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Predictive value, injury risk, standardized test

J S Sittig, C S P M Uiterwaal, K G M Moons, I M B Russel, R A J Nievelstein, E E S Nieuwenhuis, E M van de Putte
OBJECTIVE: The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. DESIGN: A large multicentre study with a 6-month follow-up in 4 ERs in The Netherlands. METHOD: Participants were 4290 children aged 0-7 years, attending the ER because of physical injury. All children were systematically tested with an easy-to-use child abuse checklist (index test)...
2016: Nederlands Tijdschrift Voor Geneeskunde
Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visceral Medicine
Patty Coker-Bolt, Andrew Barbour, Hunter Moss, Jordan Tillman, Emma Humphries, Emily Ward, Truman Brown, Dorothea Jenkins
PURPOSE: Diffusion tensor imaging (DTI) can detect injury to specific white matter (WM) tracts involved with sensorimotor processing and may provide sensitive measures for latent or nascent motor skills. We hypothesized that DTI measures of WM fractional anisotropy (FA) could predict early motor scores on a standardized assessment in a cohort of preterm infants at risk for WM injury. METHODS: In this prospective study, preterm infants (n= 26, 11 female, 15 male, mean gestational age 29...
September 2, 2016: Journal of Pediatric Rehabilitation Medicine
Adam M H Young, Mathew R Guilfoyle, Helen Fernandes, Matthew R Garnett, Shruti Agrawal, Peter J Hutchinson
OBJECTIVE There is increasing interest in the use of predictive models of outcome in adult head injury. Two international models have been identified to be reliable modalities for predicting outcome: the Corticosteroid Randomisation After Significant Head Injury (CRASH) model, and the International Mission on Prognosis and Analysis of randomized Controlled Trials in TBI (IMPACT) model. However, these models are designed only to identify outcomes in adult populations. METHODS A retrospective analysis was performed on pediatric patients with severe traumatic brain injury (TBI) admitted to the pediatric intensive care unit (PICU) of Addenbrooke's Hospital between January 2009 and December 2013...
November 2016: Journal of Neurosurgery. Pediatrics
Krzysztof A Świerzy, Robert Pudlo, Bartosz Wesołowski, Marcin Garbacz, Michał Morawski, Izabela Jaworska, Mariusz Sołtysik, Marian Zembala
Confusion on a somatic basis is a dangerous problem mainly related with aging of the population. Data says that consciousness disorders concern 10-15% of patients in general wards, and up to 50% of patients admitted to geriatric wards. The persistence of the symptoms of confusion results in increase of agitation, disorganization, fear, which increases the risk of self-injuries of patients, it causes the need for parenteral feeding and hydratation, as well as maintaining water balance, and also disturbs cooperation, worsening the course and prognosis of the primary disease...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Andrew Jin, Mariana Brussoni, M Anne George, Christopher E Lalonde, Rod McCormick
BACKGROUND: Aboriginal people in British Columbia (BC), especially those residing on Indian reserves, have higher risk of unintentional fall injury than the general population. We test the hypothesis that the disparities are attributable to a combination of socioeconomic status, geographic place, and Aboriginal ethnicity. METHODS: Within each of 16 Health Service Delivery Areas in BC, we identified three population groups: total population, Aboriginal off-reserve, and Aboriginal on-reserve...
June 28, 2016: Journal of Racial and Ethnic Health Disparities
Aashish Sharma, Jose J Zaragoza, Gianluca Villa, Leonardo C Ribeiro, Renhua Lu, Marco Sartori, Elena Faggiana, Massimo de Cal, Grazia M Virzi, Valentina Corradi, Alessandra Brocca, Faeq Husain-Syed, Alessandra Brendolan, Claudio Ronco
BACKGROUND: Renal function reserve (RFR) describes the capacity of the kidney to increase glomerular filtration rate (GFR) in response to physiological or pathological stimuli. The scope of our study was to evaluate the optimal level of stimulation using different doses of protein load (PL) for a standard renal stress test (RST). METHODS: 18 young healthy individuals were given sessions of PL with 1 and 2 g/kg body weight. Endogenous creatinine clearance was calculated...
