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https://www.readbyqxmd.com/read/27911313/challenges-in-screening-and-recruitment-for-a-neuroimaging-study-in-cognitively-impaired-geriatric-inpatients
#1
Ivayla Apostolova, Catharina Lange, Anna Roberts, Hans Joachim Igel, Anja Mäurer, Stephanie Liese, Melanie Estrella, Vikas Prasad, Elisabeth Stechl, Gernot Lämmler, Elisabeth Steinhagen-Thiessen, Ralph Buchert
BACKGROUND: Neuroimaging-based biomarkers have the potential to improve etiological diagnosis of cognitive impairment in elderly inpatients. However, there is a relative lack of studies on neuroimaging-based biomarkers in hospitalized geriatric patients, as the vast majority of neuroimaging studies in dementia have focused on memory clinic outpatients. An important aspect of study planning is a priori estimation of the rate of screen failures. OBJECTIVE: To report on the rate and causes of screen failures in a prospective study on the utility of neuroimaging (PET, MRI) for the etiological diagnosis of newly manifested cognitive impairment in acutely hospitalized geriatric patients...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27911122/an-update-on-the-use-of-cerebrospinal-fluid-analysis-as-a-diagnostic-tool-in-multiple-sclerosis
#2
Matteo Gastaldi, Elisabetta Zardini, Diego Franciotta
Intrathecal B-lymphocyte activation is a hallmark of multiple sclerosis (MS), a multi-factorial inflammatory-demyelinating disease of the central nervous system. Such activation has a counterpart in the cerebrospinal fluid (CSF) oligoclonal IgG bands (OCB), whose diagnostic role in MS has been downgraded within the current McDonald's criteria. With a theoretico-practical approach, the authors review the physiopathological basis of the CSF dynamics, and the state-of-the-art of routine CSF analysis and CSF biomarkers in MS...
December 2, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27910252/memory-performance-on-the-story-recall-test-and-prediction-of-cognitive-dysfunction-progression-in-mild-cognitive-impairment-and-alzheimer-s-dementia
#3
Jong-Hwan Park, Hyuntae Park, Sang Wuk Sohn, Sungjae Kim, Kyung Won Park
AIM: To determine the factors that influence diagnosis and differentiation of patients with mild cognitive impairment (MCI) and Alzheimer's dementia (AD) by comparing memory test results at baseline with those at 1-2-year follow up. METHODS: We consecutively recruited 23 healthy participants, 44 MCI patients and 27 patients with very mild AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association criteria for probable Alzheimer's disease and Petersen's clinical diagnostic criteria...
December 1, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27910139/characterization-of-patients-with-chronic-pulmonary-aspergillosis-according-to-the-new-escmid-ers-ecmm-and-idsa-guidelines
#4
Helmut J F Salzer, Jan Heyckendorf, Barbara Kalsdorf, Thierry Rolling, Christoph Lange
Recently, the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) in cooperation with the European Respiratory Society (ERS) and the European Confederation of Medical Mycology (ECMM) published guidelines for the diagnosis of chronic pulmonary aspergillosis (CPA). Both guidelines, however, carry significant differences. We retrospectively applied the diagnostic recommendations on a patient cohort of 71 previously diagnosed CPA patients in order to compare both guidelines...
December 1, 2016: Mycoses
https://www.readbyqxmd.com/read/27909868/dental-age-estimation-in-the-living-after-completion-of-third-molar-mineralization-new-data-for-gustafson-s-criteria
#5
M Timme, W H Timme, A Olze, C Ottow, S Ribbecke, H Pfeiffer, R Dettmeyer, A Schmeling
There is a need for dental age estimation methods after completion of the third molar mineralization. Degenerative dental characteristics appear to be suitable for forensic age diagnostics beyond the 18th year of life. In 2012, Olze et al. investigated the criteria studied by Gustafson using orthopantomograms. The objective of this study was to prove the applicability and reliability of this method with a large cohort and a wide age range, including older individuals. For this purpose, 2346 orthopantomograms of 1167 female and 1179 male Germans aged 15 to 70 years were reviewed...
December 1, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27909801/increasing-the-sensitivity-of-mri-for-the-detection-of-multiple-sclerosis-lesions-by-long-axial-coverage-of-the-spinal-cord-a-prospective-study-in-119-patients
#6
Michael O Breckwoldt, Johann Gradl, Stefan Hähnel, Thomas Hielscher, Brigitte Wildemann, Ricarda Diem, Michael Platten, Wolfgang Wick, Sabine Heiland, Martin Bendszus
Diagnostic imaging criteria of multiple sclerosis (MS) include the spatial and temporal dissemination of cerebral and/or spinal cord lesions. Magnetic resonance imaging (MRI) is the method of choice for initial diagnosis and follow-up disease monitoring. Current guidelines for spinal MRI recommend sagittal imaging of the spinal cord and lesion confirmation on axial planes if lesions are detected. Sagittal imaging is, however, hampered by technical (e.g. partial volume effects, motion artifacts) and anatomical (e...
