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Clinical prediction rule

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https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#1
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28330446/eudor-a-multi-centre-research-program-a-naturalistic-european-multi-centre-clinical-study-of-edor-test-in-adult-patients-with-primary-depression
#2
Marco Sarchiapone, Miriam Iosue, Vladimir Carli, Mario Amore, Enrique Baca-Garcia, Anil Batra, Doina Cosman, Philippe Courtet, Guido Di Sciascio, Ricardo Gusmao, Tadeusz Parnowski, Peter Pestality, Pilar Saiz, Johannes Thome, Anders Tingström, Marcin Wojnar, Patrizia Zeppegno, Lars-Håkan Thorell
BACKGROUND: Electrodermal reactivity has been successfully used as indicator of interest, curiosity as well as depressive states. The measured reactivity depends on the quantity of sweat secreted by those eccrine sweat glands that are located in the hypodermis of palmar and plantar regions. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high specificity for suicide...
March 23, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28329162/the-value-of-fluorine-18-deoxyglucose-positron-emission-tomography-scans-in-patients-with-ventricular-assist-device-specific-infections%C3%A2
#3
Alexander M Bernhardt, Mustafa A Pamirsad, Chantal Brand, Daniel Reichart, Milena Tienken, Markus J Barten, Andreas Schaefer, Hanno Grahn, Meike Rybczynski, Tobias Deuse, Hermann Reichenspurner, Florian M Wagner
BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 ( 18 F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18 F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis. METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28325604/early-prediction-of-radiotherapy-induced-parotid-shrinkage-and-toxicity-based-on-ct-radiomics-and-fuzzy-classification
#4
Marco Pota, Elisa Scalco, Giuseppe Sanguineti, Alessia Farneti, Giovanni Mauro Cattaneo, Giovanna Rizzo, Massimo Esposito
MOTIVATION: Patients under radiotherapy for head-and-neck cancer often suffer of long-term xerostomia, and/or consistent shrinkage of parotid glands. In order to avoid these drawbacks, adaptive therapy can be planned for patients at risk, if the prediction is obtained timely, before or during the early phase of treatment. Artificial intelligence can address the problem, by learning from examples and building classification models. In particular, fuzzy logic has shown its suitability for medical applications, in order to manage uncertain data, and to build transparent rule-based classifiers...
March 18, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28323801/predicting-acute-compartment-syndrome-pacs-the-role-of-continuous-monitoring
#5
Andrew H Schmidt, Michael J Bosse, Katherine P Frey, Robert V OʼToole, Daniel J Stinner, Daniel O Scharfstein, Vadim Zipunnikov, Ellen J MacKenzie
The diagnosis of acute compartment syndrome (ACS) is a common clinical challenge among patients who sustain high-energy orthopaedic trauma, largely because no validated criteria exist to reliably define the presence of the condition. In the absence of validated diagnostic standards, concern for the potential clinical and medicolegal impact of a missed compartment syndrome may result in the potential overuse of fasciotomy in "at-risk" patients. The goal of the Predicting Acute Compartment Syndrome Study was to develop a decision rule for predicting the likelihood of ACS that would reduce unnecessary fasciotomies while guarding against potentially missed ACS...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28322827/structural-divergence-of-essential-triad-ribbon-synapse-proteins-among-placental-mammals-implications-for-preclinical-trials-in-photoreceptor-transplantation-therapy
#6
Christopher R J Laver, Joanne A Matsubara
As photoreceptor transplantation rapidly moves closer to the clinic, verifying graft efficacy in animal models may have unforeseen xenogeneic barriers. Although photoreceptor transplants have most convincingly exhibited functional synaptogenesis in conspecific studies, such evidence (while ruling out false-positives due to: viral graft labeling, fusion/cytosolic transfer, or neuroprotection) has not yet been shown for discordant xenografts. From this, a fundamental question should be raised: is useful xenosynaptogenesis likely between human photoreceptors and mouse retina? The triad ribbon synapse (TRS) that would normally form is unique and contains trans-synaptic proteins essential to its formation and function...
