◽  
Clinical Tests ◽  
Ligament Injuries ◽  
Diagnostic Protocol

The clinical diagnosis of peritriquetral injuries is difficult. We describe our diagnostic technique based on specific questions and three clinical tests. The accuracy of our diagnostic technique was compared prospectively with the definitive diagnosis made at arthroscopy. Preoperatively, 19 patients were diagnosed as having triquetrolunate dissociation. This was confirmed at arthroscopy in 17. Another five patients not diagnosed preoperatively were also diagnosed at arthroscopy as having mainly triquetrolunate dissociation. The sensitivity of our diagnostic protocol was 0.77 and the positive predictive value was 0.89.

scholarly journals THU0487 DIAGNOSTIC DILEMMA: WHICH CLINICAL TEST IS MOST ACCURATE FOR DIAGNOSING SUPRASPINATUS MUSCLE TEARS AND TENDINOSIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 481.3-481
Author(s):  
E. Balevi Batur ◽  
Z. Bekin Sarikaya ◽  
M. E. Kaygisiz ◽  
İ. Albayrak Gezer ◽  
F. Levendoğlu
Keyword(s):  
Shoulder Pain ◽  
Lower Sensitivity ◽  
Clinical Test ◽  
Clinical Tests ◽  
Mri Findings ◽  
Diagnostic Dilemma ◽  
Test Drop ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
Higher Sensitivity

Background:Supraspinatus tears and tendinosis are the most common pathology that cause shoulder pain to approximately half of the patients presenting clinically.1Objectives:To investigate the diagnostic accuracy of five clinical tests in the diagnosis of supraspinatus tears and tendinosis compared with magnetic resonance imaging (MRI).Methods:A total of 116 painful shoulders of 106 consecutive patients were examined. Patients were assessed using the most commonly used special clinical tests including the Jobe test (empty can), Neer test, drop arm test, Hawkins test and full can tests to identify supraspinatus tears and tendinosis. A visual analogue scale (VAS) was used for pain detection, and the Shoulder Pain and Disability Index (SPADI) questionnaire was administered. MRI examinations were performed on 1.5 Tesla MR system and images were assessed by a blinded radiologist. The primary outcomes were to determine the sensitivity, specificity, and accuracy of the five clinical tests, and to establish their correlation with MRI for supraspinatus tears and tendinosis.Results:The mean age was 55.10 ± 10.20 years, and 32.08% of the patients were female. The Hawkins test had a higher sensitivity and accuracy in tears (sensitivity 89.66%, accuracy 56.03%, respectively) and higher sensitivity in tendinosis (79.07%). The drop arm test had a lower sensitivity but higher specificity in both tendinosis and tears (sensitivity 0%, 12.07%, respectively, and specificity 87.67%, 96.5%, respectivelyConclusion:The Hawkins test was the most sensitive in both supraspinatus tendinosis and tears compared with MRI findings.References:[1]Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA,The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am, 2006. 88(8): p. 1699-704.Disclosure of Interests: :None declared

scholarly journals The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study

2020 ◽  
Vol 2 ◽  
Author(s):  
Mikaela L. Frechette ◽  
Libak Abou ◽  
Laura A. Rice ◽  
Jacob J. Sosnoff
Keyword(s):  
Pilot Study ◽  
Postural Control ◽  
Rank Order ◽  
Stability Boundary ◽  
Measurement Tool ◽  
Clinical Test ◽  
Clinical Tests ◽  
Wheelchair Users ◽  
Eyes Open ◽  
Research Grade

Seated postural control is essential for wheelchair users to maintain proper position while performing activities of daily living. Clinical tests are commonly used to measure seated postural control, yet they are subjective and lack sensitivity. Lab-based measures are highly sensitive but are limited in scope and restricted to research settings. Establishing a valid, reliable, and accessible measurement tool of seated postural control is necessary for remote, objective assessments. Therefore, the purpose of this study was to examine the validity, reliability, and sensitivity of smartphone-based postural control assessments in wheelchair users. Eleven participants (age: 35.4 ± 17.9) completed two experimental visits 1-week apart consisting of three clinical tests: Trunk Control Test (TCT), Function in Sitting Test (FIST), and Tee-shirt Test, as well as, standardized instrumented balance tasks that manipulated vision (eyes open and closed), and trunk movement (functional reach and stability boundary). During these tasks, participants held a smartphone instrumented with a research-grade accelerometer to their chest. Maximum and root mean square (RMS) acceleration in the medial-lateral (ML) and anterior-posterior (AP) axes were derived. Participants were grouped into non-impaired and impaired postural groups based on FIST scores. Spearman rank-order correlations were conducted between the two devices' outcome measurements and between these measures and those of the clinical tests. Receiver operating characteristic (ROC) curves and the area under the curves (AUC) were determined to distinguish participants with and without impaired postural control. The reliability of outcome variables was assessed using inter-class correlations. Strong correlations between outputs derived from the smartphone and research-grade accelerometer were seen across balance tasks (ρ = −0.75–1.00; p ≤ 0.01). Numerous significant moderate correlations between clinical test outcomes and smartphone and research-grade RMS ML accelerometry were seen (ρ = −0.62 to 0.83 (p ≤ 0.044)]. On both devices, the AUC for ROC plots were significant for RMS ML sway during the eyes open task and functional stability boundary (p < 0.05). Reliability of smartphone accelerometry was comparable to the research-grade accelerometer and clinical tests. This pilot study illustrated that smartphone-based accelerometry may be able to provide a valid and reliable assessment of seated postural control and have the ability to distinguish between those with and without impaired postural control.

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