Transurethral endoscopic approach for large bladder diverticula: Evaluation of a large series

Objective: To present the results of the largest series of patients with bladder diverticula > 4 cm managed with an endoscopic approach and give tips about the execution of the procedure. Materials and methods: Data of male patients undergone the endoscopic approach for an acquired bladder diverticula > 4 cm from December 2004 to August 2018 were prospectively collected and retrospectively analyzed. The description of the monopolar and bipolar techniques are provided. The success of the procedure was defined as the reduction of the diverticula for more of the 80% of its initial diameter documented at the 3- months follow-up imaging. Continuous variables with nonparametric distribution were compared using the Mann-Whitney test, while frequencies of categorical variables were compared between groups by Fisher’s exact test with significance level set at 0.05. Results: Thirty-nine patients with a mean (+/- SD) age at surgery of 69.4 ± 8.8 years were enrolled, for an equal number of diverticula managed. The mean diverticular size was 75.1 ± 24.5 millimeters. The mean operative time was 65 ± 21.9 minutes including the prostate surgery. Twelve patients (30.8%) were managed with bipolar energy, the others with monopolar. The success of the procedure was achieved in 30 patients (76.9% - 7 bipolar and 23 monopolar - p = 0.66). Conclusions: The endoscopic approach might be considered as a useful option for patients with a large bladder diverticulum who are at risk for major or laparoscopic procedure.

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Comparison of Functional and MRI Outcomes of Microfracture with and without BioCartilage for Osteochondral Lesions of the Talus

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00389 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0038

Author(s):

Yoshiharu Shimozono ◽

Hao Huang ◽

Timothy Deyer ◽

John G Kennedy

Keyword(s):

Treatment Strategy ◽

Cartilage Regeneration ◽

Cartilage Tissue ◽

Categorical Variables ◽

Osteochondral Lesions ◽

Fisher Exact Test ◽

Continuous Variables ◽

Exact Test ◽

The Mean

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: Microfracture (MF) remains a dominant treatment strategy for symptomatic osteochondral lesions of the talus (OLT). Micronized cartilage allograft (BioCartilage) is a biologic scaffold and is utilized for MF augmentation to improve the quality for cartilage regeneration. However, there is still lack of evidence on efficacy of BioCartilage as an adjunct to MF, as no comparative studies have been reported to date. The purpose of this study is to clarify the effectiveness of BioCartilage as an adjuvant to MF compared to MF alone in the treatment of OLT. Methods: A retrospective cohort study comparing patients treated with MF with BioCartilage and MF alone between 2014 and 2017 was undertaken. Patients with a minimum follow-up time of 12 months were included. All patients received concentrated bone marrow aspirate injection at the time of surgery. Clinical outcome was evaluated with the Foot and Ankle Outcome Score (FAOS) pre- and postoperatively. Postoperative MRIs were evaluated using a modified Magnetic Resonance Observation of Cartilage Tissue (MOCART) score. Comparisons between groups were made with the Man-Whitney U test for continuous variables and the Chi-squared test or Fisher exact test for categorical variables. Results: Twenty-four patients underwent MF with BioCartilage (MF-BC group) and 24 patients underwent MF alone (MF group). The mean age was 40.8 years in MF-BC group and 47.8 years in MF group (p=0.068). The mean follow-up time was 19.2 months in MF-BC group and 24.5 months in MF group (p=0.042). Both groups showed significant improvements in all FAOS subscales. No significant differences between groups were found in postoperative FAOS subscales including symptoms, pain, daily activities, sports activities and quality of life (MF-BC; 72.8, 77.8, 87.4, 60.8, 56.6, MF; 73.3, 79.3, 86.0, 60.9, 60.6, respectively, p>0.05). The mean MOCART score in MF-BC group was higher (73.2vs64.1), but not statistically significant (p=0.315). When assessing each MOCART parameter individually, MF-BC group had significant better infill in the defect (p=0.028). Conclusion: MF with BioCartilage is an effective treatment strategy for the treatment of OLT and results in similar functional outcomes compared with MF alone in the short-term. However, MF with BioCartilage provides better cartilage infill in the defect on MRI. This finding suggests that the repair seen in a cartilage defect treated with BioCartilage augmentation may be superior to treatment with MF alone. Further long-term follow-up studies are warranted.