March 18, 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#7
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28320460/thyroid-incidentalomas-on-18fdg-pet-ct-a-metabolico-pathological-correlation
#8
N Hagenimana, J Dallaire, É Vallée, M Belzile
BACKGROUND: Thyroid incidentaloma is defined as an unsuspected thyroid lesion found on imaging study or while performing a surgery non-related to the thyroid gland. Most recent scientific literature tends to demonstrate a detection rate of 0.1-4.3% for incidental findings of thyroid focal uptake identified by (18)F-fluorodeoxyglugose Positron Emission Tomography with computed tomography ((18)FDG-PET/CT) initially prescribed for nonthyroid disease. From 10.3 to 80.0% of patients who underwent further evaluation are diagnosed with malignant lesions...
March 21, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28314756/predicting-occupational-asthma-and-rhinitis-in-bakery-workers-referred-for-clinical-evaluation
#9
Badri Sadat Jonaid, Jos Rooyackers, Erik Stigter, Lützen Portengen, Esmeralda Krop, Dick Heederik
BACKGROUND: Occupational allergic diseases are a major problem in some workplaces like in the baking industry. Diagnostic rules have been used in surveillance but not yet in the occupational respiratory clinic. OBJECTIVE: To develop diagnostic models predicting baker's asthma and rhinitis among bakery workers at high risk of sensitisation to bakery allergens referred to a specialised clinic. METHODS: As part of a medical surveillance programme, clinical evaluation was performed on 436 referred Dutch bakery workers at high risk for sensitisation to bakery allergens...
March 17, 2017: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28302702/predictive-accuracy-of-risk-scales-following-self-harm-multicentre-prospective-cohort-study
#10
Leah Quinlivan, Jayne Cooper, Declan Meehan, Damien Longson, John Potokar, Tom Hulme, Jennifer Marsden, Fiona Brand, Kezia Lange, Elena Riseborough, Lisa Page, Chris Metcalfe, Linda Davies, Rory O'Connor, Keith Hawton, David Gunnell, Nav Kapur
BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm...
March 16, 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28301998/prognostic-factors-and-staging-systems-in-hepatocellular-carcinoma
#11
Haldun Selçuk
There are a number of factors that should be taken into consideration when predicting the outcomes and prognosis of hepatocellular carcinoma. Four of the most important factors in determining survival are the severity of the accompanying liver disease, tumor size and number, extension of the tumor into other structures, and presence of metastases. The most common and widely accepted tumor staging systems include these 4 prognostic factors. The staging systems are (1) the tumor-node-metastasis system of the American Joint Committee on cancer, (2) the Okuda system, (3) the Barcelona Clinic Liver Cancer system, (4) the Cancer of the Liver Italian Program score; (5) the recent albumin-bilirubin grading system, and finally (6) the Hong Kong Liver Cancer staging system...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28299606/three-dimensional-speckle-tracking-longitudinal-strain-is-related-to-myocardial-fibrosis-determined-by-late-gadolinium-enhancement
#12
Marco Spartera, Anna Damascelli, Ferenc Mozes, Francesco De Cobelli, Giovanni La Canna
Three-dimensional (3D) speckle tracking echocardiography (STE) is a reliable clinical tool for accurate measurements of left ventricular (LV) volumes and ejection fraction (EF). In this prospective study, we sought to identify an association between 3DSTE longitudinal strain abnormalities and areas of late gadolinium enhancement (LGE). In 50 patients (52 ± 18.5 years old) referred to our hospital for clinically indicated CMR, 3D full-volume trans-thoracic acquisitions on apical views were performed within 1 h of CMR, in order to obtain LV volumes and ejection fraction as well as global and segmental peak systolic longitudinal strain...
March 15, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28298263/a-proof-of-principle-simulation-for-closed-loop-control-based-on-preexisting-experimental-thalamic-dbs-enhanced-instrumental-learning
#13
Ching-Fu Wang, Shih-Hung Yang, Sheng-Huang Lin, Po-Chuan Chen, Yu-Chun Lo, Han-Chi Pan, Hsin-Yi Lai, Lun-De Liao, Hui-Ching Lin, Hsu-Yan Chen, Wei-Chen Huang, Wun-Jhu Huang, You-Yin Chen
Deep brain stimulation (DBS) has been applied as an effective therapy for treating Parkinson's disease or essential tremor. Several open-loop DBS control strategies have been developed for clinical experiments, but they are limited by short battery life and inefficient therapy. Therefore, many closed-loop DBS control systems have been designed to tackle these problems by automatically adjusting the stimulation parameters via feedback from neural signals, which has been reported to reduce the power consumption...