December 1, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27909541/validation-of-the-has-bled-tool-in-atrial-fibrillation-patients-receiving-rivaroxaban
#7
Gorman Ew, Perkel D, Dennis D, Yates J, Heidel Re, Wortham D
Background: Atrial fibrillation (Afib) patients are at an increased risk of stroke. Patients at moderate to high risk of stroke typically receive antithrombotics, placing them at an increased risk of bleeding. The HAS-BLED tool has been validated in Afib patients receiving warfarin for prediction of major bleeding events. Although HAS-BLED has been researched in patients receiving warfarin, this tool has not been validated with the novel anticoagulant rivaroxaban. Methods: The trial design was retrospective case-control approved by the Institutional Review Board at University of Tennessee Medical Center...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909532/ajmaline-challenge-to-unmask-infrahisian-disease-in-patients-with-recurrent-and-unexplained-syncope-preserved-ejection-fraction-with-or-without-conduction-abnormalities-on-surface-ecg
#8
Francesco Pentimalli, Luca Bacino, Matteo Ghione, Giambattista Siri, Massimo Gazzarata, Paolo Bellotti
Background: Pharmacological challenge with class I antiarrhythmic drug is a recommended diagnostic test in patients with unexplained syncope only in the presence of bundle branch block, when non-invasive tests have failed to make the diagnosis. Its role in patients with minor or no conduction disturbances on 12-leads ECG has not been evaluated yet. It is also not clear which are the values of His-Ventricular interval to be considered diagnostic. We sought to evaluate the role of ajmaline challenge in unmasking the presence of an infrahisian disease in patients with recurrent and unexplained syncope, regardless of the existence of conduction disturbances on surface ECG...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908898/clinically-useful-screen-for-borderline-personality-disorder-in-psychiatric-out-patients
#9
Mark Zimmerman, Matthew D Multach, Kristy Dalrymple, Iwona Chelminski
A total of 3674 psychiatric out-patients were evaluated with a semi-structured diagnostic interview for DSM-IV borderline personality disorder (BPD). The affective instability criterion had a sensitivity of 92.8%, higher than the sensitivities of the other eight BPD criteria. The negative predictive value of the affective instability criterion was 99%. We recommend that clinicians screen for BPD in the same way that they screen for other psychiatric disorders: by enquiring about a single feature of the disorder (i...
December 1, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27908493/diagnostic-accuracy-of-the-kampala-trauma-score-using-estimated-abbreviated-injury-scale-scores-and-physician-opinion
#10
Andrew Gardner, Paa Kobina Forson, George Oduro, Barclay Stewart, Nkechi Dike, Paul Glover, Ronald F Maio
BACKGROUND: The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. METHODS: This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27908400/low-hepatic-copper-content-and-pnpla3-polymorphism-in-non-alcoholic-fatty-liver-disease-in-patients-without-metabolic-syndrome
#11
Albert Friedrich Stättermayer, Stefan Traussnigg, Elmar Aigner, Christian Kienbacher, Ursula Huber-Schönauer, Petra Steindl-Munda, Andreas Stadlmayr, Friedrich Wrba, Michael Trauner, Christian Datz, Peter Ferenci
INTRODUCTION: The pathogenesis of non-alcoholic fatty liver disease (NAFLD) is multifactorial including metabolic, genetic (e.g. PNPLA3 [patatin-like phospholipase domain-containing 3 gene]), viral factors and drugs. Besides, there is evidence for a role of copper deficiency. Aim of the study was to evaluate the role of hepatic copper content, PNPLA3 in NAFLD patients with and without metabolic syndrome (MetS). METHODS: One-hundred seventy-four NAFLD patients, who underwent liver biopsy for diagnostic work-up, were studied...
January 2017: Journal of Trace Elements in Medicine and Biology
https://www.readbyqxmd.com/read/27908353/the-risk-continuum-of-atherosclerosis-and%C3%A2-its-implications-for-defining-chd-by%C3%A2-coronary-angiography
#12
REVIEW
Armin Arbab-Zadeh, Valentin Fuster
Patients undergoing coronary angiography for suspected coronary heart disease who are found to have coronary atherosclerotic disease with <50% diameter stenosis may carry a risk of adverse cardiac events similar to that in patients with single-vessel obstructive disease. Yet clinical practice guidelines offer no direction for managing symptomatic patients with nonobstructive coronary atherosclerosis because current diagnostic criteria for coronary heart disease are not met. Accordingly, secondary preventive measures are not endorsed, and their role is not defined in this setting...