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Outcomes For Hand Burns Treated With Autologous Skin Cell Suspension In 20% Tbsa And Smaller Injuries

Journal of Burn Care & Research ◽

10.1093/jbcr/irab113 ◽

2021 ◽

Author(s):

G Malcolm Taylor ◽

Scott A Barnett ◽

Charles T Tuggle ◽

Jeff E Carter ◽

Herb A Phelan

Keyword(s):

Wound Closure ◽

Exclusion Criterion ◽

Categorical Variables ◽

Dermal Substitute ◽

Continuous Variables ◽

Exact Test ◽

Skin Cell ◽

Returning To Work ◽

Hand Burns ◽

Sheet Graft

Abstract Hypothesis In order to address the confounder of TBSA on burn outcomes, we sought to analyze our experience with the use of autologous skin cell suspensions (ASCS) in a cohort of subjects with hand burns whose TBSA totaled 20% or less. We hypothesized that the use of ASCS in conjunction with 2:1 meshed autograft for the treatment of hand burn injuries would provide comparable outcomes to hand burns treated with sheet or minimally meshed autograft alone. Methods A retrospective review was conducted for all deep partial and full thickness hand burns treated with split thickness autograft (STAG) at our urban verified burn center between April, 2018 to September, 2020. Exclusion criterion was a TBSA greater than 20%. The cohorts were those subjects treated with ASCS in combination with STAG (ASCS(+)) versus those treated with STAG alone (ASCS(-)). All ASCS(+) subjects were treated with 2:1 meshed STAG and ASCS overspray while all ASCS(-) subjects had 1:1, piecrust, or unmeshed sheet graft alone. Outcomes measured included demographics, time to wound closure, proportion returning to work (RTW), and length of time to RTW. Mann-Whitney U test was used for comparisons of continuous variables, and Fishers Exact test for categorical variables. Values are reported as medians and 25 th and 75 th interquartile ranges. Results Fifty-one subjects fit the study criteria (ASCS(+) n=31, ASCS(-) n=20). The ASCS(+) group was significantly older than the ASCS(-) cohort (44 yrs [32, 54] vs 32 [27.5, 37], p=0.009) with larger %TBSA burns (15% [9.5, 17] vs 2% [1, 4], p <0.0001), and larger size hand burns (190 cm2 [120, 349.5] vs 126 cm2 [73.5, 182], p=0.015). Comparable results were seen between ASCS(+) and ASCS(-), respectively, for time to wound closure (9 days [7, 13] vs 11.5 [6.75, 14], p=0.63), proportion RTW (61% vs 70%, p=0.56), and days for RTW among those returning (35 [28.5, 57] vs 33 [20.25, 59], p=0.52). The ASCS(+) group had two graft infections with no reoperations, while ASCS(-) had one infection with one reoperation. No subjects in either group had a dermal substitute placed. Conclusion Despite being significantly older, having larger hand wounds, and larger overall wounds within the parameters of the study criteria, patients with 20% TBSA burns or smaller whose hand burns were treated with 2:1 mesh and ASCS overspray had comparable time to wound closure, proportion of returning to work, and time to return to work as subjects treated with 1:1 or pie-crust meshed STAG. Our group plans to follow this work with scar assessments for a more granular picture of pliability and reconstructive needs.

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Transthyretin cardiac amyloidosis scintigraphy, experience in a reference cardiology center

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab111.059 ◽

2021 ◽

Vol 22 (Supplement_3) ◽

Author(s):

I Carvajal ◽

E Berrios-Barcenas ◽

E C-Guerra ◽

A Barajas-Paulin ◽

A Luna-Alvarez Amezquita ◽

...