July 2016: Clinical Nephrology
D Tosovic, C Than, J M M Brown
PURPOSE: Muscle fatigue has been identified as a risk factor for spontaneous muscle injuries in sport. However, few studies have investigated the accumulated effects of muscle fatigue on human muscle contractile properties. This study aimed to determine whether repeated bouts of exercise inducing acute fatigue leads to longer-term fatigue-related changes in muscle contractile properties. METHODS: Maximum voluntary contraction (MVC), electromyographic (EMG) and mechanomyographic (MMG) measures were recorded in the biceps brachii of 11 participants for 13 days, before and after a maximally fatiguing exercise protocol...
August 2016: European Journal of Applied Physiology
Judith S Sittig, Cuno S P M Uiterwaal, Karel G M Moons, Ingrid M B Russel, Rutger A J Nievelstein, Edward E S Nieuwenhuis, Elise M van de Putte
OBJECTIVES: The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. DESIGN: A large multicentre study with a 6-month follow-up. SETTING: 4 ERs in The Netherlands. PARTICIPANTS: 4290 children aged 0-7 years attending the ER because of physical injury...
March 22, 2016: BMJ Open
Brissi Zagadou, Philemon Chan, Kevin Ho, David Shelley
The current impulse noise criteria for the protection against impulse noise injury do not incorporate an objective measure of hearing protection. A new biomechanically-based model has been developed based on improvement of the Auditory Hazard Assessment Algorithm for the Human (AHAAH) using the integrated cochlear energy (ICE) as the damage risk correlate (DRC). The model parameters have been corrected using the latest literature data. The anomalous dose-response inversion behavior of the AHAAH model was eliminated...
March 9, 2016: Hearing Research
Che-Wei Wu, Min Hao, Mengzi Tian, Gianlorenzo Dionigi, Ralph P Tufano, Hoon Yub Kim, Kwang Yoon Jung, Xiaoli Liu, Hui Sun, I-Cheng Lu, Pi-Ying Chang, Feng-Yu Chiang
PURPOSE: During monitored thyroidectomy, a partially or completely disrupted point of nerve conduction on the exposed recurrent laryngeal nerve (RLN) indicates true electrophysiologic nerve injury. Complete loss of signal (LOS; absolute threshold value <100 μV) at the end of operation often indicates a postoperative vocal cord (VC) palsy. However, the evaluation for the injured RLN with incomplete LOS and its functional outcome has not been well described. METHODS: Three hundred twenty-three patients with 522 RLNs at risk who underwent standardized monitored thyroidectomy were enrolled...
February 17, 2016: Langenbeck's Archives of Surgery
Richard U Garcia, Henry L Walters, Ralph E Delius, Sanjeev Aggarwal
Our aim was to evaluate the Vasoactive Inotropic Score (VIS) as a prognostic marker in adolescents following surgery for congenital heart disease. This single-center retrospective chart review included patients 10-18 years of age, who underwent cardiac surgery from 2009 to 2014. Hourly VIS was calculated for the initial 48 postoperative hours using standard formulae and incorporating doses of six pressors. The composite adverse outcome was defined as any one of death, resuscitation or mechanical support, arrhythmia, infection requiring antibacterial therapy, acute kidney injury or neurologic injury...
February 2016: Pediatric Cardiology
Georg A Böhmig, Zeljko Kikic, Markus Wahrmann, Farsad Eskandary, Arezu Z Aliabadi, Gerhard J Zlabinger, Heinz Regele, Helmut E Feucht
OBJECTIVE: Antibody-mediated rejection (ABMR) is an important cause of kidney allograft injury. In the last two decades, detection of complement split product C4d along transplant capillaries, a footprint of antibody-mediated classical complement activation, has evolved as a useful diagnostic marker of ABMR. While it was recognized that ABMR may occur also in the absence of C4d, numerous studies have shown that C4d deposition may indicate a more severe rejection phenotype associated with poor graft survival...