February 24, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#14
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28293864/using-probabilistic-record-linkage-of-structured-and-unstructured-data-to-identify-duplicate-cases-in-spontaneous-adverse-event-reporting-systems
#15
Kory Kreimeyer, David Menschik, Scott Winiecki, Wendy Paul, Faith Barash, Emily Jane Woo, Meghna Alimchandani, Deepa Arya, Craig Zinderman, Richard Forshee, Taxiarchis Botsis
INTRODUCTION: Duplicate case reports in spontaneous adverse event reporting systems pose a challenge for medical reviewers to efficiently perform individual and aggregate safety analyses. Duplicate cases can bias data mining by generating spurious signals of disproportional reporting of product-adverse event pairs. OBJECTIVE: We have developed a probabilistic record linkage algorithm for identifying duplicate cases in the US Vaccine Adverse Event Reporting System (VAERS) and the US Food and Drug Administration Adverse Event Reporting System (FAERS)...
March 14, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#16
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28286843/clinical-scoring-systems-in-predicting-the-outcome-of-acute-upper-gastrointestinal-bleeding-a-narrative-review
#17
REVIEW
Hanieh Ebrahimi Bakhtavar, Hamid Reza Morteza Bagi, Farzad Rahmani, Kavous Shahsavari Nia, Arezu Ettehadi
Prediction of the outcome and severity of acute upper gastrointestinal bleeding (UGIB) has significant importance in patient care, disposition, and determining the need for emergent endoscopy. Recent international recommendations endorse using scoring systems for management of non-variceal UGIB patients. To date, different scoring systems have been developed for predicting the risk of 30-day mortality and re-bleeding. We have discussed the screening performance characteristics of Baylor bleeding score, the Rockall risk scoring score, Cedars-Sinai Medical Center predictive index, Glasgow Blatchford score, T-score, and AIMS65 systems, in the present review...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285457/group-a-streptococcus-acute-rheumatic-fever-and-rheumatic-heart-disease-epidemiology-and-clinical-considerations
#18
REVIEW
Liesl J Zühlke, Andrea Beaton, Mark E Engel, Christopher T Hugo-Hamman, Ganesan Karthikeyan, Judith M Katzenellenbogen, Ntobeko Ntusi, Anna P Ralph, Anita Saxena, Pierre R Smeesters, David Watkins, Peter Zilla, Jonathan Carapetis
Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-to-high risk populations. Initiation of secondary prophylaxis and the establishment of early medium to long-term care plans is a key aspect of the management of ARF...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28282371/increasing-efficiency-of-preclinical-research-by-group-sequential-designs
#19
Konrad Neumann, Ulrike Grittner, Sophie K Piper, Andre Rex, Oscar Florez-Vargas, George Karystianis, Alice Schneider, Ian Wellwood, Bob Siegerink, John P A Ioannidis, Jonathan Kimmelman, Ulrich Dirnagl
Despite the potential benefits of sequential designs, studies evaluating treatments or experimental manipulations in preclinical experimental biomedicine almost exclusively use classical block designs. Our aim with this article is to bring the existing methodology of group sequential designs to the attention of researchers in the preclinical field and to clearly illustrate its potential utility. Group sequential designs can offer higher efficiency than traditional methods and are increasingly used in clinical trials...
March 2017: PLoS Biology
https://www.readbyqxmd.com/read/28281228/development-of-a-risk-score-for-qtc-prolongation-the-risq-path-study
#20
Eline Vandael, Bert Vandenberk, Joris Vandenberghe, Isabel Spriet, Rik Willems, Veerle Foulon
Background More than 170 drugs are linked with QTc-prolongation, which in extreme cases can lead to Torsade de Pointes. Monitoring of this potential side effect is an important challenge in clinical practice. Objective To investigate the risk of QTc-prolongation in hospital patients who started a QTc-prolonging drug, and to develop a risk score to identify patients at high/low risk for QTc-prolongation. Setting University Hospitals Leuven, Belgium. Method All patients starting with haloperidol or a QTc-prolonging antibiotic/antimycotic were eligible for this observational study...
March 9, 2017: International Journal of Clinical Pharmacy
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