Keyword(s):

Diastolic Dysfunction ◽

Cardiac Amyloidosis ◽

Multimodality Imaging ◽

Categorical Variables ◽

Continuous Variables ◽

Exact Test ◽

Funding Sources ◽

Imaging Characteristics ◽

Septal Thickness ◽

The Face

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Instituto Nacional de Cardiologia Ignacio Chavez Introduction. Transthyretin cardiac amyloidosis (ATTR-CA) is a progressive disease that significantly reduces patients" quality of life and survival.1 In our country there are no statistics of this disease, only isolated cases. The ability to diagnose it has dramatically improved since the 2019 Multisociety Consensus for Multimodality Imaging.2,3 The study aimed to know patients" demographic and imaging characteristics in suspected ATTR-CA and the prevalence of positive cases in a reference Cardiology Center using 99mTc-pyrophosphate scintigraphy (99mTc-PYP). Methods. Prospective, observational study approved by Institutional committees. We studied with 99mTc-PYP patients from November 2019 to December 2020 sent to the Nuclear Cardiology Department with clinical suspicion of ATTR-CA and negative light chain quantification. We included parameters as red flags, ECHO suggestive findings (septal thickness >12 mm, diastolic dysfunction), and MRI suggestive findings. ATTR-CA was diagnosed by clinical suspicious, positive scintigraphy, and negative serum studies. 99mTc-PYP were acquired according to current recommendations. Frequency distribution of categorical variables were reported as frequencies and percentages; continuous variables are presented in mean. Mann-Whitney U tests were conducted for continuous variables, while Fisher"s exact test was performed for categorical variables. Results. Due to the Covid-19 pandemic, our Cardiology Hospital reconverted to covid attention; we studied a reduced number, and they were mainly inpatients: total 35 (28-inpatients, 7-outpatients). 21 (60%) were male, 14 (40%) were female, average age was 56.5 yo. 31%-heart failure diagnosis, 6%-history of carpal tunnel syndrome and 3%-spinal stenosis. ECHO: 26% had suggestive imaging, 43% with diastolic dysfunction, and 37% had a septal thickness >12mm. MRI: 42.9% had suggestive CA findings. No significant differences were found in the characteristics of suspicion between positive and negative patients. Regarding of the 35 patients scintigraphy, 7 (20%) were positives, establishing ATTR-CA diagnosis, 28 (80%) were negatives. The positivity probability was significant by H/Cl ratio, Perugini score, and SPECT findings (p 0.001). Until this protocol started and we share it among hospital physicians, we had never been asked to acquired this type of scintigraphy. Our study shows that if we purposely search for the disease, it can be found. The sample is small due to the limitations we had in the face of the pandemic; however, the study findings are significant for ATTR-CA diagnosis. It is striking that the ECHO and MRI suggestive findings were not statistically significant for the diagnosis. Conclusions. We present the initial experience of the first study of cardiac amyloidosis in our country, to show the disease"s presence and that the diagnosis can be made effectively, quickly, economically, and non-invasively by nuclear medicine scintigraphy.

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Clinical and functional outcomes of tarsal coalition resection to correct rigid flat foot

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1537 ◽

2021 ◽

Vol 15 (2) ◽

pp. 115-119

Author(s):

Rodrigo Guimarães Huyer ◽

Mário Sérgio Paulillo Cillo ◽

Carlos Daniel Cândido Castro Filho ◽

Hallan Douglas Bertelli ◽

Marcelo Morelli Girondo ◽

...

Keyword(s):

Case Series ◽

Categorical Variables ◽

Continuous Variables ◽

Tarsal Coalition ◽

Retrospective Case ◽

Aofas Score ◽

Level Of Evidence ◽

Flat Foot ◽

Flat Feet ◽

The Mean

Objective: This study used the AOFAS score to assess the clinical functional results of patients who underwent tarsal coalition resection. Methods: This was a retrospective case series of patients who underwent tarsal coalition resection to correct rigid flat foot. Clinical and functional assessment was performed with the AOFAS score before and 6 months after surgical treatment. Descriptive analysis was performed for 7 patients (11 operated feet) using measurements of position and dispersion (mean, standard deviation, minimum, median and maximum value) for continuous variables and frequency tables (absolute and relative) for categorical variables. Results: The mean patient age was 10 years, 7 months, and the majority (71.43%) were male. The most affected joint was the calcaneonavicular. The right side was affected in 54.55% of the cases. The most frequent type of coalition was osseous (81.82% of the cases). The mean pre- and postoperative AOFAS scores were 32.7 and 70.2 points, respectively, which was a significant increase. Conclusion: The increased scores after coalition resection was considered the main change between the two assessments. Thus, it can be concluded that in rigid flat feet without severe hind- or forefoot deformities for which conservative treatment failed, bar resection should be the surgical procedure of choice. Level of Evidence IV; Therapeutic Studies; Case Series.

