In Search of Quality: Echocardiographic Mitral Regurgitation Evaluation Discrepancies

2021 ◽  
Vol 2 (1) ◽  
pp. 01-06
Author(s):  
Ričardas Kundelis
Keyword(s):  
Mitral Regurgitation ◽  
Diagnostic Criteria ◽  
Quantitative Method ◽  
Female Gender ◽  
Vital Role ◽  
Method Choice ◽  
Patient Gender ◽  
Physician Competence ◽  
Echocardiographic Evaluation ◽  
Substantial Correlation

Introduction: Two-dimensional (2D) transthoracic echocardiography (TTE) for mitral regurgitation (MR) evaluation plays a vital role in choosing the adequate type of treatment. Considerable undertreatment prevalence suggests a possible knowledge gap. The aim of the present study was to assess physician diagnostic adherence according to clinical echocardiographic guidelines. Methods: 438 echocardiographically confirmed MR cases evaluated by 60 beginner, intermediate, or expert level physicians were enrolled. MR eyeballing tendencies, quantitative method application accuracy, and guideline adherence were analyzed. Results: Main discrepancies were unjustified eyeballing (66.95%; p<0.001), inaccurate application of methods (22.46%, p=0.002), and misinterpretation of diagnostic criteria (10.59%). Female patient gender (p=0.026) and lower physician competence levels (p<0.001) were identified as predictors for eyeballing discrepancy possibility. The latter was also a predictor quantitative method discrepancy (p=0.043). Method choice had the most substantial correlation to discrepancies when determining moderate–severe MR (p<0.001). Conclusions: Echocardiographic evaluation of hemodynamically significant MR discrepant in 53.88% of cases as non-quantitative evaluation of hemodynamically significant MR, methodological inaccuracies, and misinterpretation of diagnostic criteria compile the largest proportion of discrepancies. Female gender, lower physician competence, and downgraded diagnostic method application were the most substantial predictors of discrepancy occurrence.

scholarly journals High Expression of KLF10 Is Associated with Favorable Survival in Patients with Oral Squamous Cell Carcinoma

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 17
Author(s):  
Chung-Min Yeh ◽  
Yi-Ju Lee ◽  
Po-Yun Ko ◽  
Yueh-Min Lin ◽  
Wen-Wei Sung
Keyword(s):  
Survival Rate ◽  
Oral Cancer ◽  
Cancer Patients ◽  
Protective Factor ◽  
Female Gender ◽  
Vital Role ◽  
Cancer Stage ◽  
Independent Prognostic Marker ◽  
Oral Cancer Patients ◽  
The Impact

Background and objectives: Krüppel-like transcription factor 10 (KLF10) plays a vital role in regulating cell proliferation, including the anti-proliferative process, activation of apoptosis, and differentiation control. KLF10 may also act as a protective factor against oral cancer. We studied the impact of KLF10 expression on the clinical outcomes of oral cancer patients to identify its role as a prognostic factor in oral cancer. Materials and Methods: KLF10 immunoreactivity was analyzed by immunohistochemical (IHC) stain analysis in 286 cancer specimens from primary oral cancer patients. The prognostic value of KLF10 on overall survival was determined by Kaplan–Meier analysis and the Cox proportional hazard model. Results: High KLF10 expression was significantly associated with male gender and betel quid chewing. The 5-year survival rate was greater for patients with high KLF10 expression than for those with low KLF10 expression (62.5% vs. 51.3%, respectively; p = 0.005), and multivariate analyses showed that high KLF10 expression was the only independent factor correlated with greater overall patient survival. The significant correlation between high KLF10 expression and a higher 5-year survival rate was observed in certain subgroups of clinical parameters, including female gender, non-smokers, cancer stage T1, and cancer stage N0. Conclusions: KLF10 expression, detected by IHC staining, could be an independent prognostic marker for oral cancer patients.

519 Restless Legs and Periodic Limb Movements in 86 patients with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A205-A205
Author(s):  
Davide Sparasci ◽  
Raffaele Ferri ◽  
Anna Castelnovo ◽  
Claudio Gobbi ◽  
Chiara Zecca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diagnostic Criteria ◽  
Large Population ◽  
Female Gender ◽  
Clinical Findings ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Cross Sectional ◽  
Restless Legs ◽  
Maintenance Of Wakefulness Test

Abstract Introduction The aim of this study was to assess the prevalence of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large population of patients with multiple sclerosis (MS), and to compare clinical and paraclinical findings between patients with and without RLS/PLMS. Methods In this cross–sectional, observational, instrumental study, eighty-six patients (M/F: 27/59; mean age 48.0 ± 10.8 years) with a diagnosis of MS underwent a structured telephone interview assessing the five standard diagnostic criteria for RLS. Seventy-six participants underwent Video-polysomnography and Maintenance of Wakefulness Test (MWT). Instrumental and clinical findings were subsequently statistically compared to investigate their association with RLS and PLMS index (PLMSI). Results RLS and PLMS (PLMSI ≥15/h) prevalence in patients with MS was of 31.4% and 31.6% respectively. Among patients with RLS, 37.5% had a PLMSI ≥15/h. In the group with PLMS, 37.5% met all diagnostic criteria for RLS. No differences were found between patients with and without RLS (F = 0.99, p = 0.45), and between patients with and without a PLMSI ≥15/hour (F = 0.32 p = 0.94) on the pool of clinical and instrumental variables. Conclusion RLS is highly prevalent and severe in patients with MS. The prevalence of PLMS is comparable to the general population. The low percentage of patients with RLS having a high PLMSI, together with the absence of correlation between RLS and female gender and older age, support the existence of a distinct symptomatic form of RLS in MS. Support (if any):