December 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27908326/defining-and-diagnosing-sepsis
#13
REVIEW
Michael C Scott
Sepsis is a heterogeneous clinical syndrome that encompasses infections of many different types and severity. Not surprisingly, it has confounded most attempts to apply a single definition, which has also limited the ability to develop a set of reliable diagnostic criteria. It is perhaps best defined as the different clinical syndromes produced by an immune response to infection that causes harm to the body beyond that of the local effects of the infection.
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907900/insulin-resistance-in-polycystic-ovary-syndrome-a-systematic-review-and-meta-analysis-of-euglycaemic-hyperinsulinaemic-clamp-studies
#14
Samantha Cassar, Marie L Misso, William G Hopkins, Christopher S Shaw, Helena J Teede, Nigel K Stepto
STUDY QUESTION: What is the degree of intrinsic insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and the relative contribution of BMI to overall IR based on meta-analysis of gold standard insulin clamp studies? SUMMARY ANSWER: We report an inherent reduction (-27%) of insulin sensitivity (IS) in PCOS patients, which was independent of BMI. WHAT IS ALREADY KNOWN: PCOS is prevalent, complex and underpinned by IR but controversies surround the degree of intrinsic IR in PCOS, the effect of BMI and the impact of the different diagnostic criteria (NIH versus Rotterdam) in PCOS...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27907271/adult-attention-deficit-hyperactivity-disorder-diagnosis-management-and-treatment-in-the-dsm-5-era
#15
Joel L Young, David W Goodman
Objective: To increase awareness of adult attention-deficit/hyperactivity disorder (ADHD) in the primary care community and to provide guidance for the management of this condition. Despite its increasing prevalence, adult ADHD largely remains underdiagnosed and inappropriately treated in the United States. The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has provided more clear diagnostic criteria for adult ADHD, but a solid framework supporting the transition of ADHD management from pediatric to adult primary care is lacking...
November 17, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27906953/what-s-tramadol-got-to-do-with-it-a-case-report-of-rebound-hypoglycemia-a-reappraisal-and-review-of-potential-mechanisms
#16
Charles A Odonkor, Akhil Chhatre
BACKGROUND: Tramadol has gained traction as an analgesic of choice among pain practicing physicians. However some concerns regarding a previously unlabeled adverse reaction - hypoglycemia - have cast it in a dim light. Prior reports have noted an associated risk of hospitalization for hypoglycemia after tramadol use, but whether tramadol is the main causal agent is poorly understood and the underlying mechanisms are not well delineated. We present a unique case of rebound hypoglycemia as a variation of the theme of tramadol's adverse effect profile in a patient with type 1 diabetes mellitus, and reappraise potential mechanisms underlying this underappreciated phenomenon...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#17
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different dataset is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study (PTOS) registry. METHODS: Patients age≥16years undergoing scene HEMS or ground EMS (GEMS) transport in the PTOS registry 2000-2013 were included...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906711/polycystic-ovary-syndrome-in-adolescent-girls
#18
Natalie Hecht Baldauff, Selma Feldman Witchel
PURPOSE OF REVIEW: Polycystic ovary syndrome (PCOS) is a common heterogeneous disorder that appears to have its origins during the peripubertal years. The diagnostic conundrum is that the typical clinical features, irregular menses and acne, occur during normal female puberty. Understanding the physiologic origins and molecular basis of the dysregulated hypothalamic-pituitary-gonadal axis in PCOS is fundamental to interrupting the distinctive vicious cycle of hyperandrogenism and chronic anovulation...
November 30, 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/27906490/exhaled-nitric-oxide-in-the-diagnosis-of-asthma-in-adults-a-systematic-review
#19
Sue E Harnan, Munira Essat, Tim Gomersall, Paul Tappenden, Ian Pavord, Mark Everard, Rod Lawson
OBJECTIVES: To identify and synthesise evidence on the diagnostic accuracy of FE NO for asthma in adults. MATERIALS AND METHODS: Systematic searches (nine key biomedical databases and trial registers) were carried out to November 2014. Records were included if they: recruited patients with the symptoms of asthma; used a single set of inclusion criteria; measured FE NO50 in accordance with American Thoracic Society guidelines, 2005 (off-line excluded); reported/allowed calculation of true positive, true negative, false positive and false negative patients as classified against any reference standard...
December 1, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27905829/post-traumatic-stress-disorder-dimensions-and-asthma-morbidity-in-world-trade-center-rescue-and-recovery-workers
#20
Irina Mindlis, Esperanza Morales-Raveendran, Emily Goodman, Kevin Xu, Clara Vila-Castelar, Kristine Keller, Ginger Crawford, Shynah James, Craig Katz, Laura E Crowley, Rafael E de la Hoz, Steven Markowitz, Juan P Wisnivesky
Objective Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub- PTSD and for specific PTSD symptom dimensions are associated with increased asthma morbidity. Methods Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal...
December 1, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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