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Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

Advances in Virology ◽

10.1155/2021/6689669 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Víctor O. Costa ◽

Eveline M. Nicolini ◽

Bruna M. A. da Costa ◽

Fabrício M. Teixeira ◽

Júlia P. Ferreira ◽

...

Keyword(s):

Clinical Laboratory ◽

Lung Parenchyma ◽

Clinical Deterioration ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Laboratory Confirmation ◽

Chi Square Test ◽

Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

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Investigation of Burnout Levels of Anaesthesiologists and Technicians in Covid-19 Pandemic Period

Acta Medica ◽

10.32552/2021.actamedica.578 ◽

2021 ◽

pp. 1-5

Author(s):

Gülsüm Kavalci ◽

Selvi Ceran Kayipmaz

Keyword(s):

Pearson Correlation ◽

Categorical Variables ◽

Continuous Variables ◽

Research Hospital ◽

Pearson Correlation Test ◽

Training And Research ◽

The Mean ◽

Questionnaire Method ◽

High Level ◽

The Relationship

Objective: The ongoing Covid-19 pandemic further increased this stress of employees. This disease, which did not have a cure and a vaccine at the beginning, increased the anxiety of the employees and forced them to live separately due to the risk of infecting family members. This study aimed to investigate the burnout levels of doctors and technicians working in Yenimahalle Training and Research Hospital Anaesthesiology and Reanimation Clinic. Materials and Methods: This study was conducted prospectively by using a questionnaire method in the Yenimahalle Training and Research Hospital. Maslach Burnout questionnaire applied to the participants. Quantitative data were expressed as %, the number of subjects as (n). The distribution of continuous variables was evaluated with the Kolmogorov-Smirnow test. Qualitative data were expressed in mean±SD (standard deviation). X2 test was used for comparison of categorical variables. Independent Student T-test was used for comparison of continuous variables. The relationship between burnout level and variables was determined by Pearson Correlation Test. The value of p<0.05 was considered statistically significant. Results: A total of 52 volunteers participated in the study. The average emotional exhaustion score of the volunteers participating in the study was 31.13±4.6, the average depersonalization score was 15.06±3.3, and the mean personal achievement score was 23.60±3.7. There was no statistically significant relationship between any of the variables and the burnout level (p>0.05). Conclusion: The high level of burnout in a clinic that is at the forefront of the fight against Covid-19, such as anesthesiology and reanimation, is important in terms of determining the situation.

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Knowledge of medical students about perioperative nutritional care in Bahia, Brazil: a transversal study

International Journal of Health Education ◽

10.17267/2594-7907ijhe.v5i1.3433 ◽

2021 ◽

Vol 5 (1) ◽

pp. 62-70

Author(s):

Rodrigo Fernandes Weyll Pimentel ◽

Leonardo Castro Dantas Macêdo ◽

Sérgio Diniz Gonçalves Queiroz Filho ◽

Pedro Carlos Muniz de Figueiredo ◽

Magno Conceição das Merces

Keyword(s):