March 2016: Clinical Biochemistry
Alexander Sasha Dubrovsky, Elise Mok, Suk Yee Lau, Mohammad Al Humaidan
OBJECTIVE: Our goal was to determine whether the combination of tenderness at 1 of 5 commonly fractured sites and elbow extension accurately predicts the presence of acute elbow fractures or isolated effusions in children. METHODS: A prospective cohort study was performed using a convenience sample of patients. Children 0 to 18 years old with acute elbow injuries without elbow deformities or radial head subluxations were prospectively enrolled. The treating physicians assessed the injured elbow for the presence of tenderness at 5 locations and for abnormal active extension...
February 2015: American Journal of Emergency Medicine
Joaquin Calatayud, Sebastien Borreani, Juan Carlos Colado, Fernando Martin, Jorge Flandez
BACKGROUND: Dynamic balance has been considered a fundamental skill at all ages and is required for normal daily tasks, such as walking, running, or other sports activities. The Star Excursion Balance Test (SEBT) has been widely used in recent years to identify dynamic balance deficits and improvements and to predict the risk of lower extremity injury. However, no study has demonstrated the reliability of the SEBT in children while they are performing the test in a physical education session...
November 2014: Physician and Sportsmedicine
Syed Amin, Reejis Stephen, David Morris, David Kaufman
Non Pulmonary Critical Care PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: Renal ultrasound (rUS) is the standard of care for patients presenting to the ICU with Acute Kidney injury (AKI) despite previous studies suggesting that only a small subset of patients with AKI have obstructive uropathy. Thus, we sought to (1) assess which clinical findings may raise or lower the pre-test probability of finding obstructive uropathy on rUS, and (2) examine how often the finding of obstructive uropathy led to changes in management...
October 1, 2014: Chest
Giuseppe Lippi, Gian Luca Salvagno, Fiorenza Robuschi, Francesco Scioscioli, Livia Ruffini, Gianfranco Cervellin
OBJECTIVE: Non-invasive assessment using a pharmacological provocative test is an essential part of the workup of patients admitted to the emergency department with chest pain. Some doubts, however, remain about the safety of dipyridamole stress echocardiography in patients with non-diagnostic troponin and ECG. METHODS AND RESULTS: Twenty-nine consecutive patients admitted to the emergency department with chest pain and no evidence of acute coronary syndrome were subjected to standard dipyridamole stress echocardiography...
August 2014: Acta Cardiologica
Jeffrey T Somers, Nathaniel Newby, Charles Lawrence, Richard DeWeese, David Moorcroft, Shean Phelps
The objective of this study was to investigate new methods for predicting injury from expected spaceflight dynamic loads by leveraging a broader range of available information in injury biomechanics. Although all spacecraft designs were considered, the primary focus was the National Aeronautics and Space Administration Orion capsule, as the authors have the most knowledge and experience related to this design. The team defined a list of critical injuries and selected the THOR anthropomorphic test device as the basis for new standards and requirements...
2014: Frontiers in Bioengineering and Biotechnology
R D'Souza, S Keating, M Walker, S Drewlo, J Kingdom
INTRODUCTION: Heparin is often prescribed during pregnancy with the intention of improving perinatal outcomes on the basis that it exerts an anticoagulant action in the inter-villous space. Accumulating in-vitro and in-vivo evidence indicates that heparin's beneficial effects in pregnancy may result from 'non-anticoagulant' effects including the promotion of angiogenesis. METHODS: To study the effect of heparin within the placenta, we performed secondary analyses on a pilot trial where 32 women with negative thrombophilia screens and second-trimester evidence of placental insufficiency were randomized to standard care or antenatal self-administration of unfractionated heparin (UFH) 7500 IU twice-daily...
October 2014: Placenta
Gordon Ward Fuller, Simon P T Kemp, Philippe Decq
BACKGROUND: 'On the field and on the run' assessments of head impact events in professional rugby have resulted in a high proportion of players subsequently diagnosed with confirmed concussion not leaving the field of play at the time of injury. The International Rugby Board (IRB) consequently developed a process to support team doctors in the recognition and management of players at risk of concussion, including development of a multimodal assessment instrument-the Pitch Side Concussion Assessment (PSCA) tool...
April 2015: British Journal of Sports Medicine
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