scholarly journals Cervicogenic headache: Josey's cases revisited

1997 ◽  
Vol 55 (4) ◽  
pp. 841-848 ◽  
Author(s):  
Maurice Vincent ◽  
Renato A. Luna
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Clinical Picture ◽  
High Frequency ◽  
Female Gender ◽  
Cervicogenic Headache ◽  
Common Disorder ◽  
Recommended Treatment ◽  
Previous Trauma

Before Sjaastad coined the term cervicogenic headache (CH) 15 years ago, neck-related headaches have been considered by different authors for many years. Even after the publication of diagnostic criteria, dispute on the clinical picture, differential diagnosis, pathophysiology and treatment of CH still persists. A paper published in 1949 by Josey reports on 6 "illustrative" cases of cervical-related headaches. Indeed, looked from a more recent perspective, those cases could eventually correspond to CH. Important topics such as the relatively high frequency, fixed unilaterality of the pain, relation to previous trauma, irradiation from the back to the forehead, normal or slightly abnormal roentgenograms, and the mechanical precipitation of attacks are some of the topics considered by Josey. The female gender was not prevalent in Josey's series. Traction and analgesics were basically the recommended treatment. CH is probably a common disorder, an idea already considered by a clinician in 1949. This syndrome was not adequately described before Sjaastad's group papers in the 80's.

Reversibility of mitral regurgitation following rheumatic fever: Clinical profile and echocardiographic evaluation

1995 ◽  
Vol 62 (6) ◽  
pp. 717-723 ◽  
Author(s):  
Ahmed S. Kassem ◽  
Tarek M. El-Walili ◽  
Salah R. Zaher ◽  
Mohammad Ayman
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Clinical Profile ◽  
Echocardiographic Evaluation

scholarly journals Double Interatrial Septum appearing as an Atrial Myxoma: A Case Report and Review of the Literature

2017 ◽  
Vol 5 (1) ◽  
pp. 16-20
Author(s):  
Julie Wyrobek ◽  
IV Chales H Brown ◽  
Megan P Kostibas ◽  
Susan A Mayer ◽  
Duke E Cameron ◽  
...  
Keyword(s):  
Case Report ◽  
Thrombus Formation ◽  
Interatrial Septum ◽  
Vital Role ◽  
Atrial Myxoma ◽  
Accurate Diagnosis ◽  
Low Flow ◽  
Flow State ◽  
Review Of The Literature ◽  
Echocardiographic Evaluation

ABSTRACT A double interatrial septum (DIS) is a rare finding during echocardiographic evaluation and can often be mistaken for other more common atrial anomalies. The interatrial cavity created by the septum creates a low-flow state that increases risk of thrombus formation and thromboembolic events. Transesophageal echocardiography (TEE) plays a vital role in accurate diagnosis as a DIS is often not seen during transthoracic echocardiography (TTE). In this case, we report a patient who presented for surgery with a preoperative diagnosis of an atrial myxoma, was instead discovered to have a DIS, and then subsequently underwent DIS resection without complication. We discuss the differential of a DIS, including an atrial septal pouch, cor triatriatum, atrial myxoma, and aneurysmal interatrial septum and the classic features of each anomaly for appropriate diagnosis and management. How to cite this article Wyrobek J, Brown CH IV, Kostibas MP, Mayer SA, Cameron DE, Hayanga HK. Double Interatrial Septum appearing as an Atrial Myxoma: A Case Report and Review of the Literature. J Perioper Echocardiogr 2017;5(1):16-20.

scholarly journals Earnings per share impact on non-financial firms Performance

2014 ◽  
Vol 1 (4) ◽  
pp. 1-7
Author(s):  
Agha Ammad Nabi
Keyword(s):  
Financial Performance ◽  
Quantitative Method ◽  
Vital Role ◽  
Financial Evaluation ◽  
Return On Assets ◽  
Financial Firms ◽  
Earnings Per Share ◽  
Net Profit ◽  
To Come ◽  
Financial Firm

The aim of this research is to evaluate the “Earning per share impact on non-financial firm performance” concerning creation of the shareholder worth. After an assessment of the reasons behind the mixture and how they can create value, a deliberate analysis of three sectors that is  Chemical, Fertilizer and Food each sector has four companies for the period time (2007-2017). Moreover, topic is about non-financial firm performance, following variables are net profit, return on assets and earning per share which plays a vital role in managing the financial performance activities. Additionally, it was necessary to perform a financial evaluation of shareholders value created to be able to come up with a comprehensive decision. The research revolves around these variables. This research involves has a great significance in term of dealing with the different companies while you are giving a particular task on how to manage the financial criteria of the company. When it comes to the financial findings the numbers are showing the different results. Subsequently even however the analysis presents significant results the conclusion for this research is that the earning per share has created value for non-financial firms. This research would correspondingly recognize the limitations of quantitative method used with the capability of possible findings.

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