Medical Students ◽

Nutritional Therapy ◽

Cross Sectional Study ◽

Public Institutions ◽

Categorical Variables ◽

Surgical Patient ◽

Continuous Variables ◽

Cross Sectional ◽

Nutritional Care ◽

Exact Test

OBJECTIVE: Evaluate the medical students’ knowledge about perioperative nutritional care. These students are from public and private academic institutions in the state of Bahia, Brazil. METHODS: This is a cross-sectional study to analyze medical students based on an online instrument regarding topics related to perioperative care. For data analysis, absolute and relative frequencies were calculated for categorical variables, and mean and standard deviation were calculated for continuous variables. Fisher's Exact Test and G Test were used to analyze the association. Results: 209 responses were obtained. Regarding the learning on nutritional preparation of the patient submitted to a surgery, 25 (64.9%) students of public institutions and 90 (52.3%) students of private ones reported not knowing or not having been exposed to such knowledge. Regarding the importance of addressing topics related to nutritional therapy (NT), 37 (100%) students from public institutions and 168 (97.7%) from private ones recognize the importance of spreading this knowledge. Unnecessary absolute preoperative fasting, shortening techniques of fasting and bronchoaspiration prevention and reintroduction time of a diet in the postoperative period are unknown to most of the population studied. CONCLUSION: Most students included in this study do not have satisfactory knowledge in NT and for preparing the surgical patient.

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0798 “Uncovering My Feet Alleviates My Restless Legs”: Impact of Different Activities and Conditions on Restless Legs Symptoms

SLEEP ◽

10.1093/sleep/zsaa056.794 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A303-A304

Author(s):

E G Karroum ◽

S Leu-Semenescu ◽

R Amdur ◽

I Arnulf

Keyword(s):

Ambient Temperature ◽

Categorical Variables ◽

Sign Test ◽

Fisher Exact Test ◽

Continuous Variables ◽

Exact Test ◽

Restless Legs ◽

Professional Activities ◽

Wide Range ◽

Activity Condition

Abstract Introduction The restless legs syndrome (RLS) is a resting wake state disorder with inactivity/decreased movement as an aggravating factor and activity/increased movement as an alleviating factor. Other activities and conditions may impact RLS symptoms but have not been systematically studied. Methods Fifty-six patients with primary severe RLS (age: 64.1±11.3; 66% women) responded about the effect of 20 activities/conditions on their RLS symptoms. Responses were assigned a numerical value: Aggravation (-1), No effect/Don’t know (0), Alleviation (+1), with calculating a mean effect score for each activity/condition and using a sign test to determine if that score was significantly above or below zero (no effect). Responses were further analyzed based on age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, and Painful/Non-Painful RLS. Association of continuous variables and categorical variables with each activity/condition was examined using Spearman correlation test and Fisher exact test, respectively. Bonferroni p threshold was set at p=0.00036. Results Activities/conditions with significant (p<0.0001) positive mean effect scores were: Feet uncovering (0.70); Leg massaging (0.63); Cold showers (0.54); and Manual activities (0.46). Activities with significant negative mean effect scores were: Vehicle passenger (-0.80); Show attendance (-0.70); Bedsheets weight on legs (-0.57); Watching TV (-0.54); High ambient temperature (-0.45); During meals (-0.39) (all p<0.0001); and Bedsheets rubbing on legs (-0.34; p=0.0002). Activities/conditions with no significant (all p>0.00036) mean effect scores were: Driving (0.00); Gambling (0.02); Professional activities (0.13); Hot showers (0.13); Using computer (0.14); Low ambient temperature (0.21); Sexual activities (0.27); Mental activities (0.29); and Sports activities (0.34). There was no significant association between each activity/condition and age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, or Painful/Non-Painful RLS. Conclusion There is a wide range of impact of different activities/conditions on RLS symptoms. These could be further considered in the non-pharmacological treatment or prevention of RLS symptoms. Support This study was not funded.

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P4579Prediction of CABG indication in patients admitted for NSTEMI with the new CABG DAPE2S score

European Heart Journal ◽

10.1093/eurheartj/ehz745.0967 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Faria Da Mota ◽

P Azevedo ◽

R Fernandes ◽

J S ◽

J Guedes ◽

...

Keyword(s):

Coronary Artery ◽

Risk Model ◽

Artery Bypass ◽

Bypass Graft ◽

Categorical Variables ◽

Binary Logistic Regression Analysis ◽

Continuous Variables ◽

Discriminant Score ◽

Significance Level ◽

Number Of Patients

Abstract Introduction A significant number of patients admitted for Non-ST Elevation Myocardial Infarction (NSTEMI) have multivessel complex coronary artery disease (CAD) and benefit from Coronary Artery Bypass Graft surgery (CABG). These patients frequently present high-risk surgical profiles, constituting a challenging group when it comes to balancing ischemic and haemorrhagic risk. Objective To develop a simple predictive risk model of referral to CABG in patients admitted for NSTEMI. Methods The authors present a retrospective, descriptive and correlational study including all patients admitted for NSTEMI in a Cardiology department between the 1st of October 2010 and the 1st of October 2018. Demographic profile, clinical characteristics, risk factors and hospitalization data of NSTEMI patients referred to CABG were studied, and a correlational analysis was performed with Chi-square test for categorical variables and t-Student test for continuous variables (confidence level of 95%). Independent predictors of CABG in patients with NSTEMI were identified through Binary logistic regression analysis, using a significance level of 0,05. A discriminatory function was subsequently applied, and the Wilks lambda test was used to determine the discriminant score for the studied groups. The authors used SPSS 24,0 for statistical analysis. Results A total of 2476 patients were included, 668 (27%) of which were female, with a mean age of 68,5±13,4 years. In the studied sample, 273 patients (11%) were proposed to CABG. The authors found a significant association between CABG and multiple clinical, laboratorial and therapeutical variables, but after multivariate analysis only male sex, previous Diabetes Mellitus, previous angina, previous Percutaneous coronary intervention, absence of a normal EKG, ST segment depression at admission, sinus rythm and brain natriuretic peptide (BNP) >100pg/mL proved to be independent predictors of referral. Using these variables, the authors developed a risk model to predict CABG referral in NSTEMI patients: −0,614 − (0,756 x female sex) + (0,305 x diabetes) + (0,631 x angina) − (1,513 x previous PCI) + (1,216 x sinus rythm) + (0,672 x ST depression) − (0,806 x normal EKG) + (0,562 x BNP>100). In this function, variables should be substituted by 1 or 0, depending on wheter the condition they specify is present or absent. The optimal discrimination cutoff was 0,23, with a 64% sensibility and 59% specificity, and a discriminant power of 60%. Conclusion Being able to predict referral to surgical revascularization in NSTEMI may help physicians to optimize a specific approach in each patient, in particular with regard to anti-thrombotic strategies. The authors developed a risk predicting model for CABG in NSTEMI patients based on simple clinical and laboratory variables, which will require validation in a larger cohort, before it can be applied in a clinical context.

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The Predictive Value of Thromboelastogram in the Evaluation of Patients with Suspected Acute Venous Thromboembolism

Acta Haematologica ◽

10.1159/000502348 ◽

2019 ◽

Vol 143 (3) ◽

pp. 272-278

Author(s):

Tareq Abu Assab ◽

David Raveh-Brawer ◽

Julia Abramowitz ◽

Mira Naamad ◽

Chezi Ganzel

Keyword(s):

Venous Thromboembolism ◽

Emergency Room ◽

Alpha Angle ◽

Categorical Variables ◽

Clot Lysis ◽

Fisher Exact Test ◽

Continuous Variables ◽

Exact Test ◽

Significant Difference ◽

D Dimer

Introduction: The objective of this prospective study was to examine whether thromboelastogram (TEG) can predict the presence of venous thromboembolism (VTE) in patients who arrive at the emergency room with signs/symptoms that raise the suspicion of acute VTE. Methods: Every patient was tested for D-dimer and all TEG parameters, including: reaction time, clot time formation, alpha-angle, maximal amplitude, clot viscoelasticity, coagulation index, and clot lysis at 30 min. For categorical variables, χ2 or the Fisher exact test were used, and for continuous variables the t test or other non-parametric tests were used. Results: During 2016, a total of 109 patients were enrolled with a median age of 55.7 (21–89) years. Eighteen patients were diagnosed with VTE. Analyzing the different TEG parameters, both as continuous and categorical variables, did not reveal a statistically significant difference between VTE-positive and VTE-negative patients. Combining different TEG parameters or dividing the cohort according to gender, clinical suspicion of VTE (Well’s criteria), or different levels of D-dimer did not change the results of the analysis. Conclusion: The current study could not demonstrate a significant value of any TEG parameter as a predictor of VTE among patients who came to the emergency room with signs/symptoms that raise the suspicion of VTE.

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